Triage nurse reviewing a patients file

When someone steps into the ER, they need quality care that gets them the treatments they need. For a Triage Nurse this is their primary duty. Triage Nurses are the first point of contact in the emergency room, assessing patients and determining the level of priority their care needs. 

While every patient is important, those in critical condition or life-threatening situations require immediate care. The Triage Nurse determines what level of care someone needs and helps dictate the patient flow through the emergency room.

If you want to work in the ER, being a Triage Nurse may be a fulfilling career. If you’re interested in becoming a Triage Nurse, this guide will cover everything you need about what it means to be a Triage Nurse, how to become a Triage Nurse, and what to expect in this career. 

Let’s begin!

What Does Triage Mean?

Triage is the assessment and sorting of patients based on the severity of their conditions. This process helps maximize survival rates, prioritize critical care, and ensure those in the greatest need receive medical attention first. 

Triage Nurses learn how to assess emergency room patients upon intake to determine the urgency of their illness or injury. They ensure that those at risk of any life-threatening complications receive immediate treatment; they can also provide life-saving care and stabilize patients if necessary. 

What Are The Three Categories Of Triage?

There are three levels of emergency care triage. Nurses sort each patient into one of the three categories to create a flow throughout the ER — doctors will attend to patients by level of urgency, so someone who is a level 1 triage will always receive care before someone in level 2 or 3. 

Let’s take a closer look at each of the three triage levels. 

Level 1 Triage – Emergent 

Level 1 triage is for patients in need of immediate medical attention. These patients are in critical condition or at risk of life-threatening complications if they do not receive medical attention. 

These patients may require emergency intervention, such as CPR or incubation. In addition, they may need emergency surgery, blood transfusions, or other life-saving procedures. Therefore, they are primarily brought in by ambulance and always given the highest priority. 

Level 2 Triage – Urgent

Urgent-level patients need care soon, but they are stable and can wait until clinical space is available. Then, the doctor will see them as quickly as possible, usually within 30 minutes to an hour. Triage Nurses may provide them with some care while they wait to be seen by the physician, such as dressing a wound. 

Level 3 Triage – Non-urgent

Non-urgent cases are at the lowest health risk and therefore wait the longest to be seen. The Triage Nurse will still carefully assess these patients, but they will not be given top priority in the ER. Instead, they will have to wait for clinical evaluation after all of the level 1 and 2 patients have been seen. 

An important note about triage levels

Half of all American hospitals use a 5-level triage system, like the ESI or CTAS. These are based on modified versions of triage systems used in Canada and Australia. They are:

  1. ESI 1 – Severely unstable

  2. ESI 2 – Potentially unstable

  3. ESI 3 – Stable but needs urgent care

  4. ESI 4 – Stable, does not need urgent care and may require minimal testing or procedures

  5. ESI 5 – Stable, does not need urgent care and does not require any testing or procedures

In the ESI model, “stable” refers to the patient's likelihood of deteriorating while waiting for care. Those whose conditions are least likely to worsen before seeing a doctor are placed at the lowest level. 

What Work Does A Triage Nurse Do Day To Day? 

Triage Nurses work exclusively in ERs or emergency care facilities. They meet with patients when they are first admitted into the emergency room, perform an intake assessment, and determine their triage level. 

Using a set of guidelines, the nurse performs an interview and assessment to determine the urgency and severity of a patient’s symptoms. They also decide what type of care they likely need and any specialists they need to see, such as an ER dentist or psychiatrist. 

Triage Nurses also provide immediate care for patients who enter the ER if their case is severe. For example, they may bandage a wound to stop bleeding until a doctor arrives. However, Triage Nurses generally do not provide any patient care or treatments.

Once a patient is stable and waiting for the doctor, they will then be tended to by the ER nurses on staff. 

An exciting aspect of Triage Nurses’ jobs is the administrative roles they assume. They work to improve floor organization and patient flow and reduce wait times throughout the ER. However, their primary focus is to ensure people in need of the most immediate care receive it and that other patients are all tended to in a timely fashion.

There are also telehealth Triage Nurses, or TTNs, who use an online triage system to assess patients’ conditions.

They enter their information into a healthcare system and suggest what level of care they should seek, such as the emergency room or booking an appointment with a specialist in their insurance network. 

TTNs are helpful because they reduce the number of patients seeking care in emergency healthcare facilities. This role helps free up space and ensures that hospitals aren’t overwhelmed, so they can appropriately care for people who genuinely need emergency services. 

Where Do Triage Nurses Work? 

Triage Nurses work primarily in hospitals, though some may work in emergency care centers or urgent care clinics. They can also work in trauma centers, outpatient care facilities, and poison control centers. 

Triage Nurses tend to work a rotating shift that covers day, night, weekends, and holidays. Therefore, they must always be available to assist people seeking immediate medical attention. 

What Is It Like To Be A Triage Nurse?

Being a Triage Nurse can be stressful as you are likely to encounter patients in distress. Patients could be in critical physical condition or experiencing intense emotional and psychological crises. 

Because you are in charge of directing patient care, you have to work well under stress and maintain a calm, collected demeanor at all times.

You also have to be comfortable asserting yourself and being authoritative; people may argue with you, demand to be seen sooner, or become angry. This environment is natural when emotions are running high and people are anxious and afraid. 

Triage Nurses have to be able to calm people down, provide reassurance, and ensure that they can always prioritize the needs of every patient in the ER or urgent care facility. 

If you work as a Telephone Triage Nurse, you will need to rely even more heavily on verbal communication to assess a patient’s symptoms and what kind of care they need.

You must be comfortable dealing with people in high-risk situations and know how to act fast to get them the care they need. 

How Much Do Triage Nurses Make?

Triage Nurses earn around $70,000 a year. However, their exact pay will vary based on years of experience, location, and any additional credentials they have. For example, a Triage Nurse certification in ER care or a master’s degree is likely to be offered a higher salary. 

Advantages And Disadvantages Of A Career As A Triage Nurse

As with any nursing profession, there are pros and cons to being a Triage Nurse. It’s helpful to explore both the advantages and disadvantages if you’re considering this career path. Let’s examine a few of them in closer detail. 

Advantages of Choosing a Career as a Triage Nurse

  • Possibility to work from home as a Telephone Triage Nurse (TTN). 

  • Decent salary starting around $70,000.

  • Help people in urgent need of care.

  • A fast-paced job with a variety of patients.

  • Learning opportunities for skills such as trauma care, life support, and IV. 

Disadvantages of Choosing a Career as a Triage Nurse

  • A stressful job with high demand for fast performance. 

  • They are occasionally experiencing the death of patients when you and your team try to save them. 

  • A physically demanding job that requires constant multitasking and movement. 

While the cons of nursing jobs can be tolerable for most, they are also valid reasons not to pursue a particular career, even if you’re interested in it.

The good news is that you don’t need to love the high-stress environment of the ER to be a great nurse. There are many types of nurses and job opportunities in an environment that suits your unique personality. 

How to Become a Triage Nurse

To become a Triage Nurse, you must first become a registered nurse in your state. In addition, all RNs have to complete undergraduate studies and hold either an associate’s degree (ADN/ASN) or a bachelor’s degree (BSN). 

Once you’ve become an RN, you can start looking for jobs in emergency care. Triage Nurses also specialize in trauma care so that you may pursue certifications such as Advanced Cardiac Life Support, Ambulatory Care Nursing (AMB-BC), and Trauma Certified Registered Nurse (TCRN)

How long does it take to become a Triage Nurse?

It takes two to four years to earn your RN, and additional certifications can take anywhere between two to five years of work. Therefore, your journey to becoming a Triage Nurse will require you to first work directly in emergency and trauma care as an RN before you qualify for the responsibilities of triage care. 

Frequently Asked Questions About Triage Nurses

If you have questions about being a Triage Nurse, you’ve come to the right place. Below are some of the most commonly asked questions about people interested in becoming a Triage Nurse. 

What Is The Difference Between A Triage Nurse And A Registered Nurse?

Both Triage Nurses and RNs hold a nursing license, but Triage Nurses are emergency care specialists. They also provide less routine patient care than an RN or ER nurse. Instead, they focus on immediate assessment and possibly life-sustaining procedures for crisis patients. 

Are There Any Triage Nurses' Work-From-Home Jobs? 

Yes! Telehealth Triage Nurses, or telephone Triage Nurses, work remotely on a schedule. They perform patient interviews from afar and suggest what type of treatment would be appropriate for them. 

TTNs help doctor’s offices, healthcare facilities, and hospitals improve their patient flow remotely. They listen to patients’ needs from their own homes, then convey information to physicians on their behalf. 

The Telephone Triage Nurse can message a doctor directly, receive a recommendation, and relay that information back to the patient. This process can reduce extensive wait times in hospitals or urgent care clinics and help patients get in touch with their specialists.

In some cases, patients may even be able to treat themselves at home. In that case, the physician can tell the Triage Nurse their recommendations for the patient, or they can arrange a virtual care appointment through a secure telehealth system. 

Can A Triage Nurse Prescribe Antibiotics? 

No nurse can prescribe medication. Only physicians are allowed to write prescriptions for antibiotics and other medications. In addition, they can only administer medicines provided by a physician.  

Why Are Triage Nurses Necessary?

Triage Nurses ensure that hospitals, emergency clinics, and ambulatory centers are not overwhelmed with patients. Instead, they assign a level of care to each patient to ensure that those in the greatest need of medical assistance are helped first.

This vital role can reduce the risk of someone dying by ensuring those in need receive immediate care. It also helps reduce wait times and patient turnarounds by creating a natural flow through the hospital or emergency center.

As doctors can move systematically from patients of the highest urgency to the lowest, they can treat everyone more efficiently. 

What Is The Most Commonly Used Triage System In Healthcare?

There are several triage systems used throughout the world. The most common are the Emergency Severity Index (ESI), Canadian Triage Assessment Scale, and Australian Triage Score. 

Each triage system ranks patients from the highest level of emergency to the lowest. You can find modified versions of these systems throughout hospitals in the United States. No matter what levels a facility uses, the goal of a triage system is to prioritize patients with the greatest need for emergency care.