Passing the audition - the appraisal of client credibility and assessment by nurses at triage
Abstract
This paper presents the findings of one aspect of a larger study aiming to build a substantive grounded theory of the process of initial assessment at triage. Prioritisation at triage within emergency departments centres primarily on assessing the threat to physiological function of people presenting with health-care problems. This approach presumes that clinical reasoning strategies reside exclusively within the health-care practitioner, with the patient playing no active part in the process. A grounded theory/symbolic interactionist methodology. Thirty-eight recordings were made of live triage encounters involving 14 emergency nurses from two demographically distinct emergency departments. At the end of the relevant shift, those encounters in which the nurses were involved were replayed to them. The recording was stopped after each question or comment by the nurse who was then asked to say what they were thinking at the time. The nurses' thoughts were recorded, transcribed and analysed using the constant comparative method, in which hypotheses are generated and continually modified in the light of incoming data until a conceptual story line, or theory, is produced. The findings suggest that the outward clinical signs of probl...Continue Reading
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