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Page modified February 02, 2010

RPNs in Triage

Q

I am an RN working in the emergency department. My facility is considering hiring RPNs as triage nurses. It is my understanding that RPNs look after stable clients. Does this breach the standards and guidelines set out by the College?

A

An RN must conduct triage assessments in the emergency room, although the College does not have a standard specific to RPN in the triage role.  The College’s Utilization of RNs and RPNs practice document outlines key practice descriptors for both RN and RPN categories to assist nurses, employers and others to make effective decisions regarding the utilization of nurses.

RNs and RPNs study from the same body of knowledge. An RN studies for a longer period, allowing for greater breadth and depth of foundational knowledge in the areas of clinical practice, decision making, critical thinking, leadership, research utilization and resource management. The more in-depth education prepares an RN to care for complex or unstable clients.

In comparison, the RPN curriculum covers the above categories for a shorter period. This prepares RPNs to care autonomously for clients who are have less complex conditions.   When an RPN provides care to clients with more complex needs, she or he must work with an RN.

In the triage role, the nurse assesses the urgency of care needed by the client. It is impossible to predict how many clients will present to the emergency department and what their health care needs will be. Therefore, the stability of the environment and client care needs, as well as the predictability of the client conditions and outcomes, is uncertain and varied.

As a result, the triage nurse requires in-depth assessment, critical thinking and decision-making skills. For these reasons, the triage role is better suited to an RN and is beyond the level of educational preparation of an RPN.

It is worthwhile to explore with your employer other areas within the emergency department where the RPN could practice. Such areas of practice would still require some consultation with the RN and health care team.

References

Last Updated Feb. 2010

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