Triage Management During Covid-19 in Emergency Department: A Phenomenology Approach Among Nurses in Medan

Abstract

Introduction: Triage is an important link in treating critical patients, but during the COVID-19 pandemic, triage is not only to select and sort patients from emergency status, but to avoid a surge in patients from the limited hospital capacity and medical personnel. The experience of emergency room nurses is needed to formulate a nursing service strategy. The purpose of this study was to explore the experience of nurses in carrying out management of triage (client priority classification system based on the severity of the client's condition or the emergency that requires immediate action) in the Emergency Room (ER) during COVID-19 pandemic in Medan. Methods: The type of research used in this studied was qualitative research with a phenomenological approach. Sampling used purposive sampling technique with the number of participants as many as 10 people. Data collection was done through in- depth interviews. The process of data analysis in this studied used Colaizzi's approach of content analysis. Results: The results of the study found four main themes that describe the experience of nurses in carrying out triage management during the COVID-19 pandemic. The themes that emerged as a result of the research were: 1) Triage management during Covid pandemic, 2) Individual perceptions of infection/contagion Triage, 3) The burden of the triage nurses' during Covid pandemic, and 4) Nurses’ gratitude. Conclusion: The experience of nurses in conducting triage management during the COVID-19 pandemic was focused on initial screening, namely the assessment of acute respiratory infections (ARI), contact history and a history of indications for COVID-19. Then secondary triage was sorting patients based on emergency conditions. The use of personal protective equipment still did not meet the standards, the workload of nurses was high and there was gratitude by them for being at the forefront of handling COVID-19.

Cognitive appraisals and coping strategies of registered nurses in the emergency department combating COVID‐19: A scoping review

“…The secondary appraisal to effectively handle and control the pandemic‐related challenges was that EDRNs proactively updated comprehensive information about COVID‐19 (Cinar et al, 2021; Hsu et al, 2021; Kandemir et al, 2021; Wei et al, 2020). EDRNs knew that the main barrier to triage management was the poor prevention and control knowledge of the epidemic because the situation of the COVID‐19 pandemic is unprecedented (Mulyadi et al, 2022; Syapitri et al, 2022; Xu et al, 2021). As part of their duty, EDRNs chose to stay with the high‐risk patients, despite the fear of contracting the infection and passing it on to their loved ones (Arcadi et al, 2021; Li et al, 2021; Xu et al, 2021).…”

“…valuable asset for pandemic management-the life and health of the medical teams (Kostadinov & Atliev, 2021;Syapitri et al, 2022).…”

“…EDRNs experienced anxiety (Cui et al, 2021), physical and psychological exhaustion (Mulyadi et al, 2022;Wei et al, 2020), and profound stress (Li et al, 2021;Yang et al, 2022), due to the radical workplace changes. They also suffered from burnout (Arcadi et al, 2021;Jose et al, 2020;Syapitri et al, 2022;Xu et al, 2021) and higher turnover (Ahorsu et al, 2022). After the COVID-19 outbreak, 48.2% of EDRNs intended to leave emergency nursing within 5 years (Cornish et al, 2021).…”

“…EDRNs' motivation and willingness increased with their professional satisfaction and commitment (Cui et al, 2021;Kandemir et al, 2021). For EDRNs, their family, clinical fellows, and community support were sources of strength (Mulyadi et al, 2022;Syapitri et al, 2022;Wei et al, 2020).…”

“…The sense of personal accomplishment makes EDRNs more engaged in their work and more motivated to enhance the quality of care (Ahorsu et al, 2022;Jose et al, 2020). As COVID-19 might put patients in the position of suffering from inevitable death, EDRNs accompanied them to express emotion, accept reality, experience loneliness, and share feelings (Arcadi et al, 2021;Syapitri et al, 2022). To handle grief and digest negative emotions, EDRNs' responsibility with empathy and compassion reinforce the degree of cohesion and collective solidarity (Ahorsu et al, 2022;Kandemir et al, 2021;Wei et al, 2020).…”