How a single nurse in an emergency room can doom a patient's health

No one ever thinks about it, but if you are in a major accident or have a major injury and are taken to an emergency room (ER), you may barely remember the visit. Traumatic injuries and pain medications can leave you dazed, fuzzy, and unable to remember details about events, including medical treatment.

Once you arrive at the hospital emergency department (ED), a triage nurse—not a physician—will be the first person to evaluate your symptoms and decide the priority of your care within the ED. Until you’re actually taken from the waiting area, the triage nurse is responsible for keeping an eye on you and reassessing your condition.

For most people, a triage nurse’s decisions will be satisfactory. But in my 20+ years as a medical malpractice attorney in Texas, I’ve seen too many cases where a triage nurse’s poor decisions caused patients to end up in a worse position than when they arrived, including serious disabilities and death.

And in most of these cases that I see, these mistakes could have been easily prevented if simple standards of care were followed.

Here’s an example.

Recently, I represented a client who arrived at a hospital ED with serious back pain. The hospital wouldn’t allow the patient’s wife to accompany him because of visitor restrictions during the COVID-19 pandemic. The triage nurse took a cursory history, with two important omissions: The patient had started a narcotic and muscle relaxant two days earlier and he had early dementia. As a result, the nurse marked him down as a low-acuity patient—meaning he didn’t need to be seen quickly—and as a low fall risk. The nurse sent him to the bathroom independently for a urine sample and the patient fell and broke his hip.

In other words, this man went to the hospital for back pain and ended up with a broken hip because the triage nurse failed to appropriately appraise his condition and check the boxes to get the proper help he needed.

It’s this type of preventable deviation from the standard of care that causes too many patients to be harmed while in the emergency room.

As a medical malpractice lawyer, I was recently interviewed about poor triage nurse decision-making for ED Management, an industry journal for emergency department professionals. In the interview, I said time after time, I have seen emergency room cases where the care went off the tracks from the very beginning because an inexperienced triage nurse got incomplete information about the patient’s condition.

When I have a case where a triage nurse may have mishandled a patient, I explore the nurse’s educational background, training, and experience, which is where I frequently find serious deficiencies.

Patients in an ER have no choice but to place their lives in the hands of a triage nurse and hope the nurse will pay attention to them or their family and obtain as much information as possible.

If you or someone you know has been needlessly and seriously endangered in a Texas emergency room, please call me at 281-580-8800 for a free consultation about your potential case.

Robert Painter
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Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.