Assessments under pressure: Interviews with triage nurses in emergency departments: An exploratory descriptive qualitative study

Gorick, Hugh, McGee, Marie and Smith, Toby O. (2025) Assessments under pressure: Interviews with triage nurses in emergency departments: An exploratory descriptive qualitative study. Journal of Advanced Nursing. ISSN 0309-2402

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Abstract

Aims: To understand the experiences and decision-making practices of registered nurses when assessing acuity at triage in emergency departments. Design: The study utilised a qualitative exploratory-descriptive design. Methods: Purposive sampling recruited 11 registered nurses with triage experience from across the United Kingdom. Semi-structured online interviews, incorporating practice-based vignettes, were conducted between April and November 2024. Thematic analysis was selected to analyse the data. Results: Three themes were identified: (1) Pressurised decisions, highlighting the effects of overcrowding, staffing shortages, and operational burdens; (2) Holistic assessments, revealing the shift from structured to intuitive decision-making as nurses gain experience; and (3) Confidence, competence, and emotional wellbeing, illustrating the psychological impacts of triage and the importance of experience and support. Conclusions: This study provides novel insight into how triage nurses navigate acuity assessment in high-pressure environments. It shows how experience, training and institutional culture influence decision-making and wellbeing. It identifies key areas for targeted intervention. Implications for the profession and/or patient care: Triage nurses face substantial cognitive and emotional strain, which may compromise assessment quality and safety. Findings highlight the urgent need for structured triage training, protected time for assessment, and access to wellbeing and peer support systems.

Item Type:	Article
Additional Information:	Peer Review: The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/jan.70283. Data Availability Statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Uncontrolled Keywords:	triage,nursing,emergency departments,qualitative,interviews,nursing(all) ,/dk/atira/pure/subjectarea/asjc/2900
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Medicine and Health Sciences > Research Centres > Public Health
Related URLs:	http://www.scopus.com/inward/record.url?...
Depositing User:	LivePure Connector
Date Deposited:	06 Oct 2025 13:30
Last Modified:	27 Oct 2025 09:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/100645
DOI:	10.1111/jan.70283

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