How to Become a Triage Nurse

A triage nurse is a registered nurse who works in various healthcare settings to ensure patients receive the correct level of care they need.  Most commonly, triage nurses are associated with the emergency department, mass casualties/disasters, and war.

This article will provide an overview of what a triage nurse is, their salary, the skills needed to be one, what it is like to work as a triage nurse, and more!

A triage nurse helps to establish what kind of care patients need and assists them in getting that care at the right location as soon as possible. They are usually the first healthcare professionals patients see and talk to upon arriving at an emergency room or clinic. 

However, you can also find triage nurses working in:

• Poison control centers
• Physician offices
• Mental health crisis hotlines

The triage nurse's goal is to establish what type of care each patient needs and get them to the correct location quickly. Typically, patients with more serious or life-threatening conditions receive priority care over those who are more stable.

However, not all triage nurses work in in-patient care settings. There are also telephone triage nurses who assess and provide healthcare information virtually.

For example, physician’s offices may have a telephone triage nurse to perform virtual assessments before a patient's office visit. 

Some hospitals also have triage wards where they use telephone triage nurses to assess patient medical conditions to see if they should see their healthcare provider or go to urgent care or an ER. 

As the first contact person for patients in emergent or urgent care settings, triage nurses have a wide range of responsibilities, such as:

• Assess patient status quickly
• Take vital signs
• Chart the patient's medical and personal history
• Interview patients alongside their families to gather information. 
• Record medications and treatments and ensure the patient's chart is up-to-date
• Communicate the patient's condition with physicians, nurses, and other needed health professionals.
• Administer medications or provide other health treatments
• Initiate emergency treatment if needed
• Prioritize patients in groups based on the severity of medical needs per guidelines
• Reassess and communicate with patients who are still waiting for care

According to the US Bureau of Labor Statistics (BLS), the median annual pay for all registered nurses is $81,220 per year or $39.05 per hour. But according to ZipRecruiter, triage nurses in the US earn a median average of about $80,761 annually or $39/hr. However, they also reported that triage nurse salaries in the US range from around $30,500 annually to about $96,000 annually.

Triage nurses must have the same degree and credentials as every other nurse. Here is how to become a triage nurse:

Step One:  Attend an accredited nursing program

Triage nurses must have an associate's degree in nursing (ADN) or a bachelor's degree in nursing (BSN) from an accredited nursing program.

Step Two: Pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN)

Triage nurses must pass the NCLEX-RN and maintain a current and active license in their state.

Step Three: Gain several years of working experience in an emergency department or urgent care setting

Most triage positions require several years of working in a hospital setting, an emergency room, or an urgent care unit. 

Telephone triage positions in triage wards at hospitals often do not require ER or urgent care experience. However, they do usually need at least two years of bedside experience to be eligible for the position.

Step Four: Apply for triage nurse positions

If you are already working as an ER nurse or in an urgent care clinic, it is much easier to apply to work as a triage nurse in the department where you work. You will already have an in-depth understanding of how the until functions and can determine each patient's plan of care quickly.

In addition, the hiring managers will already know what a talented nurse you are and will be happy to hire you!

Becoming a triage nurse usually requires earning additional certifications. Triage nurses in direct patient care settings usually work in and prioritize care for emergency and intensive care unit (ICU) patients. Therefore, triage nurses in hospitals or urgent care clinics need the following certifications to work in the position.

• Certified Emergency Nurse (CEN)
• Advanced Cardiovascular Life Support (ACLS)
• Pediatric Advanced Life Support Certification (PALS)

Skills that triage nurses need include:

• Quick critical thinking skills
• Intrapersonal and communication skills
• The ability to perform in high-pressure situations
• Stress-management skills
• The ability to establish firm emotional boundaries between your patient and their families

Working as a triage nurse in the emergency room means that you play a role in developing care for each patient that comes through the doors. 

Hospital triage nurses in America use a triage system called the Emergency Severity Index, or ESI. It is a one-to-five number system, with one being the most critical patients who require life-saving measures and five being the least critical who can wait for treatment if needed.

The ESI is essential to prioritize patient care. However, each situation is unique, and there is always some level of stress involved for triage nurses to make the correct choices. 

According to one ER triage nurse:

“Acting the role of a triage nurse on a busy day can leave you with exhaustion that differs from working a typical assignment in the ED. You have one of the highest liabilities within the department because you are responsible for deciding who sees a doctor first and who can sit and wait for four more hours. If you make the wrong decision, a patient could be sent back out to wait and have a fatal event while someone else was seen before them.”

This triage nurse wants other nurses and the community to understand that being a triage nurse is incredibly complex and often entails being a “gatekeeper” between the waiting room and receiving treatment.

“The triage process is much more complex than many people might expect, and triage nurses often go unrecognized by patients as playing such a vital role in patient safety.”