EXPLORING THE EXPERIENCES OF TRIAGE NURSES IN THE PRIMARY HEALTH22-ARE SETTING: A FOCUSED ETHNOGRAPHIC STUDY

Abstract

Background Polyclinics are primary healthcare institutions in Singapore that provide a wide range of healthcare services. With a large number of attendances, priority, and emergency cases, polyclinics have triage systems which have only been previously used in emergency departments. While current literature has explored the experiences of hospital triage nurses, there is a dearth of evidence exploring the experiences of triage nurses in primary healthcare. Aim The aim of this study was to explore the experiences of primary care triage nurses. Methods A focused ethnographic design was used with 22 triage nurses selected through purposive sampling. Non-participant observations and semi-structured interviews were conducted across five polyclinics. Field notes, observational, and interview data were collected until data saturation. Source, time, space, and person triangulation generated emerging themes. A synthesis of Hammond’s Lens model, Evans’s 2-stage reasoning process, and the Symbolic Interaction Theory provided the theoretical and conceptual underpinnings of the study. Findings Thematic and content analysis revealed a central exhaustive description of ‘Information synthesis’, which was the culmination of three themes that emerged from the data including: ‘previous nursing experience’, ‘patients and caregivers’, and ‘inter-professional collaboration.’ In these themes, triage nurses described the role of experience in decision-making, the challenges in managing clients’ demands, and handling inter-professional conflicts. 2 Implications This study supports the need for more inter-professional communication platforms to promote better working relationships among triage staff. The emotionally stressful nature of triage work necessitates improved programmes to enhance the nurses’ support network. More research is needed to explore the experiences of patients and other triage personnel to obtain a holistic understanding of primary care triage. Conclusion The findings suggested that the role of triage nurses in primary care is complex and difficult. More support is needed to empower and help them cope with the challenges of triage work.