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Assessments Under Pressure: Interviews With Triage Nurses in Emergency Departments: An Exploratory Descriptive
Hugh Gorick1,2, Marie McGee1, Toby O Smith1,2,3
1University of East Anglia, Norwich Research Park, Norwich, UK.
Journal of Advanced Nursing
|October 11, 2025
Summary
Registered nurses in emergency departments face significant pressures during acuity assessment. Experience, training, and support are crucial for effective decision-making and nurse wellbeing in high-stress triage environments.
Area of Science:
- Emergency nursing
- Qualitative research
- Healthcare management
Background:
- Triage nurses in emergency departments (EDs) operate under demanding conditions.
- Understanding their decision-making processes and experiences is vital for improving patient care and staff support.
Purpose of the Study:
- To explore the experiences and decision-making practices of registered nurses (RNs) during acuity assessment in ED triage.
- To identify factors influencing triage decision-making and nurse wellbeing.
Main Methods:
- Qualitative exploratory-descriptive study design.
- Purposive sampling of 11 experienced UK-based RNs.
- Semi-structured online interviews and thematic analysis.
Main Results:
- Three themes emerged: Pressurised decisions (overcrowding, staffing), Holistic assessments (shift to intuitive decision-making with experience), and Confidence, competence, and emotional wellbeing (impact of psychological strain and support).
Conclusions:
- Triage nurses' acuity assessment is influenced by environmental pressures, experience, training, and institutional culture.
- Novel insights into navigating high-pressure triage environments.
- Identifies areas for targeted interventions to support nurses and enhance care quality.
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