Subtrope of Battleaxe Nurse
, a very uncaring member of the "caring profession". This is a triage nurse, staffing the desk in the waiting room, who sorts patients not according to severity or urgency, but according to their own whims and twisted love of power.
There is a tendency for many people (who don't understand the concept of triage
) to decide that the ER staff is indulging in this, even when they aren't. Add to that that the desk staff at an ER have to be firm about who they're calling, but can't explain to the other patients why they're being taken in that order, and you get an appearance of petty tyranny. While desk nurses are the most likely to get this portrayal, medical personnel in general are often seen as petty dictators who are unreasonable about things like visiting hours; admittance to the ICU; flowers, candy and food being brought to the patients; and all the other annoyances about having a loved one in the hospital.
Of course it should go without saying that in Real Life
there are very good reasons for all these rules. Sometimes that is illustrated dramatically with a medical emergency that happens right in front of the complainer and the triage nurse has to go into action while the complainer realizes that there are higher medical priorities he must respect.
Related to Obstructive Bureaucrat
. Coworker of the Battleaxe Nurse
and Dr. Jerk
- She's not a nurse, but the "bereavement liaison" in Little Miss Sunshine certainly qualifies.
- Deconstructed in Gridlock'd. The two main characters, junkies on the run from some hoodlums and the law, are desperately trying to get into rehab. They repeatedly bounce off of gridlock and red tape while talking to a number of overworked and indifferent bureaucrats. While the junkies rage at the obvious dysfunction of the system, the bureaucrats get their own licks at the junkies, showing how there are many other people just like them jockeying for the same limited resources and that the world doesn't stop simply because they suddenly decide to ask for help.
- Bringing Out the Dead has the triage nurse giving lectures to the patients that come in. "Let me get this straight. You snorted cocaine and now you feel like your heart is going to explode. We didn't buy you the cocaine, we didn't shove it up your nose..."
- In the first novel of the Star Trek: Vanguard series, the Bombay's CMO complains bitterly about "battlefield triage" - she and her staff can't treat crewmen who may need their help the most if they aren't critical to keeping the ship from being destroyed while under attack. To her, it feels like a perversion of the Hippocratic Oath.
- In the Codename: Kids Next Door episode "Operation: H.O.S.P.I.T.A.L., Sector V had to get into a hospital to rescue an injured operative who later turned out to be Bradley, because operatives who were treated there were being assaulted. Numbuh One had no luck with the triage nurse; even though she seemed friendly and harmless, she didn't take his authoritarian demands seriously. Numbuh Five, who was more polite and often the Only Sane Member of the team had more luck and got some information, but was still unable to get them admitted formally. Despite this, seeing as Adults Are Useless in this cartoon (the ones who aren't evil, anyway), sneaking in was surprisingly easy, and no-one tried to stop them. Lucky thing too, because Bradley was targeted by the assailant, who happened to be Numbuh Five's evil sister Cree.
- In most hospitals in North America, emergency department presentations are assessed according to a 5-point scale called the Emergency Severity Index, which assigns a "priority level" based on the patient's chief complaint, vital signs and a few other factors. Priority 1 patients, such as CPR in progress, major trauma, STEMI (heart attack) and stroke, skip the triage queue entirely and go straight back to the Trauma/Resuscitation area ("Resus" in department slang). Non-emergent events, such as suture removal or medication refills, are classed as Priority 5. Patients are seen in order of ESI priority, not in order of arrival time and not necessarily in order of graphic or exaggerated symptoms (i.e. nausea and vomiting isn't usually an emergencynote , respiratory distress is). Explaining the concept of triage to lay people without sounding like a petty tyrant is one of the hardest tasks of the triage nurse.
- By law in most countries, emergency department staff cannot turn any patient away until he/she has been provided a medical screening exam and, if necessary, adequate care to stabilize his/her condition. In the United States, this law is called EMTALA. If the patient isn't really that sick or injured, then they'll get the basic assessment and will be put in the triage queue to wait until the higher-priority cases are handled. Patients who are known to abuse EMTALA for drugs, attention, or other non-health-related reasons are much looked down upon by emergency department staff, as these cases are perceived as wasting time, staff and bed space that could have been better used on a legitimately sick patient.
- One of the cruel realities of any mass casualty incident, such as a large multi-vehicle wreck in the middle of nowhere or something on the scale of Katrina or September 11th, is that not everyone can be saved, even with the miracles of modern medicine. Mass casualty triage rests upon providing the most benefit to the greatest number of people; if you expend all your resources saving one catastrophically injured patient, you may have just doomed ten more to die for lack of care. Enter the principle of Simple Triage and Rapid Treatment. If you can walk: Priority 3, help carry the person next to you over to the casualty collection point. If you can't walk, but follow commands, Priority 2: We'll get to you as soon as we can. On the other hand, if the only thing you do is breathe or babble incoherently, you get out of there pretty fast: Priority 1. Unsurvivable injuries, such as massive burns or amputations, no pulse, or no spontaneous breathing? Expectant/Morgue.