I believe, based on the provided definition and details, clinical triage qualifies as a nursing subspecialty. Triage nursing focuses on timely and safe clinical assessment and classification of urgency, specifically when looking after patients seeking advice about their symptoms. It takes place in specialised environments such as pre-hospital, virtual care, emergency departments, and urgent care settings. Furthermore, triage nursing requires certification and specialised training that covers recognising symptom patterns across diverse patient populations, including various ages, health risks, ethnicities, languages, cultures, and socio-economic statuses. This specialised knowledge and skill set aligns with the characteristics of a subspecialty, as it involves a concentrated area of expertise within the broader field of nursing. Additionally, the structured nursing process modified for triage reinforces this classification. It includes essential components such as eliciting and assessing symptoms, estimating risk, communicating treatment plans, and evaluating patient outcomes. Therefore, Triage nursing not only includes specialised knowledge and skills but also uses a clinical decision-making process with time-sensitive outcomes, establishing it as a clinical subspecialty. I hope this helps

Nursing Triage is a professional nursing clinical judgement cognitive skill set developed among emergency care nurses and is an attribute of expert class professional behaviors and exemplars of the art and science of emergency nursing. The professional skill of triage (sortation and routing)to the appropriate medical-surgical service line (Surgery, Medicine, Ob-Gyn, Pediatric, Psych) without error, is a life-long life-style skill of the CEN (certified emergency nurse). Tacit knowledge gained from personal experience of delivering nursing care at the point of care in each of the different domains of service is the unique expert class clinical skill set of the professional emergency nurse. This body of experiential knowledge is what the emergency nurse draws upon when performing the hierarchical decision tree Triage Process as step-wise logic that results in connecting the correct and appropriate service line to the patient without failure. Errors have high potential for catastrophic adverse events and misadventures. Expert class emergency nurses have the best hit/miss track record of all professions for getting it right the first time! Triage the patient presenting in extremis within 45-60 seconds of field assessment, to the correct service line equipped and prepared to address the priority need of the patient, based upon years of experience delivering care to patients presenting with similar needs.

Examples: First time pancreatitis is a major surgery triage because it may be common duct obstruction and not medically treated pancreatitis. Getting this wrong (depending on emergency department) may add hours to the correct decision by emergency medical physician to get a surgical consult sooner rather than later when ruling out common bile duct obstruction, a surgical, not medical, intervention resulting.

Example: Sending a young female with belly pain to minor medicine with suspected food poisoning (and without clear understanding of menstrual status) may result in patient exsanguination and death in the minor medicine waiting area from a ruptured ectopic pregnancy! An expert skilled emergency nurse very rarely makes those types of decision tree errors in the process of Triage. Those are the errors of the unskilled and professionally unwise.

It takes years to develop that kind of Triage skill.

What is the ideal service line to triage an 18 year old female with a persistent serum leaking from her umbilicus? Surgery?

Ob-Gyn surgeon will instantly suspect a patent anterior ligament of the uterus because that is what the interior umbilical cord becomes in the female infant and if the hollow ligament is still leaking in the adult female, it is usually a simple fix. It may be a horrible experience for everyone if a first year surgical intern "learns on the job by trial and error because the "Triage Nurse" sent the patient to the emergency surgery department rather than the emergency OB-Gyn department. I confess, I speak from experience!

This is why most emergency departments require nurses to work in all areas and all service lines in the emergency department BEFORE allowing them to function in the Triage Nurse role!

Richard Gilder RN MS

[email protected]

Great Question, thanks for the opportunity to respond.

Triage is poorly understood and appreciated as well as it should be.

I believe, based on the provided definition and details.In my opinion. It is a skill that can be developed over time, depending on the department you work in clinical triage qualifies as a nursing sub-specialty. Triage nursing focuses on timely and safe clinical assessment and classification of urgency, specifically when looking after patients seeking advice about their symptoms.

It takes place in specialized environments such as pre-hospital, virtual care, emergency departments, and urgent care settings. Furthermore, triage nursing requires certification and specialized training that covers recognizing symptom patterns across diverse patient populations, including various ages, health risks, ethnicity, languages, cultures, and socio-economic statuses. Additionally, the structured nursing process modified for triage reinforces this classification. It includes essential components such as symptoms, risk factors, communicating treatment plans, and evaluating patient outcomes. Therefore, Triage nursing not only includes specialized knowledge and skills but also uses a clinical decision-making process with sensitive outcomes. I hope this helps for you

Yes of course, clinical triage can be considered a clinical subspecialty because it requires a distinct body of knowledge, specific training, and a focus on a particular aspect of patient care.