Nycole Oliver staggered onto the stage, demanded a strawberry soda and hassled the triage nurse. She was playing “Debbie,” a severely intoxicated “super-utilizer” patient brought to the emergency department.
Oliver’s antics drew thunderous laughter from the audience at the interactive, theatrical session “Edutainment: Tequila and Triage” on Friday. But the comic play underscored a sobering point: ED staff frequently triage intoxicated patients incorrectly, delaying much-needed treatment. Nearly half of intoxicated patients leave without being seen by a provider.
The session mostly kept its light tone, and the ENA Conference Education Planning Committee co-chairs, Heidi Gilbert and Bradley Rund, sported a gold gown and sparkly jacket to host the event.
As the name “Edutainment” suggested, Gilbert and Rund wanted to teach and amuse, and their cast offered plenty of physical comedy and jokes. They emphasized the people on stage were nurses and not actors.
“Surprisingly, we don’t take ourselves very seriously,” Gilbert said with a smile. In that tone, they made sure their audience had fun while they discussed a serious triage issue.
Oliver was among four nurses who acted as ED patients in the waiting room — including patients with chest pressure, back pain or an ankle pain that had lasted three days. Audience members used an online platform to vote on which patient to triage first and then chose the ESI level for each patient.
The mood took a dramatic turn when the patient with chest pain coded and, in the chaos, Debbie slipped out of the ED. The clinical team shrugged off Debbie’s departure, but she soon was found unresponsive outside. Later she was diagnosed with a serious brain bleed.
Michael Zonak, who added context to the events as he played the role of an ED educator, encouraged the audience to check their attitudes, as certain patients lead ED staff to fall into a dismissive “they are just drunk” mindset.
“You’ve got to remember that they’re intoxicated, but intoxicated people also have heart attacks, also have trauma, also have bleeds,” Zonak said. “In Debbie’s case, which came first? Did she come in with the bleed? We really can’t assume the patient is just intoxicated until a brain injury is ruled out.”
Rund and Gilbert interviewed audience members for a broad conversation about the common response to intoxicated patients, hospital policies and what happens when law enforcement requests a patient blood draw.
Several audience members acknowledged that their EDs spend only a little time on the patients who come in intoxicated, and Rund applauded them for their honesty.
“This is (an issue) we need to take a look at as a community, as well as how we triage them as nurses,” Rund said.
More Edutainment: Family Feud-Style Game of Nurses
Test your knowledge! “ENA: Tournament of Nurses,” the second Edutainment event of Emergency Nursing 2022, will be held at 6:15 p.m. on Oct. 2 in the Four Seasons Ballroom. This lighthearted Family Feud-style competition will be open to all attendees. In a nod to the “Harry Potter” movies, nurses will be sorted into four teams and led by a prefect, and then compete for points.