Triaging occurs in various setting such as managed care organization, primary and specialty care, emergency departments, and crisis lines. The laws and rules do not prohibit the competent and appropriately trained licensed practical nurse from triaging calls under the direction (direction can be following a standing order) of an authorized health care practitioner or under the direction and supervision of the registered nurse if the licensed practical nurse has the training, knowledge, skills and ability to carry out the activity safely and competently and is willing to accept any consequences of his/her actions.
Some settings may use the licensed practical nurse to manage calls after specialized training and under the supervision of the registered nurse or other authorized health care provider. The licensed practical nurse may collect demographic data from the caller and screen the patient who presents with suicide thoughts. If a patient is deemed potentially dangerous to others, the licensed practical nurse may need to consult with the registered nurse cases are considered more complex and are often deferred to the registered nurse or other professional team member who is trained to handle the needs and complexities of the patient.
It would be prudent to identify steps in the standing order as to what level a triage call becomes complex requiring the licensed practical nurse to refer to or consult with the registered nurse or other authorized health care practitioner. The licensed practical nurse should use the Scope of Practice Decision Tree to determine if specific activities are within the licensed practical nurse's legal and individual scope of practice. The Nursing Care Quality Assurance Commission's Standing Orders and Verbal Orders Advisory Opinion provides additional guidance and recommendations.
All nurses in Washington State are required to complete a suicide prevention training course from an approved list. For more information, see the Washington State Department of Health's Suicide Prevention Training for Health Professionals Approved Courses.