Triage Tyrant

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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.

Examples of Triage Tyrant include:

  • She's not a nurse, but the hospital administrator in Little Miss Sunshine certainly qualifies.
  • Played for Drama in the Tupac Shakur movie Gridlock'd, to the point where you could even describe this character as the main villain of the piece. She decides Stretch and Spoon are troublemakers, and won't even prioritize them when they are shot and stabbed, respectively.
    • However, there is later a very meaningful subversion which gets across the movie's message without dropping anvils - on the final shot of the movie, the camera pans away from the main characters and we see the entire waiting room is full of people with injuries or illnesses as least as bad as theirs, showcasing the absolute inadequacy of healthcare provision for low-income people in the movie's New York.
  • 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..."

  • Friends, the one who ends up with a face full of hockey puck.
  • One Tree Hill: "I didn't like cheerleaders when I was in school" "But she's pregnant and in pain!" "Guess who's waiting a little longer?"
  • M*A*S*H: Given that the camp typically receives dozens of wounded at a time at least, triage is a matter of life and death every time, which has lead to disputes:
    • In one episode, Frank Burns deliberately sends in American troops over Koreans even when there are Koreans in much greater need than soldiers.
      • The above is also a prime example of a bureaucratic mentality. Regulations say "Americans first, allies second, enemies last." Nothing about severity or urgency...
    • In another episode, Hawkeye is on the bus doing triage, and gets into a fight with a soldier over being a commie-lover by prioritising seriously wounded North Koreans over wounded American soldiers.
  • Nicole Sullivan, as the "Vancome lady", as a nurse in Mad TV. She kept turning people away for stupid reasons. They'd describe their emergency and she'd explain, in chirpy tones, why they should head down the street. The only one I remember was a hemophiliac who was told that Sisters of Mercy didn't support that lifestyle... Link to the episode (until it's removed)
  • In one Star Trek: Voyager episode, the holographic Doctor gets stolen and sold to an alien hospital, where patients are assessed not according to urgency, but according to how "valuable" their skills are to society. As a result, the working classes suffer in crowded, undersupplied halls while the rich recover in luxury. In the Doctor's efforts to help, both the Prime Directive and the Hippocratic Oath get severely bent.
    • In another, The Doctor is faced with two patients (Harry Kim and a Red Shirt) who have an exactly equal chance of survival. He can only treat one of them in time, and the other will die. Because his program cannot find a logical way to decide, he chooses to save Harry because he's a friend. This causes a severe malfunction in his program that forces the crew to erase his memory of the event or risk losing their only medical officer.

  • In reality, there's a federal law called EMTALA that requires hospitals and EMS services to at least assess a patient to determine how much of an emergency the patient really has. Once the patient walks through the hospital doors or is brought in by ambulance, they have to be seen and can't be sent away until they are considered stabilized. If the patient isn't really that sick or injured, then they'll get the basic assessment and put in the triage queue to wait until there's room for the less sick and injured.

People who abuse this law just to get attention or watch the parade of gore cases go by are known as GOMERs. Nothing to do with Jim Nabors or Leonard Lawrence, it's an acronym that stands for "Get Out Of My Emergency Room!"

  • One of the cruel realities of any mass casuality incident, such as a large multi-vehicle wreck in the middle of nowhere or something on the scale of Katrina or 9/11, is that not everyone can be saved, even with the miracles of modern medicine. On the same venue, time spent dealing with those patients who cannot be helped will cause those that can to die. 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 casuality 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.
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