Producing inequalities in emergency room

Organizational constraints and discriminating practices among triage nurses

Abstract

Analyzing the work of the triage nurse, this article aims to show the diffe- rentiated treatments between patients at the front desk of an Emergency Room. This study shows that the triage nurses are confronted to a dilemma while accomplishing their work as a gate-keeper. Acting as street level bureaucrats, they have to juggle both their own representations and managerial and political injunctions. While the creation of a fast track inside the emergency room (ER) could appear as a solution to decrease the number of emergencies, the organizational constraints, during its implementation, lead to many undesirable effects, which consequently result in the creation of social inequalities in the management of the patients in ER.