Emergency Nurses’ Experiences of Triaging Geriatric Trauma Patients: A Qualitative Study

INTRODUCTION: Undertriage of geriatric trauma patients remains a critical concern in emergency care, with rates exceeding 50% in this vulnerable population. Emergency nurses, as frontline decision makers, play a pivotal role in triage outcomes, yet their experiences and decision-making processes when triaging geriatric trauma patients remain largely unexplored. This study aimed to explore emergency nurses' experiences in triaging geriatric trauma patients, focusing on the challenges and strategies influencing their decision making. METHODS: A qualitative descriptive design using inductive content analysis was used. Fifteen emergency triage nurses from a tertiary trauma center in northern China were purposively selected and participated in semistructured interviews between April and June 2025. Data were analyzed using systematic coding and categorization to identify themes and categories. RESULTS: Three main categories were identified: multidimensional challenges in triage decision making, proactive strategies for managing uncertainty, and professional commitment as the foundation for perseverance. Nurses faced significant challenges owing to atypical presentations, limited information, insufficient support, and moral conflicts in triage decisions. Emergency nurses navigated these challenges by observing subtle cues, rechecking assessments, and seeking peer support. Their professional identity was reinforced by a strong commitment to patient safety despite uncertainty. DISCUSSION: Emergency nurses navigate geriatric trauma triage within a context of heightened uncertainty, resource constraints, and ethical tensions. Although they demonstrate resilience through proactive coping strategies, persistent cognitive strain highlights the need for geriatric-specific educational interventions, decision-support systems, and psychological support to strengthen decision-making confidence and reduce undertriage risk.