i was triage nurse that day and had just been out to the waiting room to clean up. since there were no patients waiting to be seen at the time, i came back to the nurses' station for a cup of hot cider from the crockpot someone had brought in for christmas. just then an admitting clerk came back and told me i had five patients waiting to be evaluated.

i whined, "five, how did i get five; i was just out there and no one was in the waiting room."

"well, there are five signed in." so i went straight out and called the first name. five bodies showed up at my triage desk, a pale petite woman and four small children in somewhat rumpled clothing.

"are you all sick?" i asked suspiciously.

"yes," she said weakly, and lowered her head.

"okay," i replied, unconvinced, "who's first?" one by one they sat down, and i asked the usual preliminary questions. when it came to descriptions of their presenting problems, things got a little vague.

two of the children had headaches, but the headaches weren't accompanied by the normal body language of holding the head or trying to keep it still or squinting or grimacing. two children had earaches, but only one could tell me which ear was affected. the mother complained of a cough, but seemed to work to produce it.

something was wrong with the picture. our hospital policy, however, was not to turn away any patient, so we would see them.

when i explained to the mother that it might be a little while before a doctor saw her because, even though the waiting room was empty, ambulances had brought in several, more critical patients, in the back, she responded, "take your time, it's warm in here." she turned and, with a smile, guided her brood into the waiting room.

on a hunch (call it nursing judgment), i checked the chart after the admitting clerk had finished registering the family. no address - they were homeless. the waiting room was warm.