As telephone triage nurses, our job is to educate. When patients are calling after hours, they are worried and seeking reassurance or they would not be calling. Many times, they think medication is going to cure the problem, they feel they need to hear the advice from the physician to make it real to them, or they are afraid the nurse will not communicate to their physician that they called or that their child is sick.
The first thing to keep in mind is you must sound reassuring and confident, even if you are new to this field and feel like you don't have any idea what you are talking about. Now, we know that is not the case, but you feel that way when you step out of familiar territory into something new. Every organization and/or facility has a training program that they have moved you through before you began, and you have protocols to follow, but until you have made it through those first few calls, you do feel very unsure.
If your voice is hesitant,or you have alot of pauses in your advice and conversation with the caller, of course, they next thing they are going to do is ask you to page the physician on call.
How do you prevent this? The best advice I can give, is know your protocols. Take some time to read through them, and familiarize yourself with the information they contain. If you know the material you are talking about, it reinforces what you are saying to the caller, because you are confident in what you are advising them of, and you are much more equipped to answer their questions.
Be prepared to give them an explanation for why you are advising them to do what you are instructing. If they have explanations, they will feel more reassured. If you advise that medications are not called in after hours, tell them why. If that pt with the UTI symptoms is asking why they cannot get an antibiotic called in, tell them that a culture must be done in order to prescribe an effective treatment plan. One antibiotic does not cure all bugs.
The next thing is to reassure the caller that you are in close contact with the physician, and that the physician gets a record of every time they call and what that call entailed, including advice that was given.
Sometimes, despite all education attempts and reassurance, the caller still will want you to page the physician, and that is ok too, but if they feel you are knowledgeable and confident, most of the time you can end the call with ease and the caller will be pleased.