Monday, August 15, 2011

Who Said This Is All Cut and Dried?

How do you begin to tell someone what a telephone triage nurse's job description entails? My advice is you just have to watch one work a shift to know. I really don't know there are enough words that could describe everything that goes on during that shift. In speaking with a colleague the other day, I described it as the hardest job I have ever done in my 20 years of nursing, and I meant every word of it. It is hard because it is very mentally demanding.
A lot of people have a preconceived notion that being a triage nurse means getting to chat on the phone and give advice. This could not be farther from the truth. You have to rely strongly on your ability to ask questions, and your ability to listen. Along with these traits, you must have excellent assessment skills, and most important of all, experience. You rely heavily on this alot.
You hope the calls you get are simple like colds or fever but the reality is, very few are like that. Many times, you make the call, thinking it is going to be something like this, and suddenly have to shift gears. The call has suddenly turned into acute croup, meaning you have to find that protocol quickly, because the ones you thought you were going to use suddenly do not pertain anymore.
You cannot physically assess the patient, and therefore, you have to be skilled in asking the appropriate questions to get the answers you need. And, if you are not listening closely, you may miss that one piece of information that could decide what disposition you chose.
So many times I hear, "This is not cut and dried as it should be. There are too many exceptions." But is not every patient different, and their symptoms different? So, how can anyone expect it to be cut and dried?
Along with the patient, each office has their own preferences on how to handle certain calls, so you must always be familiar with them, and if you make appointments, where do you make them and when? Still, along with all this, you have to have the ability to type, listen and talk. Don't forget there is the ability to control the call, and resolve the patient's problem in a timely manner, and move on because you have what seems like another hundred calls waiting.
So, in conclusion, if you are looking for something that is cut and dried, telephone triage nursing is far from it. Each day, brings new experiences and challenges, but when you hang up the phone knowing the caller on the other end is appreciative of your help, it makes each day worth it.