Wednesday, February 8, 2012

How To Be An Effective Triage Nurse

I just returned from a great two day conference in Atlanta that was hosted by Carol Rutenberg's Company, Telephone Triage Consulting, Inc. The guest speaker was Kathy Koehne, BSN, RNC-TNP. What a wonderful presenter she is!
One of the things that really stuck out to me were the characteristics of effective triage nurses. They must be self-directed, focused on short-term results, be a strong patient advocate, and have practical intelligence.
With self direction, you must be able to function independently, especially if you are working from a remote location. There is no one there to call on if you have a question, need help in making a decision, or your call volume begins to get overwhelming. Sure there are co-workers on line or one that you can call, but yet, you have to be autonomous. All the while, it is important to realize the value of your position and your role, even though your authority is limited.
To be successful, you have to have a good work ethic. You must be reliable and dependable, especially so if you work remotely. So many times nurses think if they are working from home, they can work if they feel like it. No matter the location, you still have patients depending on you, just as if you worked in a facility. If there are no nurses, the patients don't get taken care of, and therefore no business.
This position requires honesty. You are given the trust to work independently, and many times, you are the only nurse that patient encounters. Your supervisor is trusting you to be honest in your advice, documentation, and productivity.
You must also be flexible. This is not a 9 to 5 job with weekends and holidays off. If you desire a position like that, maybe you should ask yourself, "Why did I choose to be a nurse?" Sickness does not decide to only occur during business hours, and therefore, it requires us to be flexible in our schedules to accommodate higher call volume needs.
To be focused on short-term results, you have to be good with time management. You have to be able to take control of the call to complete it in a timely manner, complete your documentation before the next business day, and be able to be productive enough to be a team player in getting the calls done.
You have to like checklists and bite-sized tasks. After all, when you are assessing the patient on the other end of the phone, you are going through mini checklists of each system in your brain, and the task at hand is to get the caller to the next level of care, whatever that may be.
You have to enjoy and measure effectiveness with measurable outcomes. You are gathering information, deciding on a plan and teaching the caller. You can measure the effectiveness of your teaching by asking the caller to repeat instructions back to you, and the outcome is, did they follow your teaching by seeking the appropriate follow-up? Did you make a difference in what could be a potentially life-threatening call? Do patient satisfaction surveys reflect happy patients as an outcome?
You must be a strong patient advocate. One of the most important points in gaining a caller's trust is if the nurse is empathetic. You will also be much more effective if the caller trusts you, but be careful with giving your own personal experiences. You may think you are being empathetic, but sometimes the caller only wants to talk about themselves. They do not care to hear about you. You must know when the right time to share your experiences with the patient is.
The last characteristic, practical intelligence, is one that you either have or you don't. You cannot teach someone common sense, and to be successful in this position you must be a quick learner, relate new information to previous knowledge, and enjoy learning. You must keep abreast with new trends in healthcare, and new medications, and be able to apply that to and build on what knowledge you already have.
Wow,what a tremendous amount of responsibility! Yet, if you are a telephone triage nurse, you should be proud of your position. We have the ability to change someone's life in one phone call!
You may be the last person that caller ever talks to...Make it count!