Monday, June 11, 2012

This Takes Skill

It is time for telephone triage nursing to be recognized as a true skill. Maybe it is just me, but it gets frustrating when you attempt to explain to others, including nurses, what it is that you do, and they either just look at you or say " I am afraid I would lose my skills". This growing area of nursing IS A SKILL! Not just any nurse can do it.

I have seen a great number think this is a eat bon-bon, watch a movie, and throw a party in between calls, kind of job. That fairy tale would be a dream if it were true, but that is all it is, a fairy tale. Having been a nurse for over 20 years, and worked in many different areas of nursing, this is the most mentally challenging of them all by far. Not even managing a 150 bed skilled facility or working a 12 hour shift in an ICU can leave you as exhausted. Sure, you don't do venipunctures, start IVs or treat wounds, but if you miss one vital piece of information, you do cause un-do harm or worse yet, death to the patient you are talking to.
True triage is not just asking a few questions, and then giving advice. You are trying to come to the best solution in the shortest amount of time. You have to be a quick thinker, a good reasoner, an excellent multi-tasker, and a polite, well rounded person to be the most successful. There is nothing like trying to calm an anxious first time mom with a 3 year old crouper, listen for warning signs that may say the child needs to be seen in the ED tonight, while the other line has a physician beeping in about a medication call you paged him about 30 minutes ago. You have to be able to change courses quickly, place the current call on hold, handle the medication call, go back, finish the croup call, and then call the patient back about their medication. Don't forget, finishing your documentation falls in there, along with your co-worker asking your opinion on how to handle the newborn jaundice call they are dealing with. And, that my friends is not a skill?
I may be a little rusty on trying to start an IV right now, but I can guarantee you I can advise you on how to handle your child's bicycle accident in 5 minutes or less, and at the same time be a resource to my co-workers, speak to a physician and call a pharmacy.
Having done this job for years, I find it changes the way I problem solve day to day as well. I find I am always looking for the shortest way to reach my goals in the quickest amount of time, and I love it. I don't think I will ever look a situations any differently again.
Yes, this is a skill to be proud of, and it does not make me any less a nurse. We all have areas that we are good at, and that is what makes nursing unique. If we all liked or wanted to work in the same areas, patient needs would not be met. After all, isn't that why we chose nursing? To be a patient advocate and to care for them to the best of our ability.