Let's face it. Anyone who has ever done telephone triage knows this can be the most mentally challenging job you might ever do. It is not an easy endeavor to take on. Not only do you have to be a quick thinker and problem solver, but you must be able to coordinate looking at protocols, listening to the caller, typing and thinking of a plan....all at the same time. To be efficient and proficient, you must be able to utilize your time wisely.
One of the things I try to instill in new nurses, is to be organized. You cannot be organized enough in this position. If someone were to look at my desk, they might not think that of me, but there is a method to my madness. I know where everything is, and I can access it in a minute. I also have notes stuck everywhere as reminders and quick access if I should need it. Not everyone would be able to function like this, but it works for me. That is what matters. You have to set up your own system.
Another thing is, when you are actually taking calls, you have to be aware of the length of time you are on the call. I am not saying you should rush through it and miss important assessment information, but you should be taking control of the call. If you allow the caller control from the beginning, you may never return. We all know that many callers want to tell you everything about their life, and much of what they want to talk about is not pertinent to the call. If you begin the call with asking assessment questions, such as "So I see you are calling because John has a fever. When did this fever start?", it allows you to get the information you need much more quickly and keeps the caller focused. Saying, "What can I help you with?" is a very broad question and makes it harder to keep the call under control.
Another thing I find nurses do is skip around. It works much better to gather all of the assessment information first, and then give the advice. If you stop in the middle of the call to give fever advice and then go on to assess cold symptoms and give advice for that, it is more time consuming. Also, how can you give complete advice if you don't have the whole picture? After all, we know that one symptom can influence another.
Finally, I encourage nurses to think outside the box. You should never be so focused on protocols that you miss the big picture, and don't get yourself caught up in little unnecessary details. For instance, I have seen calls regarding immunization reactions where most of the child's arm is very red and swollen and the nurse gets caught up in what kind of immunization they had. That is great if the parent knows, but the ultimate outcome is they need to seen asap to have it evaluated. Give them the necessary advice, and move on. There are other calls waiting.
You cannot be a successful telephone triage nurse overnight. It takes time to learn and change the way you think. It is not like any other area of nursing you have experienced.