Wednesday, October 14, 2015

Educating to Comply

Education and triage fit together like icing on a cake. Triage is the cake, but it is just not complete without the education piece on top. Makes the entire call sweeter. It would not be a thorough triage experience without it. Callers need to understand what led the nurse to come to the appropriate disposition, and the more they understand, the more likely they are to comply.
When educating the callers, information needs to be relayed on a level they can comprehend. You have to consider the fact that probably 30% of the callers are college graduates, and even fewer of those have any medical background. So, using medical terms, even as simple as asking if a cough sounds congested, may be more than some callers understand. Instead, asking if the cough sounds wet or dry might be a more appropriate phrase. If the caller then tells you that with that wet cough, the child is speaking in shortened sentences and wheezing constantly, and you instruct them to take the child to the ED, they need to understand the seriousness of the child's condition. It is our duty, as triage nurses, to instill enough fear to get the caller to comply.
Should you tell them that their child will go into respiratory distress and die? Of course not. However, the diligent triage nurse would explain to the parent what is going on with the child that is causing them to wheeze and speak in shortened sentences, and if they wait, the child's symptoms could become much worse before morning. On the other hand, if the nurse just instructs the parent to take the child to the ED, and does not explain why, the parent might decide they do not want to go wait hours in the ED and decide to wait it out. This could result in detrimental consequences to the child.
An experienced triage nurse said to me recently that telephone triage is like experiencing emergency room nursing over the phone. The draw back is you cannot see or touch the patient. This could not be more true. This simply means we have to work harder to empower the callers with information to help them to make the best choice for care that is agreeable by all and safe for the patient.

3 comments: