Thursday, December 28, 2017

Why I am a Telephone Triage Nurse

As I was speaking with a friend and co-worker the other day, we talked about why we liked our job, and how we reap the benefits in our personal lives. We both agreed we would not have it any other way. That conversation has resonated with me since then, and I have been thinking about why we do what we do every day.
Thinking back to that conversation, on this cold December evening, I started remembering all the different nursing positions I have held in my career, and about the times I have had to have to go out at all hours to visit patients during my tenure as a home health/hospice nurse. I remember driving on back roads that were icy and snowy to make those visits, and even times, I parked my car, grabbed my bag, and walked in to see patients because it was just not safe to drive. I also remember, during snow storms, packing a change of clothes, telling my family I was not sure when I would be home, and catching a ride to the hospital to work my shift. All because that is what you do when you are a nurse.
Reminiscing about prior positions, different patients over the years have come to mind as well. There were patients that I can still remember their names, and there are some that their name is not so clear, but the bonds we developed, I will always cherish. There are also patients that I would rather forget because they were difficult, and well, let’s face, just mean.
Being a nurse does not come without injury at times either. You risk being bitten, hit, kicked, and God-forbid seriously injured by a patient who has serious mental issues. There are also risks of physical injury from the strain of lifting, bending and pushing objects that weigh more than they should.
When I discovered telephone triage nursing, I never knew such a position existed.  At that time, I was searching online for work at home positions for nurses. My mother had recently moved in because her health was declining, and I knew that I soon needed to be available for her more. Working outside the home was not going to be an option any longer.
I secured a position with a very small company as a contracted nurse. At that time, the pay scale was that of a new graduate, but it was not the pay I was seeking. It was the position.  Training was not paid, and I had to travel two hours one way to train with another nurse. The nurse, who was gracious enough to let me into her home, was very good at her job and made it seem so easy. I had no idea what I was getting myself into. I just knew I needed this to continue earning income. I was determined I was going to learn this position, and learn it well.
After my training was complete, my first shift on my own was a four-hour block. Admittedly, I did have illusions about working remotely as a telephone triage nurse and thinking how easy the position sounded. I quickly learned it was just that, an illusion.
I had my protocol books all laid out, and with each call, I was so focused that I do not remember even looking at the time until my shift was almost over. I also distinctly remembering I had one of the most severe headaches I ever had, and being exhausted! That is when I realized that although being a telephone triage nurse is not physically demanding, if performed correctly, it is the most mentally challenging positions you will ever hold.
As time went on, I challenged myself to learn other specialties I knew every little about. I had been an adult nurse most of my career, and now I was dealing with pediatrics and obstetrics as well. I wanted to sound to callers that I was self-assured and knowledgeable. Callers will not trust a triage nurse who does not seem to know the content of what they are speaking of.
At this point, I was enjoying my new found position. I liked the new challenges, and I also started to challenge myself to be more efficient. I admired my nurse manager, and I challenged myself to exceed her hourly completed calls. I am that kind of person who wants to excel in whatever I decide to do.
There was something else I was learning about this position. For the first time, in a long time, as a nurse, I felt appreciated. Not just by my employer, but by the callers. As I went from call to call, thoroughly assessing their complaints, finding the right protocols, and offering advice, I could hear the appreciation in their voices. Many openly expressed that appreciation. I thought I had seen all the areas of nursing there was to offer, but there is something about calling a patient’s home that seems to put you right there in the home with them. Their true emotions are exposed, and they seem to be less reserved like they might be in a facility setting.
Just like my experiences working in a facility setting, I have had some telephone encounters, working as a remote telephone triage nurse that forever changed my life. There are still the occasional difficult callers, but for every one of those, there are two who are appreciative.
Over the years, my position has allowed me to care for my mother until she passed away, home-school my children, be at school parties and functions as they got older and go to my own appointments without having to miss any work time. I have been able to work from the comfort of my own home without having to travel in bad weather, and even on days I have been ill  and would have otherwise had to be absent if working elsewhere.
I have been able to work between two homes and travel while working in this position, and ultimately, it has allowed me to be able to move to my dream home on the lake. It is located in a very rural area where positions are limited, and if not for this position, I would have to have waited until retirement to do so.
Lastly, the icing on the cake is the friendships I have developed. I have heard so many others say working at home is so isolating. It is isolating only if you allow it be. This is a wonderful opportunity to meet some great people from other cities and states that you would otherwise never have the privilege of knowing. We converse during off times at work, support each other, share facebook pictures and messages, have phone conversations, and sometimes even get the privilege of meeting face to face. Many have developed closer bonds than they have with their own friends or family who live locally.   
That is why I am a telephone triage nurse. It is not just a job. It is the opportunity to not only help someone, but possibly change their life. It is the opportunity to have a life that I love, and it is the opportunity to develop life-long friendships with awesome nurses who share the same vision.

Tuesday, December 12, 2017

What Traits Does a Successful Triage Nurse Have?

So many think that telephone triage nursing is an easy job. After all, it is just talking on the phone right? Wrong. It is so much more, and is one of the hardest nursing positions you could ever hold. You have to have the ability to "see" the patient over the phone and safely get them to the next level of care.
So, what does it take to be successful in this specialty?
1. The nurse in this role must be self directed. They must be sure of themselves and realize that although their role is limited, they recognize their importance. Flexibility is important, and they must possess a good work ethic.  This is often a very independent role, and  these qualities are a must.
2. The nurse must be be focused on the short-term goal and achieving short term results. They must possess excellent time management skills, and enjoy bite size pieces of information. They measure their success by reaching measurable outcomes.
3. The nurse must be a strong patient advocate.  They must be empathetic, have the ability to gain the patient trust, and be effective in their delivery.
4. The nurse must possess practical intelligence. Telephone triage is a constantly changing specialty. The effective nurse must enjoy learning and be a quick learner. They should also be able to  relate new information to previous knowledge and apply it when necessary.
In summary, the successful triage nurse must be able to prioritize medical emergency calls, explain lab/test results, draw on prior experiences and knowledge, use decision support tools effectively, and communicate effectively with the patient within the patient's level of understanding.
Is this the role for you? It is not for everyone. However, it can be one of the most rewarding specialties in nursing if you possess these qualities.