Telephone triage nursing
Emergency room overcrowding threatens public health. In 2007, 200 ER physicians reported knowing of a patient who died because of the practice of "boarding," or being made to wait excessively in an ER for care, according to The American College of Emergency Physicians. In the article "How Overcrowding Affects Your Access to Emergency Care," it was reported that emergency room visits had hit an all-time high of nearly 124 million in 2008.
Sara Courson, BSN, wrote in a 2005 article in Connections Magazine that telephone triage nursing is one way to take the strain off overburdened emergency rooms. “The goal . . . is to advise the patient on the right level of care at the appropriate time to reduce unnecessary physician's appointments or trips to the emergency,” said Courson in "What is Telephone Nurse Triage?"
Courson further wrote that telephone triage nurses educate and direct patients to the proper level of care over the telephone by using protocols mixed with their critical thinking abilities. “They rank patients according to urgency of need, directing them to further care as necessary,” she stated.
Defining the role
A telephone triage line is not the same as a health advice line. A health advice line might be offered through a community organization. Callers can get answers to general health care questions or find out where to go for more information. A health advice line is not meant for an acute problem or illness.
The telephone triage nurse must have the ability to think both critically and quickly, which to most in the field sounds like the definition of a nurse in general. The difference between a floor nurse and a telephone triage nurse is that the latter must make health-related decisions without the benefit of being able to physically observe the condition of the person on the other end of the telephone line.
He or she can't observe mannerisms or facial expressions, which would help a health practitioner to gauge the severity of a problem. According to Courson, what defines the role of the triage nurse is the ability to communicate and to pick up on non-verbal cues that will give the nurse insight as to the caller’s pain level, fear and knowledge of what is going on medically.
The triage telephone nurse usually works in conjunction with a health care provider. Perhaps a patient is trying to reach a physician’s office after hours. A triage nurse can advise the patient if something is urgent and if the caller should go to an emergency room. A triage nurse can also alleviate a patient's stress by reassuring him that a side effect is normal to “x” or “y” illness, so no immediate, emergency care is needed.
The telephone triage nurse has resources at her disposal — such as computer programs and books — detailing protocol when a caller phones into the health care service. The computer programs integrate medical information with the practice’s given protocol.
Cutting unnecessary ER and physician visits
When a patient telephones, the nurse investigates the most urgent symptoms or complaints and feeds the pertinent information into a protocol system. The computer programs integrate medical information with the practice’s specific protocol. The telephone triage nurse then makes judgments based on a combination of the protocols in place along with her personal observations via telephone.
The telephone triage nurse doesn’t take the place of the physician, medical facility or emergency room. His or her job is to figure out if the patient needs more help in an urgent manner, and if so, which type of help would best serve the individual. Telephone triage nurses help cut down on unnecessary emergency room or physician visits by evaluating patients over the phone, categorizing them by priority and referring them to further care if needed.
