Engaging Patients During a Nurse Triage Call and Developing Trust
The nurse-patient relationship is one that is like no other. On any telehealth call, such as a nurse triage call, two strangers must somehow find a way to communicate and trust each other in a very short period of time. Like other relationships, this one is built on trust and communication. However, unlike other relationships, this one must be formed quickly to assure the patient gets the right treatment, at the right time. Nurses and other telehealth providers also need to overcome the lack of face-to-face communication and inability to “touch and feel” the patient.
How does a triage nurse help a patient become comfortable discussing their needs and answering personal and intimate questions?
Not all nurses are natural conversationalists, and we quickly discover that what works for one patient does not always work for another. Each patient should be approached in a manner that is most comfortable for them. The nurse should be flexible. The goal is to obtain an accurate and truthful assessment, because it is the results of your assessment that are going to determine the safest disposition for your patient.
Gaining a Patient’s Trust
There are always two sides to every relationship, and each side needs something different. Patients need to know:
- You understand what they are saying
- You care
- You believe them
- You are not judging them
- You are there to help them
- You are on their side
Face to face interactions can make building trust a little easier. The nurse can use her facial expressions to show she is listening and concerned. She can reach out and touch the patients arm or shoulder to show empathy. She can smile slightly or make eye contact to show she is engaged in what they are saying. Even the nurses uniform and ID badge are symbols that tells patients “this person is a professional and able to help me.” Small jesters, such as offering the patient a glass of water or tissue if they are crying, are interpreted as acts of trust and kindness.
Breaking the ice over the phone can be more challenging. The nurse must use her voice and choose her words carefully to convey to her patient that she is worthy of knowing their personal information and competent to assess their needs and give them the right advice. She should speak slowly and clearly and start by identifying herself by her first name and title. For example, “Hello, I am Susan, a Registered Nurse that will be helping you this evening.”
Multiple Approaches for Triage Nurses to Gain a Patient’s Trust
Sometimes just being polite and professional with your introduction is enough for the patient to feel comfortable talking with you. When that is not enough, here are a few things you can try:
- The Easy-Does-It Approach: Ask a few basic or easy questions first before delving into the hard to talk about questions. You might take 60 seconds to explain your role and how the triage process works, many patients have never spoken to a nurse on the phone, so may be reluctant at first. An example of an easy icebreaker could be, “I have an Aunt/Uncle/Cousin with the same name as you.” Other easy topics include the weather, sports, or hobbies they may have. Stay away from any controversial topics, such as religion and politics.
- The Empathetic Approach: Be empathetic but sincere to the patient’s situation. You might say, “You sound exhausted, it must have been a long night. I can give you some care instructions that hopefully will help everyone get a better night’s sleep,” or “I’m so sorry that you are not feeling well, let’s see how I can help you.”
- The Professional Approach: Understand that they may be embarrassed to have had to call. When the caller has a sensitive issue that may be embarrassing to speak about, it is important to get all their symptoms while minimizing their embarrassment. This is best done by letting the patient tell his or her symptoms and then asking a few clarifying questions. Be direct and professional, but do not skip over questions that are “embarrassing” – all symptoms still need to be addressed.
- The Up-Front Approach: A good icebreaker for tough calls is the up-front approach. An example statement for this approach is, “I know this is difficult to talk about, but I assure you that I am here to help you. Tell me what symptoms you are experiencing.”
It is not just about what you say as a telephone triage nurse, it is how you say it. Your tone, speed of talking, and volume are just as important. Since the patient cannot see you, verbal cues are a must. Words such as “uh hum” and “I see” or “I understand” let the caller know you are listening. For more tips and lessons on telephone nurse triage, visit TriageLogic’s Learning Center.
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