Without the benefit of visual cues or in-person assessments, triage nurses must rely on the best communication strategies available when speaking with patient callers. When performed properly, telephone nurse triage can:
- Improve patient understanding and adherence to care recommendations.
- Alleviate patient anxiety and build trust.
- Lead to quicker, more accurate triage dispositions.
- Enhance patient satisfaction and retention.
In this article, we explore the most effective strategies that your nurses can use, including our 10-step process for handling every triage call.
Key Communication Strategies for Nurse Triage
1. Active Listening
One of the most important communication strategies for nurse triage is active listening. This means that a nurse is giving their full attention to a caller, absorbing not only their words but also their vocal tones, pauses, and background activity. This hyper focus allows triage nurses to catch subtle cues that may indicate the seriousness of a particular situation, and understand the best way to respond to a patient’s emotional state.
Avoid Interrupting: Let the caller speak freely about their symptoms before jumping in with questions. This not only shows respect for the patient, but also helps them feel heard and supported.
Reflect and Clarify: After listening to what the caller has said, the nurse should repeat back key information to confirm that they understand. For example, “It sounds like you’re experiencing chest pain that worsens with activity. Is that correct?” This reflection helps ensure that the nurse and patient are on the same page.
2. Use of Open-Ended Questions
Open-ended questions encourage patients to provide more detailed responses. Instead of asking yes/no questions like “Are you in pain?” it’s better to be specific — for instance, “Can you describe what you’re feeling right now?” This strategy helps nurses gather comprehensive information about symptoms and their context, leading to better care dispositions.
Follow-Up Questions: Once an open-ended question is answered, use follow-up questions to clarify symptoms. This may include asking about their severity, duration, and potential triggers.
3. Empathy and Reassurance
Patients often call triage lines when they’re worried, stressed, or in pain. Nurses should prioritize empathy and reassurance in their communication strategies to build trust with patients and keep them calm.
Acknowledge Emotions: For example, saying, “I understand this situation is concerning, but I’m here to help you,” can validate a patient’s feelings and comfort them.
Provide Calming Language: Unless it’s an emergency (more on that below), use soothing words and a relaxed tone of voice. This is especially important in potentially serious situations where patients may be prone to panic or become overwhelmed.
4. Clear and Concise Information
Your nurses must make it easy for patients to understand what they’re being told. That often means avoiding medical jargon and complex terms that may be confusing or distracting.
Be Direct: Clearly outline the steps patients need to take, whether they involve visiting an emergency department or following instructions for at-home care. For example, “Please stay calm and call 911 right now. Let them know you’ve been having chest pain.”
Confirm Understanding: After providing instructions, ask patients to repeat back what they’ve heard.
5. Structured Triage Protocols
Following established triage protocols is one of the most reliable communication strategies your nurses can use. Those developed by Drs. Barton Schmitt and David Thompson — long considered the gold standard in the industry — offer a standardized approach for asking the right questions to evaluate symptom severity and advise patients on the types of care they should seek.
Couple Protocols With Sound Judgment: Nurses should follow protocols to keep their calls consistent while also applying their best medical knowledge and judgment to advise patients on managing their symptoms. Although they don’t provide diagnoses, nurses assist patients in understanding the most appropriate types of care by considering potential worst-case scenarios.
Document Thoroughly: Nurses should have a way to document all patient interactions and triage protocols used to help them. This ensures a seamless transfer of information to other healthcare providers that can be referenced when needed for additional questions, practice liability, and quality assurance.
6. Additional Verbal Cues
As we mentioned earlier, tones of voice and speech patterns play a critical role in verbal communication with patients.
Tone and Pace: Calm, measured speech can help reassure anxious patients. Urgent tones can be used when prompting immediate action.
Adjust to the Situation: If a patient seems confused or overwhelmed, using slower speech and simpler terms can encourage them to focus.
7. Patient Education
Nurse triage usually involves teaching patients about their symptoms and conditions, which can empower them to take control of their health.
Educate and Inform: Provide clear explanations of what specific symptoms could mean, and the recommended care to address them. For example, “What you’re experiencing is consistent with a viral infection. Rest and fluids should help, but if your fever spikes, you should call back or schedule an appointment with your provider.”
Confirm Understanding: Ask patients to repeat the instructions to make sure they understand.
8. Time Management
Managing time effectively is crucial in telephone triage, especially when call volumes are high and patient needs vary.
Be Efficient but Thorough: While it’s important to listen carefully and gather all necessary information, it’s equally important to keep the call moving toward a resolution to avoid any potential delays in care.
Prioritize Calls: When medical message intake is accurate, triage nurses have an easier time identifying patient symptom severity and scheduling the appropriate callbacks.
9. Cultural Sensitivity
Triage nurses often help patients with diverse backgrounds. Cultural sensitivity goes a long way to making patients feel respected and understood.
Respect Diversity: Be aware of cultural differences in communication styles, health beliefs, and language preferences. Consider how these factors may affect a patient’s approach to the care instructions they’re provided.
Use Interpreter Services: If there is a language barrier, leverage interpreter services when available to facilitate clear communication and accurate assessments.
10. Continuous Feedback and Improvement
As new tools and services enter the triage field, nurse communication strategies must learn to adapt. Nurses should actively seek feedback from both patients and peers, and engage in ongoing training to stay current with best practices.
Seek Feedback: After particularly challenging calls, seek feedback from colleagues or supervisors to identify areas for improvement.
Ongoing Training: Participate in communication skills training, especially in areas like de-escalation, handling difficult patients, and managing complex medical conditions over the phone.
Once triage nurses understand how to employ each of these communication strategies, they’ll have a better time following this 10-step process on every patient call.
The 10 Critical Steps of Nurse Triage
All of our nurses are trained to follow these steps (discussed in more detail here) for effective patient calls.
- Introduce yourself and create a relationship.
- Collect the appropriate demographic information.
- Obtain a brief medical history: surgeries, medications, and relevant medical information.
- Let the patient talk so that they can explain their concerns fully.
- Pick the best protocol based on reported symptoms.
- Recommend care based on the selected protocol.
- Establish a disposition.
- Provide feedback on the care advice/disposition.
- Offer follow-up instructions as needed.
- Always reassure the patient that you are there to help them.
By following these steps and implementing the communication strategies outlined above, nurse triage can guide patients to the care they need in a timely manner.
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About TriageLogic
TriageLogic is a URAC-accredited, physician-led provider of top-quality nurse telehealth technology, remote patient monitoring, and medical call center solutions. Founded in 2007, the TriageLogic Group now serves more than 22,000 physicians and covers over 42 million lives nationwide.