February may be American Heart Month, but it’s an aspect of health care that’s relevant year-round. According to the CDC, cardiovascular disease is still the leading cause of death for men and women in the United States, which means your triage nurses need to know how to address patient callers who are experiencing heart health-related symptoms. Here are our suggestions for the best ways to handle those calls.
Use Schmitt-Thompson Protocols
Nurses should already be aware of the most common symptoms of a heart attack, along with the associated risk factors for heart disease (like high cholesterol and high blood pressure), and the best ways of prevention (a heart-healthy diet with lean meats and fewer trans fats; monitoring blood sugar levels; encouraging patients to talk with their doctors about predispositions toward heart attack or stroke; etc.). That being said, discussing these symptoms over the phone can be more difficult than an in-person evaluation. That’s why Schmitt-Thompson triage protocols are the gold standard for addressing all patient symptoms and generating dispositions based on the most likely ailment.
If a patient tells one of your nurses that they think they’re experiencing chest pain, a nurse can use these protocols to first address the ABCs: any potential issues associated with the patient’s airway, breathing, or circulation.
Evaluate All Symptoms for the Safest Disposition
Many patients delay seeking treatment for cardiovascular issues because they brush them off as stress-related or benign. Others feel uncertain, fearful, or hesitant when it comes to identifying where they’re actually experiencing pain. Whether your patient callers offer vague answers, or the symptoms they’re experiencing are vague, your triage nurses must keep two points in mind:
- Any pain between the neck and navel is considered chest pain until proven otherwise.
- All potentially related symptoms must be identified.
Why all? Let’s consider an example: specifically, epigastric fullness and fatigue. Addressed individually, the former may indicate heartburn, gas, hiatal hernia, and gastritis, while the latter is often associated with stress, acute or chronic illness, and insomnia. Experiencing them together, however, could be indicative of a heart attack. Triage nurses must evaluate all symptoms and use protocols to identify the most urgent possibility for each patient’s ailment so that they can offer them the safest disposition.
Build Trust and Empathy
The hardest part of any triage call is the fact that patients and nurses can’t see each other. That means listening is even more important on the part of nurses so that their patients feel heard, understood, and helped — especially when those patients are hesitant to seek emergency services.
Nurses must remain calm and build trust early in the call so that patients remain compliant with recommendations on which providers to visit. That means not using medical jargon that could be confusing or intimidating to patients, not cutting patients off when they’re speaking or asking questions, not offering diagnoses, and not threatening to call 911 against patients’ wishes.
Nurses should offer clear reasons when referring patients to specific providers, while also acknowledging patients’ feelings if they seem hesitant to go. That could mean telling a patient, “I understand that going to the emergency room right now may seem scary, but the symptoms you’ve described could be heart-related, and the ER is the best place to determine that. While no one wants to go to the ER, much less be taken by ambulance, the reason I’m advising you to call EMS is because paramedics can start a lifesaving intervention on the way to the hospital if it turns out that you are experiencing a heart attack.”
If patients agree, triage nurses should then remain on the line until 911 operators are speaking with them. If patients only have single lines to call from, triage nurses should tell them that they’ll call them back in five minutes to offer assistance until EMS arrives.
Accept When Patients Say No — And Document It
Not all patients will heed the advice from triage nurses when it comes to heart health. They may choose instead to drive themselves to the ER, or visit their primary care physicians in the morning. Nurses should not argue with patients who disagree with them, but they should maintain documentation that shows the dispositions that they provided — i.e., call 911 — and then note the patients’ refusals. If patients experience negative health outcomes, these notes will provide liability protection for the triage nurses with whom they spoke.
Heart Health’s Importance to Our CEO
TriageLogic’s CEO, Charu Raheja, has been a longstanding advocate for heart health due to personal experience. She lost her father to a massive heart attack back in 2009 when, as she says, he didn’t call a healthcare provider to address his symptoms. She hopes that more patients will take advantage of triage nurses, both during the day and after business hours, to discuss their symptoms and get the best advice on which providers to see.
Charu’s efforts in heart health extend beyond the realm of nurse triage. She currently serves on the board for the Northeast Florida American Heart Association, and is part of their Go Red cabinet. She’s also involved in their educational programs for reviewing social determinants and their effects on long-term healthy lifestyle choices and risks for heart disease.
Do Your Triage Nurses Need Heart Health Training?
If you’d like your nurses to get more training on how to handle calls dealing with heart health, we offer several solutions. Doctors’ offices can have their nurses review our free programs available in our learning center, request our triage certification course for a nominal fee, purchase the most up-to-date Schmitt-Thompson protocols (daytime and after hours), or even outsource calls to our 24/7 nurse call center.
Contact us when you’d like to discuss these program options.
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 9,000 physicians and covers over 42 million lives nationwide.