Often times, patients calling a triage nurse are worried, tired and overwhelmed. This can create a situation where callers are difficult to triage. This article presents tips for nurses to help callers remain calm and diffuse a difficult call. A key tip for triage nurses is to use compassion to effectively triage patients, and focus on each callers’ unique issues even when the patient is having difficulty cooperating with the nurse. At TriageLogic, our nurses use a simple three-step model to help build that bridge of communication: Listen, Relate, and Propose an Action Plan. Watch this video for more information.
Listen
Since a triage nurse is working with patients over the phone, listening will be the most important step to understand and assist the caller. Truly listening requires focus and all of the nurse’s attention. They must have a quiet environment where ALL of their attention is dedicated to the caller and their situation. A triage nurse should never talk over the patient or even think of texting a friend. A skilled triage nurse does not just listen, but actively listens. When speaking with a difficult caller, the nurse should occasionally interject supportive words or short phrases, such as “I understand” or “Yes, I see.” If there is something that is not understood, ask the caller to clarify. Always let the patient fully explain their situation before moving to the next step.
Relate
The best way a telephone triage nurse can relate to a difficult caller is to show empathy. The patient wants to know that they are not only listened to but also understood. Empathy will also help to build rapport, leading the caller to trust the nurse’s judgment. The nurse can start to build rapport by apologizing in a general or broad sense. Nurses don’t want to admit to a mistake if they haven’t made one, but they can show understanding by saying, “I am sorry about the confusion,” or “I understand how you must feel.” With trust established between the caller and nurse, patient satisfaction and compliance will increase.
Propose an Action Plan
Once the triage nurse knows why the patient is calling and has built a level of trust, it is time to offer a course of action that will solve the problem. Hopefully, by this point, the distraught caller has relaxed and is able to listen to what the nurse has to say. Based on what the concerns are, the nurse can suggest a solution or at least a step that will lead to a solution. The plan that is proposed will depend on the situation and where the nurse works. It could be home care treatment advice, a referral to the ER or urgent care, setting up an appointment with the caller’s primary care physician, or forwarding the call to a supervisor. How they propose the plan is just as important as what it is. The triage nurse could say, “I would like to help you; how about if I….” or “I would like to help fix this for you; may I bring my supervisor in on this call to assist you?” Be sure to use comforting terminology and follow the correct protocols.
Difficult callers are inevitable. A telephone triage nurse must remind the patient that she is there to help them. However, the nurse must also keep perspective. People are at their worst when sick, scared, tired or hungry. Treating callers with compassion helps them feel comfortable, allowing you to focus on assessing their situation.
