Triaging patients over the phone is challenging because nurses have limited information available to them. Telephone triage nurses are not able to use touch or visual cues. These nurses have to rely on their years of training, education, and instincts to help them make the right decision every time. Below, I discuss tips to ensure positive triage outcomes for each patient call.
- Be Objective: As a triage nurse, be careful to be objective no matter the circumstances. It can be easy to mistake a caller’s sex or age by listening to their voice. To avoid stereotyping the caller, always confirm the age, gender, and medical history before triaging a patient.
- Listen to the Entire History Before Triaging: It is easy to jump straight into triaging the first symptom mentioned by the patient. To avoid this, listen carefully to the caller’s history and symptoms and explore all possibilities. For example, abdominal pain in an older female may signal a urinary tract infection, while you may need to consider a pregnancy with a younger female. Asking a brief history and exploring the caller’s concerns in more detail will prevent overlooking a serious symptom and triaging to the wrong disposition.
- Use Your Own Professional Judgment to Assess the Situation: It is important to listen to the patient to understand their concerns and get a good history. However, patients sometimes have their own diagnosis and accepting the caller’s diagnoses can lead to a bad outcome. For example, a parent may call and say her child has chicken pox. It is the nurse’s role to understand that the caller is concerned about chicken pox. However, the nurse cannot assume the parent is correct. The nurse must do a full assessment of the child’s airway, breathing, and circulation as well as assess the rash and any other symptoms to make the correct triage decision.
- Listen to the Caller’s Concern, Voice, and Anxiety Levels: While the triage nurse is the trained professional, the callers who are anxious have to be taken seriously and get an extra thorough assessment for two reasons – to ensure there is nothing really serious going on and to reassure the caller you are taking them seriously and that they will be okay.
- Use the Nurse Triage Protocols Properly: Triage protocols are carefully and thoroughly designed, but they can still be misused. For example, nurses can omit using a protocol, use the wrong protocol, or use a protocol improperly during triage. We often see fever protocols being overused by new nurses. When any of these occur, it puts the patient at risk. It is critical for triage organizations to provide detailed and comprehensive continued nurse triage education along with good quality assurance programs to ensure high-quality patient care.
Further, nurses need to be trained to use their professional knowledge in addition to protocols. Critical thinking skills are essential for any triage nurse to adequately and safely make assessments and decisions. Triage nurses must have a balance between judgment and protocol practice.
Contact TriageLogic today to discuss your patient triage needs. TriageLogic provides software for daytime office calls or setting up your own triage call center. If you do not have the staff to cover patient triage calls, TriageLogic offers Nurse Triage On Call to manage patient calls after-hours.