Phone advice? Do you give it?

bill4745, RN · Jul 13, 2008

Not a bit of advice.

TooterIA · Jul 13, 2008

So do you just say "You will have to come to the ER" and hang up or what?

Jessica

navynurse06 · Jul 13, 2008

My lips are sealed...giving advice over the phone is taking a risk at loosing your license!

MAISY, RN-ER, BSN, RN · Jul 13, 2008

We don't give medical advice over the phone for new calls. I basically ask them what's going on, then say if they are concerned enough to call they should be evaluated. The only time I may go over a condition is if the patient was seen, has issues and may need to come back or doesn't understand instructions. Even then, I tell them if they are concerned enough, or feel worse-they must return for evaluation. Will not take a chance.

Maisy

CritterLover, BSN, RN · Jul 13, 2008

no -- no advice, ever!

it isn't as much an issue of taking a class to learn "how" to answer their questions -- it is a documentation issue.

you have no way of iding the caller, no way of recording/charting what they told you and what you told them.

we all know how selective memories are.

six months down the road, they will be swearing (under oath) that they told you that they were having pain radiating down their left arm, and were nauseated and sweating; when in reality, you asked them those questions directly, and they told you "no, it only hurts when i cough. and my nose is really stuffy. i can't breath! but boy, do i have an appetite. i can't get enough food! i must not be eating enough fat, though. my skin is all dry and flaky. moisturizer isn't helping."

in addition, telephone triage centers have strict protocols/scripts they follow. the advice isn't ad-lib'd the way you do when you give d/c instructions. just because it makes sense, doesn't mean you can recommend it. if it isn't in the protocol, then forget it.

when i get "those" calls, i repeat (as often as necessary, which is usually at least three times per call): "i'm sorry, we are not allowed to give medical advice out over the phone. however, if you feel as though you have an emergency and need to be seen, we are open 24 hours a day/7 days a week and will be happy to evaluate you."

meownsmile, BSN, RN · Jul 13, 2008

The only advice over the phone i would even consider is if it was a patient that i had discharged that day calling to ask about particulars with discharge instructions. Sometimes at discharge things are moving quickly and people just want to get out so they dont necissarily hear everything you have told them. If it is a change in their condition though i will either tell them to call the office and have the doctor call them back or i will tell them to come back to the ER to be checked out.

webbiedebbie · Jul 13, 2008

Why don't you ask if they have a doctor and if they do, they should try to call them first. I work in Telephone Triage, and we hear all the time about "it's a weekend and my doctor's office is closed". OR "Well, I don't want to bother him about this". People can call their docs after hours. BUT there are some that have gotten sneaky and put on their answering machine to go to ER!

tothepointeLVN, LVN · Jul 13, 2008

Some insurances now have a Ask a nurse line printed on the back of their insurance crds that run 24/7 perhaps you could refer them to that if the option is available. I've certainly used it personally before and it was helpful more so than my on cal Doctor who would almost always refer me to the ER

SillyStudent, ASN, RN · Jul 13, 2008

The only advice I will give is to call their physician's office with questions. :)

BookwormRN · Jul 13, 2008

Depending on the question, we refer them to the clinic's phone number---the answering service will forward their call to the on-call doc. If it is emergent, we refer them to the ED.

gonzo1, ASN, RN · Jul 13, 2008

No advice ever, except to come to the ER