ED to telephonic triage? Need advice

  1. Here is the thing: I've worked in the ER for the past 4 years on arguably the busiest shift, 11am-11pm. As of this week, I am now 7am-7pm and the past week hasn't been horrible. I recently acquired a telephonic triage nursing position that is paying only a dollar-something less per hour than what I make in the ED now, but with crappy health insurance and great everything else as far as benefits are concerned. I initially wanted out of the ED because of the stress level, but I love 12 hour shifts and four days off every week. This job will be 8 hours a day, 5 days a week, and anywhere from 3 pm to 1 am during the 90 day orientation, then anywhere from 1 pm to midnight central time (I'm on the east coast) with work every other weekend. I'm hesitant. Leave a high stress job for a bit less money and more work hours or try something I've never tried before and risk losing my dayshift spot that is so much easier than mid shift in the ED? I wanted to be home more with my 9 month old, but I feel like working more hours from home and 12 mandatory hours per month in the ED as a per diem would completely negate that goal in the first place. The health insurance isn't a deal breaker for me because I can get that through my husband.
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  2. 2 Comments

  3. by   MA Nurse
    Hi. I work in a very busy call center. I worked in the NICU for 25 years before this job. I have spoken to two former ED nurses who say the transition to telephone triage was easy for them because they are used to seeing a variety of people/problems. We get calls in Medicine, OB/GYN and Peds so it's good to have a background with variety. You never know what kind of call you will get. This job is a whole different type of stress. We are monitored very closely, calls are recorded and you don't have the freedom of just walking away from the phone without a specific reason. I don't know how busy the place is where you will be working, but I sometimes get 40 calls in 8 hrs. It's stressful at times. You can PM me for more info you need to. Good luck with whatever you decide.
  4. by   Cape47
    It's typical that the pay is lower versus front line clinical but remember that for working at home you subtract commute costs, viz, gas, wear and tear on car, time lost traveling and so on. As far as losing your 'spot' in your job, I wouldn't worry about it. I've never worked at a place where the ER was 'hard to get into.' IF they fill your position, just wait a month, I'm sure a similar position would open up in no time, in case you want to go back.

    Personally, I believe that 40 hour work-weeks for telephone triage is too much. You get burned out pretty quick, especially if its a busy center. But as they say, Nurses follow management, and what that means is that most of us would rather work a tough job with a good manager than an easy job with a terrible manager. This applies doubly for telephone triage: It's the management that makes or breaks the job. Many managers/sups have no idea what they are doing in this field, so they bumble and/or over micro-manage (which is really, really easy in this line of work) and usually what happens is there is a high turnover.

    I would ask the following, for interview
    A) How long has the management been here? If the answer is anything <6 months for more than one sup/manager, there is probably a reason why.

    B) What software do you use? This is important. You can research the interface that they use and see if it's user-friendly versus an antique POS that Agents hate vehemently. One example: E-Centaurus. I will NEVER work at another job that uses that awful, antiquated, clunky software. Ever.

    C) Will I have the option to fall back to part time? If the answer is 'no,' walk away. Some call centers will tell you "we don't hire part time," a huge mistake, because they want everyone to be 40 hours. What ends up happening is this mass exodus. And the company, rather than admitting that they goofed, will simply spend ten thousand dollars re-training and re-licensing a replacement.

    D) This job is a lot more than 'answering the phone' and there are different kinds of call centers. Some call centers are 'open' meaning that 'anybody with a phone' can call you. These are the hardest call centers with the highest turnovers, since you can (and do) get perverts, abusive callers and generally socially mal-adjusted miscreants who think that just because there's a Nurse on the other end that they have their own personal punching bag at their disposal. Also, you usually have to get all their information first which, aside from being a retarded operating model, is tedious and makes the job much harder versus the 'pre-registered' models. Imagine having to ask for someone's DOB "cold" at three in the morning when they are keeling over in pain. So yeah, no fun. But these call centers are also the easiest to get into (you basically just have to have a pulse to get in) and are good for getting TT experience.

    E) Generally, most callers are super nice and it's rewarding even when you are stacked with calls. There will be a few meanies and "entitled" callers but don't focus on those. If the call center is 'free' (the caller isn't paying for the call) some callers still act like they are paying for the call and expect a heavy white glove treatment. How much cushion the management gives you against the abusive/entitled callers will make a huge difference in your stress level.

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