Advice for Triage field

MA Nurse · Nov 17, 2017

Be prepared for high call volumes. You might get call after call with no break in between. I find this job can cause anxiety because you can't get up from your desk very often. I don't work at home. Your brain will have to reset itself with every call. Be prepared for a wide variety of calls. Some are nice, some aren't. Some are very clueless and you have to do a lot of teaching about very basic things. Being on the phone isn't as "easy" as it sounds. If you have to consult with doctors be prepared for them to barely hear half of what you say. How many hours a week will you work? 32 hrs is enough for me. If you can do less than 8 hour shifts that would be good too.

3ringnursing, BSN · Nov 23, 2017

Ask lot's questions of your coworkers, they will guide you through learning the ropes, and the how's and why's. They will be your lifeline in the beginning until you feel more comfortable.

Many of us have speciality areas of nursing, but in telephone triage you may be handling a wide variety of patients: PEDs, OB/GYN, teens, internal medicine, family practice, chronic health conditions (PEDs & adults), infectious disease, dental ... everyone starts out scared of the unknown, but eventually you'll do great. Just take a deep breath and follow your protocol. If you still are unsure then reach out to your coworkers (there will usually be one or two that will make themselves available to you even when they are off) or ask your supervisor.

If you rotate shifts some shifts (days) will have a much higher call volume. Even then all shifts can get crazy - triage by nature will always operate on the unknown. Just because it was slow yesterday doesn't mean it won't be madness tonight.

Depending on after call work time, you may need to go back later to finish a note, especially if it's busy. Pay attention to the queue - don't sit in after call work charting while calls sit waiting in the queue. It will tick off your coworkers mightily if they are taking call after call while you sit and chart on your note (this seems obvious, but some new nurses don't realize it is expected of them to get off after call work themselves sometimes in order to answer in coming calls in the queue).

If you have to be out of the calling queue for whatever reason (critical labs, contacting the on call provider, etc) keep your team mates informed of what you are doing (that way they don't get suspicious you are actually out at the store, or doing laundry). :bored:

You'll interact with a surprising number of behavioral health patients that will try to control the situation and keep you on the phone for an excessive amount of time for a variety of reasons (usually none triage related). Often times they are merely lonely, or having an exacerbation of their mental health condition - if you have a crisis response network in your area keep this number handy. You may need to perform a warm hand off transfer with these types of patients. If you don't have a BH background start practicing setting boundaries and enforcing them.

If you aren't bilingual you'll have access to interpreter services - these calls take longer. Write down the interpreter's ID number for your documentation.

Subject to how many patients your computer charting system holds - don't depend on your software hanging on to them without glitches. Write down the names and DOB's of your triage patients no matter how busy it gets, because sometimes we lose internet connection from the server itself and the system closes without a reason. If you don't have your note done you've just lost the way to back track to your information to finish. Ours for example holds 5 patients before one becomes lost in history with the addition of a 6th patient, but loss of connection will lose them all. Beware.

Some nurses have note books for information, but I keep everything on my desk top in files, and back up the important stuff on the U drive. It's easier to find things.

Get a really comfortable chair, or splurge on a gel cushion - your hynnie will get mighty sore from sitting for some extended periods of time.

Good luck in your new job! This is the best nursing job I've ever had, and more often then not I absolutely love it. My coworkers are amazing - as is my boss, and I trust them all to watch my back when things go sideways. Plus, working from home rocks!