Any Telephone triage nurses out there?

Audreyfay · Nov 20, 2005

I do telephone triage, but am an RN. I didn't realize that an LPN could do telephone triage? Even the MD offices have telephone triage. Hmmm? If I can help, e-mail me.

lorio · Nov 21, 2005

Hi Audreyfay, Thankyou for replying back to me so soon, This is my last activity before the end of the pn program, I will be grad. Dec 14. Anyway, my topic is "tetephone triage nurse" I have done some research thru the internet and came up with a lot of good info. and also I noticed that LPN's can not do traige nursing, so a RN must do.:)

The question I have a basic and not many of them, so here it goes.

I noticed there are so many area's and opportunties a RN can go into, Why did you choose "Telephone triage nursing"?

Since LPN's are not in this field, what would your responsibities be ,as a RN in this area?

Was there any special training required for you to get hired into this field, other that being a RN?

What are the pro's and con's of working in this area?

Pretty much thats all I need, unless you want to add anything else that, I might need to now for my report.

Ps, I saw from your profile that your from Wisconsin, I used to live in Two River, WI when I was in Jr. high. My Father was in the USCG, so we traveled all over the US. and I WI. was my favorite place to live. I now live in Central FL. Have been in Fl. sine 75. Thankyou very much for this opportunity, and Have a wonderful Thanksgiving! Lori

Daytonite, BSN, RN · Nov 22, 2005

I worked as a telephonic nurse for a large national insurance company. An LPNs license does not cover them giving advice so you will not find any LPNs working triage lines. I went into it because of my back. I had to find a desk job where I could sit as I have severe pain now when standing. It pretty much has ended my clinical nursing career. I was rigorously questioned about how to handle emergency situations when I was interviewed for the job. Our telephone number was printed on the back of every beneficiary's insurance ID card and they were encouraged to call us first before running off to an ER. They only hired nurses who had some years of experience working clinical areas. We were in a three week training class to learn how to use the computer program and how the company wanted calls handled. Many of the phone calls we got were similar to the same reasons people went to an emergency room. We also did a lot of teaching. We each sat at a cubicle that had a computer, telephone, and a number of printed reference books and other printed information in front of us. Calls came to us randomly and we opened a chart with each call, using a computer program designed specifically for the company, even if the call turned out to be a wrong number. We documented everything that was told to the caller. A very interesting thing I learned was that when you are told your call may be recorded and monitored for learning purposes, they mean it. At any time, the supervisor could replay any of our calls and not only hear the recorded conversation but also get a visual on the computer screen of the sequence we documented everything. It was mind-blowing. We weren't allowed to eat at the computer (for obvious reasons), but we took regular breaks and could disconnect from the phone system if we needed to visit the necessary. There was no overtime. You started and finished work on time, every time. We had a couple of regular "nuts" who called, but they were always treated courteously and we tried to get them off the line ASAP. These telephone services also do a large amount of teaching. If a person's insurance company is aware one of their beneficiaries has diabetes or some other chronic disease, they may have a division of telephonic nurses who call these patients to give them information about their disease, what benefits they are entitled to under the terms of their insurance coverage for the disease, and in order to encourage the beneficiary to follow up with their physicians. I haven't heard that talked about much on the forums when telephonic nursing is discussed. Also, some of these telephonic lines accept contractual work from other healthcare providers to handle some types of telephone teaching and triage work for them.

webbiedebbie · Nov 22, 2005

Hi...

I just started working in telephone triage. I chose this line of work because I have been a nurse since 1989 and hospital 12-hr shifts are getting too rough for me. I know I can retire from telephone triage, whereas I know I couldn't be working at the bedside for the next 20 years.

The only requirement for the job was clinical nursing skills, computer knowledge of navigating different programs, compassion, and common sense.

I just finished 5 weeks of training and "graduated". The preceptors equated the learning experience as "starting kindergarten". I equated it to "learning to drive a car".

I work in a call center, but there are many more who work from home. We even have one that works from Hawaii.

We get calls from all over. I had 2 the other night that were from Germany. We process calls for insurance companies. We also have Disease Management nurses who work days only who deal with people with chronic health conditions and do weekly follow-ups.

We are able to use translation features for those who speak spanish and for the deaf.

We have over 500 algorythms at our fingertips in the computer. These were designed by a physician; but we, as nurses are encouraged to give our input/suggestions as needed.

Some states (5) require that we be licensed in their state in order to process calls from their state, so we are obligated to apply and the company pays all fees.

I hope this helps and good luck on your activity.

lorio · Nov 23, 2005

I worked as a telephonic nurse for a large national insurance company. An LPNs license does not cover them giving advice so you will not find any LPNs working triage lines. I went into it because of my back. I had to find a desk job where I could sit as I have severe pain now when standing. It pretty much has ended my clinical nursing career. I was rigorously questioned about how to handle emergency situations when I was interviewed for the job. Our telephone number was printed on the back of every beneficiary's insurance ID card and they were encouraged to call us first before running off to an ER. They only hired nurses who had some years of experience working clinical areas. We were in a three week training class to learn how to use the computer program and how the company wanted calls handled. Many of the phone calls we got were similar to the same reasons people went to an emergency room. We also did a lot of teaching. We each sat at a cubicle that had a computer, telephone, and a number of printed reference books and other printed information in front of us. Calls came to us randomly and we opened a chart with each call, using a computer program designed specifically for the company, even if the call turned out to be a wrong number. We documented everything that was told to the caller. A very interesting thing I learned was that when you are told your call may be recorded and monitored for learning purposes, they mean it. At any time, the supervisor could replay any of our calls and not only hear the recorded conversation but also get a visual on the computer screen of the sequence we documented everything. It was mind-blowing. We weren't allowed to eat at the computer (for obvious reasons), but we took regular breaks and could disconnect from the phone system if we needed to visit the necessary. There was no overtime. You started and finished work on time, every time. We had a couple of regular "nuts" who called, but they were always treated courteously and we tried to get them off the line ASAP. These telephone services also do a large amount of teaching. If a person's insurance company is aware one of their beneficiaries has diabetes or some other chronic disease, they may have a division of telephonic nurses who call these patients to give them information about their disease, what benefits they are entitled to under the terms of their insurance coverage for the disease, and in order to encourage the beneficiary to follow up with their physicians. I haven't heard that talked about much on the forums when telephonic nursing is discussed. Also, some of these telephonic lines accept contractual work from other healthcare providers to handle some types of telephone teaching and triage work for them.

Thankyou very much for replying back to me, need this info for school, I know what you mean about that back pain. Ive been and currently a paramedic for about 25 yrs, give or take day or two, but my body has taken some beatings. Plus currently a fire fighter, I hurt all over! Im getting out of that line of work, and I grad. PN school this Dec. Not sure where or what Im going to do. I read some of these postings and I become discouraged. Anyways, Thanks again, you were very helpful. Lori:)

lorio · Nov 23, 2005

Hi...
I just started working in telephone triage. I chose this line of work because I have been a nurse since 1989 and hospital 12-hr shifts are getting too rough for me. I know I can retire from telephone triage, whereas I know I couldn't be working at the bedside for the next 20 years.
The only requirement for the job was clinical nursing skills, computer knowledge of navigating different programs, compassion, and common sense.
I just finished 5 weeks of training and "graduated". The preceptors equated the learning experience as "starting kindergarten". I equated it to "learning to drive a car".
I work in a call center, but there are many more who work from home. We even have one that works from Hawaii.
We get calls from all over. I had 2 the other night that were from Germany. We process calls for insurance companies. We also have Disease Management nurses who work days only who deal with people with chronic health conditions and do weekly follow-ups.
We are able to use translation features for those who speak spanish and for the deaf.
We have over 500 algorythms at our fingertips in the computer. These were designed by a physician; but we, as nurses are encouraged to give our input/suggestions as needed.
Some states (5) require that we be licensed in their state in order to process calls from their state, so we are obligated to apply and the company pays all fees.
I hope this helps and good luck on your activity.

Hi Debbie, Thankyou for your expediant reply on this subject, I have had a few responses from Rn's, Im shurley to get an "A" on this topic.:) Are you in the Rockies?? I lived in Durango, Co from 98-99, Loved the wildlife and scenery. Oh, and the fresh air. Have a Happy Thanksgiving. Lori

webbiedebbie · Nov 23, 2005

Glad I could help Lori. Yea, I live in Broomfield. Moved here a year ago to be closer to my mom. Moved here from North Carolina and I miss it terribly! Someday, I will return.

TheCommuter, BSN, RN · Nov 24, 2005

When I was doing clinical rotations at a lower-income family practice clinic, the triage nurse there was an LVN (though she was not into 'telephone triage'). Patients would come to the clinic without appointments, and she would interview them while assessing the severity of their problems.

Daytonite, BSN, RN · Nov 24, 2005

lorio. . .as my back was getting worse i started looking at other options that would take me off the clinical floor. one of them has been medical coding. i took a medical coding program at a local vocational school which i have since discovered is not the best route to go to learn it, but i got hired by a company that services a huge practice of er physicians because of my rn background. it was a sit down desk job and i chose to work in the building although i could have taken what they call "charts" home to code them. we would read through the er physicians dictations for each person they had treated and then place the icd-9-cm and cpt codes on them for the billers to put into the computer in the data department. that information then gets turned into a bill that is sent to the patient or his insurance company who will be paying the bill. medical coding is how all medical bills are generated. it is a growing profession as a smart, knowledgeable coder is worth their weight in gold. it is estimated that most doctors underbill or do not follow up on insurance company denials of their claims and so they lose a lot of income that way. medicare is known to be recommending that every facility doing any kind of coding have at least one certified coding on staff. california has kind of taken that to heart and a coder can't find a coding job out here without being nationally certified. starting pay, however, is $18/hr. not too bad for a desk jockey. back in ohio coders start at $12/hr.

coding led me to the community college where i have been taking a class here and there in coding and in health information management which is the career that supervises coding and billing. the jobs that are available to health information management people are very interesting, but you have to get an aa in it from a college that has an ahima (american health information management) approved course. our instructors are all health information management people who are heading up these departments in the hospitals where they work or they are security officers within their hospital computer departments. their one big responsibility is patient confidentiality of the medical record and hipaa compliance. they are always announcing job openings. one recent one was for a birth certificate registrar. him people also staff the medical staff offices, tumor registries, and the list goes on and on. a him graduate with an aa can start out at nearly the same salary as an rn. you should look into this line of work.

everything is going computerized and that is the direction things are heading. medicare is calling the shots on payment of doctor and hospital fees and the insurance companies follow what they do. they alone are probably what is most responsible for this massive growth in these healthcare careers. there is no state licensing as with nurses, but getting a national certification from ahima is pretty much expected and is purely voluntary on your part. these are primarily desk and office jobs although some of the more glamorous ones do have some travel connected with them.

lorio · Nov 25, 2005

I just might do that, the money sounds great!

Audreyfay · Nov 25, 2005

Sorry I'm so late in responding. Haven't been on the internet for a few days. I got into telephone triage for some crazy reasons. I had resigned from my very part time diabetes education job with the medical practice because I got a .8 FTE job with another organization. However, I really wanted to stay with the medical practice because I really liked it. The Human Resources Specialist said they had pool positions for telephone nurses at the call center. I applied and was accepted. I work mostly weekends, but also a few evening shifts here and there when I have time. I've been with them for 6 years now. Lots of variety.

Education/training: I had about 10 shifts of orientation, first hands-on computer training, then watching and learning triages, then practice triages, then real triages with the trainer watching, and finally on my own.

As mentioned before, we also have a computer program that has all of our protocol for different situations. We are in our own little cubicle, with a computer, phone/headset, and references. For the most part, it is a great second job. Start on time, end on time. There's always variety.

One of the reasons I really like telephone triage with a call center is that I am able to keep up on multiple specialties. I have been an RN for 29 years and have experienced a lot of different specialties. This is a way for me to keep my fingers in the pie!

Hope this helps and you are still able to use it. I like WI too. Have lived in so many different states, and have found more contentment here than anywhere else. Good luck with your paper!