Call-a-Nurse /Telephone Patient advise

[goflyslow2]

I am an R.N., working in PACU (recovery room).

We have just implimented a new program that encourages same day surgical patients and families to call our "Nurse Liason" any time, 24/7, post operativley, with questions that they may have.

Our previous and current practice, is to provide discharge instructions to the Patient and family member, related to their surgical procedure, including a Micro Medex print out of discharge instructions, and print out of medications Rx'd at that time. We also have told them to call their physician in the case of various untoward problems, preprinted on out forms (Temp, increased pain, nausea, swelling, S/S of infection, etc, etc)

My concern, is that no parameters nor guidances have been set for this new "telephone Triage". The intent of the "Call a Nurse" program, is to improve customer relations / satisfaction.

The nursing personel assigned, will be taken from a pool of PACU nurses on a rotating basis, with that nurse to carry a beeper / cell phone for a 24 hour basis, 3-4 day rotation. We are paid an "on-call" rate of $6 per hour to do this. It is voluntary, yet highly "encouraged" that we participate....or it will be assigned as an on-call duty. (we already have required on-call/standby for emergency surgeries at this 250 bed acute care hospital.

Again, no guidlines for informational output have been established. And, the nurses within our PACU department vary considerably in their knowledge and communications skills.

What should we nurses be investigating and be concerned with regarding the above "Call Our Nurse" program? What are our liabilities? How should administration be approached?

These "new and wonderful" programs seem to come from administration....without much forthought.

Thanks,

C. Scrivner RN

[santhony44, MSN, RN, NP]

You need standardized protocols, approved by the physicians. This should include under what circumstances the physicians wish to be called.

Also, keep a record of every call, who, what complaint, and what advice was given. This should probably go to the physician and into the hospital chart. If a patient ever says "the nurse told me...." you need documentation to back up what you actually did tell the person, and also what information the person gave you.

Does your facility have risk management? Has this been discussed with them and/or the facility's lawyers? Does management understand that the facility can be sued if something goes wrong with a patient and it's blamed on the nurse's advice?

I think too that the physicians need to be asked if they want this for their individual patients, too. Some may prefer to talk to their own patients; all will probably prefer some sort of standardized protocols.

I've done telephone triage as a nurse. I wouldn't do it without clear protocols from the physicians.

Good luck!

[goflyslow2]

Thank you!

Excellent sage advise! You brought up concerns and approaches that we/I had not even thought about.

Thanks again.

Chaz.....