New and need help with call times

MandaRN94 · Sep 29, 2011

I telephone triage also and some pts do like to ramble -I tend to give them other # for reference or their needs (CDC,counseling, etc..) if they have further quest about general info. Luckily my job has no pressure on # of calls I take but I find some pts are calling just to vent or have someone listen to their problems -those I will try to cut short and give them referral #.

Genista, BSN, RN · Sep 30, 2011

Thanks MandaRN94. Where I work there are very strict time constraints. I am very concerned about meeting the goals.

Genista, BSN, RN · Oct 20, 2011

Well, I already dropped my times, but I need to tighten it up a bit more. If anyone can offer some tips, I would love your help! Please PM me with ANY advice you can offer. I notice that many times callers are rambling on, or I get sidetracked by their multiple complaints, so I think it is taking me too long to identify the chief complaint. I am thinking I may need to use more close ended questions. Anything else you can offer? I appreciate it! I also want to get a good history, but in a quick way.Thanks.

MandaRN94 · Oct 20, 2011

What type of triage do you do?

Genista, BSN, RN · Oct 20, 2011

I do telephone triage for medicine/OB/peds in a call center.

MandaRN94 · Oct 20, 2011

So you basically do it "all". Some pts have many chronic issues. I've learned to figure and answer the "what is your prob today" and refer them for an appt or have their provider call them if they have mutliple non urgent questions -esp med related. I was told by my manager that we can politely tell them we have many other callers waiting so we need to wrap this up : )

KrysyRN, BSN · Oct 22, 2011

At the beginning of the call, I tell the person that I am able to help with his/her question, and that the call should take approximately 5 or 6 minutes. This has helped me tremendously with keeping call times down. Most calls end up being 9-10 minutes anyway, but they are within the company's time expectations. Hope this helps :)

cbcle · Oct 26, 2011

Before I let my pt launch into the long-winded version of what's going on, I ask the required yes or no questions first.

"Hi, Mr. Smith, you're calling about abdominal pain today?"

"Yes"

"Ok, really quickly I'm going to ask you some yes or no questions that will help me determine how urgent the situation is. Do you feel cold and clammy, feel like your heart is racing, you're breathing fast or that you're having any mental status changes?"

"No"

"On a scale of 0-10 with 0 being no pain and 10 being the worst pain you could imagine, how would you rate your pain?"

"I'd say about a 7."

"Is it so severe that it prevents you from bending, walking or working?"

"Yes, it hurts when I walk."

"Any fever/chills/nausea/vomiting/diarrhea/constipation?"

"I feel a bit feverish."

"And if you were to point to where it hurts, where would you be pointing?"

"Just below my ribs on the right side."

This takes about 1 minute, then I let them tell me what happened, when it started, what it feels like, what makes the pain worse/better, etc. This seems to cut down on the pt's narrative a lot by getting some of the key things out of the way. Hope it helps.

augnurse · Jan 11, 2012

I am just hitting the year mark as a pediatric telephone triage nurse. I also have struggled with call times. (I have been told I type just way too slow.) I love the suggestion that you are to start the call by letting them know you are there to answer their question and that the call is going to be 5-6 mins. I have started my calls with varifying names and DOB (we get faxed call sheets from services that are often wrong). When I get the quick info out of the way I can focus on the complain.

You are right that sometimes the client just wants to talk. I work alot of nights. I get alot of new mom's that are scared. Many times the baby is just fine. But they need a little reassurance and education.

I think as a nurse, it is sad that we are taught to be compassionate but are penialized for take a few extra minutes to soothe a parent's fears. Call times are more about $ than people. For that reason, I will always be told I am slow. I just think about how I want to be treated if I was upset and thinking my child was really sick. Nursing is dealing with the emotions. If I wanted to just treat the illness, I would have become a doctor instead. It is our compassion that makes us nurses; one of the most respected jobs in the world.

There are times to breeze through a call; and I do try to keep most of my calls to 5 mins. You can always tell when they are just looking for some quick advice. But never feel bad for caring or taking a few extra minutes to be the best nurse you can be. Your kindness may not be reflected in the numbers, but you may have touched a life instead!