New to triage and feeling incompetent!

Posted
by RNhuron RNhuron (New) New

Hi! I have been a nurse since 1998, always in pediatrics. I have done in-patient, PICU, public health and school nursing. I was out for about 5 years when my kids were young, and have been away from clinical nursing for some time.

I recently decided to go back to work and got a part-time job in a busy, well respected multi-provider pediatric practice as an advice nurse. We use Barton-Schmitt protocols, and I got the book about 2 weeks before my first official day, which was last TH.

Long story short, after being there for 2 days, I feel like I know nothing! The protocol book is overwhelming and the EMR is very confusing (even the experienced nurses say it's hard to learn, and they just started using it in Sept).

I am studying the protocols every free minute, but feel my common sense has gone right out the window. I'm hoping it gets better with time, but I think I'm just feeling surprised at how inadequate and nervous I am after being a nurse for so long. I feel like they expect more because I look good on paper and interview well. Maybe they thought I was better than I really am? I was confident in my abilities until I started!

Any advice would be helpful!!

MA Nurse

MA Nurse

Specializes in NICU, Telephone Triage. 676 Posts

I sent you a PM

MA Nurse

MA Nurse

Specializes in NICU, Telephone Triage. 676 Posts

Almost 200 people read the post, and no replies? Why doesn't anyone talk here? Are we afraid of being discovered or something? It would be nice to provide some help.

Cat10

Cat10

8 Posts

I am not a nurse, I've been taking nursing school prerequisites and stalking the allnurses forum for a year.

However, I just wanted to say that I empathize and to say that this sounds a great job! After I work a couple years this is exactly the kind of job I'd like to get.

Maybe flash cards would help, recording parts of the book might help too so you can listen in the car.

Good luck!

CoolKidsRN

CoolKidsRN

126 Posts

To be honest, once you get the hang of the format of Barton-Schmitt it becomes easier to navigate. Truthfully, you have valuable nursing experience but triage takes several years to truly master it. I would recommend keeping your calls short and sweet by doing the following:

1) identify the primary chief complaint

2) match that with the appropriate BS protocol

3) assess pertinent signs and symptoms

4) decide if the patient needs to be seen in the office, go to the ER, or if home care is appropriate

5) If home care is appropriate, review what to do and inform the parent of symptoms to monitor for

Good luck!

No12S, ADN, BSN, RN

Specializes in Medical Surgical. Has 24 years experience. 15 Posts

I have done telephone triage in a call center for about 7 months. It's quite different from what you describe that you do. Me and 3 other nurses triage calls for about 10 doctors, I was given each physicians protocol when I started, if I have a question or don't feel comfortable making a decision about something I email the CRNP who works for the doctor, they each have 2 full time CRNPs.

I return calls to patients, I do not answer the phone. We have admin assistants in the call center who take all calls and forward a message to the nurse if the caller has medical questions, issues or pain. I have no quota that I have to meet. I love my job! It is the best nursing job I have ever had! I have been a nurse 15 years and have worked in the ER, Hospice and Med/Surg(hated each one of those jobs). Bedside nursing is just not for me. The only regret I have is I wish I had left bedside nursing sooner! I have all wkends and holidays off, work 8-5. No more hoping I can get Xmas off or having to work thanksgiving because I wasn't the bosses favorite, bedside nursing is a slow and painful death! Never again

Edited by Danni10

thetank

thetank

Has 23 years experience. 23 Posts

Hi there. I am new on the forum. I've been an RN since 1997, and also have a background mainly in peds. I've been a telephone triage nurse for 3+ years, and it's very tough...people don't realize how tough it is. The hardest part is how rude people are on the phone. I work for a large family practice (13 providers) in a large city, and man, it is rough. I much prefer face to face nursing, but at this point in my life, I am not willing to return to bedside nursing. Please let me know how you are doing.

thetank

thetank

Has 23 years experience. 23 Posts

You are so lucky - we answer live calls.

Emmasmom03

Emmasmom03

Specializes in Transition nursing and couplet care. Has 3 years experience. 95 Posts

Telephone triage nursing is so different than what most people think. Some days go really well and you feel like you have the hang of the job and then the next day you feel like every decision you made was wrong. I mostly only have inbound calls for Tricare. We can be super busy and lots of young, new parents and lots of OB questions. I question my decisions constantly.

thetank

thetank

Has 23 years experience. 23 Posts

Yes, it's very different. How long have you been a triage nurse? Do you have a protocol to work from?

Emmasmom03

Emmasmom03

Specializes in Transition nursing and couplet care. Has 3 years experience. 95 Posts

Not long at all. Just started this year. And yes, we have lots of protocols and work instructions.

thetank

thetank

Has 23 years experience. 23 Posts

Don't despair, you're still a newbie. It takes a long time to settle into triage nursing. With each call you will build your knowledge base and confidence. Take notes if you need to and trust in yourself. It's a very tough job, and it takes a long time to get used to it. I've been at it for 3.5 years and I'm still learning every day.