norma_njm

I'm a general RN of 43 years, including 11 years of telephone triage. I understand hypochondriasis and anxiety. I've always been attune to my body's language. Having had rheumatic fever when I was 8 y.o., I self diagnosed it correctly to my family Dr. 30 years later. Years later I went to the ER with mild difficulty breathing and the. triage nurse told me I wasn't having trouble breathing. I was admitted with pneumonia. That time I can excuse because I wasn't struggling acutely. Currently I have the flu. I'm faithfully using my inhaler. This brought memories today of 2 specific times when I was struggling with breathing and I truly didn't understand the reactions of the nursing staff. 1) After returning to my post-op room subsequent to general anesthesia, I shortly developed struggled breathing. 2 nurses simply stood and watched without doing anything helpful until finally the spasms went away. They told me I was being anxious, but did nothing to alleviate it. Meanwhile I was miserable and scared. 2) Using a different brand emergency inhaler for my current flu reminded me of a similar situation a year ago. After taking a recommended dose, suddenly it felt as if my lungs were collapsing. When it subsided and then returned, my husband took me to the emergency room. They triaged me immediately, but when it subsided again, for the next hour they took a watch and see attitude. I think I got a big dose of the carrier instead of the medicine. They told me I was being anxious. You bet I was anxious which didn't help my breathing. Ultimately I was given a diagnosis of dyspnea nos, given some lorazepam, and sent home to f/u with my dr. No O2 with the 1st scenario, I think there was some O2 with the 2nd scenario. I remember the sensations clearly, I barely remember O2. I know you weren't there and can't give me a definitive answer to these scenarios. But am I missing something? At the very least empathy? Just because you're anxious doesn't mean you're not dyspneic. I suppose this can be considered a pity party, but I'd like to resolve this if there's any resolution to put it behind me. Thanks for reading and any possible responses.

There was a previous thread warning that was closed in 2011 regarding use of MEDCEU.com for continuing education. Well, a year later the company is still out there continuing its antics of automatic renewal without a reminder notice, of not having anyone answering Customer Service calls live and of not responding to messages left for call backs, of emails to Customer Service inoperative, of not indicating anywhere on its website of how to cancel your subscription. I don't take lightly not paying a bill, but after my ineffective efforts to contact the company and after locating the old thread about this topic, I put the credit charge in dispute with my credit card company. I'd like to see this thread continue for awhile to alert nurses new to allnurses.com that they still need to beware becoming entangled with this CE company.

Several of us in the telephonic triage dept. in which I work are starting to prepare for the certification exam presented by the National Certification Corporation. I located a few previous postings about this, but they were several years old. Now that the test has been around for awhile, I'm interested in current information about the exam. Has anyone taken it in the past year who can tell me about the computer format, about what information they tended to cover, about how much was devoted to the nursing Standards & Practice and URAC standards, and anything else you think is important or helpful to know? Also, how long were you allowed for the test? Also, how did you prepare for it? Please know that I really appreciate everyone who responds to this.

Sorry it's so long since you posted your question. I've just found this blog. I'm fairly new to Telephonic Triage, but I have answers to both your questions. 1) Concerning a fever script, where I work (a Medicaid HMO) we're taught that it's rare to have only a fever to triage. Usually there is/are some kind of other symptoms that you can triage & in which you'll triage the fever, also. If it's an infant of 12 weeks or less age with a temp of 100.4 degrees F or more rectally, if it's a temp. of over 105 degrees F, or if the member denies any accompanying symptoms, which is rare, then we triage the fever. In 4 months of full time hours, I think I've used the fever algorithym twice. 2) I work and am licensed in Ohio. My company manages Medicaid in Ohio, Michigan & Indiana. I haven't had to have licenses from those other states to triage those members. However, we're planning to contract with someone in California, and maybe in New York, & I understand we're being required to be licensed in those states in order to triage people from there. So far it seems that taking their state boards is not part of getting licensed. There's probably more to all of this, but I don't know anymore specifics. Happy triaging!!! Nursing in Ohio