LoveTeleNursing

Hello Nightngale & JB, I have nearly fourteen years experience in nursing, currently as a telephone advice nurse for a managed care company in NW USA. I began my nursing career in critical care, building a solid skill base, but without satisfaction in my nursing practice. For some reason, early in my career, I was at the mercy of company dynamics, downsizing and economy politics. This caused me to take positions for shorter periods of time, in a variety of nursing fields, to stay employed. I have worked as a clinic nurse in internal medicine, done home health nursing in a major metropolitan city, worked as a staff nurse, resident care manager and director of nursing in several different long term care facilities, and have worked as an agency nurse in hospitals across a fifty mile radius. I ended up returning to the ambulatory care arena, working in many specialty clinics, including Pediatrics, Womens Health, and Adult Health care. The resounding theme throughout my career has been telephone advice and health education. I like to refer to it as telephone advice, because consumers relate to that much easier than "triage." While moving in/out of short-lived nursing positions, I found a need to learn to market myself, while competing with nurses who had maturity, specialty experience, and a company track record. Employers translate this to competency and loyalty. Somehow, I needed to market myself as a unique and valuable employee. I am a highly trained and competent professional as well as a passionate nurse. I began to realize my experiences proved valuable in positions requiring independent nursing practice. I also had exceptional rapport with interdisciplinary health professionals when collaborating to meet client needs. I knew where the client was coming from whether at home or in the hospital, and I understood the variety of challenges presented to nurses in these varied fields - I lived it. I enjoy myself most when working 1:1, using my knowledge, experiences and skill to educate, enhance quality of health care, and relate personally. One of the most independent jobs in nursing is telephone triage. During some of my shorter job venues, I began to learn a little bit about business and entrepreneurship by attending several local SBA classes and trying to network in the area. I researched small business and entrepreneurship in more detail. Often, my research led me back to telephone nursing. I developed enthusiasm and desire to be involved in this emerging pioneer nursing specialty. Ever since, I have been "hooked" on becoming a nursing entrepreneur. In the meanwhile, I'm rearing a young family and enjoying simply practicing telephone nursing. When I attended seminars, I "dreamed" of being the seminar presenter, as adult education appeals to me. I have been active in public speaking through my church. I also do well with written and verbal communication. However, I want to demonstrate competency when I do venture out alone, and that is why I am proceeding rather cautiously. I have a Bachelors of Science in Nursing. I received my certificate in Telephone Triage through NCC in 2002. Nursing has been my whole life, apart from my family. Business is a stretch for me, previously protected in a "nuturing" career field. Yet, I continue to be drawn to it. I haven't been fortunate enough to meet or form any particular bond with entrepreneurs in person, and was referring simply to the "newness" of starting out as an entrepreneur, when I used the word fledgling. I have found this bulletin board most helpful, at several intervals over the past few years, when researching small business and entrepreneurship, and finally took a leap and joined the board. I served in the past on a web site, providing consumer education in health, and truly enjoyed that experience. I hope that my experiences on this bulletin board provide ample opportunity to encourage other nursing professionals to pursue their dream, and allow me to refine my dream as an independent telehealth professional. Sincerely, LoveTeleNursing

Below is a copy of a post I did elsewhere in this forum for a person who posed a similar question about seeking a telephone triage job. She was interested in what the job required, how it was performed and so on. I thought what I submitted there might be helpful. I agree with you that finding telephone triage jobs in certain areas is difficult. There aren't that many options in some parts of the US, or it is simply not marketed well enough to utilize. Another way that you might consider getting involved to a degree that might put you in position for a telephone job in the future, would be to join a large managed care group or HMO in your area, within ambulatory care (usually doctors' office work and less physically draining), that also has a telephone triage call center. This is assuming the call center isn't hiring at that time. In the clinic setting, you will often be triaging clients both in person and over the telephone, so it would be a great jumping board. Generally, a clinic nurse does a lot of triage, and some other procedures such as injections of narcotics, IV starts, assisting the doctor with setting up or doing minor procedures such as laceration repair or skin biopsies. Sometimes, depending on the type of clinic and focus of the members (adult versus child for example), you could be asked to do some case management. It would also keep your skills up and give you another "area" of nursing that shows on your resume. Also, very handy if a job in the call center does come up. OK, here's my other post. Good Luck with the hunt. --------- You will need solid experience in nursing--med/surg experience is very useful. You will need a strong sense of self-worth and confidence in your skills and ambition to do a job independently. Most telephone triage experts will advise a nurse to have at least 2-3 years in acute care (critical care or emergency nursing or acute med/surg), or 5-7 years in other nursing avenues. This provides the nurse with a solid base for doing telephone advice, which requires a vast knowledge base, and competency to perform independently. However, these are recommendations, and vary from place to place. You will need a pleasant phone voice, calm demeanor and have excellent verbal communication. You may need to document calls on a computer, so experience in keyboarding is helpful, with ability to type at least 25 words per minute preferred. One can find a telephone triage (or telephone advice) job in clinics, ambulatory/immediate care facilities, home health & hospice facilities or companies, managed care/HMO facilities, and some hospital or private sector companies. Expect to either be in an environment where you take calls for a specific population, such as oncology, or taking calls for a wide spectrum, including adult/pediatrics/ob or gyn. You can look for positions by looking up telephone triage online search, or looking for ambulatory care units/clinics/hospitals in your area, and looking up information or web sites for local HMO/Managed care facilities in your area. If you do not find a position by just browsing, go ahead and send a resume with a cover letter presenting your expertise and experience, and letting the company know that you are interested pursuing a position in patient education or telephone triage services. -------- Other possible positions you might particularly enjoy would be case management, diabetes education (if this a strong point in your experience) or home health/home infusion. Long term care, doing director of nursing or resident care management may be another area. If you know nothing about this area, they are often willing to train you. Generally these positions require less physical activity in nursing homes or rehab centers, because the bulk of the bedside care is done by LPN and CNA staff. It does however, require a lot of paperwork, and the regulatory guidelines are very stiff. Reading about Long Term Care using this bulletin board, under that forum may help you decide if this would be something you'd be interested in. They often have impressive bonuses and good benefits because this is another area that is experiencing the nursing shortage crunch. I hope this helps you get started. Best wishes in pursuing a positive career change. Below are several web sites about or related to telephone triage. It should jump start your research: Telephone Triage Web sites: http://www.rnceus.com/triage/triageframe.html http://community.nursingspectrum.co...le.cfm?AID=6873 http://www.conway.lsuhsc.edu/librar...ing/telemed.htm http://www.lib.uiowa.edu/hw/telemed/orgs.html http://www.ana.org/readroom/tele2.htm http://www.rn.ca.gov/policies/pdf/npr-b-35.pdf http://www.carolstock.com/ http://seminars.pesihealthcare.com/seminfo/rutenberg/ http://www.mxdmedia.com/ez/medical/med100.htm http://www.teletriage.com/about_tt/ I hope this helps you get started. Best wishes in pursuing a positive career change. Sincerely, LoveTeleNursing

Dear John: I have heard this term, and read about its use in certain circles of nursing, but is there a particular thread of use, such as independent contracting, that you are referring to when you asked me that? Or are you talking about use within a structured frame work, such as ombudsman, who advocate for the senior in long term care situations? A telephone advice nurse is an advocate for clients continually, for the client, and between their provider, other health care professionals, and sometimes the managed care structure or financial constraints. That is a given. Just curious what you are thinking about with this. Thanks, LoveTeleNursing

Hello entrepreneur colleagues, I am in the very early stages of researching an idea for a business. I have a BSN, and I am certified in Telephone Triage, with thirteen years in nursing. I am hoping to use my experience and expertise to become an entrepreneur in this field. I remember reading on one of these very informative forum threads, about the idea to stick your name out in the public via newsletters. I am just wondering if any of you have some more ideas about newsletters or professional journals that would be interested in information that I might be able to provide. I am an excellent communicator and considered publishing. Veteran entrepreneurs keep reminding the fledgling entrepreneur that a niche, researching competition and networking with other businesses in your field is an essential thread for success. This is a resounding theme of developing a business. People who may have started call centers in large cities, and those who are affiliated with some of the associations for telehealth and nursing--such as conference writers or presenters--are the only ones I've found that seem to meet the "entrepreneur" definition in telephone triage or telehealth nursing. Most of these people quickly assimilated into a major corporation (by starting the company) or fell back on sponsors by a related association. I'm at a loss to find nurses who have consistently stayed within the bounds of telephone triage and entrepreneur status. A few nurses I've researched have gone into business for themselves under the auspice of telehealth, but specialized in a separate subspecialty such as legal consulting or freelance publication. I am having difficulty identifying any specific small business standing on its own in this field. I already know about major call centers and telehealth associations, as I work for a managed care call center doing advice, and am certified by an association that sponsors telephone triage/nursing. I need to be careful about my association as an employee with this company because of the potential conflict of interest. So, I am being cautious about researching the business development aspect of my dream. So far, in relation to researching and developing a "niche" I'm at a loss with this part of business planning. 1. What ideas can you give me about researching in a field of nursing that is still in its pioneer stage? 2. Also, what guidelines do you suggest, when trying to network and learn to avoid opening myself up to "giving away" too much of my business idea? I am an avid communicator and sometimes I don't catch my tongue. I don't want an original idea stolen, just because I let "too much out of the bag." 3. Would you have any suggestions, from a low budget perspective, on how I could begin getting my name out there in associations that may prove to be effective in either sponsorship, financial investment or networking? Do you have any cautions about pursuing my exposure, while currently employed within the industry by a dynamic managed care group? Let me know of any ideas--accept my gratitude in advance for your input. So far, having read this forum thoroughly in past few weeks, I have gleaned a lot of information and developed hope for a positive future as an entrepreneur! Thank you for the encouragement. Sincerely, LoveTeleNursing

Dear Informatics Experts, Any guidelines on making a fledgling web site more visible online? I have two areas I'm not sure how to research or learn about: 1. Getting the web site noticed on the world wide web. 2. Figuring out how to edit my current web site through my ISP. I use a template system, as to new at this to understand developing with HTML language on my own. 3. How does one learn about how to set up a counter to mark "hits" on a web site? I think with some time I can figure out how to edit it through my ISP, but am not certain how one begins the process of making the site more visible in hyperspace or http://www. Thanks in advance for your time.

You will need solid experience in hands on nursing; it sounds like you have that down. Oncology nursing is certainly a challenging arena of nursing, physically and emotionally for all involved. You will need a strong sense of self-worth and confidence in your skills and ambition to do a job independently. Most telephone triage experts will advise a nurse to have at least 2-3 years in acute care (critical care or emergency nursing or acute med/surg), or 5-7 years in other nursing avenues, that provide the nurse with a solid base for doing telephone advice, which requires a vast knowledge base, and competency to perform independently. However, these are recommendations, and vary from place to place. You will need a pleasant phone voice, calm demeanor and have excellent verbal communication. You may need to document calls on a computer, so experience in keyboarding is helpful, with ability to type at least 25 words per minute preferred. One can find a telephone triage (or telephone advice) job in clinics, ambulatory/immediate care facilities, home health & hospice facilities or companies, managed care/HMO facilities, and some hospital or private sector companies. Expect to either be in an environment where you take calls for a specific population, such as oncology, or taking calls for a wide spectrum, including adult/pediatrics/ob or gyn. You can look for positions by looking up telephone triage online search, or looking for ambulatory care units/clinics/hospitals in your area, and looking up information or web sites for local HMO/Managed care facilities in your area. If you do not find a position by just browsing, go ahead and send a resume with a cover letter presenting your expertise and experience, and letting the company know that you are interested pursuing a position in patient education or telephone triage services. Other possible positions you might particularly enjoy would be home health case management, or quality improvement services in continuing care spectors (HH, Hopsice, Infusion home services, Ancillary rehab therapy). I hope this helps you get started. Best wishes in pursuing a positive career change. Below are several web sites about or related to telephone triage. It should jump start your research: Telephone Triage Web sites: http://www.rnceus.com/triage/triageframe.html http://community.nursingspectrum.com/MagazineArticles/article.cfm?AID=6873 http://www.conway.lsuhsc.edu/library/nursing/telemed.htm http://www.lib.uiowa.edu/hw/telemed/orgs.html http://www.ana.org/readroom/tele2.htm http://www.rn.ca.gov/policies/pdf/npr-b-35.pdf http://www.carolstock.com/ http://seminars.pesihealthcare.com/seminfo/rutenberg/ http://www.mxdmedia.com/ez/medical/med100.htm http://www.teletriage.com/about_tt/ I hope this helps you get started. Best wishes in pursuing a positive career change. Sincerely, LoveTeleNursing