telephone triage for busy pediatric office

T-Bird78 · Apr 6, 2014

Most phone triage setups will have the pt (or parent in this case) leave a message. Our phones have a red light that flashes when there's a message, some don't and you have to check the lines every 30 minutes. We take the message on a legal pad, some offices have specific message sheets, then send an e-message to the doc via the computer system. The easy ones, like med refills, can be handled without the MD answering. Always call the pt back and let them know what the outcome of their call is or if it's being worked on (i.e., lab results pending, CT scan being scheduled). Also have the daily schedule pulled up so you can see if someone can be worked in for same-day visits. Some offices let triage nurses do this, some make you check with the front desk for any work-ins. Good luck!

SleeepyRN · Apr 6, 2014

Thank you! That clears it up perfectly

kh321 · Apr 6, 2014

I do telephone triage for a busy peds office. We talk directly to the parents. They call in and tell us what it going on. From there we decide if they need to come in for a sick appointment or if they can treat at home. We have a book of triage protocols we follow. We send all of our notes/decisions to a doctor. They get back to us or call the parent directly at home if necessary.

I call and check on my patients who I advised to treat at home. For instance if a kid is vomiting I give the protocol and call mom/dad to check on them about 4 hours later or the next morning.

Typically if the parent is looking for a refill or a test result they can just leave a message. We get back to those through out the day.

I didn't think I would like it but I absolutely love it.

Good Luck!!

SleeepyRN · Apr 7, 2014

I do telephone triage for a busy peds office. We talk directly to the parents. They call in and tell us what it going on. From there we decide if they need to come in for a sick appointment or if they can treat at home. We have a book of triage protocols we follow. We send all of our notes/decisions to a doctor. They get back to us or call the parent directly at home if necessary.
I call and check on my patients who I advised to treat at home. For instance if a kid is vomiting I give the protocol and call mom/dad to check on them about 4 hours later or the next morning.
Typically if the parent is looking for a refill or a test result they can just leave a message. We get back to those through out the day.
I didn't think I would like it but I absolutely love it.
Good Luck!!

This was more than helpful. Thank you for your response.

SleeepyRN · Apr 7, 2014

Living in the suburbs of Chicago, pay rate tends to be higher than many other states. The job description stated: administering vaccinations, phone triage and family teaching. There are 5 doctors and it is a busy practice. Any thoughts on what to negotiate on salary wise?

I also work (only 8 hours a week) at an asthma/allergy office. I had to pretty much beg him for 14 an hour. I had interviewed with a family practice, and they start in the lower 20's. So that gave me an idea on what office nurses in my area should be paid. What are your thoughts for salary?

kh321 · Apr 7, 2014

You're welcome.

To be honest in the hospital I was making 23/hr without shift differential. I am making slightly lower than that now. I don't really know what the other nurses are making. They have all been at the practice for several years. I have a friend who works in an office specializing in behavioral health and her salary equals out to 17/hr which is way too low in my opinion. (I'm not salary though. THANK GOODNESS!!)

You and I live in totally different regions though. The cost of living here is not very high.

I really wish you luck!!

SleeepyRN · Apr 7, 2014

Do you find that there is a common reason families call, or does it vary widely day to day. If so, what are the most common things parents call about?

And what are the most common reasons for appointments? Besides regular check ups and those that are needed for entering a new grade.

I guess I'm trying to figure out what to brush up on first in pediatrics since my experience lies with asthma and administering allergy shots and skin testing.

I appreciate your help. Thank you

Anyone care to chime in on your experience such as pay and reasons for visits, also what your job duties are please do so.

KelRN215, BSN, RN · Apr 7, 2014

Do you find that there is a common reason families call, or does it vary widely day to day. If so, what are the most common things parents call about?
And what are the most common reasons for appointments? Besides regular check ups and those that are needed for entering a new grade.
I guess I'm trying to figure out what to brush up on first in pediatrics since my experience lies with asthma and administering allergy shots and skin testing.
I appreciate your help. Thank you
Anyone care to chime in on your experience such as pay and reasons for visits, also what your job duties are please do so.

I don't work in a pediatric office but, as a pediatric visiting nurse, parents call me about stuff they should be calling their doctor about, stuff they should be calling 911 about and stuff that they don't need to call anyone about.

You will get parents calling for things like:

-My 2 day old spit up a little after his bottle, what do I do? (Nothing)

-Why isn't my baby sleeping through the night? (Because he's 2 weeks old, next)

-My 2 year old keeps pulling on his ears and has a fever of 101 (Bring him in)

-My 4 year old has a fever of 104 and has been seizing for 10 minutes, what do I do? (Hang up the phone right now and call 911...)

-My baby's poop is yellow and seedy, what does this mean? (Your baby is breast fed and is fine)

rnsrgr8t · Apr 7, 2014

Before I became an APN, I worked for a busy pediatric practice and did phone triage a lot. The key is to have good protocols and document, document, document. When I first started, I took the protocol book home with me and read through it to learn the things we used most often. During cold/flu season, you are going to go over the homecare instructions for colds etc, over and over again. :). Same thing when the stomache flu goes around. I used to say I wanted to make a recording so I could just play it for the parents and not have to say it over and over. I did have families call a few times when kids were having severe allergic reactions that they had to call 911 for. I once had a daycare for a 4 month old who was having an analphylatic reaction to formula. I had to have them call 911 and then call the mom who was driving to the daycare to let her know what I recommended so she would not freak out when she got there.

The key is to document EVERYTHING you tell these parents to cover yourself. Used to have them call back complaining (no one told me to do that!!!) and you could easily go back and look at my notes and see what I told the parent. There is a lot of liability in doing this so you have to make sure you are covered. If you are not sure, run things by the providers (and document that you did). I also got one of the hands free handsets which made it easier to talk on the phone and document at the same time and not get neck pain.

Good luck!

T-Bird78 · Apr 8, 2014

And plan on Fridays around 3:30 being slammed with phone calls because mom or dad "forgot" their child needed a refill on their medication, or baby's been coughing all day but NOW they need an appt. It never fails. You'll be able to tell what's going to come across the phone lines based on what's coming in the door during the day--whether it's a stomach bug or strep throat running amok in the nearby elementary school, and the ever popular flu in the winter. Document the time the call or message was received because, despite the outgoing message stating to please allow 4 hours for a call back and rx refills within 24 hours, you WILL get the irate parent call, leave a message, then hit redial and 0 to yell at the front desk that "I called and nobody called me back yet!". Never fails. :)

jae_mc · May 26, 2014

and plan on fridays around 3:30 being slammed with phone calls because mom or dad "forgot" their child needed a refill on their medication, or baby's been coughing all day but now they need an appt. It never fails. You'll be able to tell what's going to come across the phone lines based on what's coming in the door during the day--whether it's a stomach bug or strep throat running amok in the nearby elementary school, and the ever popular flu in the winter. Document the time the call or message was received because, despite the outgoing message stating to please allow 4 hours for a call back and rx refills within 24 hours, you will get the irate parent call, leave a message, then hit redial and 0 to yell at the front desk that "i called and nobody called me back yet!". Never fails. :)

agree agree agree agree!!!!