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Specialties Triage

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I have been a telephone triage nurse for 3+ years for a large family practice. We take live incoming calls. We work from triage software. Two of our doctors are suboxone prescribers. I think the hardest part of this job has been the rudeness of callers. Many of them call asking to make an appt...so we have to transfer them to scheduling. Many ask for medication refills, so we have to explain our refill policy. The narcotics patients become evil on the phone...and if they do not get what they want, they call our manager and complain about us. I just got called in last week about this...our manager does NOT have our back. I've been an RN for 23 years, and I have done it all - bedside nursing for 15 yrs, home care for 2 yrs, school nursing for 2 yrs, and now this. While I prefer working face to face with patients, I will never return to bedside...and I like the hours and M-F 8-5 aspect of this job. I just need some help from all of you. How do you deal with the nasty patients when you don't have a manager who supports you?

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That is crazy that the manager does not support you. In the ER we deal with these same narcotic patients, but in person. Luckily, our management does have our back. One thing that I have learned about those patients is how nice they are UNTIL they are told that they are not getting narcotics or any more narcotics!!! Then, they become "another person." They yell, cuss, and our just nasty....to me, the nurse, that has nothing to do with whether they get that narcotic or not. I honestly HATE when I get a patient that is "overly nice" and calling me by my first name EVERY other sentence!! That is ALWAYS the patient that turns on me when they do not get what they want from the doctor! Hopefully you will get a new manager or find another telephone triage position. Have you ever considered Utilization Review. In some positions you do not even have to speak with the patients, as long as you're not doing case management, too.

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Specializes in NICU, ICU, PICU, Academia.

Transfer those calls to her phone?

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Thank you for replying. Of course they are nice until they are told no, then they are evil. Yep, I hate the overly nice ones too, they are Jekyll and Hyde. We keep praying for a new manager, but she's been there 5 years, don't think she's going anywhere. I've been watching for an opening within the network. I've not considered utilization review. What is that?

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Thank you for replying. Of course they are nice until they are told no, then they are evil. Yep, I hate the overly nice ones too, they are Jekyll and Hyde. We keep praying for a new manager, but she's been there 5 years, don't think she's going anywhere. I've been watching for an opening within the network. I've not considered utilization review. What is that?

It is a part of case management. UR nurses that work for the hospital look at the record and ensure that the hospital gets paid from the insurance company. They review and fix denials. Stuff like that. If you are a UR nurse for an insurance company, you review medical records to ensure that the admission is "legitimate," ie: does it meet the criteria for admission. Both look at the "length of stay" for patients. Stuff like that.

I do not have experience with the UR job personally. There is more to it than the above; however, you don't have to talk to angry patients, and it is mainly telephone/computer work. I've been talking to people at work that do it and checking out the "case management" forum here. Do a search under that forum for "Utilization Review" and start reading. You can also find telephone triage jobs where you work from home. I applied and started the interview process with one company, but decided I wanted to pursue case management/utilization review instead.

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We have guidelines within our regional call center which allow me to disconnect ( hang up) on any caller who becomes rude. I give the caller one warning and if the behavior ( yelling, cursing etc) continues then I hang up. If the caller calls back I transfer him/her to our police department.

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Wow DorothyMay, transfer to the police? Nice. We are allowed to hang up on rude callers after giving them a warning too. Do you have certain scripts that you say when patients start getting rude?

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We do have suggested scripts we can use for what my organization calls "challenging callers" ;) If someone is ranting (about the general state of the healthcare system, lack of care from all their drs, their family members and the supermarket clerk) we might say "what is your health related concern I can help you with today" if they continue ranting we might say "I don't there is anything else I can help you with right now, please follow up with physician or call us back for any health related concerns, I will be ending the call now". This is usually for a someone who has mental health issues and repeatedly calls with no specifIc concern other than rambling. Of course we due rule any medical concerns first.

If it's just general abusiveness we give a warning and if repeated end call at our discretion. If we get repeated very abusive callers (usually multiple multiple calls per day, every day) there is a process where management can escalate a concern to block their number but that's a last resort.

It's too bad your manager will not back you up - does she expect you to tell a patient something different than truth about your rx policy ???

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Thanks for your reply. We've been asking for scripts to deal with rude callers, but mgmt has not responded. We've been working directly with the providers on this too. I think it might be getting a little better. My own attitude has changed as well. I've really been working on it.

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