Telephone Triage Stories

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Hello all, can you share your stories of doing telephone triage as an ambulatory clinic nurse? I would love to hear them :) What works for you, what didn't work, your most interesting call and how you handled it, etc. What have you learned from telephone triage?

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One thing I learned, if pt needs to call 911 from house, do not let pt hang up with you. You get another person from Dr's office to call 911 and give the info to 911 regarding pt, while you keep pt on the phone. I started this at my clinic because, you can see the liability, if you tell pt to hang up and dial 911...but he dies before he can call, it is my liability. Also, Get yourself a good triage book if your employer does not have one.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

One of the more interesting areas where I did this was dermatology. You'd think it was pretty straightforward as usually the patient can describe their rash, wart, bump, lesion, skin tag or other whatsits - how long they've had it, etc. I learned to what degree mental illnesses can manifest as what seems to those who refer calls to be a skin problem. I remember a lady who started out describing a rash, but as she talked she started to mention strange things like "my breasts are bleeding" as I talked with her it became obvious this was most likely an undiagnosed psych problem so I was able to get her to come in and see one of our IM docs (no psychiatrists on staff) who made the appropriate referrral. I hope she got the help she needed.

So the tip would probaby be to listen to what is unsaid as well as what is said. Another time when I was fairly new I got a call from someone who'd had their allergy shots and called in to report a symptom that I'd never learned was related to the onset of an anaphylactic event and a little voice said "better run that by the doc" as he was still there - uh yes call 911 was the proper advice. Listen to the nagging voice and err on the side of caution.

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Thank you for sharing nursel56 and elprup!

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Specializes in Med/surg, pediatrics, gi, gu,stepdown un.

Triage is a different world for nursing. You have to know what questions to ask to get the information you need to help the patient . We have 3 great triage protocol books we use. Adult , Pediactric and Women's Health. I work in a rural clinic in Missouri. Fortunately we can have them come in and be seen by a doctor :heartbeatmost of the time.

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Specializes in Geriatric/Sub Acute, Home Care.

How does one get into telephone triage nursing, I am very much interested in this line of nursing but dont know the first thing about where to look or apply?

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Specializes in nursing education.
How does one get into telephone triage nursing, I am very much interested in this line of nursing but dont know the first thing about where to look or apply?

RN's who work in a physician practice generally do telephone triage to varying degrees. Start by looking at outpatient clinics. Our hospital system has an after-hours triage service that is used by almost all the affiliated physicians. Since they work 24/7, they need a lot of RN's on staff. Good luck!

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Specializes in Ambulatory Care/Community Health.

I agree that triage is a different world- especially triage over the phone! I have only been doing this for a little while now, but it always stresses me out when after triaging, I determine that a pt. needs to be seen, and the next available appointment is like 3 months away! uggh. Then I have to go beg (a.k.a. advocate) for a Dr. to double book (or triple book) in order to get the pt. what they need. :(

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

Yes but the patients need us to do that . . . if you develop a reputation for only dumping something that could've waited on them once in a while they may thank you someday for a good catch -- and it's great practice in growing a pair -- I mean a backbone since it seems many nurses are intimidated by the docs based on what I read here! :-)

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Older thread but i have so so many stories.

4:45 on a friday evening (we closed at 5, closed on the weekends, family practice call center)

"Can dr so and so write me a script? I need ones

for opanas, xanax and percocet. I'm getting ready to be d/c from the hospital i'll need them for the weekend."

Friday evenings were always calls for pain meds and viagra for the weekend.

One man called trying to get a member pump covered by his insurance (i think it ended up being covered)

When calling w negative std results it was always funny to hear the sigh of relief in some pt's

voices!

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Yes, Fridays are usually the worst. Calls for refills of Narcs or psych meds. Otherwise, I've learned so much this past year!

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