Hello, This Is The Nurse

Triage nurses determine the seriousness of the caller's illness both by following clinical protocols listed on the computer screen in front of them and by using good professional judgment. "We ask the most worrisome questions first," explains Kathleen Ostenby who spent nearly a decade as a care line nurse at HealthPartners.

For instance, if a caller complains of vomiting, the nurse will ask when it started. If the answer is "24 hours ago," the nurse will recommend that the patient go immediately to urgent care or the emergency room.

But if the caller only recently started feeling sick, is not vomiting blood and has no other symptoms, the nurse will advise him or her to rest, eat nothing for an hour and then take sips of clear liquid.

During calls, nurses enter data into the patient's electronic health record, which they may also check for information about the patient's history. On-call physicians are also available for consultation, and nurses working in triage centers often consult with each other.

Experience Is Key

According to the Minnesota Nursing Practice Act, only RNs can do telephone triage. "Experience is also essential. It's not a job for new graduates," says Ostenby, who became a triage nurse only after spending a dozen years in a variety of nursing settings.

Besides well-honed assessment skills and a strong nursing background, triage nurses also need excellent problem-solving ability, a customer-service orientation and good computer skills.

Flexibility And Independence

Daytime calls are usually handled by clinic nurses who also do patient care. But triage nurses working after hours, on weekends and on holidays spend the entire shift on phone, talking with four to six patients per hour.

"The work is mentally fatiguing, but there's little physical strain and no worry about infection control," Ostenby says. "Plus you have a great deal of independence." The hours are usually flexible, and many triage nurses work part time.

Triage nursing is good preparation for jobs in health informatics, case management or clinic management. Ostenby, for example, recently took a job as patient placement manager for Fairview Health Systems. "In this new setting, I use what I learned as a triage nurse every single day."

The Right Stuff
Successful triage nurses are:

• Experienced with a variety of areas and patient populations.
• Confident of their skills.
• Thorough with documentation.
• Up-to-date on new developments in nursing.
• Computer savvy.
• Excellent problem-solvers.

Learn more:
What is Telephone Nurse Triage?, www.connectionsmagazine.com.
See also: www.dmoz.org.