Is It Difficult for Telephone Triage Nurses to Adequately Assess Patients?
Telephone triage nurses, or telehealth nurses, are nurses who assist and advise patients over the phone. They are extremely helpful in reducing patient care loads for physicians while helping patients avoid potentially high co-pays for doctor or emergency room visits. More importantly, they can decide which service is appropriate for their needs.
While telephone triage nurses have access to electronic medical records, the difficulty lies in not being able to visualize the patient. Nurses are trained to assess patients from the moment they lay eyes on them. Much of a nurse's assessment comes from non-verbal cues. For example, a patient may say he is feeling tired lately, and light headed. A nurse can check for mottling or cyanosis, and deduce there may be a respiratory or cardiac issue going on. This can be challenging over the phone. A nurse may ask questions, but the patient may not know what to look for.
Many organizations develop protocols for telephone triage nurses to follow which will help collect pertinent data and determine the best service for them- such as home care advice, a doctor visit, or a trip to the emergency room.
While protocols are helpful, nothing beats a nurse's sharp assessment skills and clinical experience. Telephone triage nurses learn to hone listening skills and pick up on other cues and incorporate that into their assessment. For example, let's say a patient calls for the previously mentioned complaint of fatigue and lightheadedness. While asking pertinent questions, the nurse listens for shortness of breath, difficulty completing sentences, slurred speech and mental status changes. The patient may answer all the questions in which home care advice might be indicated, but a nurse's clinical judgment can override a protocol to recommend an ER visit.
Telephone triage can be challenging, but a strong nurse's critical thinking and decision-making can overcome the challenges of not being able to lay eyes on a patient.