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This electronic magazine or e-zine is a response to the many and growing requests for information about Telephone Triage Nursing aka Telephone Nursing Services. Submissions are welcome from nurse-readers and others who wish to share their successes and challenges. Check the bottom of this ezine for details on submissions.
Information is not limited to activities in the United States. An international scope of practice approach will be pursued. In addition, opinions and approaches from all health care professionals may be included to broaden the quality of information shared.
All submissions are included or excluded at the sole discretion of the Editor. This is a non-commercial ezine published at intervals to be determined by reader response and article submissions. The goal is monthly.
Unlike some other electronic magazines, TNT allows and encourages you to PRINT this communication ezine and share it with your colleagues - for educational purposes. See the bottom of the ezine for more information and copyright information.
Q: Is there a Nursing Organization specifically for Telephone Triage Nurses in the U.S.?
A: No, to the best of the Editor's knowledge there is no organization devoted solely to telephone nursing.
The American Academy of Ambulatory Care Nursing (AAACN) currently has a Special Interest Group (SIG) for Telephone Triage Nurses. This SIG was established at their Annual meeting in Washington DC in 1995. This SIG met again as a group at the 1996 annual meeting in New Orleans (1996).
You can reach the AAACN at the following snail-mail or email address for information about membership or their Special Interest Group.
American Academy of Ambulatory Care Nursing [AAACN]
East Holly Avenue
PO Box 56
Pitman New Jersey 08071-0056
Phone:(609) 256-2350 or 1-800-AMB-NURS
If any readers know of other nursing (or other) organizations currently supporting Telephone Triage through SIGs or special committees, please submit this information to the TNT, and it will be shared with all readers.
Q: Where did the term "Telephone Nursing Services" come from?
A: The special interest group (SIG) from the AAACN coined the phrase as better describing current practice in "Telephone Triage". This term includes all nurses in all practices who use the telephone to advise, educate and/or assist their clients in making the best health choices. You may also see the phrase "Telephone Nurse Consultant" used to describe a nurse who helps clients via the telephone.
Triage is from a french word meaning "to sort" and includes the practice of nursing where a nurse assesses symptoms, determines "acuity" (seriousness) and gives appropriate advice. It *never* includes making a medical diagnosis. Triage is not only done over the telephone -- it has been performed in Emergency Rooms and physician offices for many years. The term "triage" is also used to describe "in the field" -- as in war-time -- assessment of injuries "to sort" the seriously wounded from the "walking wounded".
Telephone Nursing is done is a variety of settings, formally and informally. However in recent years in the U.S. organized call centers have become increasingly popular -- with Telephone Nursing becoming a legitimate nursing specialty. The goal of telephone triage is a safe and effective disposition for the client. Many telephone triage services use physician-approved guidelines or protocols, and may or may not be computerized.
The practice environment of Telephone Nursing Services is diversified -- it can be (to name just a few):
Some telephone nurse consultants do not give advice per se, but do share health information on a variety of topics. Other nurses work with subjected-oriented hotlines, such as those seen with Poison Control or 'New Mom Lines'. Still other nurses focus on telephone services closer to case management issues or "disease management" when a client with a specific disease entity or health problem is followed by telephone over a period of time to ensure they have all the information they need to lead healthier lives. Examples of health management programs using nurses are those for high risk pregnant women, pediatric asthma patients or clients with weight management problems.
Thus the need for a broader and more generic term to describe what has been commonly known as "Telephone Triage" Nursing. TNT carries the newer name but may also use "Telephone Triage" due to the fact the new name has not gained enough popularity yet to be easily recognized by nurses within the specialty.
Q: What is the best general conference to attend on Telephone Triage?
A: In the Editors opinion, Contemporary Forums has the most interesting conference devoted entirely to the practice of Telephone Triage. This years conferences will be held in Hollywood CA and Boston MA in the fall. Please check the Telephone Triage page at http://www.katsden.com/telenurse/confer.html for exact dates and contact information. This conference is appropriate for those involved in Telephone Triage at any level, from frontline "Nurses on the phone", Managers, Administrators, Medical Directors and those involved in the marketing aspects of organized programs or call centers. The Editor has attended these conferences before and hopes to attend the Boston session this year.
For Nurse specific information, the AAACN's annual conference includes segments devoted to Telephone Nursing Services, along with SIG activity (as described briefly above). Check the above link for more information about dates/times. The next AAACN annual meeting will be in Seattle WA in the spring.
Q:Is there an Internet web page on Telephone Triage Nursing?
A: Yes. This Telezine is a part of it, and is also maintained by the Editor. You can find it at:
http://www.katsden.com/telenurse/index.html
So why a Telezine? So that contributions from readers could be posted and shared - more effective than using a guestbook, and larger submissions can be accepted. The Editor wants this ezine to reflect the thoughts, feelings and current practice of Telephone Nursing from YOU the reader.
Telephone Triage: Innovative Strategies for the 21st Century centers on avoiding legal and practice obstacles.
Want a comprehensive, current analysis of the critical legal and clinical issues unique to telephone triage? This seminar is for nurses and other health care professionals, especially those with a beginner or intermediate level of experience in triage -- and those with little or no protocol development.
Carol will be in Jacksonville, Orlando, Tampa and Fort Lauderdale during the month of October. Workshop fee is $130 per person, with a discount for multiple or bulk registrations. Seating is limited so early registration is advised. Approved for 8.1 contact hours by the Washington State Nurse's Association.
For more information, contact
Carol Stock & Associates at POB 31114, Seattle WA 98103 or by phone/fax at (206) 789-0909 PST.
TNT will keep you posted as Carol plane hops about, spreading the good word about telephone triage!
Sheila Q. Wheeler MA RN is a well-known Telephone Triage "personality" and national speaker.
Her book Telephone Triage: Theory, Practice and Protocol Development has become the "bible" for budding triage programs across the country. Most triage nurse educators place it at the top of the list for "must read" materials. What's even better? For real, she's an endearingly nice person.
Sheila recently put up her own web page at: http://205.186.245.11:80/teletriage/
and TNT recommends you check it out. Information on how to order her book is included on her page.
JCAHO
The Joint Commission now has a web site on the Internet at http://www.jcaho.org/
In general, hospital-based Call Centers performing Telephone Nursing Services (triage) have not been scrutinized during JCAHO surveys, to the editor's knowledge. However with telephone nursing services gaining wider popularity and Call Centers popping up at a rapid rate, we can expect this to change in the future.
For those nurses intimately involved in JCAHO surveys, there is a list service devoted to the topic called
JCAHO WATCH. You can receive discussions via email about ongoing JCAHO surveys around the country.
Check out:
http://www.usa.net/iex-cgi/lwgate/JCAHO-WATCH/
This web site allows you to subscribe to the listserv right from this page.
Some Triage centers based in HMOs (Health Maintenance Organizations) or insurance companies have been included in National Committee for Quality Assurance accreditation surveys. The NCQA is responsible for assessing and reporting on the quality of managed care plans, including HMOs. Their site is at:
http://www.ncqa.org/
Would appreciate information or submissions from nurses whose Triage programs have been included in JCAHO or NCQA surveys, with any information or success stories you have to share.
Gotta new buzz on...
Check out a new site for Emergency Room Nurses at http://www.hooked.net/~ttrimble/enw/index.html named Emergency Nursing World. A new venture of Tom Trimble RN, this site offers a variety of resources and information. Way to go, Tom!
Electric Topics in Telephone Nursing Services
A woman called a community health line for assistance with her husband.
She said: "My husband is having pain in his tentacles." Needless to say, the nurse had to pause a few seconds to compose herself before answering. After assessment, the nurse discovered the caller's husband had pain in his testicles. He was referred appropriately to the Emergency Room rather than to a Marine Science lab.
The Editor Speaks Out!
In the "old days" of telephone nursing there was an annoying tendency for hospital-based programs to pay Triage Nurses less than the usual staff nurses salary because we didn't do what was neatly coined "hands-on nursing". Excuse me!???
As nursing and health care moves from an inpatient to an ambulatory care focus, more and more nurses and health care professionals will, in fact, be working with families and clients via the telephone. The most financially successful hospitals with be those without a single patient in a bed. Can we even do this without using a telephone? How do we "keep a community healthy" without contact, both direct and indirect?
I started in Telephone Triage over 9 years ago -- coming in with a mature Emergency Department background, hospital supervisory experience and above-average computer skills. It took all my known skills *plus* six months of telephone experience before I could say to myself "I am a good telephone triage nurse".
Are we using fewer or MORE skills when nurses are essentially BLINDED by not being able to see a client? Is it easier or harder to assess someone in person or over the phone?
When hiring a triage nurse, I looked for someone with several years of good nursing experience plus basic computer skills, great communication abilities, outstanding critical thinking, and the amazing ability to handle a caller well -- no matter how strange or annoying. I discovered these qualities were not easy to find.
The GOOD NEWS? The current trend is to pay telephone nurses the same, and at one location even a higher salary, than the traditional staff nurse. This is not by formal survey, but via my personal knowledge of at least a hundred call centers across the country. The newer site Managers I have spoken to just starting up are taking a more intelligent approach to compensating Triage Nurses appropriately for their level of skills.
Doesn't the saying go "you get what you pay for"? If you want a quality telephone-based nursing program, expect to pay fairly for it. Great Telephone Nurses are hard to find. And as triage nursing expands and there is more competition for experienced nurses -- they will be harder to keep.
Hard to find them better!
All Children's Hospital in St Petersburg FL is seeking RN's for their telephone triage program which is currently setting the clinical standard of excellence for pediatric services. This position offers RNs to opportunity to manage after hour pediatrician office calls providing education, information, guidance, emotional support, and counseling. For more information contact: Wendy Smith RN, Nurse Recruiter at 813-892-8222. Resumes may be sent to All Children's Hospital, Human Resources, 500 6th Street South, POB 31020, St Petersburg FL 33731-8920.
HOW TO SUBMIT
All submissions are preferred via e-mail at tnt@katsden.com
Email submissions will be easier to identify if you use the word "TNT submission" in the SUBJECT field.
For larger approved articles, readers may contact the Editor via e-mail and a "snail-mail" address will be provided. The editor has OCR scanning capabilites so that text can be converted to an electronic file format when needed. Pictures of special note can also be scanned and included with author's permission.
The submitted text, articles or pictures must be accompanied by a written request for submissions of the information in the TNT newsletter. Use of the e-mail subject field with "TNT submission" is acceptable.
It will be assumed that the name and email address of the submitter is to be included unless noted differently.
When using the Internet to submit, bear in mind that the Editor uses Netscape(tm) and Eudora(tm) to access files. Please attach files that are compatible to that format (including: text/ASCII, gif, jpeg, or html and others).
TNT is open to previously published and simultaneous submissions. You may want to mention you are using this approach as a matter of courtesy. Please be sure that your name, address and/or email address is on each submission.
SUGGESTED SUBMISSIONS
Submissions of interest to Telephone Nurses in all occupations and environments. Preferred material is from Registered Nurses, Physicians and other health care professionals currently involved in the speciality.
Topics may include but are not limited to:
PAYMENT
TNT regrets there is no payment for submitted material. However, if accepted, you will receive full byline credit for your submission. Anonymous submissions are acceptable under certain conditions. Discuss this with the Editor if you prefer to not have your name or email address publicized.
RIGHTS
For the honor of publication, you trade first serial print rights, permission for TNT to post your material at Internet locations and permission to refer to the material in subsequent volumes of TNT. All rights of possession are retained by YOU the author/artist. TNT merely asks permission to reproduce the material according to above possibilities. See also: TNT's reproduction policy below. You DO make a giant contribution to other Triage Nurses world-wide by sharing your thoughts or expertise and making Telephone Nursing Services the best it can be. Need I say more?
EDITORIAL APPROVAL
The Editor of TNT reserves the sole right to accept or reject all submissions without question. As a matter of professional courtesy, explanations will be provided when appropriate as to why material was not felt suitable for ezine publication. Commercial information will be highly scrutizined and will be published solely at the whim of the Editor. This is a professional nursing publication intended for the sharing of informaton about a nursing specialty.