This issue of TNT is focused on upper respiratory infections, so common to the winter season. I am sure most of you are already experiencing the influx of seasonal respiratory calls along with perhaps an increase in illnesses among staff only stressing an already tight schedule. Lets hang in there together and hope for an early spring.
I wish all TNT readers the warmest of holiday seasons. Christmas is right around the corner, so I'm sharing a special poem that I wrote last year for the Telephone Triage Nurses at All Children's Hospital On-Call program. Rather than include it in this issue, I've added a link to it here, so make sure you print it along with TNT to share. Its called "A Triage Nurse's Night Before Christmas".
And may the spirit of compassion and love be with us every day of the year.
Work is seasonal in the telephone triage setting. Very busy in the winter and more routine in the summer. The "off season" is a great time for telephone triage nurses to evaluate how the past busy season went and plan for the next one. What worked well? What was stressful? Did we run short on supplies? staff? How were the patient's needs met? Were there certain topics that staff needed more education and information about?
Having a "training camp" is great way to prepare staff for this busy time in ambulatory care and telephone triage nursing practice. Our call center recently held a workshop day where we focused on the goals that we as a team of nurses providing telephone triage need to meet during the virus season. The verbal and written feedback of this workshop was extremely positive. Staff nurses have now been prepared physically and mentally to tackle the highs and lows when they arise and be able to support each other during those times.
Outlined below are seven points to remember when preparing your staff and clinical setting that may be implemented into a workshop day or use as mental checklist.
Predicting viral trends is like "looking into a crystal ball" according to Denver Children's Hospital Nurse Epidemiologist, Susan Dolan MS,RN. But, every year these representatives get updates on anticipated trends for your region of the country. This information can help your call center anticipate staffing patterns for peak call volumes. This information also supplements the nurse's knowledge base in educating patients to infectious diseases published in the bi-annual Red Book. It is also good to check with that representative periodically through the winter season to get updates and changes in your region.
Encourage staff to get flu shots and to take care of themselves. Most hospital or clinics offer free flu shots to employees to keep them healthy while in contact with sick patients. In a telephone triage setting you are in close contact with fellow employees who are also transmitting viruses. Some call centers issue separate mouth pieces and/or headsets to cut down the spread of germs. Another great idea is to wipe down your workstations before and after your work shift and do a thorough cleaning at least once a week. Check with your environmental services department to assist your with day-to-day and weekly cleaning and choosing proper cleaning solutions and materials for telecommunication equipment.
As with the coming and going of each season, turnover of staff most likely occurs in the summer. In the fall, new staff should be hired and trained to assist with peak call volume times. In the up and down "flexing" phase it is wise to keep a strong core group of staff together to get you through each season. More flex or per diem staff are needed for those call "bursts". These new hires will do well in shorter shifts to fill the "holes" of staffing schedules. Look at your weekly staffing patterns for times of day and days of week to anticipate fluctuations. Most staff who choose the per diem life, enjoy the flexibility of this type of staffing.
Your client population will dictate the type of topics you provide educational offerings on. If you're in a pediatric setting such topics as RSV, asthma and croup would be recommended since respiratory illnesses are top on the list of childhood viral illnesses. If you serve an older population common topics recommended would be influenza, gastrointestinal illnesses, strep, and bronchitis. Nurses will need the overall picture of common illnesses so as to make better assessments and judgments in using the protocols.
Occasionally, throughout any season, outbreaks of infectious diseases (e.g. meningitis, hepatitis, pertussis, E Coli, etc.) , weather related (e.g. frostbite, sunburn, etc.) or even national news reports on new health information (e.g. Acetaminophen brand labeling and dosing, flu shots, etc.) can flood a telephone triage line with questions and heightened concern from callers. Ask your medical director for guidelines or contact your state or local health department on certain topics to get complete and up-to-date information to provide the callers in your patient population. Most callers are frightened when they telephone about these current health topics. Callers specifically want to know educational information, incubation and exposure timelines, how they are affected, and how they can protect themselves now and in the future.
During the more routine times in a clinical setting, productivity of staff slows down. Gearing up for the busy times requires that staff are at their most competent and efficient. Nurses new to telephone triage may find this expectation to somewhat overwhelming to achieve. Of course, every nurse wants to serve their patients to the best of their ability in the most timely manner. If everyone works toward the expectation as a group, then the entire team becomes stronger during stressful moments.
Any staff who are struggling to meet the team expectation probably need a skills review. Since telephone triage requires the use of many skills simultaneously, usually one or two skills are slowing a nurse down. Any type of educational/skills review should be done in a supportive manner conveying that the they are part of a team and the team is behind them all the way. Telephone triage skills that staff may need brushing up on may be:
As a team it is wise to let each member know what is going on during the good, the bad, and the ugly moments that occur during the busy viral season.
These seven points are convenient mental checklists to make sure you keep your clinical setting, professional, and personal life in order. Plan an entire workshop day or refer to these in times of indecision or crises to ensure that you have remembered all the important steps in operating your clinical setting. Providing an optimal telephone triage and advice system with your staff and to your subscribers and patients is the optimal goal for a winning team.
Patty Reisinger MS,RN is the Clinical NurseV at the After Hours Care Program, The Children's Hospital, Denver, Colorado where she coordinates the nursing educational services. The call center has been a national model since 1988 for similar After Hours Care Programs across the country. Patty is also the Chairperson of the Telephone Nursing Practice Special Interest Group for the American Academy of Ambulatory Care Nurses. She can be reached via email at reisinger.patricia@tchden.org
DISCLAIMER: The health information provided in this article is for educational purposes only and geared for health professionals. The information provided is not a substitute for a professional medical opinion. If you have a medical problem, please contact your doctor.
There is no doubt that the winter cold and flu season brings with it frenetic activity in nursing call centers everywhere. Call volumes can double almost overnight, making even the usually calm triage nurse crazy. "Please not another cough or cold!" we can hear triage nurses whine. Although telephone nurses do not attempt to make a medical diagnosis, they do need to be familiar with the most common upper respiratory illnesses that cause this surge of calls in order to perform the best possible telephone assessment.
The 'common cold' is the layman term for a viral infection of the upper respiratory tract (nose, head, throat and/or chest) which usually lasts from 3-5 days. The medical terminology is "upper respiratory infection" or "acute coryza". A cold can appear at any time during the year with its lowest incidence in the summer months. In the winter, cold symptoms may precede influenza, which may result in more serious problem. Most adults will get colds and upper respiratory infections about three times a year. Children may get them more frequently. Between 30-50% of colds are caused by a type of rhinovirus. Late fall and winter colds are most frequently caused by influenza, parainfluenza, and respiratory syncytial viruses (RSV).
Symptoms of a typical cold may include a runny nose, sneezing, a sore throat, cough, a mild headache and low grade (or absent) fever. General fatigue and malaise are also not uncommon associated symptoms. Nasal secretions which may be watery and profuse during the first day or 2 of symptoms may become more mucoid and purulent during the course of a cold. Mucopurulent nasal discharge results from the presence of leukocytes (predominantly granulocytes) but not necessarily a bacterial superinfection. Despite this fact, many parents become concerned about the color of nasal discharge even though all other symptoms are mild.
Indications that a cold may becoming more serious include: Prolonged fever or cough; chest pain, shortness of breath or difficulty breathing, increasingly severe cough with purulent sputum, earache, facial or upper molar pressure/pain (sinus), problems swallowing and rashes.
Patients at higher risk for complications include: Elderly, patients with chronic heart/lung conditions, patients with asthma or reactive airway disease (RAD), very young children.
Respiratory syncytial virus or RSV is the most frequent cause of serious respiratory tract infections in infants and children younger than 4 years of age. RSV is so common that by the age of three almost all children have been infected with it. In many children the symptoms of RSV are indistinguishable from a common cold. RSV is most common in young children, though older children and adults may get with RSV though often with mild symptoms. Although RSV can occur at any time during the year, it is most common during winter months, with community outbreaks occurring yearly between December and March, peaking in January and February. In about 40 percent of children with primary RSV, infections progress to the lower respiratory tract, causing bronchiolitis and pneumonia.
Symptoms of RSV may be indistinguishable at first and in mild cases from any other viral respiratory infection. These symptoms include runny nose or stuffiness, low grade fever, cough, and sometimes ear infections. A culture of RSV from respiratory secretions is often used by a physician for a positive diagnosis. The respiratory symptoms of RSV may last for 1 to 2 weeks, and cough that sometimes persists beyond 2 weeks. More serious symptoms include: increasing respiratory difficulty or respiratory distress, increased coughing, feeding difficulties (trouble eating or drinking), dehydration, irritability, vomiting or other indications the child is getting sicker. Apneic spells can develop early in the course of RSV and may be the first sign that something serious is occuring.
Home treatment for uncomplicated RSV is similar to that of the common cold. Antibiotics are not prescribed unless a physician feels there is a associated bacterial infection. Most cases of RSV infection are mild and self-limiting and do not require specific treatment or hospitalization. If a child is hospitalized with RSV, a antiviral drug called Virazole (ribavirin) may be ordered by a physician dependent on the child's overall condition and severity of illness. Patients at higher risk for complications include: newborns especially premature infants less than six months old, children with complicated medical histories including congenital heart and lung diseases, immunosuppressed patients and the elderly.
Influenza goes by several common layman terms including "flu" or "the grip". It is an acute viral respiratory disease usually occuring as an epidemic during late fall and the winter months. Seasonal epidemics often occur in 2 waves --the first in students and active family members, the second mostly in shut-ins and persons in semiclosed institutions. Severe cases may result in severe respiratory problems including hemorrhagic bronchitis, pneumonia, and sometimes resulting in death. Influenza A virus is the most frequent single cause of clinical influenza; other viral causes include influenza B, paramyxo-, pneumo-, and (rarely in adults) rhino- and echoviruses.
Usual symptoms include fever, coryza, cough, headache, malaise, and inflamed respiratory mucous membranes.
Persons at highest risk of developing severe disease are those with:
In addition to high risk individuals, close contacts and health care workers should be vaccinated against influenza. The best time to get the flu shot is from October through mid-November and it begins to protect the vaccinated person after 1 to 2 weeks.
A cough is a symptom that can be associated with many problems ranging from a common cold, asthma, and bronchitis to pneumonia, gastroesophageal reflux or aspiration of a foreign body.
During the cold season, the "croup" may develop, a viral inflammation of the larynx, windpipe, and bronchial tree. True croup is usually caused by the virus parainfluenza (74%), with a small percentage caused by RSV (10%). It is most prevalent during the winter months.
The croup usually affects children between three months and five years of age, and in most cases follows an upper respiratory infection. Common symptoms of croup include a low grade fever, a brassy, barking (seal-like) cough, a hoarse cry, inspiratory stridor (a harsh sound from the windpipe during inhalation) and difficulty breathing. The cough associated with croup usually worsens at night and comes and goes. The acute stage of this illness usually lasts 3-4 days.
Risk factors for croup include: male child (1.4 to 1 odds), the season (late fall to early winter with peak in November) and a strong family history with tendency to recur.
Acute epiglottitis is a sudden, life-threatening inflammation of the supraglottic larynx. The age of onset is usually in children between 2-7 years with the peak at 3.5 years, with male to female ratios at 3:2.
When looking for the symptoms of epiglottitis beware of 4 "D's" - dysphagia, dysphonia, drooling, and distress. Stridor can be moderate to severe and a cough is either minimal or absent. Eventually the child is unable to swallow saliva and will drool.
Whooping cough or pertussis is a contagious bacterial infection of the bronchial tubes and lungs caused by the bordetella pertussis bacteria. Initially it may resemble a cold. Half of the cases occur in children less than one year old. Older children and adults can carry the germ and spread it but usually have only mild symptoms. Although the number of cases of pertussis have greatly decreased due to immunization efforts around the world, it has been making a comeback in recent years, Anyone can get pertussis who has not had pertussis or pertussis vaccine.
Pertussis can be a severe illness in children less than one year old, especially if a baby is premature or has lung disease. Pneumonia, seizures, and nerve problems are common, and death can occur. The disease is preventable if a child is vaccinated. About 75 percent of infants with whooping cough and are less than six months old receive hospital treatment, and about 40 percent of older babies are also hospitalized. Hospital treatment may decrease complications such as pneumonia, which occurs in about 20 percent of children with whooping cough who are less than one year old.
Bronchitis is an inflammation or infection of the bronchial tubes which can be acute or chronic and caused by a virus or bacteria. Symptoms of bronchitis generally include cough with mucus, chest discomfort, fever and extreme tiredness. Most common in winter, severe cases of bronchitis can progress to pneumonia.
Bronchiolitis is an infection of the very small airways of the lungs and is usually caused by a virus (such as RSV). It most often occurs during the late fall and early winter and usually occurs in young children. It often starts as cold symptoms and progresses over several days to a cough and wheezing.
The risk of developing bronchiolitis for infants passively exposed to cigarette smoke in the home is about four times greater than for infants from a smoke free environment.
Per the Merck Manual, in the USA about 2 million people get pneumonia yearly and between 40,000 to 70,000 die from it. It has the distinction of being the most frequent lethal hospital-acquired infection. Bronchopneumonia can be caused by a variety of bacterial and non-bacterial (viruses and fungi) organisms.
The onset of pneumonia can be sudden, with symptoms such as fever, chills, cough, headache, chest pain from pleurisy and general debilitation. Profuse sweating and nausea are also observed. In children, pneumonia is frequently manifested as only fever and tachypnea.
Conditions placing people at higher risk for pneumonia include: respiratory viral infections, alcoholism, institutionalization, cigarette smoking, heart failure, chronic obstructive airways disease, age extremes, debility, immunosuppressive disorders and therapy, compromised consciousness, dysphagia, and exposure to transmissible agents.
Respiratory symptoms can be the result of a large number of medical diagnoses. The triage nurse should focus on the specific symptoms along with their severity to determine the best guideline to use during a call. Patients at high risk for complications should be identified by obtaining a health history. Patients and caregivers should be educated so that they are aware of symptoms of serious disease and when it is appropriate to call back.
Recognizing symptoms of an increasing respiratory problem is important especially with children who cannot communicate their distress. An increased respiratory rate, wheezing and stridor, plus retractions and nasal flaring all indicate a worsening respiratory condition.
For More Info Visit These WebSites:
Merck Manual Online (coryza, RSV, influenza, pneumonia) -->http://www.merck.com
New TeleNurse Organization
Observations of Jan Call, MS, RN
In November 1997 at the National Telephone Triage Conference held in Washington DC, a small group of curious individuals met to discuss the pros and cons of forming an international
telephone triage association. This was met with mixed emotions and many concerns. "Why form our own group?" "There is strength in other organizations and their numbers." "We need our
own group to help set standards and guidelines." "Can we practice across state lines on one nursing license?" etc. etc. etc. So many questions by our peers, yet telephone triage continues to
forge into territories that are understood less by others in the nursing profession, all the while being governed by them.
Currently, telephone triage falls under the title of "special interest group" in several national organizations, all the way from emergency room nursing to ambulatory care. Chinn and
Kramer (1991) state in their book "professional identity that evolves out of theory provides a basis from which nurses can control the aspects of their practice." It is time for the practice of
telephone triage to establish its own professional identity. Standards by which we can control the aspects of telephone triage. This can be done by establishing an organization that talks the talk,
walks the walk of a telephone triage nurse. It becomes an organization that sets and supports the standards by which we practice, thus eliminating confusion and error in a rapidly changing
healthcare environment.
Melodie Chenevert (1985) uses an analogy, (which I have changed as needed to fit this particular incident) by likening health care to that of boarding an airplane. Just like health care, airline costs are high, the market place very competitive, everyone is vieing for your contract. As
a customer, you must follow complex rules, regulations and guidelines, all the while hoping that you have boarded the right plane and land safely at the right destination. This becomes very intimidating, confusing and down right frustrating.
Once on board most of your contact is with one of several stewardess'. S/he welcomes you, helps you with your carry on luggage, makes sure you are comfortable and most of all, makes certain your seatbelts are securely fasten and all tray tables are stored in their upright and locked position. As telephone triage nurses we follow similar guidelines. We are concerned with
caller safety. We want to help callers take care of themselves, to feel comfortable, but most of all to access the appropriate level of care at the right time and place. To further the analogy, Chenevert (1985) goes on to compare the doctor to the pilot.
The nurse also assumes the doctor is in the pilot's seat. She scurries about the cabin smiling and serving. When turbulence occurs, she goes forward to the cockpit. To her horror she finds it empty. She slides into the pilots seat, not out of choice but out of necessity.
She is catapulted from stewardess to pilot. Hearing the passengers ring for service, she is confused. Which is real nursing? Cabin or cockpit? She shuttles back and forth trying to do both jobs at once. Her confusion is compounded by space-age doctors who beam aboard at irregular and unpredictable intervals. They materialize for a few moments, demand
to know why the nurse is in the pilot's seat, and order her to return to the cabin where she belongs. The nurse complies.
Before long the plane goes into another tailspin, and once again she finds herself in the pilot's seat. She sits uneasily. She never wanted to steer. She just wanted to serve. Yet in real life, the nurse is more analogous to the pilot than the doctor is. Think about it. In this analogy the doctor cannot be the pilot for one simple reason. He is not on board. Actually, the doctor is more analogous to ground control. Essential but absent.
Nurses know getting in touch with ground control is difficult at best. The communication system is unreliable. Messages are garbled. Even when contact is established, nurses often get nothing but static. As long as doctors and administrators insist on flying by remote control, they would be wise to upgrade the communication system and stop downgrading nurses.)...." So much for Chenevert's analogy, you get the picture...if we are to survive as telephone triage nurses, we must take command of the cockpit, demand clear and concise ground communication, form our own association to establish, implement and steer our telephone triage airplane. Luckily there is a dynamic group out there that has taken the initial steps in formulating a telephone triage association group. They are wanting to hear from all of us!!! Do it now!!!
There has also been another group that has set up some initial guidelines/standards for us to follow. But, we need to bring all of these rapidly forming off shoots into one group before telephone triage becomes more fragmented and we cease to be anything more than special interest groups. We need to come together unified to define, guide and steer our own telephone triage identity...otherwise we will not survive!
References:
The Christmas spirit abounds on the Internet with enough virtual mistletoe and holiday greetings to fill up your hard drive.
At Search for the Meaning of Christmas, customs and traditions associated with the birth of Christ, along with literature and poetry references. Learn about old traditions and perhaps the true meaning of some you already have.
If you're in the mood for some online holiday reading, there are Christmas stories including "Yes Virginia there is a Santa Claus" supplied by the Net Rag.
And last but hardly least, Toys for Tots website tells us how the US Marines since 1947, are the unchallenged leader in looking after America's neediest children at Christmas. In over 200 communities throughout the nation, Marines collect and distribute new toys to needy children each Christmas. Check out this website for the site closest to you!
Search for Meaning -->http://techdirect.com/christmas/
[Photo of snowman from "Christmas Art from St. Andrew's Episcopal School " at Barry's ClipArt Server]
[EDITORS NOTE: All employment opportunities
have been submitted directly to the Editor of TNT for inclusion. Please
check with the manager or recruiter listed for all details and job requirements.
TNT takes no responsibility for verifying information submitted. Applicants
must deal directly with listed "reply to" or inquiry contacts. There is
no fee charged for posting employment desired or available, but submissions
must be of an acceptable size and format for the ezine.]
January
1997 - New Year, New Approaches [Telenursing/Telemedicine]
The Web Page
The Telephone Triage Nursing Web Site is at http://www.katsden.com/telenurse/index.html
Preparing for the Virus Season
by Patty Reisinger MS, RN
Staying Sane and Respiratory Illness
by K. Webster RN, Editor
COMMON COLD
A cold will usually run its short course with or without home remedies; antibiotics and the flu shot are ineffective and will not prevent a cold. Some over-the-counter medications will provide short-term relief of the annoying symptoms but can be misused by the layperson who may feel "more is better" and may take more than the recommended dosages or combine drugs with similar ingredients. Home treatment especially for children includes avoiding unnecessary medications.
RESPIRATORY SYNCYTIAL VIRUS
Unlike the common cold, some children develop a severe respiratory infection with RSV, often with the first infection of the virus. Children who do get RSV a second time often have milder symptoms than the first time. According to the American Lung Assocation, RSV causes approximately 90,000 hospitalizations and 4,500 deaths each year. Althought RSV infection can be fatal, less than 1 percent of hospitalized children die of it.
INFLUENZA
COUGHS, CROUP AND MORE
Croup
Epiglottitis
Pertussis
The paroxysmal cough that accompanies pertussis is characterized by 5-15 rapid coughs followed by a very characteristic inspiratory "whoop", some normal breaths, then more of the same (chronic cough). The child's face may become red or cyanotic and the coughing fit may end in vomiting. Fever is usually low or absent. Although coughing may be more common at night initially, they later become more frequent during the daytime.
Bronchitis
Pneumonia
SUMMARY
UCLA Student Cold Clinic (coryza) --> http://www.saonet.ucla.edu/health.htm
Ear, Nose & Throat: Sinusitis --> http://www.ear-nose-throat.com/sinusitis.html
CDC, RSV --> http://www.cdc.gov/ncidod/diseases/hip/pneumonia/1_rsv.htm
Spotting, Treating, Stopping RSV [*CE]--> http://www-nurseweek.webnexus.com/ce/ce563a.html
ICN Pharmaceuticals (RSV) --> http://www.icnpharm.com/pharma/whatrsv.htm
American Lung Association (RSV, influenza) --> http://www.lungusa.org
BugBytes, LSU Med Center (influenza) --> http://www.ccm.lsumc.edu/bugbytes/bb-v1n9.htm
Get the Flu Shot, Not the Flu --> http://fightflu.hcfa.gov
National Jewish Medical Center (croup, bronchitis) --> http://www.njc.org
PedBase (croup, pertussis, epiglottitis) --> http://www.icondata.com/health/pedbase/index.htm
Pertussis FactSheet --> http://www.charm.net/%7Eepi1/pertuss.htm
KidsHealth (pertussis) --> http://kidshealth.org/parent/common/whooping_cough.html
Bronchiolitis FactSheet -->http://www.voicenet.com/~paaap/ecels/fact/bronchio.htm
Resp Tract Pathology (pneumonia) --> http://fester.his.path.cam.ac.uk/big/synapse/000p0075.htm
Virtual Hosp (Pneumonia) --> http://vh.radiology.uiowa.edu/Providers/ClinRef/FPHandbook/FPContents.html
Acute Upper Airway Obstruction --> http://www.mmcc.monash.edu.au/paediatrics/uao.html
In The Telephone Triage World
IHC TeleHealth Services
Salt Lake City, Utah
"They see themselves as captains, kings, or quarterbacks. The hospital administrator also leaps to the conclusion that the doctor is the equivalent of the pilot. He sees doctors, like pilots, as necessary. He sees nurses, like stewardesses, as nice but not necessary. Nonessential nurses: interchangeable, disposable. Hospital policies reflect his view.
Internet On the Line
Christmas Celebrated
Like driving around to check out Christmas lights? At the website Maddog 'n' Miracles, you get the chance to tour through virtual photography the Christmas light show of a central Texas town.
Maddog 'n' Miracles -->http://www.primenet.com/~trix/hallo.htm
Christmas Stories by the Net Rag -->http://www.infostarbase.com/tnr/xmas/
Toys for Tots -->http://www.toysfortots.org/1997/Story.html
Employment Line
==California==
MANAGER - NURSE TRIAGE CALL CENTER
Our client, a national healthcare provider, has engaged Management Recruiters -Tampa/North to identify a Manger for a regional telephone triage call center in Southern California. Qualified candidate will be an RN with previous experience in managing a telephonic triage center.
This is an opportunity to grow the center and eventually take on additional related responsibilities company wide.
Our client offers a competitive salary, bonus, relocation and benefits package.
To be considered:
Contact Greg Aymie - Project Manager
Management Recruiters - Tampa/North
4012 Gunn Hwy Suite 140 Tampa, FL 33624
Business: FAX: E-mail: (813) 264-7165 ext 113 (813) 968-6450 g_aymie@earthlink.net
Management Recruiters is the world’s largest executive search firm. Management Recruiters -Tampa/North specializes in the Healthcare Industry and is recognized as a leader in Healthcare recruitment.
==California==
Kids Doc , an after hours pediatric clinic, managed by Childrens Hospital at
Mission, is currently seeking RN’s for telephone triage. Qualifications
include current CA RN license, 5+ years nursing experience including recent
pediatric experience, excellent communication skills, and computer/keyboard
proficiency. Previous telephone triage experience and knowledge of the
principles of managed care preferred. Bilingual a plus.Per diem positions
are available and require a commitment of every other weekend, varied shifts.
Send resume to: Human Resources, Mission Hospital Regional Medical Center,
27700 Medical Center Rd., Mission Viejo, CA. 92691 or fax resume to
(714)365-2498.
==Colorado==
Medical Systems Trainer, Pueblo, CO - Be part of a start-up call center.
Responsible to design, implement, and manage an on-going educational
training program. You will be accountable for standardized quality
training and will manage the clinical algorithms CQI program and contribute
to testing. RN required. Travel up to 60%.
Please call:
Jill Mooney at
STATSearch
7 Colby Court, Suite 4-204
Bedford, NH 03110
603-666-5500 Voice 603-623-5322 Fax
or email at hunter@statsearch.com
==Florida==
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 the opportunity to manage after hour
pediatrician office calls providing education, information, guidance, emotional
support, and counseling.
For more information contact: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.
==Florida==
At Baptist Health Systems of South Florida, healthcare answers and career opportunities are just a phone call away. We are currently seeking qualified professional RN’s for our new after hours Telephone Triage Nursing service. Applicants must have a valid Florida RN license along with 3 years of recent acute care experience in one of the following areas: Pediatrics, Pediatric inpatient setting, ambulatory care clinic or family practice office, ER, or PICU. Bilingual in English/Spanish is required.
We offer an excellent flexible benefits package and competitive compensation.
For immediate consideration please contact: Michele Sfakianos RN, Recruiter, Human Resources, Baptist Hospital, 8900 North Kendall Drive, Miami, FL 33176, ph. (800) 327-2491 ext. 5824, fax (305) 598-5958.
For more information on employment opportunities, please contact our website at www.baptisthealth.net
==Indiana==
Manager of Referral Systems and Physician Relations
RN needed to manage expanding medical call center in South Bend,
Indiana. Must have experience managing RN's and be proficient in using
a computer and quick to learn new software applications. Must also have
experience working with physicians and making presentations to medical
groups.
Position is with Memorial Health System in South Bend, Indiana
Please mail resume to Diane Stover, Memorial Health System, 615 N.
Michigan Street, South Bend, IN 46601 or Call Carol Lyle Ford at
219-284-3274.
Memorial is a community-owned independent health system
with over 2,200 employees.
==Texas==
TELEPHONE TRIAGE STAFF NURSE
Houston Call Center is seeking an RN interested in joining our team, for
an afternoon/night shift position. We take an average of 6,000 clinical
calls monthly and are starting our 5th year of operation. We are
supported by a state-of-the-art communications system and on-line
guidelines to assist the nurse in providing the caller with health
information, and triage/referral services.
Qualified candidates will have:
Send resumes to Fax Number 713-756-5787
Further information is available at 713-756-8844
==Utah==
Come and ski Utah while working for a busy
and rapidly expanding 24 hour call center.
IHC TeleHealth
Services is part of Intermountain Health Care (IHC), which is widely
known for its community based health information, triage/referral service.
IHC TeleHealth Services has expanded into facilitating personal health
management across the health care continuum for IHC Health Plan members
in Utah, Idaho and Wyoming, while maintaining our community service line.
IHC TeleHealth Services answers between 1100-1400 calls per day.
We are currently hiring RNs
for full and part time evening positions. Both these positions are
benefit eligible. Minimum qualifications include a current Utah RN license
with a minimum of 3 years high acuity nursing experience. Must enjoy working
with people on the telephone. Must be able to sit for extended periods
of time and talk while typing with few errors.
Send all inquires
via E-mail to aajcall@ihc.com or call
Jan at 801-978-4045.
Please include your name and phone numbers
where you can be reached.
Can't Get Enough on
Telephone Nursing?
Review Previous Issues of TNT in 1997
February
1997 - Spring Ahead!
March
1997 - Marching Forward
April/May
1997 - Celebration of Nursing
June/July
1997 - Men's Health
August 1997 - Summertime
September 1997 - Culture on the Phone
October 1997 - Just a HeartBeat Away [cardiac monitoring]
Next months topic:
Back to Basics in 98
WANTED!