Becoming a Telephone Triage Nurse

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Telephone triage nursing goes by a few different names, including telehealth nursing and telepathology. This credentialed medical specialty was designed to help patients in immediate need who are unable to get to a doctor’s office or hospital. The specialty is also designed to help those who do not have primary care physicians. The telephone triage nurse works to determine the level of care a patient needs and guides the situation to resolution. Unlike on-site nurses, these professionals must help patients purely by speaking with them on the phone.

Most medical professionals working in this field are licensed nurses and are most commonly referred to as "telephone triage nurses."

The Telephone Triage Nurse Profession

A telephone triage nurse is charged with everything from working with patients to determine if they need to seek emergency treatment, to instructing them to make an appointment with a doctor, to advising them how to treat themselves at home.

The underlying role of a telephone triage nurse is to help patients assess the severity of their health problem—saving them a trip to the doctor's office or a trip to the emergency room. This service is especially useful for homebound patients, those in rural areas who can't get to a facility, or those unable to pay for medical services. Additionally, telephone triage nurses help doctors reduce their patient load so that they can see patients in more critical need—hence the word "triage." Because of their work, telephone triage nurses also help reduce overcrowding and waiting time in emergency medical facilities such as urgent care centers and hospital emergency rooms.

Because telephone triage services are operational 24/7, telephone triage nurses may need to work weekends, night shifts, and holidays.

Training

To become a telephone triage nurse, the first thing you need to do is earn your nursing degree or diploma. After that, you must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

Additional certification as an ambulatory care nurse is suggested and will increase one's chances of getting a job. The certification is offered by the American Academy of Ambulatory Care Nursing and is useful because a section of the exam focuses on telephone triage. If you want to take the exam, you need to have already performed at least 2,000 hours of nursing experience in a clinical setting.

Necessary Skills

In addition to the obvious medical training, telephone triage nurses must possess excellent communication skills above everything else. Also, they have to be nimble and think on their feet because health problems aren't static—they can worsen at any time. Telephone triage nurses must remain calm throughout the conversation, being empathetic and really listening to patients. They also have to be able to assess each situation quickly.  

Places of Employment

One of the advantages of this career path is that telephone triage nurses can find employment in a multitude of environments—most notably dedicated telephone triage service centers. That said, jobs are also available in physicians' offices, hospitals, outpatient care facilities, trauma centers, poison control centers, and crisis hotlines.

A Typical Call

The first thing a remote nurse does is pull together basic information about the patient. The nurse finds out the person's age, sex, weight, and height—all of these contribute to the overall assessment. Next, the nurse inquires if the patient has any known diseases or ongoing health issues such as diabetes, high blood pressure, a history of panic attacks, or a known heart condition. To accurately assess the patient's situation, the nurse must get the patient to describe the symptoms as accurately as possible.

For example, for a patient who complains of feeling lightheaded, the nurse might ask whether they feel dizzy, faint, or weak.

Once confident that all the necessary information has been collected, the telephone triage nurse can recommend a course of action. For example, if the assessment is that the patient is suffering from heat exhaustion, the patient would be directed to drink fluids and find an air-conditioned room to rest in. If a patient is bleeding heavily from a cooking accident, the telephone triage nurse would direct the patient to compress the wound and seek immediate medical attention. Also, based on the severity of the health issue, the nurse will determine if the patient should schedule a follow-up visit with their general practitioner (GP).

What If a Patient Doesn't Have a GP?

Many patients don't have the money to visit a general practitioner on a regular basis. For that reason, nurses may also dispense information they think the patient needs from a social welfare perspective. For example, they may direct low-income individuals to programs that can provide financial aid.

Pros of Being a Telephone Triage Nurse

The pros in this profession are as follows:

  • You're only dealing with one patient at a time.
  • You feel appreciated because you helped someone in need.
  • There's no endless paperwork to fill out.
  • After a call, you have a sense of accomplishment because you completed a task—and you can move on to the next call.
  • There's no fear of contracting a communicable disease, such as tuberculosis.
  • You don't have to deal with needles and injections, which can be challenging.
  • You don't have to put up with patients who complain about every ache and pain because (for the most part) you're dealing with a real health issue.

    Cons of Being a Telephone Triage Nurse

    The cons in this profession are as follows:

    • You could help save a life but you don't get to see how someone improved based on your advice.
    • You have to rely on someone's ability to describe something difficult, such as a rash.
    • It can be stressful working on your own when dealing with a seriously ill patient.
    • People tend to be less polite on the phone because they can't see the person behind the voice. 
    • Your tone of voice has to be spot-on because a patient can't see your facial expressions, which communicate a lot in person.

    Salary and Job Outlook

    According to salary.com, as of June 2018, an RN staff nurse, phone triage worker earns a median salary of $71,931, with a range of $65,635 and $81,344.

    While the U.S. Bureau of Labor Statistics (BLS) does not post salaries for registered triage nurses, it does post a comparable median salary of $70,000 for registered nurses. And, according to the BLS, employment of registered nurses is projected to grow 15 percent from 2016 to 2026. This is much faster than the average for all occupations due to employment growth in the field as the population ages and the need to replace workers who will be retiring over the coming decade.