Telephone triage nurses perform an essential work in helping patients receive the care that they need no matter where they are. Like all nursing, telephone triage can be a challenge, and there are many moving parts that are different every single day. To thrive in such an environment, telephone triage nurses should exhibit several foundational triage nursing skills.
Triage nurses work with people—often distraught people—all day every day. In such an environment, helping patients that are frightened or in pain find a sympathetic ear is a vital triage nursing skill. Triage nurses should use positive tones, address callers by name, and be courteous and prompt with their responses. It is helpful for nurses to combine questions with the reasons for them, i.e. “I need you to feel if your baby is hot to touch so we can work out how best to help him.”
Triage nurses should also be able to establish emotional boundaries. They should not take aggression personally and should treat each patient individually without letting calls become blended together or with things in their personal lives.
Part of having effective interpersonal skills is treating each patient with patience. Telephone triage nurses handle many calls each day, and callers are often not in a very clear frame of mind. Nurses should be patient to reassure the patient and to conduct an effective triage session.
Active listening is a triage nursing skill that goes beyond generic communication skills. Active listening combines verbal and non-verbal forms of communication while steering away from common responses that are habitually employed just to fill the space. Active listening includes things like paraphrasing what the caller has said to make sure the nurse understands, restating and validating how the caller is feeling, and summarizing the symptoms and conditions without resorting to labels (i.e. referring to “a person with epilepsy” rather than “an epileptic”).
Along that same vein, triage nurses should combine a good bedside manner with professional open mindedness. Certainly all nurses should eschew criticizing, name calling, or threatening, but avoiding more subtle forms of judgment is also a triage nursing skill. Nurses should steer away from moralizing and excessive or inappropriate questioning, and they should leave any diagnosing to the attending physician.
The nature of a telephone triage session is defined by the kind of questions asked. Asking effective questions, including closed, probing, and open ended questions, is an essential triage nursing skill. Avoiding ineffective questions, such as leading and negative questions, is equally important.
Triage nurses, in addition to other soft triage nursing skills, must be able to retain information. This applies to what patients say during calls and to specific clinical knowledge. During the course of any triage call, triage nurses should be able to follow what the patient is saying and hold an effective two-way conversation about the patient’s concerns and care.
The reason telephone triage is effective is because triage nurses on the line have the appropriate medical training to help patients identify their next step. Therefore, triage nurses must be able to retain the clinical information obtained during training in order to accurately identify patient problems. Triage nurses do not have to know everything, but they should have standard medical knowledge and know how to find the answers they don’t have.
While it is vital to follow prescribed protocols and procedures, an effective nurse needs to be able to make decisions. An adept telephone triage nurse will work within the established process to sort out problems that arise. He or she will also be able to set aside information that is not relevant to helping the patient receive proper care.
Patients calling into triage centers do not generally have the medical experience necessary to describe their concerns, instead relying on subjective language. Part of critical thinking triage nursing skills is being able to recognize and extract the objective from the subjective in order to apply the appropriate triage process for the caller.
Triage nurses have to make many decisions in a short amount of time. Effective nurses have the ability to cope with a high stress environment, remaining calm with the ability to make rational decisions.
While computer competency may not spring to mind when considering the list of necessary triage nursing skills, basic computer skills are an essential part of the job. These include standard computer navigation processes, such as negotiating standard programs and typing at a certain speed, as well as familiarity with more specialized systems.
It is common for triage centers to make use of facility-specific software and electronic medical records (EMRs). Triage nurses should be able to use these effectively to augment patient care and meet client specifications. Using such systems correctly plays an important role in protecting patient information and the integrity of their care.