By Ravi K. Raheja
Telephone triage nurses have a more important role than ever before. Nearly one in five U.S. adults lives with a mental illness (44.7 million in 2016), which is why many adults with mental illnesses go untreated (60 percent according to a report from USA Today). This article addresses the growing concerns for mental health awareness and education.
Telephone triage nurses are often the first point of contact for those struggling with a mental illness and can help a patient recognize the need for intervention. So, what can telephone triage nurses do to help?
Provide Accurate and Timely Triage
Telephone triage nurses are often the first point of contact for a patient with mental health symptoms and as a result, nurses should be patient, flexible, and have great communication and listening skills. The nurse must combine both clinical judgment and emotional connections to assess the patient’s situation to identify possible mental health issues. The telephone triage nurse’s role is to obtain the most accurate medical history and assessment to rule out medical symptoms that require immediate attention.
Remove Biases That Can Impact the Triage Process
Good telephone triage nurses always remove any biases and stereotypes. Having preconceived notions and distinctive sets of thinking can lead to error in the treatment of patients.
Assess the Environment
The Emergency Nurses Association recommends treating patient agitation as if it’s “the chest pain of behavioral emergencies.” Key phrases such as “I understand” can help place a patient at ease and give them the space to talk to the nurse. Throughout the call, the nurse should assess the patient’s environment and resources available to determine the most appropriate care plan.
Not all patients will be able to accurately describe their condition, history, medical conditions, or other pertinent information. It is up to the nurse to decipher this uncertainty.
- Assess the situation: How is the patient presenting? Is his or her speech coherent? Are they answering questions appropriately? Hallucinating? Delusional? Rambling?
- Address the whole patient: One common occurrence within mental health care is “diagnostic overshadowing.” This happens when the focus on a patient’s mental health diagnosis overshadows their physical health needs.
- Be an advocate: Triage nurses are the first to communicate with, provide support to, and manage patients with psychiatric or mental health issues. Acting as a patient’s initial advocate can be life-changing for that patient
Triage nurses always have the callers’ safety in mind. They combine both clinical judgment and emotional connections to assess the patient’s situation and to identify possible mental health issues. Nurses need to know the local emergency assistance numbers in case they need to reach out for more assistance. Just talking about their problems for a length of time can help a great deal for many callers who might be suffering from a mental illness.
Ravi K. Raheja, MD is the COO and medical director of the TriageLogic Group. Founded in 2005, TriageLogic is a URAC accredited, physician-led provider of high-quality telehealth services, nurse triage, triage education, and software for telephone medicine. Their comprehensive triage solution includes integrated mobile access and two-way video capability. The TriageLogic group serves over 7,000 physicians and covers over 18 million lives nationwide. For more information visit www.triagelogic.com and www.continuwell.com.