Nurse Triage - Don't Leave Home Without ItA few months ago, I took some time off to spend a rejuvenating week at the beach. The sun was hot and bright, the waves were churning and the breeze was refreshing. Everyone around us was on vacation and relishing the fact that they did not have to wake up to an early morning alarm, attend a meeting or meet a deadline. There was no mention or thought of work from any beachgoer–except for me.

Don’t get me wrong; it was not a bad thing to be thinking of work while on vacation. It was quite the contrary, in fact. See, I am a nurse, and I work in the one constant specialty of healthcare: after-hours nurse triage. On three separate occasions, my fellow vacationers shared stories with me about how their lives or the lives of their loved ones had been saved or drastically improved—simply by having access to a nurse while they were on vacation.

It made me proud.

One morning, an elderly woman was strolling down a sandy stretch of beach with her two sisters, as they enjoyed their annual trip to the Atlantic. One of them had accidentally left her carry-on bag in an airport restroom while traveling, and had not realized it until arriving at her destination. She was not initially concerned when thinking about the magazines and snacks that were in the bag, but began to panic when she realized all of her medications had also been in that bag.

Unsure what to do, she called her daughter at home and explained the situation. The daughter had a very active role in her mother’s health care provision, and knew that her Primary Care Physician (PCP) had a 24/7 nurse line that they had utilized in the past with other dire issues. It was well after her mother’s PCP office had closed, but with one call to the nurse line, a friendly voice on the other end assured them an RN was available at that moment to assist them.

For senior citizens, immediate access to medications is often a vital necessity. Not having that access can be the basis for potential disaster, especially when the individual is nowhere near their PCP office. For the elderly vacationer, it had become a frightening reality. However, this problem was one of many a triage nurse is specifically accustomed to solving. She alleviated the woman’s anxiety and reassured her that the situation was under control. The nurse directed the woman to a store one block from the beach and provided enough of her prescription to get her through the entire vacation. The woman and daughter thanked the triage nurse for her help–and then the nurse reminded her to be sure to wear sunscreen while walking along the beach!

One evening as I sat looking at the ocean and listening to the waves, I was interrupted by the familiar sound of a siren approaching. Looking down the road, I noticed an ambulance pulling in to the driveway of a beach house just down the road from ours. In any setting, that picture is cause for alarm, but it is even worse when you are away from home. A short time later we saw the ambulance head back up the road, most likely to a local hospital or other healthcare facility. The next day while visiting with some neighbors, we learned that a 54 year-old man had been sitting on his deck watching sunset with his wife (just as I had been doing) when he began experiencing chest pain. His wife knew he needed medical care, but had no idea what to do or where to go. She remembered seeing a magnet on the refrigerator door with a phone number to call for medical emergencies. The emergency service was staffed by community triage nurses and available to anyone in need. The skilled nurse directed the woman to have her husband lie down and remain on the line while she contacted EMS for assistance. The nurse offered support and reassurance to the wife, and was even able to speak to the husband. Once the emergency responders arrived, the triage nurse hung up and let them take over.

The chest pain ultimately ended up being cardiac in nature and potentially life threatening. Once the local Emergency Department stabilized the man, he was transferred to the nearest major medical center. The wife called the rental company and thanked them for placing the magnet on the refrigerator. She said that the ‘wonderful’ triage nurse helped her and her husband through one of the worst experiences of their lives.

Although I did not know that nurse, I was so proud of her and wished that she could have heard their heartfelt compliment.

I heard one final story while sitting in the airport. As we waited for our flight home, I noticed a toddler with a bright red sunburn on her face and arms. That is an unusual sight these days, since many parents I know cover their children from head to toe with the highest SPF, water-proof lotions available. The child’s mother must have noticed me looking at her daughter with concern. She said, “You should have seen her yesterday.”

She went on to explain that a family friend had offered to put sunscreen on the toddler prior to a family outing. The mother assured me she always uses a high quality, high SPF sunscreen approved by her daughter’s pediatrician. In this case, the family friend unknowingly applied a SPF 8 tanning lotion instead of the mom’s sunscreen. After walking in the sun for only 20 minutes, the toddler’s cheeks and forearms began to turn red and blotchy. They decided to get out of the sun and assess the child’s condition. While her arms and face were warm to the touch, the young girl was happy and interacting with her family as normal.

Regardless, the mother was very concerned about any present or future harm the sunburn may cause to her daughter. She decided to call Mary Jo, the triage nurse at her pediatrician’s office, as she does whenever she has health concerns for her daughter. Mary Jo asked some specific questions about the symptoms related to the sunburn and assured the mother that it appeared the little girl was going to be fine. She suggested some basic home care instructions, which included giving her daughter a lukewarm oatmeal bath, moisturizing the area while the skin is still moist and administering a dose of an OTC analgesic if her daughter was uncomfortable.

The mother expressed to me her complete trust in the advice she receives when calling her nurse help line. She especially appreciates the respect and understanding she receives when calling, never being made to feel that her question is foolish or that she is overreacting. That is very important to any concerned parent who only wishes to make sure their child is going to be okay.

There is no denying the fact that a call to a trained triage nurse is often the first step taken whenever a need for medical advice or instruction arises. Having this type of access to definitive health care is both comforting and effective. I was very proud to hear these heartfelt stories from three separate strangers during my vacation. It further confirmed to me the value of a service that I have felt to be invaluable for decades. Nurse Triage – Don’t leave home without it.

Gina Tabone, MSN, RNCGina Tabone MSN, RNC
Vice President, Strategic Clinical Solutions
TeamHealth Medical Call Center