What Makes an Excellent Telephone Triage Nurse?

By Michelle Holztrager

Telephone triage nursing has become a highly skilled and specialized field of nursing. At TeamHealth Medical Call Center, we believe telephone triage is an art. We have found that the most successful telephone triage nurses excel in four areas: process skills, clinical knowledge, critical thinking, and listening skills.

Process Skills: Process skills consist of typing and computer navigation skills. We utilize a number of tests to evaluate software comprehension, keyboard dexterity, typing speed, and multitasking. Our nurses must access a number of different programs and client EMRs to meet client specifications and drive patient-centered care. It is important that nurses not lose focus on patient interactions by difficulties managing technology.

Clinical Knowledge: The need for clinical knowledge is obvious, and excellent phone assessment skills are paramount. Generally, nurses with broad experience – in particular ER nurses – are a good fit for telephone triage. Ambulatory care nurses usually have the benefit of previous in-patient experience coupled with phone assessments from their practice experience. For call center specialties and sub-specialties, we seek nurses with specific experience. TeamHealth Medical Call Center also provides intensive training on phone assessments, guideline selection, and the clinical phone triage process.

Clinical Thinking: Adept critical thinking is another crucial attribute of a telephone triage nurse. A telephone nurse must be able to follow the triage process to do well. Deviating from the process or the guidelines often results in poor decisions or the nurse going down the wrong path. A nurse with strong critical thinking skills can take in extra information and sort out important nuggets without allowing the extraneous communication to influence the call. Callers are usually subjective in their words, and the telephone triage nurse must be able to separate the objective from the subjective and apply the triage process to the presenting facts.

Listening Skills: Lastly, successful telephone triage requires excellent listening skills. There are no physical cues as to the patient’s disposition, and thus the nurse is dependent on truly hearing and clarifying what the caller says. Listening skills and the ability to hear the important details are vital to the process. At TeamHealth Medical Call Center, we focus on listening skills and verbal indicators throughout our training program.

I like to say that the art of telephone triage is the science of nursing with the addition of specially trained listening skills. Nurses are used to physically multitasking, but telephone triage requires very focused mental multitasking. Nurses who are proficient in these four areas will usually shine in the field of telephone triage.

Michelle Holztrager, RN, is the director of education and staff development at TeamHealth Medical Call Center.

[From Connection Magazine Mar/Apr 2015]