Elsevier

Nursing Outlook

Volume 50, Issue 4, July–August 2002, Pages 160-164
Nursing Outlook

Regular paper
Resurfacing the care in nursing by telephone: Lessons from ambulatory oncology*

https://doi.org/10.1067/mno.2002.125319Get rights and content

Abstract

The practice of providing telephone mediated advice and assistance is often described as “telephone triage” in relevant literature. The decision-making processes required for priority-setting and the provision of advice have been found to be complex and multifaceted. Conceptualization of this valuable patient care activity as a linear “triage” function serves to make invisible the nursing care provided. This article explores the current practice of providing telephone mediated advice and assistance in the following 2 distinct nursing care settings: emergency departments and ambulatory oncology centers. Examination of this activity in these 2 settings provides a forum to discuss and critique legally and fiscally driven prescriptive protocol use to inform decision-making. The effectiveness of experiential knowledge coupled with the strengths of nurse-patient relationships suggests that a need exists to highlight the caring aspects of telephone mediated assistance.

Nurs Outlook 2002;50:160-4.

Section snippets

Telephone triage in emergency nursing

The word triage comes from the French word trier, which means to sort or to sift. Its use in health care originated from battlefield and mass casualty situations, in which large numbers of severely injured people needed to be rapidly assessed and care prioritized to ensure the most effective use of limited medical resources. Typically, priority is given to those who are most likely to benefit from available interventions. Characterized by brevity of assessment and algorithmic categorization and

Protocolization and the opacity of care

One important factor that serves to cloud the caring component of telephone mediated care is the pervasive movement toward the use of prescriptive protocols and algorithmic intervention strategies. Many authors advocate the use of problem-specific protocols to standardize telephone assistance in emergency room and ambulatory oncology settings.9, 10, 18, 20, 21, 22, 23, 24, 25, 26Ostensibly adopted to increase standardization and thereby ensure consistency of outcomes, it is nonetheless

Conclusion and future considerations

Telephone mediated care remains an easily accessible form of patient assistance that can be linked anecdotally to improved outcomes in both emergency and oncologic patient care. The potential exists for this valuable practice to be rendered invisible by protocol use, particularly in clinical areas in which the depth of patient-nurse relationships diminishes their utility and necessity. Reductionist tendencies toward a purely legalistic or fiscal discourse around the implementation and

Acknowledgements

The authors wish to thank the primary care nurses of the Nova Scotia Cancer Centre, Halifax, Nova Scotia, for providing inspiration for this article.

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    • Cited by (0)

    *

    Reprint requests: Rosemary Wilson, RN, MN, ACNP, CON(C), Empire 2, Kingston General Hospital, 76 Stuart St, Kingston, Ontario, Canada K7L 2V7.

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