of 1 /1
June 2002 28:3 JOURNAL OF EMERGENCY NURSING 253 MEDIA REVIEWS/ Lane, Kellner, and Yee The benchmark data, for example, once again validate that as the number of registered nurses decreases, the wait- ing time increases. Leaders can use these data to support the need for changes in their ED staffing patterns. The data also support the concerns related to ED over- crowding. Almost 80% of emergency departments report- ed problems related to overcrowding. The guide does not offer solutions but will help lead- ers identify where they are excelling, where they are similar to other emergency departments, and where they need to improve.—Trudy Lane 18/9/125098 doi:10.1067/men.2002.125098 Telephone Triage Protocols for Nurses, 2nd ed Briggs JK. Philadelphia: Lippincott Williams & Wilkins, 2000, 576 pp, $42.95, ISBN 0-7817-2786-3. Telephone Triage Protocols for Nurses is a usable handbook for experienced telephone triage nurses. The information found in the introduction to the manual by Ms Briggs encompasses a large number of nursing assessment con- cerns. She reminds us to identify special circumstances, concomitant disease processes, the need for standardized protocols and many other issues that must be addressed for safe telephone triage. While very aptly describing the mechanics of telephone triage, she continues to remind the reader of the need to remain focused on the patient. She also reminds us of the need to be empathetic with the caller. Importantly, Ms Briggs places special emphasis on the need for the nurse’s educated judgment to supercede any protocol. The author of this book is incredibly knowledge- able, as evidenced by her great introduction. (Nursing instructors may consider it for a synopsis of assessment concerns.) The tools are good if, like all tools, they are used by someone with expertise. As someone with 5 years of telephone triage experi- ence, this reviewer’s bias is that I am seeing the potential for trouble in telephone triage because of a heavy reliance on protocols, guidelines, care maps, etc, in general. You may have heard the old nursing adage, “Treat the patient, not the machine.” The same refers to any assessment tool. No tool should be considered infallible. In any patient situa- tion, the nurse must ultimately make the decision. The following examples show the importance of hav- ing an experienced triage nurse use this type of tool. For abdominal pain in a child, the action list states “emergency care now” for heavy vaginal bleeding, but it does not dis- cuss vaginal bleeding in the context of possible abuse and does not relate the concern to the age of the patient. Another example occurs with vaginal bleeding. If a patient is more than 20 weeks’ pregnant, the patient is instructed to seek care within 24 hours. However, a bleeding pregnant woman may need immediate contact with her physician or she may need to be seen in the emergency department. Another area of difficulty relates to levels of emergency assessment. “Seek emergency care now” does not differen- tiate 911 on-site emergency care versus transport by private vehicle. Only experienced qualified nurses would be able to make those judgments. I believe that experienced nurses will do well with this handy interview tool. The layout makes it easy to identify which protocol to use. Cross-references are available for other related symptoms and maladies. The appendix has preprinted documentation and evaluation forms, which will make managers’ lives a lot easier. Seasoned nurses in any busy office or department may want to consider using this manual.—Regina Kellner 18/9/124761 doi:10.1067/men.2002.124761 Cadet Nurse Stories: The Call For and Response of Women During World War II Robinson TM, Perry PM. Indianapolis: Center Nursing Press, 2001, 210 pp, $19.95, ISBN 1-930538-03-0. The answer to the nursing shortage when America was in the throes of World War II came in the form of one of the biggest recruitment efforts in the history of nursing. Faced with a critical lack of nurses on the home front and on the battlefields, the federal government funded a 5-year pro- gram in which 124,000 young women became nurses. This program is described in a fascinating account, Cadet Nurse Stories: The Call For and Response of Women During World War II. Written by 2 sisters who were in the US Cadet Nurse Corps, this easy-to-read paperbound book with a col- orful cover is filled with pictures and personal stories sent in by more than 300 nurse cadets who served in the Corps.

Telephone Triage Protocols for Nurses, 2nd ed

  • Upload
    phamque

  • View
    213

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Telephone Triage Protocols for Nurses, 2nd ed

June 2002 28:3 JOURNAL OF EMERGENCY NURSING 253

MEDIA REVIEWS/Lane, Kellner, and Yee

The benchmark data, for example, once again validatethat as the number of registered nurses decreases, the wait-ing time increases. Leaders can use these data to supportthe need for changes in their ED staffing patterns.

The data also support the concerns related to ED over-crowding. Almost 80% of emergency departments report-ed problems related to overcrowding.

The guide does not offer solutions but will help lead-ers identify where they are excelling, where they are similarto other emergency departments, and where they need toimprove.—Trudy Lane

18/9/125098doi:10.1067/men.2002.125098

Telephone Triage Protocols for Nurses, 2nd ed

Briggs JK. Philadelphia: Lippincott Williams & Wilkins, 2000, 576 pp,$42.95, ISBN 0-7817-2786-3.

Telephone Triage Protocols for Nurses is a usable handbookfor experienced telephone triage nurses. The informationfound in the introduction to the manual by Ms Briggsencompasses a large number of nursing assessment con-cerns. She reminds us to identify special circumstances,concomitant disease processes, the need for standardizedprotocols and many other issues that must be addressed forsafe telephone triage. While very aptly describing themechanics of telephone triage, she continues to remind thereader of the need to remain focused on the patient. Shealso reminds us of the need to be empathetic with the caller.

Importantly, Ms Briggs places special emphasis on theneed for the nurse’s educated judgment to supercede anyprotocol. The author of this book is incredibly knowledge-able, as evidenced by her great introduction. (Nursinginstructors may consider it for a synopsis of assessmentconcerns.) The tools are good if, like all tools, they are usedby someone with expertise.

As someone with 5 years of telephone triage experi-ence, this reviewer’s bias is that I am seeing the potential fortrouble in telephone triage because of a heavy reliance onprotocols, guidelines, care maps, etc, in general. You mayhave heard the old nursing adage, “Treat the patient, notthe machine.” The same refers to any assessment tool. Notool should be considered infallible. In any patient situa-tion, the nurse must ultimately make the decision.

The following examples show the importance of hav-ing an experienced triage nurse use this type of tool. Forabdominal pain in a child, the action list states “emergencycare now” for heavy vaginal bleeding, but it does not dis-cuss vaginal bleeding in the context of possible abuse anddoes not relate the concern to the age of the patient.Another example occurs with vaginal bleeding. If a patientis more than 20 weeks’ pregnant, the patient is instructedto seek care within 24 hours. However, a bleeding pregnantwoman may need immediate contact with her physician orshe may need to be seen in the emergency department.Another area of difficulty relates to levels of emergencyassessment. “Seek emergency care now” does not differen-tiate 911 on-site emergency care versus transport by privatevehicle. Only experienced qualified nurses would be able tomake those judgments.

I believe that experienced nurses will do well with thishandy interview tool. The layout makes it easy to identifywhich protocol to use. Cross-references are available forother related symptoms and maladies. The appendix haspreprinted documentation and evaluation forms, whichwill make managers’ lives a lot easier. Seasoned nurses inany busy office or department may want to consider usingthis manual.—Regina Kellner

18/9/124761doi:10.1067/men.2002.124761

Cadet Nurse Stories: The Call For and Response of WomenDuring World War II

Robinson TM, Perry PM. Indianapolis: Center Nursing Press, 2001, 210pp, $19.95, ISBN 1-930538-03-0.

The answer to the nursing shortage when America was inthe throes of World War II came in the form of one of thebiggest recruitment efforts in the history of nursing. Facedwith a critical lack of nurses on the home front and on thebattlefields, the federal government funded a 5-year pro-gram in which 124,000 young women became nurses. Thisprogram is described in a fascinating account, Cadet NurseStories: The Call For and Response of Women During WorldWar II. Written by 2 sisters who were in the US CadetNurse Corps, this easy-to-read paperbound book with a col-orful cover is filled with pictures and personal stories sent inby more than 300 nurse cadets who served in the Corps.