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P62 - Hire Not Fire! Selecting the Best Qualified Candidate for Telephone Triage Nursing

Excellent registered nurses do not always make excellent telephone triage nurses. Imagine a patient complaining of a leg ulcer. The office nurse sees the redness around the wound, smells the odor emitted from the ulcer, feels the lower extremity is warmer than the surrounding areas, and hears the mild shortness of breath that the patient is experiencing. Now imagine assessing that same patient with a blindfold. That is the work of the RN telephone triage nurse: providing telephonic care without the ability to directly see, hear, smell, or touch the patient. These nurses acquire unique assessment and communication skills to elicit these same symptoms. How do you determine who has mastered these skills? It is difficult to ascertain these distinctive skills when interviewing candidates for a telephone triage position. When candidates are hired and are unable to perform essential triage competencies, patient safety is jeopardized and healthcare costs are increased due to nurse turnover. Research indicates that nurse turnover can result in an increase of six percent of a total operational budget. Hiring the best candidate reduces this increased cost while improving nurse retention and ensuring quality care for patients.

Selecting the proficient RN triage nurse is a topic that is consistently questioned by telehealth nurse managers. Qualities of a competent telephone nurse include, among others, active listening, autonomous decision-making skills, multi-tasking, and problem- solving expertise. These characteristics reflect emotional intelligence and critical thinking which impact decision-making and reasoning abilities. Research states that emotional intelligence is a key to performance because the nurse has awareness of her own feelings that leads to a better understanding of the emotions of others. Nurses who exhibit high levels of emotional intelligence demonstrate empathy, provide feedback, view criticism as a growth opportunity, and pause before speaking, resulting in effective communication. Critical-thinking skills allow nurses to analyze critical situations, excel in decision-making, formulate creative options to problems, and remain open-minded to see all aspects of a situation.

This poster presentation provides an interview format that supports nurse managers in finding the best telephone triage candidate. The interview begins with reviewing the resume for attention to detail and documentation clarity. Job history reveals dependability and experience to include a minimum of 3-5 years in acute care and ambulatory care nursing preferably in an autonomous environment. The interview includes the first phone call to the candidate revealing voice tone and telephone etiquette. At the face-to-face interview, the candidate is asked to draw a picture of teamwork which exhibits critical-thinking skills. Specific behavioral questions that embrace emotional intelligence and critical-thinking aptitude are asked, and information, such as orientation is omitted to determine a questioning attitude.

Does the interview process make that much of a difference in selecting excellent RN Telephone triage nurses? Absolutely. Nurses hired using these interviewing techniques are patient-focused and great collaborators, handle frequent stressful situations, and formulate high-quality dispositions providing safe nursing care while displaying empathy: a win for the nurse and the patient!