Sister, Can You Spare Some Advice?

Oh yeah. We know 'em. Hopefully we know more than one!
But don't think you're gonna find out who it is by calling the emergency department!

We don't give advice over the phone.

The secretary has informed you that we don't have an advice nurse in the department. They have told you that we are not allowed to give advice over the phone. They may have even mentioned that the unit was very busy and no nurse was available.

But you insist on speaking to a nurse. And, after all, "Customer Service" is our middle name and so you are asked to wait and are placed on hold.

A person calls an emergency room for advice for many reasons:

• They are injured and are from out-of-town.

• Their doctors never returned their call.

• They aren't sure if they are sick enough to require a visit.

• Their relative is very ill and they are worried.

• They have a question about a medication.

They usually want help with one or more of three symptoms:

• Pain

• Fever

• Vomiting

I can't give advice on any of them.

But I don't mind taking the calls because even though I can't give advice, I can listen

I can also ask questions to get the gist of how severe an illness may be. I tell callers that while I can't actually give advice I'd be happy to listen and perhaps direct them to someone who can help.

• I can tell them:

• That their regular doctor has someone on call 24 hours a day and that they can call the doctor even though it is the middle of the night.
  

• I once had a caller who was adamant that they could not get through to the answering service after trying for hours. I knew we were getting through okay, so I called the answering service and had them call the patient.

• Hey Docs! Call your patients. I often hear that a message has been left for you, but they never heard back.
  

• If it is a pediatric patient, there is a local pediatric advice line open 24 hours.

• Any questions on medicine I can refer to the local 24-hour pharmacy.

• I let them know that while I can't make the decision of whether or not to be seen, we are open 24/7 and are happy to see them should they decide to utilize the ER (which usually earns me a dirty look from the ER doc on duty...)
  

• I can tell them to hang up and dial 911 immediately.

Every now and then, the call is a definite life-threatening emergency. It's because of those rare times that I don't mind taking an "advice call". First of all, I've learned how to "give advice" without really "giving advice". All the patient really wants is someone who will hear and validate their concerns, which can all be done by listening and letting them know that we are there should they need to come in.

It's funny. All of the above can be done, and in my facility are usually done by our unit clerks whenever possible.

But sometimes, it's just got to be the nurse.