One of the registered nurses answering the NWT’s 811 calls says the free and confidential information they provide is like getting advice from a nurse next door.
Another says the telephone triage service is like a virtual emergency room, except you get “seen” a lot faster and receive help to determine what your next step should be.
The nurses are based in Atlantic Canada – many of them work from Newfoundland and Labrador – and work for Fonemed, a company that trains nurses to provide medical advice over the phone when you dial 811.
This article is the first in a three-part series where we meet the registered nurses behind the NWT’s 811 non-urgent health line, learn what training they’ve done to be ready to meet the needs of NWT patients, and understand what types of questions the 811 nurses are able to answer. To help protect the nurses’ privacy, Cabin Radio is only using their first names.
If you aren’t sure about your child’s fever, need to know how much medication you can take, or want to know the symptoms of chickenpox, these nurses can help – any day, any time.
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“I grew up in a rural fishing community where we were isolated geographically … away from the centres,” said Rhonda, explaining that serving small communities in the territories and the Maritimes really isn’t that different.
“In today’s world, where you don’t have that closeness with your next-door neighbour to call and say, ‘What am I going to do with my child?’ – unless you’re really close to your neighbour – we provide that service,” Rhonda continued.
“811 provides that helping hand and helping ear to help you decide if you need to go on the road, to be seen at another centre, or if you can stay at home with the advice and call back if needed.”
Rhonda has been nursing for 30 years, doing everything from paediatrics to palliative care. She’s now works at Fonemed.
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“I thoroughly enjoy telephone triage and I figure all my learnings are brought home to telephone triage,” she said.
Laura, a registered nurse who spent the majority of her 30-year career in emergency rooms and long-term care, said nursing over the phone is a little different – and listening carefully to patients is the key.
“You really have to actively listen to somebody when you’re speaking to them. They might be calling with a bad foot, but you realize they’re having trouble breathing and when you dig into that, the foot is the least of his or her worries at that time,” she said.
“I’m tuned into what the alarming things are to look for and know what questions to ask to dig in and get information from people,” she explained. “I can generally tell them if they need medical attention immediately or if they can wait, or if they can just treat their condition at home.”
Conversations are collaborative, the nurses said, describing phone calls as a time to work through problems together with callers. At the end of a call, the nurse checks to make sure the patient is comfortable with what they decided together – and patients are encouraged to call back if anything changes or they have more questions.
“I’m not a loud person,” said Laura, explaining that she speaks in a calming voice and reassures patients that everything they say is confidential.
“It’s not going to go anywhere – it’s just between that person and myself,” she said. “And hopefully that’ll help gain their trust. You get them to open up to you, tell them what’s wrong with them, and you troubleshoot with them.”
Many of the nurses who spoke with Cabin Radio for this series have spent 30 years or more nursing, though the minimum acute care requirement is two years. Some nurses who work for Fonemed still take shifts at their local hospitals or health centres to maintain their clinical skills.
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“We’re looking for people’s ability to critically ‘think on their feet,’ to be able to assess a situation very quickly on the phone, and figure out where this person needs to go for the best care,” said Jennifer, a senior team lead, who spent the majority of her three decades as a nurse working in intensive care units.
Kim, the director of clinical and client services – who has more than 35 years of nursing experience – said the more experience her staff have, the better, but that’s not the only thing Fonemed looks for when hiring.
“Our nurses have a commitment to offering guidance, and they’re able to navigate through complex clinical situations and help callers determine what the next step should be. But they’re very professional,” she said.
“They ensure all their callers get accurate clinical information and appropriate recommendations all at the same time. They instil confidence and trust in their callers.
“I’m very, very proud of the nursing staff that I work with and, of all the places that I worked, I honestly can tell you that this is the best bunch of nurses that I’ve ever worked with … They take immense satisfaction in making a positive impact in their patients’ lives.”
The calls are just as varied as the callers.
“I just love being able to talk to people of all ages,” said Laura. “You might get a younger teenager calling and you could get a 90-year-old woman calling – so you talk to all ages and all different kinds of people.”
“It could be something that could be life-saving,” she said.
This article appears as part of a paid partnership between Cabin Radio and the Government of the Northwest Territories to promote the free 811 service in the Northwest Territories. To learn more, visit www.gov.nt.ca/811.