Telephonic Triage Nurse

Telephone triage nurses apply the nursing process to advise patients about their symptoms or other health questions over the phone or via video call. Other names for this role include advice nurse, telecare nurse, nurse counselor, and remote triage nurse.

This article will explore what it takes to work in remote triage, including:

• What does a remote triage nurse do?
• Where do remote triage nurses work?
• A day in the life as a remote triage nurse
• Background and experience for remote triage nurses
• Certifications for remote triage nurses
• Interview tips for remote triage nurses
• Salary ranges for remote triage
• Pros and cons of working as a remote triage nurse

What does a remote triage nurse do?

Remote triage nurses provide health advice and support to patients who need guidance about a particular symptom or health problem using phone, email, or video conference software.

Telephone triage nurses may counsel patients about:

• Whether to go to the emergency room (ER) or if it’s safe to wait to speak to their provider during regular business hours
• How to manage minor symptoms at home
• Making appointments with their provider
• Medication education, like the correct way to take a prescribed medication or how to manage potential side effects
• Mental health support and symptom management
• Health resources available to the patient through their insurance company or employer, depending on the role

Some triage nurses also handle other patient queries or non-urgent health messages, like reporting on test results, responding to referral requests, or general health questions submitted via a health system’s patient portal.

It’s important to understand that telephone triage nurses do not diagnose patient problems. Instead, they rely on their nursing expertise to ask careful questions to determine what kind of help the patient requires.

A remote triage nurse must have strong verbal communication skills to build a rapport with patients who call for advice. They ask targeted questions to better understand the patient’s problem, such as:

• Current symptoms or presenting problem
• Past medical or surgical history, as relevant to the presenting problem
• Current medications
• Patient’s ability to manage the problem at home
• Patient disposition or distress level (are they calm enough to drive to the emergency room if needed?)

Each employer utilizes a set of triage protocols to prompt the triage nurse to ask specific questions to assess the patient’s acuity level and determine the appropriate support required.

After evaluating the patient and determining the appropriate plan of care, the nurse then ensures that the patient understands what action to take next, which may include:

• Calling 911 or going to the emergency room
• Making an appointment with their provider the next day
• Using home remedies, like acetaminophen for a child’s low-grade fever in the absence of other concerning symptoms
• Signs to watch for in case of worsening symptoms that may require additional care

Finally, the nurse documents the call. Often, the nurse will have a set time to document the entire call before the nurse is “returned to the queue” and may receive additional calls.

Who hires telephonic triage nurses?

There are many ways to work as a remote triage nurse, from occupational health to OB to urgent care. Possible employers include:

• Individual providers or provider groups
• Hospital systems
• Insurance companies
• Employer-provided health services

Depending on the employer, a triage nurse may receive inbound calls from a queue, or they may receive information from an operator and then follow up by making outbound calls to patients. 

A day in the life as a remote triage nurse

A typical day as a remote triage nurse can vary widely depending on the employer and the shift. Day and evening shifts often involve higher call volumes, whereas the night shift can be very quiet.

On a typical day, a telephone triage nurse will respond to either inbound calls or return outbound calls in a queue. They may also check patient messaging in a provider’s portal or handle non-urgent health communications, like calling patients about their test results.

In addition to speaking with patients, triage nurses must ensure all patient documentation related to the call is up-to-date and thorough so that other members of the healthcare team understand the situation and plan of care.

Background and experience for remote triage nurses

Remote triage nurses should have a good handle on the nursing process, including nursing assessment and documentation. 

Most positions require at least two years of bedside experience, but this can include any kind of patient care, from med-surg to mother-baby to pediatrics. While ICU, ER, and urgent care experience are helpful, it’s not essential. Nurses with clinical experience in outpatient care, hospice, or home health are also highly sought after as remote triage nurses.

Many remote triage employers include robust training programs and triage protocols to support their nurses. Most triage nurses say they felt extremely well-prepared to begin taking calls after undergoing employer-sponsored training.

Certification options for remote triage nurses

There are no specific certifications for telephone triage nurses. However, nurses interested in furthering their skills may consider continuing education units (CEUs) in related topics. For example, the American Academy of Ambulatory Care Nursing (AAACN) offers a telephone triage course that may be useful to new triage nurses.

Another option is to pursue certification in ambulatory care nursing since telehealth is a big part of ambulatory care. The American Nurse Credentialing Center offers the Ambulatory Care Nursing Certification (AMB-BC), which requires 2,000 hours of ambulatory care experience in the last two years and 30 hours of ambulatory care-related CEUs in the last three years.

Interview tips for remote triage nurses

Nurses interested in moving into remote triage should be prepared to answer behavioral interview questions that test their analytical nursing skills and critical thinking. The STAR interview method can help you prepare for these types of interviews.

Nurses interested in this career path might consider researching the Schmitt-Thompson Triage Guidelines, which provide guidelines for most medical call centers in the United States.

Most employers are willing to hire nurses without specific triage experience as long as they demonstrate that they have other valuable skills, including independence, the ability to prioritize, and a willingness to learn.

Other skills to highlight during job interviews include:

• Prior clinical experience, particularly ER, ICU, or ambulatory care
• Reliability and initiative, to show that you can work independently from home without oversight
• Strong documentation skills, since this position requires quick, clear documentation after every call
• Excellent interpersonal skills, including the ability to support, educate, and reassure patients while also gathering essential information to make a clinical recommendation

The Nurse Fern resume templates are the perfect solution for prospective job applicants who need a resume refresh. Don’t forget to update your LinkedIn profile before beginning your job search since most employers also check this resource before interviewing candidates.

How much do remote triage nurses earn?

According to Salary.com, the average telephone triage nurse earns $79,450 per year. This varies according to prior experience and whether the nurse also holds other responsibilities, like supervisory duties. It can also vary based on location, certifications, and education level.

Pros and cons of working as a remote triage nurse

Many nurses report that working as a remote triage nurse is much less stressful than floor nursing. 

Some of the benefits of this career path include:

• Work from home: No commuting during a snowstorm, work in your cozy clothes, fold laundry or do a home workout between calls, and eat your own snacks.
• Opportunity for more patient teaching: Spend time with patients discussing their concerns without worrying about the call bell going off in the next room or your med schedule.
• Set schedule: Depending on the employer, you can choose a shift schedule that meets your needs, from early mornings, nights, weekends, or day shifts.
• Work with a broad population group: Depending on your role, you may have the opportunity to apply nursing knowledge from peds to geriatrics.

This role isn’t for everyone, though. Some downsides of telephone triage include:

• No bedside patient interaction: This job won’t allow you to practice hands-on nursing skills.
• Metrics and oversight: Most jobs record all triage calls and require specific performance metrics, like length of call or number of patients assisted.
• Requires you to be stationary: Most roles in this field require employees to be close to their computer or headset at all times, with a set schedule for breaks and meals. This means you can’t unload the dishwasher while waiting for the next call (unless your employer provides a system with a remote headset). 
• Potential for loneliness: Some telehealth nurses report that they miss working with other colleagues and that there are few opportunities for social interaction with work friends.

Remote triage nurses should also be prepared to obtain nursing licenses in multiple states or a compact nursing license, depending on their job responsibilities. While employers typically pay for this expense, it can be a lengthy process.

Are you interested in working as a remote triage nurse?

Telenursing is an excellent opportunity for nurses looking for a change from bedside nursing but who still want to work directly with patients. Check out the Nurse Fern job board for the latest job opportunities in telephone triage. 

Do you work in telephone triage? Share your experiences in the comments or in our Facebook community!