Got a Question? Health-Care Advice Lines Have Answers

FRIDAY Aug. 13, 2010 -- The nurses who staff a health-care call-in line never know what the next question might be.

"We get calls from folks who have gotten lab results from their doctor and don't know what they mean, or they see something on TV about a condition or medication and want more information," she said. "We get calls from people who are having symptoms. Sometimes it can be something as simple as a cold or sore throat, but it can range all the way up to someone with crushing chest pain or who has just spilled a pot of boiling water."

Susan Miller, a registered nurse in Morristown, Tenn., takes such calls. Miller works as a clinical supervisor on a nurse advice line for SironaHealth, a nationwide medical call center based in Portland, Maine. She manages a team of 16 triage nurses, only six of whom she's ever met face-to-face. They all work from home.

The nurses take calls from people who need medical information. Their company provides the service for a variety of health-related businesses, including health insurance companies, hospitals and private physicians.

"The client, whoever it is, will provide their patients with a toll-free number and give them information about the fact that the nurse line is available," Miller said.

This sort of service is highly touted by medical consumer groups, who say people can save themselves money by calling a nurse before heading to the emergency room or doctor's office.

The nurses affiliated with Miller's call center work eight-hour shifts, and the call-in lines are open 24 hours a day, seven days a week. Miller said the calls taken by her and her nurses vary widely.

"You never know what the next call is going to be," she said. "You don't know if it's going to be a routine information question, or someone considering suicide, or someone with chest pain, or someone worried about H1N1. It could just be anything."

About 60 to 65 percent of the calls Miller and her team receive involve problems that can be handled with home health care, she said. Many pediatric calls are like that, she said; the mothers and fathers just want to be sure they're doing right by their baby.

"The most rewarding thing is talking to the callers," Miller said. "Ninety-nine percent of the time you make them feel better, no matter what the call was all about, even if it's just reassuring them that they are doing the right thing. They are so grateful to have someone who will listen to them and help them break things down into pieces of information that make sense to them."

Nurses are busiest during cold and flu season, she said. Then they'll field five to six calls an hour apiece. Day shifts tend to be slower because doctors' offices are open and people looking for advice often call there first.

One of her proudest moments on the job came early in the five years she's been with SironaHealth, Miller said. An elderly woman just diagnosed with diabetes called her for help.

"She was in tears because she was so scared," Miller said. "The doctor had diagnosed her, gave her medication and syringes, and told her to go take care of it. They hadn't really taught her what the insulin does and what you have to look for. They hadn't taught her about diet or exercise, or what to do when she got sick."

Nurses typically spend about 10 to 12 minutes on a call. Miller took 45 minutes to help the woman calm down and better understand what she needed to do for her health.

"She was so much calmer and felt so much more capable of handling this when we finished up the call," Miller said. "I wish I knew how she was doing. I feel that way with many of our callers, but we can't take the time to follow-up like that. There's always another person waiting on the phone."

Posted: August 2010


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