What does a 13 HEALTH nurse do?
Monday 23 September 2019
For Queenslanders in need of health advice, an expert is only a phone call away. When you call 13 HEALTH (13 43 25 84), you’re connected with a registered nurse like Ann Massey, who brings over 30 years of nursing experience to every phone call she takes.
We spent some time with Ann and the 13 HEALTH team to learn what it’s like to be on the other end of the line, and how 13 HEALTH provides around-the-clock support for Queenslanders.
What is 13 HEALTH (13 43 25 84)?
13 HEALTH is a confidential phone service that provides health advice to Queenslanders, 24 hours a day, 7 days a week, for the cost of a local call. It is not an emergency service and it doesn’t replace medical consultation; instead, it connects Queenslanders to registered nurses who can assess symptoms and provide health information. This advice helps the caller to understand if they need to seek further advice, how urgently it is needed, and what they can do to support their own health.
Because calls are confidential, 13 HEALTH nurses cannot access your existing medical records, and only staff within 13 HEALTH can access phone call information. Calls are monitored to ensure patient safety and to deliver a consistent level of care.
To ensure the service is accessible for all Queenslanders, 13 HEALTH works with interpreting services for spoken languages, as well as text and relay services for callers who are deaf or hard of hearing.
‘Real nursing is communicating with people’
For telephone triage nurse Ann Massey, working at 13 HEALTH has been a rewarding part of her 30-year nursing career. Ann had mostly worked in the hospital setting before making the switch to telehealth.
“It was really exciting – for first time I really understood telephone triage and how we can assist through technology. There's just so much room for growth, so much we can use to help people,” said Ann.
People may not immediately associate nursing with a phone service, but as Ann explains, communication is at the heart of what she does.
“I do get people saying, ‘Don't you miss real nursing?’ People think ‘real nursing’ is in the hospital, whereas nurses are in every area. We work in law enforcement. We work in companies. Nurses are in just about every area. So I am doing real nursing; it feels like the only real nursing I've ever done.”
13 HEALTH nurses focus on one call at a time, which provides an opportunity to explore health issues with callers and empower them through education.
“Part of real nursing is communicating with people. When you're on the hospital wards, often you have to cut conversations short. What I love about this job is I get to talk to people and really explore things with them. I am thanked so many times in the day. It's rewarding.”
What does a ‘day in the life’ of a 13 HEALTH nurse look like?
Ann’s work day could start in the morning, afternoon or night, because just like nurses on the hospital ward, the 13 HEALTH team works shifts to deliver care 24/7. After logging onto her computer and doing a brief email check, it’s time to start taking calls.
The 13 HEALTH team receive around 1,000 calls each day. Call volume is typically higher in the evenings and on weekends, when GP clinics are closed. Tracking call volume helps ensure the right amount of staff can be rostered on during each shift.
Callers to 13 HEALTH have a diverse range of questions and needs. 13 HEALTH nurses use a range of protocols to guide the triaging process, similar to an emergency department. The protocols work like an algorithm that assists the nurse to assess the severity of symptoms, consider the range of reasons for the caller feeling the way they do and recommend the best course of action. Around 70 percent of callers to 13 HEALTH are recommended self-care or to visit their GP. The nurses at 13 HEALTH get great satisfaction from educating and supporting callers to understand their health and the health of their children and families.
Protocols, like a piece of medical equipment, require an experienced operator to use it effectively, put information into context, and deliver individualised care. That’s why staff in the 13 HEALTH team have at least 4 years of experience as a registered nurse, and regularly complete training to enhance their critical thinking and clinical reasoning skills.
“The education here is sensational. There’s so much. We’re fully supported that way, and I’m learning something new every day,” said Ann. “The autonomy is sensational – I just feel like they trust my competence.”
With such a diverse array of questions coming through the 13 HEALTH phone service, the combined knowledge across the team is one of its strongest assets.
“There’s hundreds of years of experience in the team. One of us has got an answer, or we know where to get an answer, or we will search until we find an answer.
It's personal – these are our Queenslanders. We really care about who our callers are.”
From child health to chest pain and everything in between
Fevers, tick bites, sexual health, chest pain, poisons…Ann has handled a wide variety of calls in her three years at 13 HEALTH.
“Forty per cent of the calls are child-related. Of those calls, the majority are, ‘My child has a fever. What do I do?’ So there's a lot of fever education that we do in order to educate our mums and dads and grandmas and grandpas about how best to manage that fever,” said Ann.
“One of the calls that I've had recently was about a 12-year-old. His grandmother had rung, she was caring for him while his mum was away, and he'd had two days of headaches and mild fevers. Grandma just didn't know what to do, and so she called us. We have a fever protocol that usually starts with checking for meningitis, checking for breathing problems, checking all those things to make sure that they don't need an ambulance. We came out with self-care and see the doctor in one to three days.”
Ann discussed hydration and symptom management strategies with the caller, who appreciated the practical and timely advice.
“I know that these are competent parents and grandparents, but it's just that little bit of knowledge that they ring us for, just to check, ‘Do I need to take him to the hospital? He's got these fevers. He's got this cough.’ They can be confident we're giving them good advice.
It’s about empowering parents and carers that they are capable, that they can do these things. And if they don't, ring us. We're here 24 hours a day.”
What happens when someone calls 13 HEALTH?
When you call 13 HEALTH, you will first speak with a customer service advisor whose initial questions help to determine the best advice needed and then will transfer you to the next available nurse.
When your call is answered, the nurse will document your personal details as part of a clinical record. Your phone number is important in case you need to be transferred to an ambulance or if the call drops out, so you don’t have to re-enter the queue. The nurse will then step through a range of questions so they can understand your situation.
Callers often want an answer straight away, but as Ann explains, there are important reasons for every question being asked.
“The way the protocols work is we look at worst case scenarios first because if we need an ambulance, we don't ask any more questions. We call the ambulance.
I always try to describe it like going to the last page of a book and not knowing the middle. I assure them that if it was emergent, we would be dealing with it straight away.”
It’s not only a legal requirement that certain questions are asked – it provides essential information for safe and appropriate advice.
“We ask their medical history, their medications, what's happened to them in the past, any allergies. All that information is stored only with 13 HEALTH – none of it is shared anywhere else. We don't have any access to anyone's files from any hospital, so what they tell us is all we know.”
Once the 13 HEALTH nurse has the information required, they will give you advice on when and where you should access health care. They also provide health education, link callers with appropriate health services, and support them to manage their own health.
Nurses don’t panic – listen to their advice
It may be surprising to hear that Ann has to convince some people that their situation is serious and requires urgent care. Ann’s experience helps her walk the fine line between helping someone see the urgency of the situation without leading them to panic.
“It's very frustrating trying to talk people into getting an ambulance. They don't want the fuss.
I'm quite forceful especially if I think they're currently having a heart attack. Every minute is the death of a cell. So that's their heart dying in front of me. I say that. I explain to them what is happening now. You could have the ambulance come, and they can put you straight on an ECG. If they do go into cardiac arrest, they have the equipment in the van. They have all the medications, and they have a paramedic. Why would you drive yourself?
A registered nurse would not want to call an ambulance unless it was needed. Nurses don't panic. We are in extreme situations regularly. So if they tell you to see a doctor or go to the hospital, listen.”
A 13 HEALTH nurse is always just a phone call away
The 13 HEALTH service is available to all Queenslanders, 24 hours a day, 7 days a week. To speak with a registered nurse, phone 13 HEALTH on 13 43 25 84 from a landline or mobile phone.
If you’re not in Queensland, you can contact your local health service provider or call HealthDirect Australia on 1800 022 222.
In an emergency, always dial Triple Zero (000).
Thank you to Ann and the 13 HEALTH team for sharing your stories and providing an insight into your work.