Holmström IK, Kaminsky E, Lindberg Y, Spangler D, Winblad U. Better safe than sorry: Registered nurses' strategies for handling difficult calls to emergency medical dispatch centres - An interview study.
J Clin Nurs 2021;
31:2486-2494. [PMID:
34570927 DOI:
10.1111/jocn.16061]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/26/2021] [Accepted: 09/09/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES
To describe strategies employed by registered nurses for handling difficult calls to emergency medical dispatch centres.
BACKGROUND
At emergency medical dispatch centres, registered nurses encounter a range of difficult calls in their clinical practice. They often use clinical decision support systems, but these may be of limited help if the caller is for instance abusive or has limited language proficiency. Much can be learnt from strategies developed by registered nurses for handling difficult calls.
DESIGN
A descriptive qualitative study was conducted.
METHODS
A purposeful sample of 24 registered nurses from three different emergency medical dispatch centres were interviewed. The transcribed interviews were analysed using qualitative content analysis. The COREQ checklist was applied.
RESULTS
An overarching theme was established: "Using one's nursing competence and available resources for a safe outcome", based on three sub-themes: Use one's own professional and personal resources, Use resources within the organisation and Use external resources. The themes in turn consist of ten categories.
CONCLUSIONS
Registered nurses employed a range of strategies to deal with difficult calls, often in combination. They used their personal resources, resources within their own organisation, and collaboration partners to make safe triage decisions and use resources wisely. The effectiveness of these strategies, however, remains unknown. When registered nurses were unable to rule out a high-acuity condition, they used safety-netting and sent an ambulance. Evaluating current strategies and making strategies explicit could further improve the ability of nurses to handle difficult calls.
RELEVANCE TO CLINICAL PRACTICE
The strategies described by registered nurses for handling difficult calls to EMDCs included using a consecutive set of strategies. Some of the strategies seemed to be used deliberately, while others seemed tacit and applied in a routinised way. These strategies could potentially be useful for RNs working with telephone triage in different contexts.
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