MEDICAL CENTER REPORT
11/19/08
Smooth operators: Emergency nurses' phone calls enhance patient health
BY DIANE ROGERS
Courtesy of Stanford Hospital & Clinics |
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Nurse Mary Durando is on the award-winning team that makes follow-up calls to emergency room patients. |
"This is Mary, the callback nurse."
It was 9:58 a.m. on a hectic Monday, and Mary Durando was on the phone, trying to locate the parents of a youngster who'd been treated in the Emergency Department the previous evening. "I'm calling to speak with the parents of James Doe to discuss his test results," Durando said, leaving a message on a home answering machine. [The patient's name is confidential.]
Durando's next call went to the work number that was listed on the patient's medical record. "Is this the father of James Doe?" she began. "His tests came back this morning, and he needs to start some antibiotics." Several minutes later, she had confirmed which pharmacy to call with the attending physician's prescription. She'd also explained how and when the antibiotics should be taken.
In her 36th year of nursing at Stanford Hospital & Clinics—the last 30 spent in the emergency room—Durando is a veteran of ED programs. This year that expertise was acknowledged, as she and five other ED nurses were named the 2008 Best Nursing Team by Advance for Nurses, a magazine that serves nurses in northern California and Nevada.
"The nurses recognized a need to follow patients after their release," editor Shelby Evans wrote. "Serving as a point of contact, providing education on medication management and assisting in making appointments, the team has had a substantial impact on the nearly 45,000 annual visits to the department."
Durando, BSN (bachelor of science in nursing), RN (registered nurse), CEN (certified emergency nurse), TNCC (trauma nursing course certified), shares the award with Patricia Pipp, BSN, RN, CEN; Kelly Johnson, BSN, RN, CEN; Gennette Olalia, BSN, RN, CEN; Ana Nelson, RN; and Divina Masaquel-Santiago, RN.
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"Sometimes we're on the phone for 30 minutes," Durando said about the 45 calls she handles during a typical 12-hour shift, working out of a former storage room off the pediatric waiting area. Often she makes sure that discharged patients understand the need for prescribed medications and follow-up clinic appointments. "We always try to end the conversation with, 'Is there anything else we can help you with?'"she said.
Durando also takes incoming calls from nursing facilities that are sending patients to the ED by ambulance. "I've had physicians call me and say, 'I love having someone I can talk to right away,'" she said.
The callback program is an answer to the growth of the emergency department, said Karen Stuart, RN, BSN, the assistant patient care manager who helped to launch the service, which is funded by a donation from high-tech entrepreneur Marc Andreessen and his wife, Laura Arrillaga-Andreessen. "We had to find a way to unburden the attendings and relieve the charge nurses of responsibilities that took a lot of their time."
As charge nurses managed increasing numbers of incoming patients, they had less time to follow up with those who were discharged. Once they left the ED, "people might not understand how to get a referral," Stuart said, especially if they didn't speak or read English. "Now we can make sure that they have help making appointments."
The callback nurses are on the phones seven days a week, from 9 a.m. to 9 p.m. They explain the services that are available to seniors, and they help patients negotiate the complicated medical system. And when it takes a few calls to reach a patient? "We're like bloodhounds," Durando said. "We track them down."
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