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Medicine In The Express Lane

I don’t know many professionals who do what I do: hold dual positions as a Triage Nurse and a psychotherapist. For the past eleven years, there’s only been a few seasons where I’ve worn both hats simultaneously. For the most part, Triage Nursing is fast paced, problem centered, and focused on what is happening right now. Psychotherapy is typically slower paced, person centered, and focused on the effect of the past on the present and immediate future. While these descriptions sound diametrical, they actually describe how my training and current work helps me deliver good medicine in the express lane of life.

Busy people need medicine that meets them where they are at.

Modern Life: You Are Too Busy

Most people are too busy to slow down. Their jobs don’t allow them as much leisure time if they are sent home with emails and smartphones. Lunches and breaks often turn into work time relegated for “catch up”. I can’t tell you how many times clients have told me that the only time they can call for help is after hours, when most clinicians have gone home. By the time many call in for help, they are already stressed, fatigued, or ill.

You Need It Now

Getting same-day appointments can be difficult. As a Triage Nurse, it’s my job to assess who needs to be seen by a PCP today versus tomorrow, and who needs education for good home care treatment. Similarly, counseling clients often wonder if their problems are urgent enough to warrant home care (rest, time off, medication), or the attention of a therapist.  For example, if you’ve never been clinically depressed, a few days of feeling down can easily be mistaken for feeling run down, and many clients misdiagnose their own symptoms for something somatic (body) versus emotional/mental.

Regardless, when you feel you need to be seen by someone, you want to know if you can be seen sooner than later.

Is This OK?

Often times, people are simply wanting to know what they should do with a situation. Is that pain in the chest something serious, or is it acid reflux? Can I just take a few antacids for this, or is that tingle in my shoulder worth reporting? I encourage all people to listen to their instinct for survival and health. Something that is new, unusual, painful, and/or persistent is usually NOT something to dismiss. Calling your PCP’s office is a good idea, and many providers have personnel to triage your call so that you know if you should be seen by your physician.

How To Get Medicine In The Express Lane (without getting run over)

If you want to access medical care appropriately, here’s what you should do:

1. For medical emergencies: dial 911. That’s what’s going to happen anyways if you try to call your doctor’s office with your true medical emergency. Trying to walk-in on your PCP office, which runs by appointment, will likely result in a trip to the ED.

2. If you’re not sure you’re having a medical emergency, and your HMO has a triage line, call it. The representative on the other side of your call is trained to ask a few questions that will help direct you to speak to the appropriate person, or help book an appointment for you in a reasonable timeframe. This will often save you time and grief, because delaying vital care is often more expensive than doctor’s visit.

3. Don’t try to call a triage center on a mobile phone while driving. Not only is it distracting and unsafe to you, it is often very difficult to hear because of ambient noise. Pull over, park in a safe area, and make your phone call. Give your full attention to the call and what is being asked of you. Dont’ be afraid to repeat yourself.

4. For mental health issues, it’s imperative that you report any signs of suicidal thinking, changes in medication, and any unusual circumstances, such as exposure to chemicals, a concussion, electrical shock, or a sudden change in your mood that you cannot account for. Many HMO triage lines accept mental health inquiries as well. Behavioral health specialists are there to assist you if you cannot wait to book an appointment with your therapist.

5. Don’t keep asking for what isn’t available. If your doctor isn’t available to see you, your medical record can be seen by a qualified PCP in the same group. It’s more important to be seen by a doctor in the right timing, than to wait too long to see your doctor when your problem may have significantly worsened. If you’re asked to see another clinician, there’s usually a reason.

Since a lot of medical services are being delivered over the phone, fax, and email these days, it’s important to remember that triage isn’t perfect in these formats. However, they allow professionals like myself to help you get the help you need, when you need it most.

What do you think? Is fast medicine just what you do when you ask Siri a question about your health, or Google a question about your medications? Have you ever tried to use a triage telephone number of your HMO when you’ve been sick? What was your experience?

By Imei Hsu

Imei Hsu is a mental health counselor, active retired RN, writer, triathlete and arts promoter in the Seattle area and through online services. With 29+ years in healthcare (20+ years in mental health), Imei has a commitment to helping people discover insight into their health, relationships, and connecting. She is the owner of Seattle Direct Counseling and the blog, a presenter and speaker on a variety of psychological topics, and a positive force on the Internet. She is launched her personal project, My Allergy Advocate, in 2018. Imei is two-time Ironman Finisher (Mont-Tremblant 2016, Ironman Canada 2018), and is currently training for her third Ironman in August 2020; she also finished her first ultramarathon in 2017 and has gone on to race the 100K distance while preparing for two separate 100 Mile trail races in 2020. You can find her running everywhere and eating all the thingz, watching movies, and cooking real food.

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