My Story: The Importance of Nurse Triage for an Objective Medical Opinion

By Charu G. Raheja, PhD

Anyone can suffer from a serious medical condition, regardless of his or her diet, exercise habits, or education. The difficulty for many patients, however, is recognizing whether something is an emergency or just something that requires home care.

We have found that as many as 70 percent of the patients who thought they required an emergency room visit actually did not. However, about 8 percent of the patients that didn’t think they had an emergency actually had a serious condition that required an ER visit.

I recently experienced this firsthand. My experience illustrates how a healthy person can experience a sudden medical condition and have difficulty in evaluating its seriousness.

During a business trip to Miami earlier this year, I started experiencing a severe headache. In the past, I experienced headaches from time to time, but this one was different. The pain was intense and localized on the left side of my head. I assumed it was a migraine, triggered by heat or hunger. Determined not to let a headache hinder my evening, I tried to ignore the pain and go out to dinner with my colleagues.

I tried to enjoy dinner, but as the evening progressed, the headache persisted and became more intense. The entire room began to spin, and I noticed that I was sweating profusely. No longer able to ignore the pain, I lay down on the bench next to me. My husband and friends quickly rushed to my side. My husband took me back to our room. Other doctors who noticed were concerned and wondered if this was a serious condition, something that required emergency care. However, given my age and overall good health, they were not extremely alarmed.

After returning to my room, the headaches and dizziness continued, and I began vomiting. My husband tried to take me to the emergency room, but I was too tired and felt hesitant about going to an unfamiliar ER. He let me sleep and kept watch by my side. Despite the persistent symptoms, I chose to rest and rehydrate. We flew back home the following day.

Over the next couple of days, the pain returned from time to time, and I would need to lie down. I felt exhausted, but I kept ignoring this because my focus was on work. We were going through the URAC-accreditation process for our call center, TriageLogic, and my schedule was full of business meetings. Finally, a week later, since the headaches persisted, I called my neurologist, and he sent me to get a brain MRI.

We were all shocked to find that the MRI revealed a blood clot, measuring about three by five centimeters on the left front part of my brain, resulting from a brain bleed that occurred during my trip to Miami. Fortunately the bleed had stopped on its own, and I was extremely lucky to be alive.

My case demonstrates the importance of an unbiased medical opinion. I had been in the company of multiple doctors. While my symptoms could have been compatible with a brain bleed, my husband and friends felt a serious condition was unlikely because they knew me to be healthy and fit. I myself underestimated my symptoms.

In medical situations it is vital to have an objective opinion. This is exactly why nurse triage is such a beneficial medical service. Had I called an objective triage nurse and had my symptoms been applied to the Schmitt Thompson protocols, I would have been referred to the emergency room for further evaluation.

Sometimes a loved one’s judgment has its disadvantages. He or she assesses your situation with factors a triage nurse would not find relevant. Your loved one’s mind is naturally inclined to deny that you may be having a serious illness. Obtaining an unbiased assessment of a patient’s medical state is vital for appropriate care. In some situations, just like mine, it could identify a life-threatening emergency.

Charu G. Raheja, PhD, is the chair and CEO of TriageLogic. TriageLogic is a URAC-accredited company offering Web-based telephone triage software and nurse triage services. With almost ten years of service, TriageLogic has provided triage solutions to over seven thousand doctors.

[From the October/November 2013 issue of AnswerStat magazine]