Telephone nurses' communication and response to callers' concern--a mixed methods study

The aim of this study was to describe telephone nurses' and callers' communication, investigate relationships within the dyad and explore telephone nurses' direct response to callers' expressions of concern

Telephone nurses assessing callers' need of care is a rapidly growing service. Callers with expectations regarding level of care are challenging.

RIAS and content analysis was performed on a criterion sampling of calls (N=25) made by callers who received a recommendation from telephone nurses of a lower level of care than expected.

Telephone nurses mainly ask close-ended questions, while open-ended questions are sparsely used. Relationships between callers' expressions of Concern and telephone nurses responding with Disapproval were found. Telephone nurses mainly responded to concern with close-ended medical questions while exploration of callers' reason for concern was sparse.

Telephone nurses' reluctance to use open-ended questions and to follow up on callers' understanding might be a threat to concordance, and a potential threat to patient safety.