CHAPTER 25
Work Environments
LEARNING OUTCOMES
Upon completion of this chapter, the nurse will:
1. Explain the advantages and disadvantages of different work environments for providing telephonic care
2. Analyze the work environment that would best suit the nurse’s personality and work processes
3. Strive to achieve the best possible work environment to support client care
ENVIRONMENTS
In general, there are only two types of work environments for telephonic care: a call center and home. All telephonic care organizations started by using the call center format.
Call Center
A call center is a big office, with cubicles or desks, lined up in rows. Depending on the size of the office, 50 to 100 desk spaces could be in the center. Each nurse has a desk space, or cubicle, that typically includes:
A desktop
A telephone
A computer and peripherals (keyboard, mouse)
A few desk drawers
A bookshelf
A trash can
A desk chair
It is up to you to try to make this work environment as comfortable and useful as possible. Some nurses bring pictures of their family and pets to place on their desk. Others might have small plants to add a bit of “green” to the environment. Unless there was a policy stating otherwise, nurses have been known to bring their goldfish with them to work and watch them swim happily while the nurse makes telephonic calls.
You will need desk supplies. This is different from needing a stethoscope, rolls of paper tape, and syringes to provide care. Supplies to set up your desk would include:
Tablets/paper
Pens/pencils
Paper clips
Push pins
Binders
Hole punch
Highlighter markers
File folders
Envelopes
Tape
Calendar
Oftentimes, the organization will have a room set aside for supplies to set up a desk space. Preparing the desk is usually one of the last things done at the end of the orientation period and before actual care calls are being made.
In time you might find that you need additional items to make your work area more comfortable to enhance your productivity. You might need:
A chair pillow
A small desk lamp
A clock
The telephone system might take some getting used to when beginning to provide telephonic care. Holding a telephone handset up to your ear for hours at a time can be tiring. Because of this, most organizations provide headsets. This is a device that has a receiver over one ear and a tube that is used to talk through. Some nurses find headsets uncomfortable at first but that quickly goes away. The alternative is holding a handset, which can be challenging if trying to type, talk, and balance a handset between the ear and shoulder at the same time.
There are advantages to working in a call center for telephonic care. Some of these advantages include:
Having other people with which to discuss client care situations
Feeling like a member of a team
Having access to a photocopy machine
Having many different resources available
Having someone available to help if the computer or telephone breaks
Other advantages to providing telephonic care that a nurse who has worked providing direct client care may not realize include:
Not wearing uniforms anymore
Not having to prepare for report
Not having to give the next shift report
Not having to count narcotics
Not having to document on several assigned clients at the same time
Not having to provide medications, treatments, or therapies at specific times
Not having to call physicians to report laboratory values or take verbal orders
Not having to rotate shifts or work a “double” because of staffing issues
The client situations in telephonic care are different as well. Remember, the client is at home and you will not need to:
Measure or evaluate vital signs
Monitor intake and output
Prepare and administer medications
Prepare, administer, and monitor intravenous fluids or blood transfusions
Flush multiple tubes and drains
Follow up with tasks delegated to other staff members
Work mandatory overtime to cover other staffing issues