NursiConnect and Triage Nursing

The podcast episode is about triage nursing. The guest, Ms. Ramada Sofia, shares her nursing journey and her experience during the pandemic. She talks about working in New York during the peak of COVID-19 cases and the challenges she faced. She eventually discovered remote nursing and now works as a triage nurse in a call center, helping patients with their medical concerns and providing guidance on whether they should go to the emergency room or seek primary care. She describes her daily routine and the protocols she follows in her role. Welcome to the NurseyConnect podcast. My name is Ava. I'm the Chief Executive and Founder of the Remote Nurse Staffing Agency, NurseyConnect. On this podcast, we talk about all things remote nursing, and today's episode is about triage nursing. So I had to grab a triage nurse herself. Okay, I'm gonna let Ms. Ramada Sofia introduce herself. Welcome to the show, Ms. Ramada. Hi Ava, thank you for having me. I'm really excited to be here. I love NurseyConnect. My name is Ramada Sofia. I'm a registered nurse. I graduated in 2016, so I've been a nurse for a little bit over eight years, I believe. I checked like last month ago. I've been a nurse. And so I primarily started off in the neurology specialty, so that's like my specialty and then I started off in a step-down, on a step-down unit, and then from there I transitioned to the neuro ICU, and that was all being a staff nurse at one of the top hospitals in Boston. And then from there, actually the pandemic happened. First of all, 2019, I just started feeling like really unfulfilled at work and I was going on because, you know, I wanted to be a nurse. So I just, I didn't know that like burnout was a thing, but then as I started researching on handy-dandy YouTube, I was like, oh this is how I'm feeling, like I'm burnt out, you know. So then, coincidentally, the pandemic happened. So then they were on the news asking nurses to go to New York because they needed all hands on deck and all of that. But then I was like, you know, maybe I should go to New York because maybe that'll just like help my unfulfilledness, you know. So then I ended up going to New York and I did a few weeks there and that was, it was crazy, you know. And it was crazy just being in that whole environment because at the time New York was the epicenter. So just being in the ICU and like literally imagine walking into just, it looked like a, just like a gym type of, so it's in a hospital but the best way I can describe it is it was just, it looked like an empty, like just like a gym, let's say. Or just like an empty studio. It was an empty floor and it was just beds. So everybody was primarily a travel nurse. So then you would have, you know, your patients. We would have three patients sometimes. But they were really, really, really sick. And so I saw a lot being out in New York and I was like, oh, I need a break, you know, because I was like, that just kind of took it over the edge. So I went to California for a little bit. I'm licensed in Massachusetts, California and New York. So I went to California for a little bit and then after that I took a break. And then, you know, like I said, I really was like, do I even still want to be a nurse? And I'm like, but I do want to be a nurse. I went to school, like going through nursing school is like boot camp, you know, and if we could get through nursing school, we could get through anything. And I'm like, I still want to be a nurse because I love helping people, you know, but what else is there out there? So then I was just researching online and then I came across remote nursing and I'm like, what is this? I never knew nurses could stay at home, you know, I like literally didn't. I thought it was really just like the hospitals or, you know, nursing homes, long term care, all of that. Then I applied. I applied for a little bit for remote positions and then eventually I got the position that I'm in right now and it was triage nursing. So, yeah, that's where I am right now. Ramada, oh my gosh. Yeah, being a nurse during COVID in New York, I can only imagine how stressful that was because I remember when COVID first hit New York, you said New York was like they had the highest amount of cases for months. So I just know that was a stressful point for you in your nursing career, probably the most stressful. Hopefully we don't live through another pandemic in our lifetime. But yeah, that time, I think that was a realization for a lot of people in the way that we do work in nursing and like our overall just how we live. I can only imagine that was, that was rough. I got a little bit sick. I became a nurse like in 2021. So it was like the pandemic was still going on, but it was not hitting like 2020 when it first started. We had the vaccine and everything, but patients were still pretty sick. It was really sad, like, you know, because at the time, it was 2020, like at the beginning. So we really didn't know what was going on. We didn't have a vaccine at the time. A lot of hospitals were short ventilators. So I worked in the ICU as a travel nurse. So and then also like the whole PPP situation, like where you'd go to work and they wouldn't have PPPs for you to wear. Thankfully for me in New York, they had PPPs. We would basically wear it our whole shift, but they had good quality PPPs. They had ventilators, but it was sad because, you know, when the patients would come in, their family wouldn't be able to come in with them. So they'd come in with phones. And I had to a few times for a good amount of patients use their phone to FaceTime their family to see their loved one for the last time. And then literally and let or giving their family an update and saying, yes, your family member is doing okay, you know, progressing. And then all of a sudden, they just take a turn and then they just pass away. I remember I worked in steam. So I was kind of like in the hood. And so walking into work, like I would take the train in and then walking into work. So I would work 7P to 7A night shift. And then the people that live there. So imagine like it was a neighborhood. So it was like apartment buildings and then home. They would wait at like 645 for all the nurses to like as we're walking in, and they'd be outside banging with pots and pans screaming, thank you for your service. I'm like, am I a soldier right now? Oh my boy. Wow. It was crazy. I would never ever forget that time in my nursing career ever. Only in nursing. I mean, yeah, that's like, like I said, hopefully that's once in a lifetime. But okay, so you already shared your nursing journey. Alright, so you applied to the remote role. Is there a reason why you chose triage nursing? Was there something that attracted you to it? Right. Like I said, I was applying for a while. And then this position just kind of was the first one that reached back out to me. And then the fact that it was work from home. I need that. Okay, well, can you give us like a definition of what a triage nurse is in case people listening don't quite understand? Sure. So triage nursing is when a patient calls into a call center, and then you basically get their issue or why it is that they're calling and then you triage them. You know, for me, I work, my triage center works for primary care. So we cover clients who are primary care, so their patients would call in, and then as a nurse, I would listen to their chief complaint, and then either triage them to, you know, go to the emergency room, go to an urgent care, I would listen to their complaints and see if this is something that can wait until their primary care office is open. And then also, you know, just basically triage them and then answer their questions, whatever questions they may have, you know, for example, oh, I was walking through the woods, I got a tick bite, the tick is still in, what should I do? And then we basically have a protocol that we go through on our end with their medical records, with their charts open in front of us. And then with through going through the protocol, we can basically tell them what to do. Okay, you have a tick bite, is the head still on? Have you taken it out? And they answer us and you know, it's kind of hard because we can't see our patients face to face. So it's a lot of just really using your ears as a nurse to assess if they're in danger or not. And then this is like broad. So we have adults calling us and pediatrics calling us. So then, you know, going through the protocol, telling them, this is what you need to do. If it sounds like an emergency, then I need to triage you to the emergency room or the urgent care. So, you know, that's pretty much what my type of work has been so far. Okay, and can you go over like a day in a life for you? Like what is your shift like from start to finish? Sure. So, okay, let's say I'm working a weekend, which would be like 8am to 4.30pm. So I usually log in around 7.40. That's the time I'm very like militant about that. So I come downstairs where my office is. First off, the company sent me a monitor, a laptop, headset, just basically everything that I needed for the job, which was good. So then I come downstairs, I log in, I open up all of my applications. So I would open up my EMRs. Right now we work with four different EMRs. And then I would log in to just make sure I have all of my on-call providers lists in front of me, you know, just for easy access. And then I also will log into Microsoft Teams, which is like our nursing station. And then throughout our shift for the people who are on, and then also our like charge nurse, they call them a lead, but charge nurses will be able to communicate back and forth with them. Then once all of that is up, it's eight o'clock. I just basically put my headset on and then put the phones on. So then a call would come in. Let's say this call was like for COVID, for example, you know, they they'll say, you know, I am positive for COVID and this and that, but then I'll kind of pause them. I'll take all of their identifiers for them, put them on hold, go in, make sure I am able to look them up and pull up their medical record before me. And then I'll go back on the phone, have the patient explain to me, you know, what it is they're calling for. Let's say, for example, they said I'm positive for COVID, I would go over our whole protocol. So it's basically just typing in COVID and that's the protocol. So then I would just ask them a series of questions. And then depending on how severe the COVID is, the protocol system that we use will let me know if they need to go to the emergency room or if they can just get home care instructions, home care remedies and all of that. A lot of them will, you know, majority of them will ask for a past COVID. Let's say, for example, so if they do, I would have to reach out to the on-call doctor because as nurses, we're not able to prescribe anything. So it's just kind of like a lot of back and forth. And then let's say the on-call doctor gets back to me. I will call back the patient, let them know what's going on and then document and then move on to the next patient. So that's like for an example for COVID. But then calls are very different. You know, I've had a call where a person called in and I got all of their identifiers. I went into their medical record number. I came back and asked them how I could help them. And then the person just immediately started screaming like, I can't breathe. My chest hurts. And I'm like, okay, I need some more information from you, you know. And then like I said, we can't see the patient. So that call was pretty scary because I have to then dispatch 911 to this person. But it was hard because the person didn't know where they were. And they were going in and out of consciousness. I didn't know if they were having a heart attack, a seizure, a stroke, you know. But then 911 thankfully got to that person. So it just all depends. You know, I have pediatric patients that call in as well. So it's kind of like boom, boom, boom. You take one patient, you triage them, you document, you go back in, another person calls. And so it's just a series of calls throughout my shift. Okay. And what hours did you say you normally work? So it pretty much, it depends. So like over the weekend, I'll work. I usually work during the day. So over the weekend, I'll do like 8 to 4.30 type of thing. And then during the week, we'll do like evening. So it'll be like 5 to like 10, 5 to 9, you know, different type of shifts like that. And then if they need coverage, which a lot of times, you know, they do, so then like we could pick up hours. Oh, that's nice. And do y'all get any like differentials too? Yeah, we definitely do. Differentials are really good. We get differentials. And then if they are short, you know, they'll like pay you a lot more actually to come in. So that's, you know, a lot of us just kind of jump on that. I really honestly, I love what I do. Like, every time I log in, I'm always like, I love what I do. And then I'll help a patient, they'll be like, thank you so much, Ramada. And then I'll hang up the phone. And I'm like, I love what I do. Like, because you still get to be a nurse, you still get to help patients. They respect us being nurses. They respect that they're able to call in and get nursing advice. But it's not the hustle and bustle of, for example, in my case, the ICU. Or when I did step down, it was kind of like med-surg. You know, it's not that. Triage nursing is the bomb. I love it so much. Yeah, I feel the same way about inpatient virtual nursing. While I did not enjoy, like you said, the hustle and bustle of med-surg and bedside nursing, inpatient virtual nursing, it takes me away from physically being at the bedside. But I still get to see the patients and still care for them differently. And like you said, they really appreciate having that nursing expertise. Even though you're not physically there, the patients still really appreciate it. But I feel like us as nurses in the community that we are in, like, if you're not doing this type of specialty as a nurse, or if you're not doing this as a nurse, are you still a nurse? Yes, you are. Yes, you're very much still a nurse. I had to deal with that for a second. I was like, dang, I'm stepping away from the bedside. I'm not touching patients. Like, you know, what about my nursing skills? But the patients still love you all the same. You're still up here to them. Like, what you say is gold. Like, your expertise really is valuable to them. So I struggled with that for a little bit. But the more I did, the more, the longer I've worked as a remote nurse, I was like, I actually love it. I actually really love nursing. I just didn't like the environment I was practicing in initially. And I'm glad I didn't just quit on it altogether. And that's kind of what Nursey Connect encourages nurses to do. You know, explore remote options like you did before. You just be like, I don't want to be a nurse anymore, you know, because we lost a lot of nurses during the pandemic, you know. And I'm pretty sure, you know, more nurses knew these options were available. They probably would have tried it before they were like, peace. I don't even want to be a nurse anymore. Take my license. Here you go. So I'm glad that you love what you do. I love what I do. Like, the patients really, like you said, they value our expertise. And even the doctors, you know, they value what we do. I just, I love this because there's different aspects to nurses. So it kind of, I don't understand when people try to make you feel like, oh, so I really don't understand when nurses try to make you feel a certain way, like, oh, you work home health or you work from home, like you're not really a nurse. Like, no, nursing is nursing. I feel like with how the world is going anyways, triage nursing and telehealth nursing, virtual nursing is about to skyrocket because, you know, a lot of things are being done virtually anyways, you know. Yeah. I remember, it was like a couple shifts before I was working at the bedside. I was getting ready to leave, working there permanently. And I was talking to one of the traveling nurses that was helping us out in the unit. And he was like, oh, I heard you're leaving or whatever. I was like, yeah, I'm going to go do remote nursing. He was like, why would you want to sit at home and answer phones all day? Like, you don't like doing this? And I was like, no, I don't like it at all. So like, I feel like he was trying to make me feel bad. And I almost felt like, you know, like, I feel like he was trying to make me feel bad. And I almost, because of that comment, I almost second-guessed it. I was like, I'm not going to do it. But little did I know, this decision, you know, changed my life as far as how I view nursing, how I view work. So definitely the nurses that are listening and you're like, I don't know remote nurses for me. Me and Ramona, I tell y'all, we love what we do as nurses. I don't know how many times you hear that on social media, a nurse telling you that they love what they do. That's kind of hard. I feel like when I'm still on TikTok, I just see nurses saying they don't like the work that they're doing. But me and Ramona are telling y'all, we love what we do as remote nurses. So. I absolutely, I love it. Like, I genuinely can say that. There was times, you know, pre-work anxiety is real. And I didn't know, like I said, you know, with the burnout, I didn't know that pre-work anxiety was a thing until I started researching more and more nurses started coming out about their testimony and all of that. And like, I was miserable, but I used to have anxiety going into work, like anxiety. I would get to the parking lot and I would just sit in my car and I'm like, this isn't life. Like, I would rather go work retail because I used to work retail when I was like a teenager. Like, I'd rather go do that because I loved it versus this. And I'm like, what is going on? So I'm here to tell any nurse, if you feel that pre-work anxiety, or if you feel like you don't want to be a nurse anymore, I've been there, Ava's been there, but you work too hard for that degree. So don't let anyone come into your mind and make you feel like you're not, you're going to be less of a nurse if you go do, if you go home, if you like, you know, accept a remote nurse position and you're on the phones all day. It's definitely more than being on the phones all day. We're really making a difference in our patient's life. And this is just a different aspect of nursing. So I encourage anyone that's thinking of, you know, doing remote nursing, whether it's virtual nursing, triage nursing, do it. You're going to love it. I absolutely love what I do. All right. Now we're switching gears a little bit. Let's talk about the pay a little bit and how, because I do get a lot of nurses ask about this, go from travel nursing to remote nursing. And sometimes the pay is a little, it's a lot different. It's a lot different. So can you talk about that a little bit? Yeah, the pay is definitely a lot different from travel nursing. So some of the positions that I've looked into for triage nursing, it's anywhere from like $27 to like $50 an hour. Has it been that high? $50 an hour if you, you know, I think if you work in like California, you know, because California, their pay is usually a lot higher. So from like $27 to $50 an hour. But it depends on where you live. But like I said, a lot of companies have like differentials, so weekend differentials. And if you work night shifts, and then also, I don't know if it's throughout, you know, the board, but the company that I work with, they do really good at compensating you if you pick up a shift. And a lot of times with triage nursing, it gets really busy during the holidays, during flu season, COVID season, and then also during the summertime. You wouldn't, like people call in on Sundays early in the morning just to like talk to someone about something, you know. So the pay varies. It may not always be as high as $50. It's not going to be like travel nurse money, but you know, it's really up to you. And then like I said, there's differentials that you have. Yeah, the pay is slightly different. Like Ramada said, I did take a little bit of a pay cut, but I didn't do what Ramada did. She went from travel nursing. Y'all know that's the big money. I just went from bedside nursing. I'm in the South, so like it went from $28 to maybe $40 an hour. So at the bedside, I was making like $35. And now I transitioned to remote, and I'm making $32, which I was like, I'm not tripping off of it. I think it's fine for the time being. And remote work, because it doesn't physically drain you, I feel like it opens you up for more financial opportunities. Like if I did want to pick up a ship at the bedside right now, if I wanted to, I could still go do it and work my full-time job as a remote nurse. I don't know, would you say the same thing, Ramada? Yeah, a lot of nurses that work with me, that's what they do. Like for me, I'm strictly remote for right now, because like I said, I was at the point where I wanted to leave altogether. But then when I did travel nursing, I took a break. But nurses that work with me right now, some of them have staff nurse positions, and then they're per diem there. So they'll pick up shifts during the week. We also have people who are in NP school, so they are able to have income and then also go to school. So you're able to do both. Yeah, it definitely opens you up for a lot more financial opportunities. I see the same thing at my job. At my job, we do 312s. So the nurses will work full-time as an inpatient virtual nurse, and they will pick up a shift one day a week at the hospital working PRN. And PRN nurses make like $50, $60 an hour. So I mean, it really does open you up for quite a bit. So if you're going back and forth about that pay cut, we'll let you know there's opportunities for you to make more money even if you take a pay cut on the initial. Right. And then also there's opportunities for like entrepreneurship as well. I mean, I don't know if every nurse is thinking about that, but if you are thinking of doing something else as well, it's like you can do your remote nursing job. It's not as taxing on the body, and then you can do whatever you have to do on the other side as well. That's what I love about it. Yes, yes. It's definitely the entrepreneur aspect. It helps a lot not feeling so drained after your shift, y'all. It really does. It's like you just have more energy to do more, to do more, to be more. Same. Okay. I was thinking you said something. So like I don't even mind the pay cut because I don't feel drained after every shift. So I don't mind it. It is what it is. Yeah. Let's talk about work-life balance since we're talking about how we physically feel. So Roberta, how do you feel like your work-life balance has changed since you transitioned into remote work? Oh, Ava. Like I don't think I've ever been this excited about a job before. You get what I'm saying? First off, I'm going to say it again. I love what I do. I love being a triage nurse. And then the work-life balance is I don't, like, I get to walk my dog during my breaks. You know what I'm saying? I get to walk around my house on my half-hour break. I'm able to like go lie down on the couch or, you know what I'm saying? I work pretty much, like I said, in the mornings. And when I worked in the hospital or even as travel nursing, I worked at night. So work-life balance is amazing. I don't have any complaints there. Do you have any kids, Roberta? No, not yet. That's it? Do you want any? Yes, I do. You do? I love babies. I love babies. I get asked all the time about working remotely and having children. And I will say some jobs you can, I feel like some jobs, it depends on if you're full-time or part-time, but most of the time it's like just like you're at work. They want you to be available all the time. But work-life balance for me as a remote nurse, like you said, like you're able to do things on your break. And even if there's like a low period between patients, you're able to just get up and go for a walk. You're not in a building for 12 hours, well, 16 hours, which was also nice. So I'm glad to hear work-life balance is better for you. Yes, we have a few nurses I'll add to that. They just had babies and they're breastfeeding. So then they'll usually go on break a little bit more. And then they'll just let us know like, hey, I'm just going to go, you know, feed my baby and I'll be back. And I thought of that. That's so cute, you know, because it's like, obviously maybe like their workstation is away from their child, but to be able to like go into the comfort of your own home, see your baby, kiss them, breastfeed them, and then come back to work, it's just like... Especially new babies. Oh my gosh, that's nice. You already kind of answered a few of my questions. All right, we're getting close to the end here. So what is the best part of being a nurse for you? The best part of being a nurse is really helping people. Like, I know it sounds cliche, but I love helping people. And for whatever reason, a lot of my patients, they're not rude. They just, you know, they want to just talk, you know, they feel comfortable talking to me. And I just love hearing just about what people are going through, you know, because like I said, I kind of took a break. I took like almost a year off of nursing after like I came back from California. I'm like, no, like I need a break. But then I started feeling like, no, but I want to like talk to people again, you know. So what I love is that I'm just able to help people. They're able, they trust my expertise. They trust what it is that I tell them. And yeah, that's what I like. Being a nurse is one of the most rewarding things. And I keep hearing these theories in nursing, like you have to find your spot, you know, you have to find your place in nursing. And once you find your place in nursing, you can feel that fulfillment. Like, I feel like that's what you're, that's what you've been talking about. And you can enjoy it to the fullest, I feel like. You can't just be a nurse anywhere and still say it's fulfilling. Because I can honestly say I did not feel fulfilled working, I did not feel fulfilled working at the bedside. But yeah, it was, it was a mess. But it wasn't horrible, you know what I'm saying? But then, like when I was doing step down, I loved it because these were people who just finished having like some type of neurosurgery, you know. And then after that, they were recovering on my floor. And then they'd be up and about and I'd be able to talk to them. But when I transitioned to the ICU, you can't talk to these patients. It was sad. And I'm like, and just running around and, you know, yes, you only had two patients, but those two patients kept you busy if they were really critical. And that just really burnt me out. And I'm like, I don't like doing this. It wasn't that I didn't like caring for the patients, but I didn't like that aspect of nursing. It was the hustle and the bustle, you know? Yeah, it was bedside. Bedside is a lot. It definitely is. You have to be passionate about that, you know? Some people love bedside and kudos to them. I didn't love bedside, but I love triage nursing. What would you say to all the nurses listening to this podcast who aspire to work from home or to get into remote triage nursing? What are some tips you have for them? I would say start applying. You know, for me, it took me a little bit to get this position. So I would say start applying. Go on Indeed or go on like work boards or go on LinkedIn as well, too. And then just like every week, just make it intentional to just see what's out there. Look up triage nurse positions on Indeed. You could do like virtual nursing or work from home, RN, those type of keywords. But just be intentional about looking online for work, and eventually something will come up for you. All right, Ramada, can you let the nurses know where they can contact you, where they can follow you? What do you have going on? So yes, you can follow me on TikTok. I'm really only on TikTok for right now, but it's Ramada Sophia, at Ramada Sophia. And yeah, so this is like, this interview with Nursey Connect is like my first interview as being a nurse. Because even though initially in the beginning of my journey of being a nurse, I was really excited, but then I got burnt out and that left like a bad taste in my mouth. And I was like, I'm kind of like over it. I'm just a nurse to make, you know, my living and then I'm like off doing other things. But no, like I really love being a nurse. So you can find me on TikTok, at Ramada Sophia. If you have any questions about triage nursing, if you have any questions about pre-work anxiety, if you have any questions about just anything, you can reach out to me there. All right. I am Ava Bethea. I'm the Chief Executive and Founder of the Remote Nurse Staffing Agency, Nursey Connect. We're looking to place remote nurses, so inpatient virtual nurses, nurse case managers, and second year nurse practitioners. I will put the link in the description so you guys can also contact Ramada and check out our website. We're still getting open roles, but you can still submit a resume, speak to a recruiter. Again, my name is Ava Bethea. Thank you so much Ramada for coming on this show. Thank you so much for having me. Yes, we will see y'all in the next one.