Had I better defined the problem early on in the call, I could have cut the frustration on both our parts by going directly to the objective of requesting an appointment via a message for cold signs and symptoms. Being more decisive would have led me to generate as many potential solutions as possible. I could have then been presented them clearly to the patient and allowed the patient to choose home advice, telephone treatment, or message to her physician for a call back (Hesketh 1997). Acknowledgement of the cultural aspects of the person is necessary if nurses are to provide holistic care to the recipients of health-care services (Slusher and Newell-Withrow (1996). And, exposure to and personal interactions with people of diverse cultures foster an acceptance of multiculturalism that can be beneficial (Thobaben and Mattingly, 1993). However, I believe my knowledge regarding the cultural belief of a medical doctor being the only one to assist her got in my way of truly and objectively helping her.

Further, my frustration with the lengthier than usual call was increased by the large volume of patients on hold for help from a registered nurse. At the same time, I am aware that most reasons for inadequate call management involves inadequate history taking and closing the consultation too early before all the issues have been thoroughly explored (Crouch and Dale, 1998). Errors can lead to costly malpractice lawsuits and damage my professional reputation. Thus, I am constantly struggling with balancing the time it takes to adequately resolve a call with the wait times of clients who may need emergent care.

On further reflection regarding my experience dealing with the Vietnamese caller, I realize that I have plenty of room for improvement as a Telephone Triage Nurse. Good communications skills and patience are skills that imperative to being a good initiator and I need to work on developing these areas. Nursing in communities, the environmental context of clients' everyday lives, requires attention to social, cultural, economic, and political circumstances that influence both health status and access to health care (Osaka and Nanakorn, 1998). While I agree with the assessments of Osaka and Nanakorn and various other healthcare advisors, I've also learned that there is a fine line between being sensitive to these factors and the possibility of using them to provide biased...

Providing adequate assessments in a reasonable amount of time is challenging given that there's always another caller waiting who may have more serious health issues than the current person on the phone. This problem is compounded by cultural and language barriers, with little assistance available to help overcome these obstacles in a timely manner.
Still, I enjoy being a Telephone Triage Nurse and find the work both rewarding and challenging. Despite my shortcomings discussed in this paper, I believe that my dedication to the nursing profession and my strong desire to help others allow me to continually develop new skills to cope with everyday trials. And, I also know that as soon as I learn how to deal with a certain situation, there will always be a new challenge to take its place. However, I'm prepared to constantly learn and evolve and that's why I believe that I'm an excellent Telephone Triage Nurse even with my weaknesses.

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