Local nurses cover medical calls while doctors sleep
Pair act as liaisons between patients and their doctors after hours and on weekends
By greg stiles
Mail Tribune
Editor's note: Nurse On Call — PRN was incorrectly listed as Medical Messenger in this story, which ran in Tuesday's paper. Here is the corrected version:
Suzanne Qualls and Jean Mackey bridge the gap between anxious patients and their doctors when the office door is locked.
Qualls figured she could help both panicked moms and sleep-deprived doctors when she founded Nurse On Call in 2003. But the 68-year-old registered nurse's intentions weren't merely altruistic.
"I was getting to the point where I couldn't work an 8- to 10-hour hospital shift," Qualls says.
Nurse On Call provides after-hours, weekend and holiday telephone triage for nearly 30 local doctors, handling everything from diaper rash to suicidal callers. On some days, the women can handle everything themselves; on others, they call the doctor or suggest a trip to the emergency room. Occasionally, they call 9-1-1.
"What this has done for physicians is actually give them a home life after hours," says Karen Sheperd, clinic manager at the six-doctor Family Practice Group in Medford.
Similar services are usually provided by large banks of nurses in metropolitan areas.
"We felt local nurses know our problems and our people and are more of an extension of our clinic rather than something cold and indifferent," Sheperd says. "It's really a benefit to the patient and obviously a benefit to physicians, because they're not getting 20 calls when only five should have been put through. At the same time, patients can have a question answered that needs a response. They don't want to wait until the morning and getting medical advice doesn't cost them anything."
Nurse On Call charges $14 per call and the initial set-up fee is $250 per clinic or doctor to set up pertinent information for the practice. The nurses get five to 15 calls, averaging 15 to 20 minutes, per night during the week. Activity picks up on Saturdays and Sundays to 20 or 30 calls, Qualls says.
"Summer holidays can be very slow," she says. "The heavy season runs October through April. We call that the 'flu season' in our business, where we get a lot of virus and upper respiratory illness."
The busiest time of the night is between 5:30 and 9:30 dwindling steadily until midnight. "From then until 8," Qualls says, "it's very slow."
The pair use a software program developed by Mackey's nephew Brian Myers of Talent, which allows them to generate empty forms and ask the same questions a clinic would when a patient came for a visit. Nurse On Call then faxes a report on each call to its doctors.
Mackey, 54, recently returned from China, where she taught muscular skeletal ultrasound techniques for 10 days.
"This is something I've been able to do since I injured my neck and shoulder," Mackey says. "You can clean house, cook or whatever in between calls. It's a wonderful concept to do at home and ideal for somebody with a disability."
Qualls dabbled in a variety of pursuits, from driving truck to sales and marketing and operating a bakery before embarking on a 15-year nursing career. She was training for a similar phone triage program at Medford Clinic when it was dissolved at the end of 1999. Although she didn't immediately launch her own business, she saw the value and potential.
"We can talk to the office manager, see what the service is about, how it operates and how much it costs," she says. "But they still have to take a leap of faith. Doctors are so busy during the daytime and rushed by the volume of patients. By the time the day ends, after making the rounds to hospitals and nursing homes, they're exhausted. For some of the doctors it was easy for us to do the job and for some, it was a very difficult thing. The hardest obstacle to overcome was to be comfortable with us."
The payoff for doctors comes when an infant's unrelenting cries trigger a 2 a.m. call. Ashland Pediatrics physician Diane Williams says that having someone else handle routine matters is worth the cost.
"A pediatrician gets numerous calls at night in addition to Caesarean sections and new admissions and those kinds of things," Williams says.
"It allows one to get a little sleep and to be able to handle the problems during the day. Before we had Suzanne, we would be awakened two or three times a night for a diaper rash that becomes an emergency at 3 a.m. That can get old pretty quick, considering you have to be on call at 6:30 a.m. the next morning to do procedures or whatever."
While most of the calls fall into the routine category, some require getting a patient to the hospital quickly and using 9-1-1. Others are even more tricky.
"I've gotten calls from suicidal people," Qualls says. "I keep them on the phone and listen to what they say. I'll try to have the husband or someone else get on the line to give them information. As soon as we can get an address we can cross-reference it. But with more people using cell phones instead of land lines, it's slowing down the process."
