Hello, Melinda:
We don't have a specific policy; however, each call should be treated as if it was the first time the patient called. You never know when you'll find the zebra!
Non-nursing issues should be transferred to non-clinical staff to handle. You can try to summarize the last few times that the patient called and asked for advice but chose not to use it, and now that they are calling about the same thing, your advice would be the same (after the assessment). When everyone does this and the patient sees there is consistency and standardization (in what you tell the patient and in transferring to non-clinical staff for non-clinical needs), they may understand that what one nurse says/does, all nurses say/do.
Hoping that you have "The Art and Science of Telephone Triage" (my Bible), see pages 214-220, 293-296. These pages deal specifically with "The Frequent Caller" and "When the Patient Won't Comply with Your Recommendations." Nurses can always "tell" or advise the patient what they need to or should do; however, we must accompany the patient on their own health journey, even if that means they choose not to follow our recommendations.
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Michaelene Wolff, BSN, RN, OCN, AMB-BC
Coordinator, Clinical Programs
Chair, Ambulatory Telephone Protocol Committee
University of Colorado Hospital
Aurora CO
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