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Triage nurse provides information, referrals

His two small children had eaten candy bars still wrapped in foil and their father, a faculty member, had no idea how many they had consumed, so he called the Medical Department's urgent care center.

First, triage nurse consultant Patti O'Brien had to determine whether the children were vomiting, choking or having difficulty breathing. The father said they weren't. Relieved, she said, "I gave him a lot of reassurance, which is what he needed," and referred him to the poison control center.

Ms. O'Brien, who joined MIT six months ago in the newly created position after 12 years as an emergency room nurse at Beth Israel Hospital, is available for telephone consultations Monday to Friday from 8:30am-5pm at x3-4481, or by e-mail at <>.

"I answer questions and concerns; provide information about self-care management for things like colds, flu or sore throat; triage walk-in patients with specific needs; and help refer patients to appropriate providers -- the Medical Department or other medical facilities such as in the case of a life-threatening emergency or when a plan member is out of state and in need of medical attention," she said.

Given the demands on their time, MIT students often are reluctant to make an appointment and visit the Medical Department. That's one of the reasons Ms. O'Brien's position was established.

"I can help them determine if it is necessary to be seen," she said. "I also do a considerable amount of follow-up on patients, especially those who seek self-management."

Ms. O'Brien, who is completing work toward her bachelor's degree in nursing at Curry College, receives 40 to 60 calls a week, about half from students. The students mostly ask about medications, hepatitis B and how long it takes to recover from mononucleosis. She also gives tuberculosis tests and vaccinations.

Sometimes she misses the excitement of the emergency room. On the other hand, she has learned a lot about treating injuries incurred in laboratory mishaps.

"Most of our students are pretty savvy about what to do," she said. "They know the protocols. The first thing they do is flush the affected area."

Ms. O'Brien spends about 40 percent of her time doing telephone triage. She also see patients by appointment after they have been screened by the front desk and coordinates care with students' physicians.

"I must emphasize that I am not a nurse practitioner," she said. "I cannot prescribe, treat or discharge without a physician's orders."

Ms. O'Brien helped create a triage telephone line at Beth Israel before she answered a newspaper ad for the MIT position. So far, it's been terrific.

"I like the students and I like being on campus," she said. "Plus it's a new position, which allows me to be creative in developing my role as I go along. That's a challenge."

A version of this article appeared in MIT Tech Talk on October 22, 1997.

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