For one parent, being able to call 811 when their child had an allergic reaction – and the health centre and pharmacy were closed – got them through a worrying situation.
The registered nurse answering the phone was able to suggest home remedies and kept the family calm, the woman said. She asked for anonymity to discuss her child’s medical condition.
“I’ve never waited for more than 10 minutes for a nurse to call me back,” she said of the NWT’s 811 service. She has called when her children had fevers, when they fell and hit their heads and, one time, when a child had eaten too many fruit-flavoured chewable Tums tablets.
This article is the third in a three-part series where we meet the registered nurses behind the NWT’s 811 non-urgent health line, learn what training they’ve done to be ready to meet the needs of NWT patients, and understand what types of questions the 811 nurses are able to answer. To help protect the nurses’ privacy, Cabin Radio is only using their first names.
“I can call 811 to get some guidance and peace of mind, and that’s huge for parents,” she said, noting the helpline saved her from multiple trips to the emergency room.
“As a parent taking your small child out of their homes, taking them into emerg can be not only a lot of work, but traumatizing for anybody involved. So having the ability to call 811, know you’re speaking to a credible health professional, and potentially and hopefully avoid having to go to emerg at all, is a lifesaver.
“Sometimes I know everything’s OK. But I want to hear it from a professional.”
Danielle MacIntyre, who manages the 811 program for the NWT government, says 811 helps people get information from the comfort of their homes and “ensures people who need in-person care can be prioritized.”
The service is run by registered nurses working for Fonemed, a company based in Newfoundland and Labrador.
Whereas 911 is for emergency services and immediate in-person help, 811 is different.
811 nurses offer health advice based on symptoms the caller describes – though if the nurse determines the caller needs emergency services, they can transfer the call to the NWT’s 911 line.
So what happens behind the scenes at 811?
If the lines aren’t busy, a registered nurse will pick up the phone. If they are busy, your call goes to a healthcare navigator, who is trained to assign each call a priority level.
A call deemed a “direct transfer,” such as for something like chest pain or difficulty breathing, will be immediately transferred to a nurse, who may pause a less urgent call to help someone with a more immediate problem.
If a call doesn’t fit the direct transfer criteria, it’s coded as either priority one, two or three and added to a queue as nurses become available.
“You don’t necessarily need symptoms to call. Maybe you just need some information,” said Kim, a registered nurse and Fonemed’s director of clinical and client services.
As an example, Kim said, asking for background information on chickenpox would be a priority three call.
Calls are typically answered within 30 minutes. Callers can choose to receive a call-back within the same timeframe.
Nurses answering the phone use a triage questionnaire to help determine the supports each caller needs.
“Based on the answers from the caller, we will then determine: Do you need to call 911? Or do you need to go to the emergency room? Do you need to see your doctor today?” Melissa, a registered nurse for 30 years, explained.
“Can you wait for three days? Two weeks? Or can we give you advice to handle this at home? Sometimes our calls are actually no medical intervention other than what we provide on the phone line.”
‘No question too big, no question too small’
“There’s really no limit on what [questions] we get. There’s a new one, I think, just about every shift,” said Melissa.
“The sky’s the limit. And there’s no question too big, no question too small,” she said, noting questions range from chest pains to stubbed toes and head injuries.
When questions come in, nurses consult a system known as the Schmitt-Thompson Clinical Content telephone protocols, a series of more than 700 protocols – or guidelines – which are peer-reviewed and updated yearly to help nurses ask the right questions and give the right advice.
Melissa said the questions in the protocols “help get to the heart of the matter.”
“They’re excellent, excellent resources for our nurses and also for the people that we talk to,” said Jennifer, a nurse who once consulted the protocols to help someone get rid of the hiccups they’d had for days (the caller later called back to thank her for the advice).
“I don’t think we’ve ever come up against something we could not answer at all.”
There are, however, themes nurses often encounter. Parents calling about fevers, for example, is a common concern. Rashes, head injuries and colds come up a lot.
“We’ve heard a lot of misinformation with regards to how dangerous fevers can be for most kids,” said Jennifer. “When you can get on the phone at 12 o’clock in the night, with a very upset and frustrated and concerned parent or caregiver of a child with fever, it’s really good to be able to give information so that you’re taking care of their fever – actually giving education to these parents as to what we consider a dangerous fever, versus one that can be treated at home.
“It really does empower the callers to be able to take care of their kids at home.”
MacIntyre, the NWT government program manager, said 811 is not necessarily expected to reduce overall visits to a healthcare centre as some people still need to be seen in person. But the goal is to help people better understand which healthcare resources are available and connect them with reliable information.
She adds that 811 might be used by a youth who wants to ask something they are too afraid to talk about in person, by people who’ve just had surgery and have questions while recovering at home, or by new parents with worries in the middle of the night.
“This line is hopefully going to improve the time in which people gain access to information, and can work alongside in-person health clinics,” MacIntyre said. “Both are needed resources.”
This article appears as part of a paid partnership between Cabin Radio and the Government of the Northwest Territories to promote the free 811 service in the Northwest Territories. To learn more, visit www.gov.nt.ca/811.