Triage Team: Faces of Cardiac Care
Meet Jennifer Mahannah, RN; Lynne Horan, RN; and Lisa Bushueff, RN, at the Cardiovascular Center in Falmouth. Their critical thinking and assessment skills help determine the appropriate level of care for patients.
On the third floor of the Falmouth Hospital Medical Office Building, there is a bit of detective work going on in a small corner office.
Jennifer Mahannah, RN
When the phone rings, triage nurses Jennifer Mahannah, RN, Lynne Horan, RN, and Lisa Bushueff, RN, at the Cardiovascular Center, begin their objective assessment from a patient’s subjective information.
“Do you have shortness of breath?” “Are you experiencing chest pains? “Has your weight changed?” “Have you taken the medications we have on our list?”
These are just some of the questions the triage nurses ask patients who are experiencing heart-related issues. Calls come in directly from patients, through the front desk or from medical assistants. The nurses perform clinical assessments to determine the urgency of the problems and work as a team to decide next steps. Sometimes calls last a couple of minutes; other times it could take a day or two to find answers as the team reaches out to several clinical staff members.
“We try to prevent them from coming in or landing in the ER,” says Horan. “We have to take the patient’s own assessment, determine its details and then send this information to the doctor.”
Mahannah says the end goal is to gather accurate clinical information so that the doctor can make an informed decision for the best clinical outcome and prevent hospitalization. “The doctor is treating the patient based on what we say, and if it’s not accurate, then we can do more harm than good. That’s why it is so important to get the correct information."
Treating a wide range of patients and problems
Lynne Horan, RN
Patients range in age from 40 to 100. “We have an elderly population, but then we have 40- to 50-year-olds who are just beginning cardiac issues,” says Bushueff. “The most common problems include low or high blood pressure, dizziness, responses to medication (needing more or less), swollen ankles or arrhythmia.
Quite often, the nurses share heart-healthy tips, such as reduce sodium, manage stress, hydrate, exercise, focus on a healthy diet, decrease alcohol intake and drink caffeine in moderation.
“Our goal is to help people, make them feel better,” says Horan, a longtime critical care hospital nurse. “I was concerned that would be a problem for me, not being able to touch patients when I got here, but you can make them feel better over the phone as well.”
But some things, like chest pains and stroke-like symptoms, won’t be solved with a simple phone call, and that is when they advise patients to go to the ER immediately.
Tightknit trio from different backgrounds
Lisa Bushueff, RN
Mahannah, who started her career as an EMT and a firefighter in the late ’80s, says she has always enjoyed helping people. Mahannah then pivoted and worked as a medical assistant in a cardiology office before going to nursing school. As a triage nurse at the Cardiovascular Center now for 12 years, Mahannah is the veteran of the group. “Cardiology always interested me and I had the most knowledge of it. So I just continued on that path.”
Horan worked in critical care for 35 years in Boston and says cardiology was always her first love. After commuting from the Cape to Boston for several decades, Horan was delighted to find something closer to home two years ago. Her philosophy on cardio care: “Cardiology patients can turn on a dime,” says Horan, “but you can turn them back as well.”
Bushueff describes herself as the new kid on the block in cardiology. She arrived here a year ago, but has been with Cape Cod Healthcare since 2009 as a nurse at Falmouth Hospital. “Throughout my nursing career, I’ve wanted to take care of my family if they ever needed it. I also dealt with my own personal cardiac issues and ended up here once as a patient. I’m sure that contributed to me landing here.”
Horan and Bushueff are part-time and have alternating schedules, so only two members of the team are in the office at the same time. They both concur it’s so helpful to have Mahannah on the team because she is a great resource and provides “buckets of information.”
“If I didn’t have Jennifer and Lynne, I would be lost,” says Bushueff. “I will ask—is this something I need to bring up to the doctors or can we solve this without bothering the doctor?”
‘We bounce things off each other,” says Mahannah. “I have been doing this for so long, but it’s harder to get into this role where you are so used to being on the floor and the doctor is right there. It’s just thinking of things in a whole different way.”
Every day, the team takes pride in solving puzzles and building an accurate picture for the doctor to help patients. “If we ever ended up leaving our jobs, Mahannah jokes, referring to their detective-like roles, “we could all go work for NCIS.”
