Angela Ayala

Story Vault

By Angela Ayala

When I started my career in nursing in 2003, I never anticipated a door opening to the exciting experience as an Academy-certified Emergency Communication Nurse (ECN) in our clinical call center at the North Shore-LIJ Health System in Syosset, N.Y.

Having worked as a registered nurse in pre-hospital and hospital settings, I initially doubted a venture of this magnitude. I never imagined an avenue of quality care delivered indirectly, without the benefit of face-to-face contact.

But since putting my fears aside and digging in with both hands, however, I’m confident our Emergency Communication Nurse System (ECNS) team is going to have a positive impact in the face of certain changes in health care, specifically the care provided outside a hospital setting.

My career choice was based on fulfilling a need that has existed through the ages.

We all require food, water, a stable environment, respect, and care. As a nurse, I am responsible for the care provided to patients who may have very different needs. While that will never change, the environment and ways this can be achieved are moving from direct patient care in a hospital setting to the virtual world offered through electronic communications.

The ECN works directly with the EMD to ensure the patient receives optimal care.

At North Shore-LIJ, the EMD-certified EMTs and paramedics staffing the communication center handle nearly 1,500 calls each day. The type of call varies from an unstable cardiac patient needing emergency cardiac catheterization to time-sensitive pediatric intensive care unit (PICU) transfers and prescheduled basic life support transports.

As required by ECNS, I am a registered nurse and an Academy-certified EMD.

EMD training prepared me for hysterical, fearful, and upset callers, and taught me how to provide over-the-phone CPR, child delivery, and dislodging an obstruction in a choking patient. The training was a vital step in our journey to ECNS because of the protocol-driven system that helps me to understand nurse triage. I learned the importance of applying clinical knowledge in tandem with the LowCode software.

The instructors, Dr. Conrad Fivaz, Emergency Response Operations Director, and Jennie McQueen, an RN and Emergency Nursing Communication Specialist, worked diligently to help us understand the connections between all of the important facets of nurse triage. They knowledgeably handled our questions and concerns and provided specific examples of positive interactions with our future patients.

The nine ECNs at North Shore have differing clinical backgrounds and experience, but through ECNS training, we are a team of one, headed toward a necessary movement in health care.

Since the program is new to North Shore and our patient population, we are baby stepping into ECNS through managing a specific patient population that contacts us directly for nurse advice. As we continue to grow the possibilities are quite endless, and I would urge others to look into how ECNS can help your community.

Preliminary results show that ECNS is beneficial. It’s patient-centric, directing patients to the care they need and want.

As an RN who formerly worked on the hospital floor, I know that most patients would rather not be there. So often I would hear: “I would do better if I was home” or “I wish I didn’t have to go through all of this in the ER.” ECNS provides an opportunity to grant a patient’s wish and increases his or her future involvement in medical decision-making.

For quality health care to survive, the ability to remotely assess patients, provide treatment, and follow up remotely is a way of the future. ECNS is an exciting vehicle, and I look forward to the direction it will continue to take us.

As an ECN, I rely on my clinical skill and the protocols to help a patient beyond the walls of an emergency room. It’s the ideal mix that I never thought was possible, until now.