A triage nurse approaches you to let you know that a patient called asking for advice as he is having chest pains. Tell me what you direct the patient to do.
In this situation, there are multiple directions that a resident could give the patient. In a situation when a patient is having chest pains, the patient should be directed to go to the emergency department immediately or call 911 even. While care can be given at a physician's office or urgent care center, a patient with chest pains could be in the midst of a medical crisis that requires the service of an emergency department. The interviewer is asking this question to determine that you understand the clinical significance of chest pains and the fact that the patient needs to be evaluated in the emergency department.
"If a patient called with complaints of chest pains, I would tell them to go to the emergency department immediately after hanging up. Even though the patient's chest pains may not be from a heart condition, there is a chance that they could be and an evaluation in an emergency department is necessary. In these situations, it is easy to assume the patient's symptoms or conditions may be caused by an ancillary condition, such as anxiety, but until they are properly evaluated, it is too risky to assume. I would also ensure that the patient was able to drive by talking them through that and, if necessary, I would advise them to call 911 to get an ambulance on-site as soon as possible."
To effectively answer this question, you should indicate that you would direct the patient to hang up and immediately go to the emergency department. Whether you direct the nurse to or you do it yourself, talking to the patient about their ability to drive is important because calling for emergency medical service to their home may be of importance, depending on the individual situation.
