Sun dial: A New Mexico nurse hotline

Those calls used to be separately outsourced. But Nurse Advice New Mexico (NANM) handles them all now. The service was the brainchild of a state-run task force looking to decrease medical costs while increasing services. Setting up a hotline for both public and private use took five years of steering committees, red tape, and arm-twisting. But the results are well worth the effort.

The NANM hotline currently fields between ten and fifteen thousand calls a month. Callers covered by Medicare and Medicaid, those from New Mexico's three managed care organizations, and anyone else who gets the number are all fielded.

NANM's goals are twofold. First, it wants to provide preventative health care to all patients who call. "This way, [patients] aren't just doing crisis management," executive director Cheryl Lopez, RN, MBA, said. The RNs can set up appointments with primary care clinics throughout the state, 24 hours a day. Callers thus can find a true medical home. Since 60% of the hotline's calls are for children, this often means a pediatrician's office.

The quantity of callers rise during emergencies: during a recent snowstorm that shut down the state, it fielded about 250 calls a day. "When we're looking at emergency service, possible pandemic planning, this will be critical for the state," said Lopez.

NANM has a dozen or so full-time employees, all RNs. Many more work part-time. New technologies allow nurses to receive NANM calls at home. This makes part-timing for them very convenient, especially for retired nurses who want to stay active in the field. In the future, NANM would like to get even more specific with call routing, so that a caller from Las Cruces would speak with a nurse from Las Cruces, not Santa Fe.

Language is not a barrier. NANM contracts with an on-call translation service. "Spanish, Farsi, you name it," Lopez said.

It took some serious ball-rolling to get the program started, but now other states are taking notice. Lopez has talked with Washington and Idaho about growing similar programs there. She suggested geographically dispersed states like Alaska and Hawaii could benefit from the program as well.

One of the biggest compliments of the program came from a primary care physician in a rural practice. "I just want you to know," he told them, "that since we contracted your service, this is the first full night's sleep I've had in 25 years."

"There are young mothers out there that are so in need," Lopez said, "and they don't have a support system." NANM, she said, "is a great safety net for these moms."