Aims: The aim of this study was to describe telephone nurses' and callers' communication, investigate relationships within the dyad and explore telephone nurses' direct response to callers' expressions of concern
Background: Telephone nurses assessing callers' need of care is a rapidly growing service. Callers with expectations regarding level of care are challenging.
Method: RIAS and content analysis was performed on a criterion sampling of calls (N = 25) made by callers who received a recommendation from telephone nurses of a lower level of care than expected.
Results: Telephone nurses mainly ask close-ended questions, while open-ended questions are sparsely used. Relationships between callers' expressions of Concern and telephone nurses responding with Disapproval were found. Telephone nurses mainly responded to concern with close-ended medical questions while exploration of callers' reason for concern was sparse.
Conclusion: Telephone nurses' reluctance to use open-ended questions and to follow up on callers' understanding might be a threat to concordance, and a potential threat to patient safety.