by Jason P. Smith
The phone rings at the Rocky Mountain Poison Center, and on the other end of the line is a frantic mother. Her child has ingested something toxic – what should she do?
This scenario is one with which staff supervisor and certified poison information specialist Cheryl Montanio, RN, MSN, is very familiar. A successful call brings immense relief and a unique connection, Montanio said.
"The most rewarding part of my job is developing an immediate rapport over the telephone with a mother, and then hearing her voice turn from panic to relief," she said.
An agency of Denver Health Medical Center, the Rocky Mountain Poison Center is a regional poison center serving the states of Colorado, Montana, Idaho, Hawaii, and the city of Las Vegas, Nev. The center also contracts with business and industry clients to provide emergency information and treatment recommendations on a variety of products. Last year a total of 173,559 telephone calls were received, including 105,088 human exposures. Of those, 64,477 involved children.
Nurses at the Rocky Mountain Poison Center provide emergency poison information and treatment recommendations to the public and health care professionals by telephone, 24 hours a day, 7 days a week. More than half of the incoming calls involve the treatment of children younger than five, and most of the pediatric cases can be managed at home without sending the child to the emergency department, Montanio explained.
As supervisor, she coordinates training of new staff nurses.
"There is an immense amount of learning up front – computer operations, telephone communication styles, toxicology theory – that must occur before a new staff member is approved to answer the emergency telephone lines. It is fulfilling to work with a new nurse, coaching that person through training and witnessing her satisfaction as she puts it all together and helps her first parent on the emergency line," Montanio said.
As with any type of nursing, there are trying times at the emergency poison call center, she said. "The most difficult time – as I think it is for most nurses – is when a patient dies, especially a child, and particularly if it was a poisoning death that could have been prevented."
The center stays focused on its mission, though, and Montanio especially enjoys the collegial atmosphere and multidisciplinary approach to helping poisoning victims.
"I am honored to work with a group of nurses and other health care professionals who are experts in their field and display the highest level of dedication and pride in their work. It is extremely rewarding for me to work with our nursing management team and the doctors and pharmacists on our staff," she said.
Technology has had a profound effect on health professionals in the poisoning and toxicology specialty fields. Montanio pointed to the fact that today, nurses must become proficient in the use of computers and rapid electronic information retrieval.
"Twenty-five years ago, we looked up product information on microfiche cards using a microfiche reader, and we documented all our patients’ notes by hand on paper," she said.
"Now everything is computerized, so it’s a matter of seconds to search for product information, and we type the patients’ case notes into an electronic medical record. This has shaved minutes from the length of a call, increasing efficiency and patient care."
The experience that inspired Montanio’s career in nursing was far from high-tech, though.
"In high-school, I participated in a volunteer project with some elderly patients at a local nursing home and saw how the nurses cared for each resident. As a volunteer, I felt tremendous satisfaction in being of service to the residents and could see the nurses had that same sense of service and caring. I knew nursing would be a way for me to continue in that role," she said.
She attended Loretto Heights College in Denver for a bachelor of science in nursing degree, and graduated in 1976. In 1992, she received her master’s degree in nursing from Denver’s Regis University.
"My best memories of school center around the camaraderie and friendships developed with my fellow students and professors. We helped each other learn, study for tests, and share experiences. There was a great feeling of support and encouragement to succeed and shine," Montanio said.
After graduation, Montanio worked at St. Luke’s Hospital as a team leader in the post surgical unit and a charge nurse in the neurology/stroke rehabilitation care unit. In 1978, she began working with the Rocky Mountain Poison Center, and has never left. She’s moved up the ladder at the center from staff nurse to professional education coordinator, assistant nurse manager, nurse program manager and staff supervisor.
Montanio feels fortunate for all the professional opportunities afforded her by the center.
"I have given several radio, television, and newspaper interviews on topics including poison prevention, childhood safety, accidental misuse of drugs by the elderly, toxic plants and seasonal hazards," she said. "I have participated in numerous seminars, symposiums and professional presentations on topics including care of the poisoned patient, use of antidotes, management of snake venom poisonings, iron poisoning in children, and toxic syndromes.
"I was the first author on two poster presentations given at the national meetings of the American Association of Poison Control Centers," Montanio said. She has co-authored chapters for editions of "Emergency Nurses Association Core Curriculum" and "Emergency Nursing Secrets." A case report she completed about a pediatric ingestion of warfarin was published in a national medical journal. She has also written test questions for the national certification examination for poison information specialists.
Besides her long and fulfilling career at the poison center, Montanio enjoys music, needlepoint, gourmet cooking and long walks with her husband and dog. The volunteering spirit that guided her toward nursing remains a strong inspiration, too.
"I plan to continue in my current position at RMPC, but would like someday in the future to work again with elders, perhaps in a volunteer role again," she said.