**The big picture:** Guideway Care highlights the financial and operational inefficiencies of in-house nurse triage staffing, arguing that traditional models fail to scale effectively with fluctuating demand. **Why it matters:** Healthcare organizations face significant challenges in maintaining 24/7 RN coverage, leading to budget overruns, patient leakage, and increased burnout among existing staff. **Between the lines:** - In-house triage incurs high costs beyond hourly wages, including benefits, overhead, and constant retraining due to high attrition. - Understaffing leads to patient abandonment and burdens bedside nurses, while overstaffing results in idle capacity. - High turnover compromises care quality, as new nurses require extensive ramp-up time. **Staffing & HR impact:** The article underscores how high attrition rates and the need for constant recruitment and training severely impact staffing firm margins and operational efficiency in healthcare. **The bottom line:** Outsourcing triage workforce management can offer predictable costs and scalable solutions, mitigating the compounding negative effects of internal staffing challenges.