The Head Bone's Connected to the Neck Bone...

My first test in college anatomy we were given a piece of paper with numbered lines, 1-206. Instructions were simple: Name the 206 bones in the body. I made 100% - thank you. Learning anatomy of all the body systems, and the physiology of how they interact is my love in the medical field. The science of it all fascinates me.

There is a logical physiologic reaction to bodily injury, and a RN Case Manager's critical thinking skills help anticipate symptoms and complaints. If you hit your thumb hard with a hammer, we know you will have pain, and probably stiffness; and if you smashed it good enough, you could have "sympathetic" stiffness of adjoining fingers in the hand. That is a known physiologic response.

Stacy Mathis, RN has a patient with multiple injuries has begun to relate all aches and pains to his MVA. The problem is, not all his complaints can be physiologically connected to the injury. This is quite common in catastrophic injuries, but also happens in other injuries as well. Whether intentional or not, the mind can begin to rationalize the association of aches and pains to an injury and it takes the critical thinking skills of a great RN Case Manager to work with the physician team to prove or disprove the connection based on objective evidence.

Ankle bone connected to the heel bone,

Foot bone connected to the toe bone,

Dem bones, dem bones, dem dry bones,

Now hear the word of the Lord!

Comments

Case Management GPS

W The next time I purchase a new vehicle there are several features I have on my wish list. For as much as we case managers travel, Navigation is high on the priority scale to make life easier. Under the pressure of arriving at a physician appointment on time, it's never a good feeling to take a wrong turn or get lost. There are times our role as a case manager is much like a navigator. Deana Scott, RN had that experience just yesterday while attending a physician visit. After three years of treatment for a work injury, the physician had nothing further to offer, and there appeared to be issues of malingering and symptom magnification. There was a point at which the physician actually had a look in his eye of being lost as far as how to bring the treatment course to an end. Confusion centered around the injured worker's return to work goals. It's at times like this, a Case Manager is able to maintain focus and much like a navigato...

A Brilliant Mind

Visit Our Website Connect with me on LinkedIn It’s kind of an inside joke around our office that I’ve been called “brilliant” by a physician for my interpretation of a lumbar MRI. This story happened several years ago when Stacy Mathis, RN working with me in training, and was my witness! This physician is known for his eccentric personality, and he went all out to make me feel as though my critical thinking skills really were brilliant! I was attending a clinic visit for MMI and PPI assignment of a shoulder and lumbar injury. The shoulder had been complicated by a postoperative infection, and was now healed. The lumbar injury had been diagnosed as a strain, although an MRI had been obtained to rule out a disc herniation. I was expecting a high ra...

Pills, Pills, Pills - What's in a Name?

Yes, I know medical terms sound like another language to lay persons. Sometimes we medical people get a good laugh out of patient's pronunciations. My mother always called the "pharmist" to refill her meds. My friend's mother said she needed "cadillac" (cataract) surgery. One injured worker told me he was x-rated and sent home from the ER. But the funniest was a lady talking about her "rotisserie cup" surgery - translated "rotator cuff". Medication names - particularly generic names, can be very confusing. That's why I always recommend carrying a written list of medications in your wallet. It's great to have in an emergency, or when you are filling out clinic history forms. While we can laugh off some mispronunciations, medication names are very important NOT to get confused. Stacy Mathis, RN had a patient this week that is a perfect example. An injured worker had been recommended to return to his psychologi...

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