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...

Crystal's Small Task Saves Big Bucks!

A very special customer to JMS requested a small task in obtaining an impairment rating from a physician. There seemed to be some communication issues, between the adjuster and the physician. The file initially did not have any case management services to help guide the treatment. and at the end of the process nearing file closure, there was a very high impairment rating assigned by the treating physician. Crystal Gilbert, RN got to work! Performing a file review, she found discrepancies with the past surgical history of the injured worker. The injured worker had failed to give an accurate medical history. We gathered and provided the treating physician with medical records showing a prior WC injury to the same extremity and prior surgery to the same extremity of injury. Crystal was able to get a face to face meeting with the physician - because she's just that awesome - and review the medical records and providing documentation of the prior impairment ratin...

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...

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