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

Slipping Under the Radar

A work injury is NO vacation! Most of us would agree with that statement. It's never fun to get hurt, yet it doesn't stop an injured worker from trying to turn recovery time into paid time off. It is very common to have clients make requests to postpone procedures, therapy and return to work for personal reasons. If this request is made to a physician under their group health insurance, it is not really an issue. However when such a request is made during healing timeframe from a work injury, this is not an appropriate or reasonable request. As Case Managers, we must remind both the injured worker and providers that during recovery and rehabilitation time the injured worker's "job" is to heal and comply with appropriate treatment and work status. Just this week, Deana Scott, RN had a client to request postponing her light duty return to work until she could finish outpatient therapy. What Deana reminded her of, was that the activity of...

Working Both Sides of the Fence

Our Case Management role is so multifaceted. While we are patient advocates to help injured workers obtain the best treatment on the road to healing, we also find ourselves working the other side of the fence - working just as hard to expose those defrauding the workers compensation system. This week one of our RN case managers discovered in review of records that a patient had "chronic" back pain, when she had denied ANY pre-existing back pain or treatment for her reported work injury. This patient DOES need treatment, but it should be on her health plan, NOT workers compensation. On the other side of the fence, he has a patient that was discovered to have a serious underlying cancer causing what he thought was pain from a work incident. He is working with the carrier to refer the patient to an appropriate provider. Case Management is such a rewarding field, and for so many reasons. It's a great feeling when you've assisted someone to obtai...

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...

Cheryl's Blogspot

Search This Blog