Cheryl's Blogspot

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 obtain treatment

When we are taking care of treatment arrangements and details, calling clients for updates and problem solving, attending physician visits with clients - sometimes with lengthy wait times, we establish a professional relationship with them.  From the client's perspective it can seem even "personal", although it's overwhelmingly a 1-sided sharing of information.  This is true not only in case management, but in every field of nursing, because nurses show empathy and compassion for others as we provide "care" for them. I caution adjusters and carriers not to think of case manager tasks as clerical, or messengers, or that our clinic wait time is a "waste" of time.  All our communications with clients are taking care of their needs - "medically" physical and emotional.  The results of our nursing can seen not only in the gathering of information, treatment planning, but also in improved patient compliance and understanding, and outcomes.