Making it Personal

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. All going toward the goal of healing within optimal time frames. We ARE making it personal - to the patient.

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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...

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...

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