Last week, I shared a story titled When the System Works It Works Well. A comment from a reader made me rethink this story and see a different perspective that I had not considered. I wanted to share it with you as it was an important realization that we must remember as nurse case managers and other healthcare team members. The Comment: Great story. In this case, as was the patient, healthcare professionals were thoughtful and willing to be flexible. The insurer was willing to work with both parties and approve payment. The result was a successful treatment and healthy outcome. The success c ..read more

Many good outcomes happen in healthcare. In this post, I want to share an example that shows when the system works, it works well. I had such a case a few years ago where I was asked to work with a man who hurt his back while working as a pipefitter in Jacksonville, FL. I will call him Jake. My service request said that Jake had severe back pain due to a work injury. He worked in Jacksonville, FL, but his home was in Miami, and he wanted to be closer to home for treatment. Once cleared from the emergency department, his company arranged for him to be brought to Miami by ambulance. I was to wo ..read more

Over the weekend, I watched several college basketball games. I like college basketball as it is all about heart and soul. As I watched, I recalled how I got interested in the sport. I remember back to March of 1986 when I did a few home care cases for extra money. One of the patients was John. John had advanced ALS. He could not do anything for himself but was awake and alert and could still talk. Allowing us to carry on some interesting conversations. I worked with him all through March when the  college basketball teams were having their tournaments to see who would get into the NCAA ..read more

What is a ChatBot? Take a few minutes to read this article to learn more. Chatbots, artificial intelligence, and machine learning tools are becoming part of everyday life. Here is an example of a recent run-in I had! I was trying to upgrade my Vimeo account and had a few questions about the best plan for me. I had been on a free account but was notified when I went to save a few files that I was out of space and needed to upgrade my account to continue saving files. So I started reading the information on the website about the various plans, but the page did not give me the answer I was looki ..read more

To be an active healthcare team member, you must start with being organized. Here are some ways to get started: Be aware of who’s who. In your doctor’s office, ask to meet the office manager. When you meet them, ask for their business card. Let them know when things go well. If there was a problem, let them know and suggest a way to improve the system. As the patient, you see things differently from the staff and may have a good idea that can help others. Keep all the cards you collect in your notebook to use if you need to reach out. After appointments, you can go into your patient portal t ..read more

Hope for the Best and Be Prepared For The Worst is a quote by Maya Angelou that we must remember when entering the healthcare system. Recently, I met a woman who had an elective knee replacement. The Orthopedic Surgeon is part of a bundled payment program, which means he has a stringent protocol to follow. Her rheumatologist referred her, so she thought she would be in good hands. Unfortunately, she had many challenges that were not addressed before the surgery, which made the post-op period challenging for her and the doctor and caused much anxiety and costs that might have been avoided with ..read more

In my last post, I talked about talking to your healthcare team. In this week’s post, I wanted to discuss building trust with your health insurance company. The first thing I suggest when you have a question for your insurance company is to look at your member handbook. The Member Handbook has information on how to use your insurance fully. The handbook can provide information that should answer most of the questions. If you did not get one when you started with your company’s carrier, look at your health insurance company website. You should find a PDF called Member Handbook under the patien ..read more

I cannot stress enough the importance of talking to the healthcare team. Doing this can be intimidating as you know you are not at the same level as the doctors, nurses, pharmacists, and other healthcare team members. When I was a patient being treated for a Brain Tumor in 2014,  I felt intimidated when the doctors made rounds, and everyone circled my bed and talked about me, and I  had been a nurse for over 40 years! However, I knew how important my input was in my care, so I became a very active patient and involved in every aspect of my care plan. I hope these tips help you to un ..read more

Case Managers are in place to assist people (patients and caregivers), coordinate care, and work with your team to help you obtain resources to meet your needs. They are in a place to advocate for YOU, the injured worker, the employer, and all healthcare team members. It has been said they are the glue that keeps the healthcare system together. Case Managers are in every segment of the healthcare system, but sometimes they are hard to find. If you see yourself in a confusing system where you need to know what is happening, ask for a case manager. They should respond to your needs and help you ..read more

When you go to the doctor’s office, do you prepare? Do write a list of questions on things that have come up since the last visit? Do you review your medications and make notes about how you are feeling, or note any side effects you notice? If you had lab work or any diagnostic testing done, do you check to make sure the results are in your patient portal so you can talk to the doctor about them? If so, print them off and keep them in your folder so you can show them to the doctor if he does not have them for your appointment. Doing these things can help you have a productive doctor’s appoint ..read more