1. As an RN what do you like most about your job as part of the NOMS 360 Care Management Team?
I enjoy working with the most acute patients. I am lucky to work for two offices that allow our 360 Care Management Team to be clinically autonomous. I enjoy working with my providers and learning how they treat their patients. I have learned a tremendous amount about the geriatric population due to the doctors’ compassion and willingness to teach.
2. What has been a positive experience in your position that stands out when working with a patient?
Although over the years, I have had many positive experiences, I have one that particularly stands out. A patient was going to be having a pacemaker installed and was quite nervous about the surgery. I was able to walk him through the process and coordinate with the cardiologist to ensure he had all pre-surgery testing completed. After the patient’s surgery, I continued to monitor him closely and tell him what to expect afterward. The continued coordination of communication between the cardiologist and the provider was what I believe won the patient over on the value of having a nurse to call upon when in doubt. Although this surgery is very common, the patient was forever grateful for my reassurance and the continuity our program provided.
3. What has been the most rewarding part of your job as a Care Manager?
When I first started this job, I didn’t realize the type of impact I would have on patients just by calling them. I thought, what could I possibly do by phone that would benefit them as much as seeing them in-person and providing traditional treatments. It was when I began calling patients and realized how care management is critical to best patient outcomes, that I began enjoying the intrinsic rewards; I find my work tremendously fulfilling. A large part of my job satisfaction also stems from the outstanding providers who support and allow me to function with ease in the team-based process.
4. What is something you find most patients don’t know or understand about Care Management?
When first broaching our program with patients, often the objection is, “I already have a home health nurse,” or “I have a nurse that calls me from my insurance that checks in with me monthly.” I try to explain to them the difference between my role and their other services. First, it’s fine to have a nurse call from the insurance carrier, but the point is just that: they represent the carrier, not their provider. Our team has the capability to quickly and directly reach the provider if there is a concern with their care, making that personal connection between our team, the provider, and patient. That’s what NOMS 360 Care Management is all about.
5. How do you balance the needs of the patient with those of their families/friends?
Sometimes this can be difficult. I find the wishes of the patient don’t always match the family’s - and sometimes our team is in the middle, communicating these wishes, which are not always well received. With the help of the providers, we can facilitate the family’s understanding of what is best for the patient, versus their own, however well-meaning, agenda. Our team is the extension of the doctor, and most times the family understands; our role is to be the advocate for the patient and make sure they are being heard.
6. What kind of help do you find most common for patient/family needs?
Candidates for participation in NOMS 360 are generally Medicare and Medicaid recipients. The most common needs involve placing the patient into a long-term care facility, or facilitating a transition-of-care-call once they are discharged from the hospital. After any type of hospital stay, the patient and families are given a lot of information to process; our call can help alleviate concerns and be a reassuring voice. Another very common way we help is through medication affordability and medication/chronic condition education.
7. Outline a situation when a patient/family member expressed their gratitude for you or the Care Team.
That is one thing that just never gets old. I sometimes forget that what I believe is “just my job,” can mean so much to someone else - especially if they are dealing with a new life transition, or a loved one is having difficulty with the transition. I have received cards, flowers and numerous “thank yous.” And each and every time, it makes me stop and appreciate the value my position brings, to those I am lucky enough to support. One thing I hear often from my patients is, “I know if I call you Angela, you will get the job done!”
8. Most of your communication with patients is over the phone. How do you feel about developing rapport with patients via a phone call and what challenges, if any, does this have?
I have learned to meet patients where they are, meaning if they are not ready to make certain lifestyle changes, I don’t press them. It’s very hard to get a call from a total stranger reminding them of how sick they may be. I usually try to find a commonality between us; not all talking must be about health! I have also learned it is a very important part of the puzzle to meet your patients if able, just being able to put a face to a name makes a big difference when trying to overcome that challenge. And now with highly successful emergence of telemedicine, more than ever, patients are becoming comfortable talking with their healthcare team via phone or on the screen.
Guest blogger: Angela Downs, RN. Learn more about NOMS 360.