Nurse Advocate’s Story

My name is Anne Llewellyn. Some people (family and close friends) call me Nancy, but professionally I go by Anne. I live in South Florida and am married to my best friend.  I have two brothers and one sister. My husband has three sisters and one brother. We are both the oldest of our siblings. Between our two families, we have a blend of wonderful people who we love. I love to swim, travel, and connect with people. I live a full life and look forward to new and exciting adventures.

My nursing career has been varied with a wide range of experiences that have spanned Medical-Surgical Nursing, the Emergency Department, and finally the Respiratory Intensive Care Unit. Each step of the way, I learned more about being a nurse and caring for patients and the workings of the healthcare system. This has translated into education in being able to really listen to my patients, their families and to understand that the human spirit is resilient, particularly when quality care, competent clinicians and care providers, and a strong support system are in place.

I returned to school in 1978 to become a Registered Nurse and earned my Associates’s Degree in Nursing. I worked for several years at a Center City Hospital where I learned a great deal that enhanced my nursing education and expanded my insights into life, people, and the role I played as a nurse.

You have to know that I am someone who has always been open to new ideas, and I challenged myself to continually develop and evolve in my field. So when an opportunity was presented in a Risk Management position, I jumped. An Emergency Department colleague told me about an opening at a Risk Management Company.  I inquired and was asked to come in for an interview. I met with the head attorney, who explained the nuances of the position and of what my duties would consist of. He gave me a test of various situations and I had to write down what I would do in those scenarios. Keep in mind, I really had no clue what a risk manager did, but I was intrigued. I found the situations interesting and used my nursing skills in answering the questions. I was offered the job, accepted it, and began an exciting career as a Risk Manager in 1984. One thing that I have done throughout the majority of my time as a nurse has been to continue to work part-time in the Emergency Department on weekends to keep up my skills. This has allowed me to keep current with changes and advances in the healthcare industry as well as grounded in the role and function of our complex healthcare system.

As a risk manager, I covered four hospitals in the Philadelphia area. I would visit one each weekday and on the fifth day, I would go to the office to review my cases with the company’s attorney and the other risk managers. And then there was the paperwork.  It was during this phase that I learned that the hospital was a dangerous place, despite the fact that competent and expert professionals strive to provide good care. I was also made aware that what happened in one section of the hospital could also happen in another area. Reading through the incident reports allowed me to see patterns and education opportunities that could improve quality and safety within the hospital.

My job was to review incident reports that came into administration and conduct interviews so we would know what happened, how the incident had occurred, and how the patient currently was. If the incident was serious, I would write a report in the event of a lawsuit.  I worked with the doctors, the patients and their families, and the hospital administrator to understand what happened and to relay the commitment of the hospital to analyze and correct any medical error or mistake.  I would investigate the incident while the details were fresh in everyone’s mind and work with the team to design solutions that would prevent such an error from happening again. It was an interesting role, it opened my eyes to the complexity of the hospital and the importance of looking at the big picture versus one unit. I learned how bad things could be prevented by the team working together, encouraging the patient and their family to ask questions, and educating staff on how to handle a negative situation if it did arise.

In 1988, I was married. My husband was working in Fort Lauderdale at the time so after the wedding, we moved there which is where I began my married life. I moved to Florida as a traveling nurse and took a position at a community hospital in the Emergency Department. It was a slower pace than I was used to, but I adjusted. We used our off time to explore South Florida and find a new home.

I had kept in touch with many of my friends in Philadelphia and was talking to a good friend one day who had just moved into the area of case management. She shared that the company she was working for was looking for nurses in the Fort Lauderdale area. I called, got an interview. Again, not really knowing what case management was as the supervisor who interviewed me to explain the role. She said that case management was just good nursing, ensuring the patient got what he or she needed in the least restrictive setting for the most cost-effective price. I did well on the interview and was offered a job! I signed up to do 20 hours a week in addition to my position as an Emergency Department Nurse.

I fell in love with case management and felt it closed the circle of nursing.  As a nurse, I saw people who were so sick yet recovered enough to go home or to a nursing home or rehabilitation center.  I attended many meetings with patients and families regarding the plan of care as a nurse, but as a case manager got to see what challenges a patient had when they went home or to another setting depending on their condition. This experience provided me with a different perspective. – As a case manager, I learned how people who were sick, disabled, or dying, could adapt to their situation with an advocate by their side. I saw how having an advocate helped to ensure they transitioned through the system safely, avoided duplication, and progressed through the process in a positive way. This meant adapting to a lifelong injury or chronic disease, or accepting and planning for a dignified death. My role was to make sure the patient and family had the resources they needed to meet their personal goals.

In November 2014, I experienced the role of the patient when I was diagnosed with a central nervous system lymphoma brain tumor. There were no interviews this time, but there was a learning curve for sure. It is amazing how your life can change on a dime.

Even though I was a nurse, I was not capable of making serious decisions so my husband became my advocate and was at my side every step of the way. Hearing the doctor say, “you have a brain tumor” closes your ears to the plan of care and next steps. My husband was able to listen and ask questions that I could not formulate. As we moved forward in the journey, we talked about these situations and I learned a lot about what I missed and how much he had to do to keep me safe and save my life. I will be forever grateful to him.

I was lucky to have an excellent team of physicians, nurses, social workers, and rehabilitation professionals who worked to save my life. Currently, the tumor is gone and I am in rehabilitation to address complications from chemotherapy. I am improving slowly and appreciating every day.

I begin writing Nurse Advocate as a way to share my experience and share tips that I learned that can help others to navigate successfully through our complex, and sometimes scary and dangerous health care system. Today, Nurse Advocate has the same goal but has expanded to a full website where I offer services that empower people to grow, learn and be the best they can be.