I recently starting doing some private nurse advocate work. It has been several years since I have done this type of work, and I was a little hesitant. I found that I had not lost my skills and could ease back into this role. Today, I call myself a Nurse Advocate as I feel that is what I am doing, advocating for patients verses managing cases.

One of the most challenging things I have found is finding the right person to talk to and getting information that helps me understand where the patient is on their journey. Even with the patient’s consent that allows me to speak to the doctor, the nurse, the hospital case manager, or another member of the team, finding the right person is a challenge especially when calling versus going onsite. Being present allows you to know who you are talking to and they know who they are talking to. Unfortunately during the pandemic, we have been forced to use the phone. This has raised frustration levels from all sides.

I also find that many nurses and case managers use the HIPAA release form as a reason not to give information. I find this surprising as my involvement will help them – it will assist them in moving the patient along and putting together a plan of care to meet the patient’s needs. Isn’t that what we are all there for?

I am getting referrals as people are lost in the system. They are confused as to what to do and where to turn for help. My role is to break down barriers and get answers to tough questions. I also work to improve communication between the various stakeholders, in particular the patient, their families, the healthcare team and payors. Challenges that drive a patient or a family to hire a Nurse Advocate include inadequate care coordination, financial issues, trouble getting resources they need to do simple activities of daily living, and most of all communication issues – getting information to help them understand what is going on.

An uncomfortable finding is that a few case managers are defensive when asked what the plan of care is. I find this because they don’t know and don’t want to admit they don’t know what is happening with their patient. I have run into people who have been put off and refuse to look outside their traditional ways of doing things. In a few cases, I have been embarrassed and wonder why they stay in this type of work if they really don’t like it.  Case management is not for the faint of heart. It takes compassion, critical thinking, empathy, and respect for all involved.

When a patient hires a private advocate or a case manager, they are in place to assist them in navigating the complex healthcare system. They find the need to have an advocate as they are frustrated, uncertain, disappointed, and guilty as they can’t function in the current environment and last but not least exhausted from fighting the system and not getting anywhere.

People are starting too looked outside of the traditional way of doing things because they recognize they need help. They need someone who they can call, get answers, and help to ensure their voice is heard. I often find myself thinking that ‘the current healthcare systems is built for the healthcare system – not the people who use it.’

As a result, the workforce is being redesigned to meet the needs of the consumer – independent nuse case managers and patient/health advocates are stepping up to meet this need.

Today healthcare is costly, fragmented, and confusing and, yes at times, unsafe. In addition, people are responsible for paying for more and more of the costs, so they want to have someone to advocate for them – to help them navigate the complex healthcare system. Today, every patient needs an advocate when when they enter the healthcare system.

Maybe we will meet someday. If so, I hope you will welcome me as I am part of the team, as we are both on the same side – working to meet the individual needs of the patient so they can manage their health and healthcare in an efficient and organized manner.

I look forward to your comments. Feel free to share this post with those you feel would benefit!

Have a good week

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