Over the past few months, I have gotten back to doing onsite nursing case management and what I call nurse advocacy. It has been an eye-opening experience. I find my key role is finding resources for my patients and improving communication between members of the healthcare team such as physicians, other healthcare professionals like physical therapists, attorneys, adjusters, patients, their families to ensure things get done.
What I learned is since being ‘back in the game’ is that there are more people to communicate with. Insurance companies have provider networks, which in theory should streamline things but adds another layer to an already confusing system. I also see how busy people are and many things get missed or are put off, which just delays the process.
I find myself making calls but not getting a resolution and having to circle back hours later to follow up on what I called about in the first place. It seems like a lot of duplication and delays in what are simple requests for services.
Trying to keep everyone informed and on the same page is a challenge. I have started to have group calls, where I get the provider network care coordinator, the provider, and myself on the phone so we all hear the same thing and leave with an understanding of what each of us is to do so we can move forward.
I see my role as the one who untangles issues and advocates for my patients as they seem to get left behind in the complex system we call healthcare.
It has been fun being back, but it has also been disappointing to realize that we still have a fragmented system built to meet the needs of the healthcare system and not the people it serves.
The bottom line: stay well, so you do not have to get into the system! But if you do…..hire a nurse advocate as it will save your sanity!
Have a good week!