Question of the week: What are your Superpowers?
The Case Management Society of America, Standard of Practice for Case Managers were recently updated. In reviewing them, I came across one of the guiding principles that caught my eye. It was that case managers facilitate clients’ self-determination and self-management through the tenets of advocacy, shared and informed decision-making, counseling, and health education, whenever possible.
As I reflected on this principle, I thought about my practice and how I interact with my patients. I found that these were the strengths that I bring to my patients in helping them navigate the complex healthcare system. Here are some examples of how I meet this guiding principle.
- I attend most of my patient’s doctor’s appointments and review what we want to discuss with the patient before going in to have talking points when we meet the doctor. Going through this exercise helps us both focus and prepare for the meeting.
- I invite the patient’s family (or the central contact person) to doctors’ appointments. If they can attend, we all prepare for the meeting as noted above. If no one can attend, I ask if they want me to call them when we meet with the doctor so they can ask any questions or bring up concerns they have. Doing this helps them to hear firsthand what the doctor is planning and have input into the plan and allows all parties to be on the same page and streamline communications.
- If I cannot attend a patient’s appointment, I ask the patient to call me so I can be present once the doctor is in the room. I also text any questions or issues I want to remind the patient to cover at their appointment, so we get answers during the visit.
- If I try calling a provider, an equipment company, or a home care agency, I try to have the patient on the call with me. This allows the patient to hear my questions and the provider’s answers. It empowers the patient when they are on their own to ask questions and clarify their hearing information.
- I hold team meetings with the various providers on complex cases. This allows us to address current issues and issues that we want to prevent. It gives everyone a heads-up about where we are and where we want to go.
- I talk to the patient and the family to set realistic expectations. I try to explain how the system works and help them understand that even though it is frustrating, working through processes in an organized manner help get answers to questions.
- I let the patient vent and share frustrations. I try to show empathy and help them understand that it is not them personally – but a system generally in place for the patient and not the people who use it.
- I explore alternatives when the insurance company cannot approve a service or resource. I don’t always understand the rationale, but I work to find community resources to meet the patient’s needs as best I can.
- I let the patient/family know they can pay for things themselves and not rely on the payer for everything.
- To me, the most frustrating thing people experience when thrust into a complex healthcare system experience is the loss of control of their lives. I try to give the patient/family some control over their situation as much as possible. By involving them, I help them regain control by learning how to self-advocate for what they need.
What are your superpowers? Let me know how you meet your patient’s needs in our complex and fragmented healthcare system.
Case Management Society of America Standards of Practice for Case Managers. If you work as a case manager, these are the Standards that all must adhere to in our practice. Download your copy at www.cmsa.org/sop22
Stories from a Nurse Advocate: This was a special report that I complied to share stories I have written to share my experiences and learnings from my practice. Feel free to download the PDF at https://anne-llewellyn.s3.amazonaws.com/Anne+Personal/Storytelling+From+a+Nurse+Advocate/PDF+-+Storytelling+from+a+Nurse+Advocate.pdf
Anne, your process is well organized and I really like how you strive to include the relevant people in meeting with the providers.
Do the providers appreciate you attending the appointment with the patient?
How do the providers react to having family members on the phone during the appointment?
Thanks for commenting Yvonne,
Yes, they do like me attending. In the beginning I need to explain who I am and what I do, but once they see me a few times, they see I can help them.
I ask the provider if they mind if I call the family member who is out of town and they always agree
These superpowers have served me well throughout my career–
The ability to listen without judgement
The ability to observe, read and gently query non-verbal behavior
TO hear my voice as I speak with patients and providers
AND..to be present (mentally and emotionally0 in every patient centered interaction
Speaking as a practice administrator, we LOVE LOVE LOVE when a patient presents with a NCM. We believe that NCM’s are such a blessing. Anne, how do you work with patients when English is not their primary language? I imagine it’s difficult for you to arrange an on-demand interpreter?
When the patient speaks another language other then English, the case manager would get a translator. Most of the carries will cover this. also, Most hospitals have translators
Thanks for your note. I am glad you had a good experience.