A New Perspective: From Case Manager to Patient
by Mary Beth Barber, RN, CCM, CPUR

I may be coming from a different angle on this approach, but having been a case manager for 13 years, I had started to feel as if I had seen it all. But sometimes fate has a way of surprising us and knocking us down to get a message through.

Five years ago, my work and family life seemed to be moving on course, when suddenly out of nowhere I developed one of those head colds determined to stick around. Like most nurses, I believe in self treating (why would I want to bother a doctor, I see them all day long with my own patients). My home remedies treatments failed and the virus decided to move rapidly. Within 48 hours, I had crushing chest pain, shortness of breath, wheezing, high blood pressure, and high blood sugar. My doctor admitted me to the hospital for all sorts of work ups to include cardiac, pulmonary and internal medicine. After being poked and prodded with IV and IM needles, cardiac catheters, cold X-ray slabs and pulmonary therapy treatments, I was told I would be in the hospital for five days and then could go home.

My cardiologist said, “Congratulations, your heart and vessels are sound. Your chest pain is coming from your lungs.” My pulmonologist said, “You have a bad case of asthma, but we will get it under control.” My internist said, “You have diabetes, and the IV steroids that are helping your breathing are keeping your blood sugars high.” Like the typical nurse, I said as I was breathing into my oxygen mask, “I can go back to work, can’t I?” He shook his head and said, “Don’t plan on going anywhere for three months.” That is when the shock hit me. “I must be really sick!”

To my surprise, my personal health insurance and my short term disability insurance each had assigned a telephonic case manager to me, for my three months duration. I never got their last names, but if you both see yourself in this story, expect to get one step higher in heaven, because you deserve it. Suddenly through the shock of it all, I forgot my nursing medical education, and I was a simple patient, going through all of the emotions of a major trauma. Denial, sadness, anger, bartering and then, finally, acceptance. My two case managers stuck with me like glue, calling me daily at first, then easing off down to once a week. They were my cheerleaders when I said I couldn’t do this insulin stuff. They scolded me if I became lazy and went back to bed instead of taking a walk, like my treatment plan said for me to do. I learned very quickly that for three months I had to be accountable to two nurses, who designed a treatment plan, gave me questions to ask my doctor at each visit, totally ignored the fact that I was a nurse and gave me lots of patient education on diabetes, asthma and all around good health. They became downright annoying at times, but I had to laugh, thinking about how many times I could be annoying to my patients.

Three months later I was on track, back to work coordinating my patients’ care. My case managers signed off of my case and congratulated me for staying on track. So don’t ever think that you’re not important, or that you are not accomplishing anything with your patients. Just by staying in contact with them, you are giving them the message that you do care, and you want them to get better.

You never know, someday you might be the patient, and I might be your case manager!