Case Management: A Personal Perspective
by Ann Condon
On December 12, 2006, my life changed, and I would never see life the same again. My career as a nurse case manager and my experience as a neuro operating room nurse came full circle, staring me in the face. I was still in shock listening to my sister’s words, “Mamma has a brain tumor.” Over the past year 2 years we had sought out every specialist, all exams being normal. The following morning I began the 200 mile journey to the hospital.
I arrived at the hospital, hours passed and no news arrived. My role as a case manager has been to advocate for the patient, to assist in treatment planning in a timely manner with the physicians, and to coordinate and implement that plan. I was afraid and tired of waiting. I asked to review the chart informing the charge nurse. The neurologist arrived quickly after my request and reviewed the findings of the MRI. The neurologist painted a picture that was bleak: a glioblastoma or an astrocytoma, both malignant tumors. The neurosurgeon was not far behind the neurologist in disagreeing with the diagnosis, stating that he felt 90 percent sure the tumor was benign. The MD stated his treatment plan for surgery, which would include removal of the tumor the following week after days of steroids to reduce the edema. The family sat and evaluated the options as they looked to me to guide them in the decision making process. We determined a second opinion was needed and a hospital transfer to a teaching facility was the best option. An immediate transfer to Vanderbilt Medical Center was requested. I coordinated the acceptance to Vanderbilt through a neurologist that had treated a family friend and I worked with the onsite case manager at the hospital to obtain the transfer. The transfer came late into the night, and we were on our way. The following night the family met with the neurosurgeon, and surgery was scheduled for the following day. The tumor, as expected, was a glioblastoma multiform grade IV.
My case management skills allowed me to coordinate safe, effective treatment in a timely manner, to maintain communication and to advocate for my mother to obtain the best and most appropriate treatment available, allowing my mother and family to make the best decision in regard to her healthcare needs. Making an informed decision and choosing not to take chemotherapy was a decision she has been very comfortable with. Willing to live with her cancer every day, she sees it as a blessing to be here with her family.
I am so grateful that I am a case manager. I am grateful that I can assist patients, as well as my own family, in making good medical decisions, advocating for the best, meeting their needs from a health and a human perspective by being their guide through the healthcare maze.
