Living the Case Management Process
by Kathy Kaczmarek, RN, CM
My life changed in one instant. I was a Home Health Nurse, loving my life, my career, the freedom and autonomy, the challenges and sense of accomplishments. One day after an appointment I was hit by another car. Not just once. The other car hit me head-on, spun around, hitting me a second time in the driver’s door. My career in Home Health was ended, although it took years for me to know it.
I was taken by ambulance to the nearest ER where I was checked from head to toe and deemed “fine.” I went home and woke the next day unable to move without horrendous pain. The company sent me to their preferred clinic where, again, I was checked out and determined to be “fine.” Time passed, but the pain did not. I was taken off work. Eventually, an MRI confirmed a disc was compressing my spinal cord. Well, that only took six months to figure out! I was sent to a surgeon who complained about his malpractice premiums going up! I was getting very nervous and demanded a second opinion.
A nurse case manager was assigned. Over the next year and a half, she attended appointments, sat and waited with me, made calls and explained processes. She listened while I ranted and raved and bemoaned my fate. My case manager encouraged me to persevere and explained the case management process. She guided and worked quietly behind the scenes. She taught me how to do for myself what needed to be done. She described potential outcomes of each choice laid before me.
Two surgeries later, I was deemed Permanent and Stationary with a 50 pound disability. “Ok, you’re done, have a nice life,” came from the doctor. “But, what do I do now, my career is over, my life is over, what now?” I asked. My case manager again sat with me and explained (again) the case management process, but this time from a very different perspective. She suggested I consider this field of nursing as it does not have the lifting aspects of home health care. She listened and in her quiet way said, “Try this, as you have experienced the case management process in a way that few other case managers have. You have lived it.”
The “case management process” changed my life. The “process” not only walked me through the surgeries, the paper work, the PT, the medications, but also paved a way to my new future. Now, a case manager myself, I am unwavering about explaining the case management process, discussing the choices, the repercussions and the potential outcomes. Case management taught me to be who I am today, though I must admit, I am not quite as good at sitting quietly as my case manager was who sat with me. Because of my surgery I can hug my kids. Because of my case manager I can educate my claimants and provide the support they need to help get their lives back on track.
