The Case Manager as Patient
by V. Bruce Mills, MRC, CRC, CDMS, CCM, ACCM
I have been in the field of case management for more than 30 years now. I often feel that from time to time case managers need to have experiences or go through situations that heighten the empathy that is so necessary if they are to work successfully with their clients.
I had such an experience in early 2005 when I learned somewhat precipitously that I would need to have open heart surgery to repair a diseased aortic valve. Since my father died as the result of complications of the same surgery some forty years earlier, I took more than the normal amount of anxiety into preparing for both the hospitalization and the procedure.
On January 13, 2005, I received a bovine pericardial tissue valve to replace my aortic valve. Although the procedure was successful, I experienced a life-threatening arrhythmia, and a hospital stay originally projected for five days turned into 10.
It is during this process that I experienced the case management process from the perspective of my experience as a patient. I have never felt so weak or debilitated in my life. It was through the compassion and caring of the entire team of medical professionals, i.e., physicians, nurses, case managers, social workers, chaplains and physical therapists that I began to conquer my fears and begin to fully participate in the rehabilitation process.
I was incredibly fortunate that through my employer, GENEX Services, Inc., I have excellent health insurance coverage. This took away the financial stress attendant to any such major surgical procedure. It also, however, assisted in two other critical ways. First, it paid for a 12-week outpatient cardiac rehabilitation program. Throughout my outpatient cardiac rehabilitation, I partnered with a nurse case manager who both helped design my program and oversee the results, assuring optimum outcomes. In addition, our health insurer, Anthem Blue Cross and Blue Shield, has provided the ongoing services of a telephonic nurse case manager to monitor my progress and provide ongoing counseling regarding health related issues, nutrition, exercise and general fitness.
I am absolutely convinced that this experience has elevated my level of empathy in dealing with my clients. I have traveled down the same road. I have experienced the fear associated with waiting for a major surgical procedure. I have been incredibly debilitated and weak. I remember describing to my partner when I got home from the hospital that I felt “weak as a baby.” It is through the effort of a team of case management professionals, however, that I found the strength to work through my fears and take an active part in my own rehabilitation. It is one of the most difficult things that I have ever done, but also one of the most rewarding! The good news is that 12 weeks after my surgery I returned to full duty employment and I have never felt better in my life.
As a result of this profound experience, I feel that I have become a better case manager, one who is more well-rounded and in tune with the clients that I serve. The real reward, however, is that I became a better person: one who is more appreciative of each new day that God grants me!
