DorlandHealth

“Walk like what?” Elaine asked. “Tell him to walk like a penguin!” I responded. “Tell him to keep his center of gravity low and use his arms as stabilizers.” Once again, Elaine had called to tell me that my father had fallen. With each call she would explain how he fell and how they managed to get him up off the floor. These calls have become part of our everyday life.

If you were to use any fall risk assessment tool for my dad you would quickly realize he needs an adult-sized baby walker, and for quick identification purposes he should be entirely encased in yellow. (Locally, yellow is the color which signifies a patient who is at risk of falling.)

Fall risk assessment tools are widely implemented in every hospital and nursing home across the country. They tell us how likely a person is to fall while in our care. What they don’t tell us is how stubborn a person can be or how willing (or unwilling) the person is to achieve compliance.

Scoping the Challenges of Trauma Case Managers

Hospital case management is a demanding field, where challenges spring up in a moment’s notice. Crystallizing these challenges is the level one trauma center, which places case managers in what are often formidable positions.

Walk a shift through the eyes of a trauma case manager and here’s what you’re likely to face (in the Southwest meltinig pot where I work, at least): establishing the identification of a deceased trauma victim and engaging local police in an effort to assist; notifying family or friends of a victim that just arrived; crowd-control and grief resources for 30 Native American family members presenting en masse following their loved one’s death; an illegal foreign national patient without any funding for services post-discharge, the discharge plan requiring medication; patients requiring durable medical equipment and rehabilitation; out-of-state visitors triaged to the center requiring transportation home, which is six hours away; respecting and adhering to religious beliefs of the exsanguinating Jehovah Witnesses patient refusing blood products; discussing organ donation of a teenager; homicides; suicides; psychiatric crises; and the always varying ages and socioeconomic situations of infants, teens, elderly, professionals, homeless, high-profile celebrities, and the “John Doe” unidentified patients.

Whew.