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In this section, feature-length articles bring you up close to common and rare clinical areas. With a focus on disease states, workers' compensation, disease management, long-term care and more, these resources will broaden your clinical base and enhance your delivery of care. Begin with the topical articles below, or start by exploring the five clinical categories to the left.
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Workers' Compensation
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Written by Dorothy Consonery-Fairnot, BS, MSHA, RN, CCM, CLNC
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Friday, 02 October 2009 21:30 |
 Addressing the Physical, Psychological and Psychosocial Needs of Older Workers
When an employee becomes injured on the job, it is essential to consider the needs of the whole person — physical, psychological and psychosocial — in order to facilitate a successful return to work. Although much of the emphasis in a workers’ compensation case is placed on the physical body, issues ranging from depression and fear of reinjury to a lack of support systems cannot be overlooked.
With an older employee, psychological and psychosocial issues may be more imperative. Fears surrounding losing one’s job (even if unfounded) and feeling a loss of control in one’s life can become real impediments that keep older workers from returning to work and successfully staying on the job.
“There are specific issues when older workers are out on workers’ compensation,” says Thomas Emerick, president of Emerick Consulting LLC of Fayetteville, Ark. “Older workers in this situation have special concerns such as fear of being able to return to work, combined with worries over seeing their careers suddenly being limited.”
For case managers handling workers’ compensation cases, being attuned to the red flags and warning signals can ensure that psychological and psychosocial issues are addressed along with clinical and rehabilitative aspects of care. |
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Catastrophic
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Written by Kathy Singleton, RN, MSL, CLL
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Friday, 02 October 2009 21:16 |
 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. |
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Disease Management
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Written by Helen M. Sorenson, MA, RRT, FAARC
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Friday, 02 October 2009 21:08 |
 Sleep Apnea: Defining the Need for Respiratory Care Case Managers
Over the years changes in the health care environment have dictated changes to what we have come to understand as case management. Presently, the role of the case manager in most areas of the country is performed by nurses. This is due in part to general shifts in health care. The advent of the diagnostic related groups in the 1980s shifted the focus of case management from making more resources available to making social services more economically feasible, and in some cases limiting access for patients. Nurses, viewed as trusted professionals, established a medical necessity for many services.
The economic situations facing hospitals over the past few decades also have been a driving force in the utilization of case managers as an alternative to the delivery of direct care services, as Peggy Rossi highlights in her book Case Management in Health Care.
What this means is that case management has become, in a sense, defined by limitation. Case management, however, is not and should not be discipline-specific. Not in a strict sense. The variation in expertise among and between disciplines lends itself to the potential for enhanced satisfaction among patients assigned to case managers. Dealing with someone knowledgeable in specific areas of patient care management will provide a higher level of comfort to the patient and may ultimately lead to better compliance with therapeutic interventions. |
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