Diane Willis, RN has been a clinical manager with Crawford & Company since 2007. “My passion for caring for people began in high school when I volunteered to be a candy striper at a local hospital,” says Diane, who spent her college summers working both as certified home health aide and as a certified nursing assistant and activities leader in a nursing home.
After graduating from Stony Brook University’s nursing program in 1984, Diane’s hospital experience grew exponentially. She worked in the Pediatric Intensive Care and Adolescent Units, and in the Emergency Room. Later, she left the hospital to work in home care as an infusion therapy nurse. “At first, I worked in the field–going to people’s houses and teaching them how to do things such as administer their own IV antibiotics. Eventually, I took a job coordinating all of the infusion home care cases. Over time, this coordination included setting up all aspects of the cases from different insurance companies. This was the beginning of my passion for case management.”
“With care management, I can help fix problems and bring comfort and happiness to my clients. I love being able to walk into a client’s home and do my evaluation with just a little bit of information, and then discovering additional needs than were first identified by the family or trust officer. My least favorite part is getting stuck in traffic. I often travel to medical appointments with my clients and we need to be on time. It is so frustrating to encounter bad traffic, knowing that we could potentially miss an appointment and have to reschedule.”
Today, Diane has reached her five-year anniversary with Crawford & Company and looks forward to her 10th anniversary. “When I first started working for the company, I took the care management course. I plan to take the Case Management Certification Exam this year.”
Diane’s tips for new case managers include:
- Be organized.
- Be flexible with your time–be willing to go the extra mile for a client that depends upon you.
- Have a passion for helping people. “The biggest surprise about being a care manager is how involved I become in all aspects of their lives. I have helped clients purchase, renovate, clean, and even redecorate their homes. Some clients don’t have anyone besides their care manager to help out with things that they would like to do.”
- Collect as many nursing experiences as you can, because it is important to know the system. This includes working in institutions with Medicare and Medicaid regulations. It is important to understand the dynamics in hospital and other medical facilities, such as assisted living or skilled nursing facilities.
- Know what resources are available to clients in the home care setting.
- Always remember: to keep a full tank of gas, a fresh bottle of water for yourself and your client, a snack, tissues and wipes. Also, never forget your date book, badge, business cards, or client information sheets.
When initiating new care management cases, Diane recommends performing a comprehensive assessment intended to discover and document the various needs of the client including, but not limited to, medical, psychosocial, and supplies needs. “I also get the client and family involved,” says Diane, “I ask them to share what they perceive as problems to be addressed.” She adds, “The assessment process is ongoing.” As the client changes, so do the client’s needs.
A typical day in the field begins with a confirmation call to the client. Once appointments are confirmed, Diane transports her clients. Sometimes, she transports her clients to the doctor’s office–other times, she’ll take her clients shopping or even out to lunch.
In case of medical emergencies, Diane serves as a client advocate. She speaks “with the doctors and nurses, providing all of the information needed about my client so the hospital staff can make the best health care decisions for my client.”
“I stay with my client until they are discharged from the ER or admitted to the hospital and are resting comfortably in their beds. If my client is not safe alone, I set up home health aides and wait until someone arrives before I leave.”
As an example, Diane shared some details regarding one of her cases, “A client of mine has schizophrenia. He was admitted to the hospital for surgery. Three days later he was discharged from the hospital and admitted to a rehabilitation facility. The medications that the nurses gave to him looked different from the medications he was used to taking at home. My client refused to take their medications because he thought he was being poisoned.
Within a few days of not taking his medications to treat his schizophrenia my client became psychotic and had to be readmitted to the hospital on their behavioral health unit for treatment. My client again refused to take the medications that the hospital was giving him because the medications looked different than his usual medications; again he thought he was being poisoned.
I advocated for my client by going to the head of the psychiatry at the hospital. He gave me permission to bring my client’s medications in from his home. He also authorized that all future medications could be filled at my client’s pharmacy. Even though it took a few months for my client to get better psychologically, he finally did come around and is now living at home independently in his boarding house. He is back to his old routine and is very happy.”