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Nurse Case Manager Chronicles

Flight Attendant to Nurse Case Manager: A Fulfilling Second Act

One nurse case manager found her calling later in life, bringing life experience, passion and drive to workers’ comp claims.
By: | June 18, 2018 • 5 min read

Second-career nurses may not have started their professional lives as case managers, but for some, it’s a deeply felt calling that’s worth the wait.

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“When a nurse comes from a different background, [employers should] remember the nurse chose this. They are passionate. Organized,” said Genex nurse case manager Theresa Martin.

Such a decision isn’t as simple as choosing a college major; these nurses are well into an already-lucrative career. They might have a family to look after and a house to run.

“It’s not easy to make that choice, to go back to school in the middle of everything. [The nurses] who do it are well-rounded individuals. You have someone used to being a professional who doesn’t need a lot of mentoring.”

First Career Skills

Martin was a second-career nurse herself. She wanted to study nursing in her undergraduate years but was involved in extracurriculars that took up a lot of her time.

“I had always wanted to be a nurse, but I think I had the maturity at that age to know it would have to wait. I put nursing on the back burner.”

Instead, Martin became a flight attendant before joining the nursing workforce. There, she said, she learned how to organize herself and solve problems quickly. Having an argument on a plane can set passengers’ teeth on edge. Martin was the person who had to calm down passengers while solving their issues.

“As a flight attendant, I had to solve problems as they happened. We couldn’t land the plane. And you can’t have drama on a plane. You can’t ignore it.”

Theresa Martin, nurse case manager, Genex

In nursing, she said, you have to think on your feet and utilize quick problem-solving skills just like on a plane.

The work may be different, but the skills behind each profession are the same. Martin works hard to know her claims inside and out; she’s readily available to answer any questions for the carrier, the adjuster, the worker or the employer; and she’s proficient at coming up with solutions on the spot.

When problems arise, Martin taps into the communication and interpersonal skills she learned early in her flight attendant career. So much so, she said, she uses these skills “every day, all day.”

“Case management is a surprise; you never really know how your day will be. No matter what you do, a million factors can enter into a claim. Everyone has to be on the same page.”

The Right Switch

Transitioning into nursing was hard, Martin said, “but not as hard as I thought it would be.”

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She recalled one case in particular that solidified that career change for her.

A worker fell from a skylight to the first floor and was gravely hurt. He had multiple orthopedic injuries and multi-system failure, including his kidneys.

Martin was assigned his case and met with the worker’s father at the hospital.

“It was touch and go at first. The trauma surgeons were suggesting removing the worker from life support, and the father said it was a decision he felt he couldn’t make for his son,” she explained.

Martin sat down with the father and talked about the injured worker’s options.

“Case management is a surprise; you never really know how your day will be. No matter what you do, a million factors can enter into a claim. Everyone has to be on the same page.” — Theresa Martin, nurse case manager, Genex

She told him, “You don’t have to decide right now. Let the trauma team take care of him. Let the interventions [in place] happen.”

Martin explained that when a body falls from a tall height like the worker did, the body’s muscles will release proteins. This excess protein in the body can trigger organ failure. In the case of this worker, his kidneys began to fail, and the trauma team put him on aggressive kidney dialysis. The dialysis, Martin said, was one of the main interventions in place.

The worker’s father chose not to take his son off life support. The team gave the injured worker a few days to see where his progress landed. Slowly, he improved, woke up and began to gain back his strength.

From there, Martin worked to get the worker out of ICU and into rehab at a facility where she had already established connections early in her nursing career.

When the injured worker went back to work, Martin said this solidified her choice to become a nurse. “I felt like I was doing what God wanted me to do. It made me feel grateful to be in this profession, to be able to say, ‘you don’t have to decide right now,’ and give him options.

“It’s a lot, asking the family to trust you,” she said. “It was a catastrophic case, but we were able to get him back.”

One Woman’s Journey to Nursing

Martin grew up on a farm in Indiana and attended Purdue University because it was still close to home.

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“I didn’t see much of the world then,” she said. So when presented with an opportunity to see the world at the age of 22, Martin took it. American Airlines was hosting a “casting call” for new flight attendants, and before Martin knew it, she was training to take flight.

It was her golden ticket: earning a wage while traveling at the same time. “I could see the whole world,” she said.

She enjoyed flight attending, but it was “never enough.” Then, in the 1990s, the airline workers went on strike.

Martin was a single mother and she knew she needed a more stable career if she was going to support her kids. She entered into a nursing program and graduated in 1998 at the top of her class — a feat that was no surprise to her. “Nursing had always been my passion.”

She started in med-surg, then entered neurology. Home care case management came next, and by that time, her kids were in middle school. She wanted a steady 9-to-5 position and took up telephonic workers’ comp case management for 10 years.

Now, as a case manager, Martin likes having that one-on-one contact with injured workers, their family, the adjuster and other parties on a claim.

“How do I turn it off?” she quipped. Martin said even on weekends or her days off, she’ll still take calls from her patients. “Case management is my passion. I do have to find the balance with my personal life, but I just really enjoy what I do.”

In fact, she loves nursing so much, she mentors young nurses entering the case management field. Many of them are stepping out of a hospital setting.

“When coming from a hospital setting, the young nurses need to learn how to organize their day,” said Martin. She related it back to her flight attendant duties: “First thing I would do is organize my cart. Drinks, ice, food. It was all set.

“Nursing is like that. You have to start your day by organizing it. Know what your duties are and prep for them.” &

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

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Insurtech

Kiss Your Annual Renewal Goodbye; On-Demand Insurance Challenges the Traditional Policy

Gig workers' unique insurance needs drive delivery of on-demand coverage.
By: | September 14, 2018 • 6 min read

The gig economy is growing. Nearly six million Americans, or 3.8 percent of the U.S. workforce, now have “contingent” work arrangements, with a further 10.6 million in categories such as independent contractors, on-call workers or temporary help agency staff and for-contract firms, often with well-known names such as Uber, Lyft and Airbnb.

Scott Walchek, founding chairman and CEO, Trōv

The number of Americans owning a drone is also increasing — one recent survey suggested as much as one in 12 of the population — sparking vigorous debate on how regulation should apply to where and when the devices operate.

Add to this other 21st century societal changes, such as consumers’ appetite for other electronic gadgets and the advent of autonomous vehicles. It’s clear that the cover offered by the annually renewable traditional insurance policy is often not fit for purpose. Helped by the sophistication of insurance technology, the response has been an expanding range of ‘on-demand’ covers.

The term ‘on-demand’ is open to various interpretations. For Scott Walchek, founding chairman and CEO of pioneering on-demand insurance platform Trōv, it’s about “giving people agency over the items they own and enabling them to turn on insurance cover whenever they want for whatever they want — often for just a single item.”

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“On-demand represents a whole new behavior and attitude towards insurance, which for years has very much been a case of ‘get it and forget it,’ ” said Walchek.

Trōv’s mobile app enables users to insure just a single item, such as a laptop, whenever they wish and to also select the period of cover required. When ready to buy insurance, they then snap a picture of the sales receipt or product code of the item they want covered.

Welcoming Trōv: A New On-Demand Arrival

While Walchek, who set up Trōv in 2012, stressed it’s a technology company and not an insurance company, it has attracted industry giants such as AXA and Munich Re as partners. Trōv began the U.S. roll-out of its on-demand personal property products this summer by launching in Arizona, having already established itself in Australia and the United Kingdom.

“Australia and the UK were great testing grounds, thanks to their single regulatory authorities,” said Walchek. “Trōv is already approved in 45 states, and we expect to complete the process in all by November.

“On-demand products have a particular appeal to millennials who love the idea of having control via their smart devices and have embraced the concept of an unbundling of experiences: 75 percent of our users are in the 18 to 35 age group.” – Scott Walchek, founding chairman and CEO, Trōv

“On-demand products have a particular appeal to millennials who love the idea of having control via their smart devices and have embraced the concept of an unbundling of experiences: 75 percent of our users are in the 18 to 35 age group,” he added.

“But a mass of tectonic societal shifts is also impacting older generations — on-demand cover fits the new ways in which they work, particularly the ‘untethered’ who aren’t always in the same workplace or using the same device. So we see on-demand going into societal lifestyle changes.”

Wooing Baby Boomers

In addition to its backing for Trōv, across the Atlantic, AXA has partnered with Insurtech start-up By Miles, launching a pay-as-you-go car insurance policy in the UK. The product is promoted as low-cost car insurance for drivers who travel no more than 140 miles per week, or 7,000 miles annually.

“Due to the growing need for these products, companies such as Marmalade — cover for learner drivers — and Cuvva — cover for part-time drivers — have also increased in popularity, and we expect to see more enter the market in the near future,” said AXA UK’s head of telematics, Katy Simpson.

Simpson confirmed that the new products’ initial appeal is to younger motorists, who are more regular users of new technology, while older drivers are warier about sharing too much personal information. However, she expects this to change as on-demand products become more prevalent.

“Looking at mileage-based insurance, such as By Miles specifically, it’s actually older generations who are most likely to save money, as the use of their vehicles tends to decline. Our job is therefore to not only create more customer-centric products but also highlight their benefits to everyone.”

Another Insurtech ready to partner with long-established names is New York-based Slice Labs, which in the UK is working with Legal & General to enter the homeshare insurance market, recently announcing that XL Catlin will use its insurance cloud services platform to create the world’s first on-demand cyber insurance solution.

“For our cyber product, we were looking for a partner on the fintech side, which dovetailed perfectly with what Slice was trying to do,” said John Coletti, head of XL Catlin’s cyber insurance team.

“The premise of selling cyber insurance to small businesses needs a platform such as that provided by Slice — we can get to customers in a discrete, seamless manner, and the partnership offers potential to open up other products.”

Slice Labs’ CEO Tim Attia added: “You can roll up on-demand cover in many different areas, ranging from contract workers to vacation rentals.

“The next leap forward will be provided by the new economy, which will create a range of new risks for on-demand insurance to respond to. McKinsey forecasts that by 2025, ecosystems will account for 30 percent of global premium revenue.

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“When you’re a start-up, you can innovate and question long-held assumptions, but you don’t have the scale that an insurer can provide,” said Attia. “Our platform works well in getting new products out to the market and is scalable.”

Slice Labs is now reviewing the emerging markets, which aren’t hampered by “old, outdated infrastructures,” and plans to test the water via a hackathon in southeast Asia.

Collaboration Vs Competition

Insurtech-insurer collaborations suggest that the industry noted the banking sector’s experience, which names the tech disruptors before deciding partnerships, made greater sense commercially.

“It’s an interesting correlation,” said Slice’s managing director for marketing, Emily Kosick.

“I believe the trend worth calling out is that the window for insurers to innovate is much shorter, thanks to the banking sector’s efforts to offer omni-channel banking, incorporating mobile devices and, more recently, intelligent assistants like Alexa for personal banking.

“Banks have bought into the value of these technology partnerships but had the benefit of consumer expectations changing slowly with them. This compares to insurers who are in an ever-increasing on-demand world where the risk is high for laggards to be left behind.”

As with fintechs in banking, Insurtechs initially focused on the retail segment, with 75 percent of business in personal lines and the remainder in the commercial segment.

“Banks have bought into the value of these technology partnerships but had the benefit of consumer expectations changing slowly with them. This compares to insurers who are in an ever-increasing on-demand world where the risk is high for laggards to be left behind.” — Emily Kosick, managing director, marketing, Slice

Those proportions may be set to change, with innovations such as digital commercial insurance brokerage Embroker’s recent launch of the first digital D&O liability insurance policy, designed for venture capital-backed tech start-ups and reinsured by Munich Re.

Embroker said coverage that formerly took weeks to obtain is now available instantly.

“We focus on three main issues in developing new digital business — what is the customer’s pain point, what is the expense ratio and does it lend itself to algorithmic underwriting?” said CEO Matt Miller. “Workers’ compensation is another obvious class of insurance that can benefit from this approach.”

Jason Griswold, co-founder and chief operating officer of Insurtech REIN, highlighted further opportunities: “I’d add a third category to personal and business lines and that’s business-to-business-to-consumer. It’s there we see the biggest opportunities for partnering with major ecosystems generating large numbers of insureds and also big volumes of data.”

For now, insurers are accommodating Insurtech disruption. Will that change?

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“Insurtechs have focused on products that regulators can understand easily and for which there is clear existing legislation, with consumer protection and insurer solvency the two issues of paramount importance,” noted Shawn Hanson, litigation partner at law firm Akin Gump.

“In time, we could see the disruptors partner with reinsurers rather than primary carriers. Another possibility is the likes of Amazon, Alphabet, Facebook and Apple, with their massive balance sheets, deciding to link up with a reinsurer,” he said.

“You can imagine one of them finding a good Insurtech and buying it, much as Amazon’s purchase of Whole Foods gave it entry into the retail sector.” &

Graham Buck is a UK-based writer and has contributed to Risk & Insurance® since 1998. He can be reached at riskletters.com.