Nurse Case Manager Chronicles

The Injured Worker’s Family

Incidents at work affect more than the injured. How can a nurse case manager help the family cope?
By: | January 10, 2018 • 4 min read

Wendy Woodard knows what it takes to get a catastrophic case moving. In just six months, this nurse case manager for Ascential Care got an injured patient back on his feet and cleared for work without restrictions.

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But the road leading to recovery wasn’t always smooth; like in many claims cases, Woodard had her fair share of obstacles to overcome.

“Nurses work with the patient’s family emotionally so they can get the patient where they need to be,” she said. “This [particular patient’s] family did not work in the medical field. They were worried about him being placed so far away with no one around him.”

The patient, a pharmacist by profession, was driving when a tree fell on his vehicle, cracking the roof of the car — and his skull.

He suffered a traumatic brain injury, a spinal fracture, pulmonary contusions and facial fractures, among other ailments. Woodard went to the hospital two days after the patient was admitted to the ICU.

His condition was critical.

“I didn’t know the extent of his injuries until I got there,” she said. “The hospital was still trying to stabilize the patient.”

Immediately, Woodard began coordinating the best care option for the patient. They lived in an area with a level one trauma center but not a rehabilitation center for traumatic brain injuries. The nurse knew the patient’s best chance at recovery would be at Shepherd Center, a spinal cord and brain injury rehabilitation center in Atlanta, Georgia — five and a half hours away.

Wendy Woodard, nurse case manager, Ascential Care

The family was hesitant.

“The patient was in his late fifties. He had four children, a brother and his ex-wife waiting for him. There was a lot of back and forth on who would manage his care,” Woodard explained.

The patient’s oldest daughter and his brother both wanted to be the go-to person for decisions, but they found the long trip to Shepherd daunting. They didn’t want their loved one so far away during a critical and demanding time in his life.

Woodard, a nurse case manager for 18 years, knew what to do: She talked to the family.

“We talked about not having the right rehab facility. If he was going to make a full recovery, we had to get him where he needed to be,” she said. “My role was to provide them with knowledge on brain injuries and get the right care to the patient.”

She brought in pamphlets, pulled up Internet searches on the patient’s injuries, explained each type of fracture to the family and answered questions. But Woodard didn’t stop with facts; she entered the hospital every day for three weeks, checking in on the family’s emotional state.

“I was there, every day, offering emotional support,” she said. “The patient’s daughter cried on my shoulder. We went over and over what his best options were.”

In the end, the family agreed to send him to Shepherd.

Recuperation and Recovery

Once the patient was stabilized — a process that took three weeks — he was moved to the rehab facility.

When he started to respond, Woodard said the team assessed any permanent damage. The injury left the patient with permanent left-side facial paralysis and cranial nerve deficits. He had lost hearing in his left ear, was dizzy, disoriented and discouraged.

“He wouldn’t speak, was withdrawn and depressed,” said Woodard. The team worried about the patient’s cognitive function. As a pharmacist, the man needed to gain back his cognitive abilities if he wanted to work in the field again. Woodard noted he was a very intelligent man, and, after three weeks, he started to understand.

“It’s remarkable how well he did. He was very determined.”

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Slowly but surely, the patient regained his speech and other cognitive functions back, and he transferred to a half-way house. Woodard coordinated with the physical therapist and the occupational therapist, setting up appointments and monitoring progress. She worked with the claims adjuster to guarantee the patient’s schedule for checkups with his neurologist.

By the time the patient returned home, the nurse had his appointments set, eliminating delays in care.

“My goal is always to get my patient back to work and back to a normal life, because that’s the best thing for them,” Woodard said.

Six months after the injury, doctors cleared the pharmacist for a return to work with no restrictions.

“I do not think he would have gained his cognitive skills if the family hadn’t agreed to move him,” she said. “The educational role nurses play is so important to the family.” &

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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The Profession

For This Pharmaceutical Risk Director, Managing Risk Means Being Part of the Mission to Save Lives

Meet Eric Dobkin, director, insurance and risk management, for Merck & Co. Inc.
By: | September 28, 2018 • 5 min read

R&I: What was your first job?
My first job out of undergrad was as an actuarial trainee at Chubb.I was a math major in school, and I think the options for a math major coming out are either a teacher or an actuary, right? Anyway, I was really happy when the opportunity at Chubb presented itself. Fantastic company. I learned a lot there.

R&I: How did you come to work in risk management?
After I went back to get my MBA, I decided I wanted to work in corporate finance. When I was interviewing, one of the opportunities was with Merck. I really liked their mission, and things worked out. Given my background, they thought a good starting job would be in Merck’s risk management group. I started there, rotated through other areas within Merck finance but ultimately came back to the Insurance & Risk Management group. I guess I’m just one of those people who enjoy this type of work.

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R&I: What is risk management doing right?
I think the community is doing a good job of promoting education, sharing ideas and advancing knowledge. Opportunities like this help make us all better business partners. We can take these ideas and translate them into actionable solutions to help our companies.

R&I: What could the risk management community be doing a better job of?
I think we have made good advancements in articulating the value proposition of investing in risk management, but much more can be done. Sometimes there is such a focus on delivering immediate value, such as cost savings, that risk management does not get appropriate attention (until something happens). We need to develop better tools that can reinforce that risk management is value-creating and good for operational efficiency, customers and shareholders.

R&I: What’s been the biggest change in the risk management and insurance industry since you’ve been in it?
I’d actually say there hasn’t been as much change as I would have hoped. I think the industry speaks about innovation more often than it does it. To be fair, at Merck we do have key partners that are innovators, but some in the industry are less enthusiastic to consider new approaches. I think there is a real need to find new and relevant solutions for large, complex risks.

R&I: What emerging commercial risk most concerns you?
Cyber risk. While it’s not emerging anymore, it’s evolving, dynamic and deserves the attention it gets. Merck was an early adopter of risk transfer solutions for cyber risk, and we continue to see insurance as an important component of the overall cyber risk management framework. From my perspective, this risk, more than any other, demands continuous forward-thinking to ensure we evolve solutions.

R&I: What’s the biggest challenge you’ve faced in your career?
Sticking with the cyber theme, I’d say navigating through a cyber incident is right up there. In June 2017, Merck experienced a network cyber attack that led to a disruption of its worldwide operations, including manufacturing, research and sales. It was a very challenging environment. And managing the insurance claim that resulted has been extremely complex. But at the same time, I have learned a tremendous amount in terms of how to think about the risk, enterprise resiliency and how to manage through a cyber incident.

R&I: What advice might you give to students or other aspiring risk managers?
Have strong intellectual curiosity. Always be willing to listen and learn. Ask “why?” We deal with a lot of ambiguity in our business, and the more you seek to understand, the better you will be able to apply those learnings toward developing solutions that meet the evolving risk landscape and needs of the business.

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R&I: What role does technology play in your company’s approach to risk management?
We’re continuing to look for ways to apply technology. For example, being able to extract and leverage data that resides in our systems to evaluate risk, drive efficiencies and make things like property-value reporting easier. We’re also looking to utilize data visualization tools to help gain insights into our risks.

R&I: What are your goals for the next five to 10 years of your career?
I think, at this time, I would like to continue to learn and grow in the type of work I do and broaden my scope of responsibilities. There are many opportunities to deliver value. I want to continue to focus on becoming a stronger business partner and help enable growth.

R&I: What is your favorite book or movie?
I’d say right now Star Wars is top on my list. It has been magical re-watching and re-living the series I watched as a kid through the eyes of my children.

R&I: What is the riskiest activity you ever engaged in? When I was about 15, I went to a New York Rangers versus Philadelphia Flyers game at the Philadelphia Spectrum. I wore my Rangers jersey. I would not do that again.

Eric Dobkin, director, insurance & risk management, Merck & Co. Inc

R&I: What is it about this work you find most fulfilling or rewarding?
I am passionate about Merck’s mission of saving and improving lives. “Inventing for Life” is Merck’s tagline. It’s funny, but most people don’t associate “inventing” with medicine. But Merck has been inventing medicines and vaccines for many of the world’s most challenging diseases for a long time. It’s amazing to think the products we make can help people fight terrible diseases like cancer. Whatever little bit I can do to help advance that mission is very fulfilling and rewarding.

R&I: What do your friends and family think you do?
Ha! My kids think I make medicine. I guess they think that because I work for Merck. I suppose if even in a small way I can contribute to Merck’s mission of saving and improving lives, I am good with that. &




Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]