Cathy Cress

Expert in Aging Life and Geriatric Care Management

How Important are Nurse Care Managers?

 

My husband Pete and our family have our own RN case manager.

Pete had open heart surgery 3 days ago at Stanford Hospital. The utility and utter comfort of having a care manager hit me personally on this health care journey.

Our Stanford Cardiac Care Manager

Stanford’s cardiac unit is a wonder to behold. Your family touchpoint is, of course, the care manager. She is your navigator, comforter in chief, and patient-friendly-dispenser of information framed in a  digestible synopsis.

In her warm yet filled with authority voice, our care manager Christine Harris RN BSN greeted us in pre-op and explained what would happen during the surgery. She soothed our fractured nerves. Facing open heart surgery was, as with all patients, like taking a long trip you researched well but never understand the whole journey nor the wrong turns you just might take. 

It had taken Pete 7 years to get to this point as he was one of a category of 2% heart patients that had no symptoms. He had not wanted to do the surgery and they respected his wishes. In the last few months, they found his heart not getting enough oxygen, so he finally decided to do it. The day before surgery he was chopping down a plum tree, among the many, in our California yard.

12 Hours of Open Heart Surgery

As the open heart surgery was 12 hours long- most of it pre-op and then post-op, Christina our care manager became our navigator through the long hours of waiting  She came to us at every stage, shared information that calmed us and made us feel health literate about what was happening to Pete.

Trouble on the Tracks

But in the late afternoon, when we were feeling so sure he was sailing through the procedure, we became alarmed. Stanford has a color-coded electronic screen of all patents in surgery showing you their operating stage. We were watching this large electronic surgery board, much like an airline flight board with scheduled take-offs and landings. Pete was about to land in post-op then before our eyes -reversed to the operating room. Pedro, the navigator of the board,  had no idea what happened but told us Christine would be down to talk to us. My two daughters and I were then on red alert and our lovefest with the ease of all this dumped back into reality.

Tear in the Heart

As any case manager would, Christine arrived with calming information. As they were about to close up Pete’s chest after the new valve went in flawlessly, they noticed a small tear in the aorta. She explained that the aorta, like all of Pete’s body, was almost 8o- years old and thin enough to tear. Dr. Fichbine saw bleeding, along with the  30 residents who were watching, did a small patch, closed up the incision then sent him on his way to post-op. In reality, it was more serious, but she shared the steps taken and he was in truth patched up and on his way to recovery. She gave us the right information mellowing it out enough that we went from Post  9/11 color-coded red- terrorist attack imminent —to calming green – low threat. Pete arrived back in post-op and we got to see him at 7:30 that night 13 hours after his trip through the surgical theaters.

Christine is also our head discharge planner and goes to see Pete every day, along with Dr. Fishbine on rounds. She will be there at discharge when she, a Stanford pharmacist, and a cardiac nurse share discharge plans.

So thanks to all the care managers who like Christine, guide us over troubled waters, comfort us and hold our hands while they navigate us to a safer shore.

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