Many people are familiar with the role nurse case managers play in the return to work process. They review an injured employee’s medical records, coordinate and expedite medical treatment and procedures, locate the best medical care and physicians to treat the injury and ensure employees can safely return to work — all while reducing the total cost of risk for employers and helping them retain a valued employee. But behind the scenes, they do so much more than that. Nurse case managers are advocates for every employee’s health and well-being. And amid the pandemic, their role has taken on new relevance.
In “normal” times, before an injured employee has a procedure or begins a new treatment, they may feel overwhelmed, frustrated or unsure of what’s to come. A nurse case manager is often one of the first points of contact for an injured employee; when they reach out, that initial conversation can be a defining moment. It’s an opportunity for the nurse case manager to listen to concerns, provide educational resources, give reassurance and offer solutions — bringing new meaning to the value of empathy within a claim. When COVID-19 was brought into the mix, those feelings of uncertainty became more prevalent, and the need for an empathetic connection ever more valuable.
Supporting injured employees when it matters most
During the pandemic — as hospital systems initially became overwhelmed and as subsequent waves affected hard-hit areas — many surgeries and in-person appointments were postponed. Some nurse case management providers saw little opportunity for impact and temporarily closed their files. But at Sedgwick, we took the opposite approach. Our nurse case managers focused their efforts on facilitating alternative options for treatment to ensure injured employees had the support they deserved.
When COVID-19 restrictions began to delay or cancel some surgeries and procedures, many nurse case managers began looking for alternatives when surgery was postponed, and seeking “stay at work” options for employees until they could reschedule. This included arranging telehealth visits with providers to ensure continuity of care, helping injured employees in onsite physical therapy transition to a telePT option, and getting creative with modified duty work options.
Staying in touch with physicians and developing relationships with schedulers helped ensure that injured employees remained top of mind for when offices opened back up. In the meantime, nurse case managers helped set restrictions and accommodations to keep those who had some ability to stay at work until surgery could be rescheduled. These nurses strategized on how to keep injured workers as mobile as possible to minimize complications and maximize recovery and made consistent efforts to encourage injured employees to take advantage of all the resources available, despite many of them being offered virtually.
Nurse case managers also began offering support and guidance to employees with a known or presumed case of COVID-19 to help mitigate the impact to a client’s business. It started by answering calls from those who had been exposed, evaluating the risk of exposure and providing information regarding quarantine, isolation and return to work. When an employee tested positive for COVID-19, the nurse case manager was there to help support those recovering at home by reaching out to monitor symptoms, identifying any comorbidities known to increase severity and providing guidance on when to seek care if symptoms worsened. When the vaccination period began, nurse case managers also began providing support for those who experience side effects potentially related to the vaccine. And when these nurses recognize stress and psychological impacts of the pandemic, they are connecting employees to behavioral health specialists for appropriate guidance.
The stories that inspire us
After an employee named Bradley* was injured on the job last year, he underwent many tests and later, a spinal surgery. This period of time was incredibly stressful to navigate on his own and he often had questions about the workers’ compensation process. That’s where Hilda Snowden came in. As a Sedgwick nurse case manager, she stepped in not only to coordinate physical therapy for Bradley, but also to be there for emotional support, addressing his concerns and being a listening ear. Reflecting on those tough times, Bradley said, “Hilda is someone I truly believe had my best interests at heart.” And he’s not the only one who feels that way. Hilda received many compliments from other parties to the claim for the way she shared care and compassion for Bradley during his recovery.
Back in March of 2020, in the beginning of the pandemic, another individual named Karla* had arm surgery. The time period between surgery and physical therapy is critical for long-term mobility, so her employer’s nurse case manager, Angela Moore, was in constant contact with her to ensure timely and successful treatment. In Karla’s case, she was in a sling for more than six weeks with extreme pain and inflammation, on a heavy amount of pain medication and unable to drive. And the added obstacles that COVID-19 brought along certainly didn’t make it any easier. Angela’s role became even more essential to the success of Karla’s physical therapy and return to work. She kept close contact to help manage the work-related injury, pain control, comorbidities and patient expectations. Karla shared that, “It was nice to hear from a nurse who understands the painful and stressful conditions that are occurring. I appreciate having people checking in on me and making sure I can make it out of this.”
More than one year after COVID-19 was first identified, the pandemic continues to affect organizations around the globe, forcing them to make adjustments to the way they conduct business. It continues to impact injured employees like Bradley and Karla, who faced increased challenges during their treatment, recovery and return to work process. But with the guidance and expertise that nurse case managers like Hilda and Angela can provide throughout the life of these claims, better outcomes and faster return to work are on the horizon.
*Names have been changed in these cases to protect privacy.