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How Mr. Y found strength with a nurse’s help

By Chelsea Moravek | December 14, 2017 | Insurance Education

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At times, healthcare can feel overwhelming and isolating.

Mr. Y was facing kidney failure, uncontrolled Type 2 Diabetes and high blood pressure. After more testing, he was diagnosed with multiple myeloma, a type of blood cell cancer. Mr. Y was facing many healthcare needs but was facing them alone.

This led to missed appointments, unreliable transportation, and irregular doses of medication; none of which is a prescription for tackling health challenges.

Introducing Blue Cross NC’s Sandra (Sandi) Kelly, RN, CCM, the nurse who worked with Mr. Y to tackle his health challenges as a team.

Mr. Y, it’s Sandi calling

Sandi is a certified Case Manager at Blue Cross NC. Many members do not know about our case management team. We have over 100 nurses who help our members navigate complex disease and sickness.

Think of them as your accountability buddy. They help guide you through healthcare, help you understand what is important about your situation, and serve as your own cheerleader.

At first, Mr. Y was hesitant to speak with Sandi. He was aloof and mostly mumbled responses to her questions. But, Sandi stuck with him and built a relationship with him. She provided a trusted voice, helpful information, and vital resources during a scary period.

“After a while, it became apparent that Mr. Y felt safe sharing his thoughts with me,” she says. “He was eventually able to verbalize his fears, concerns, and needs that I was able to impact.”

Easing the burden of illness, together

Working hand-in-hand, Mr. Y began to better manage his illnesses.

  • With Sandi’s help, he was able to connect with a personal pharmacist. This helped him keep an updated medication list and better self-administer them with more organization.
  • Knowing one of Mr. Y’s biggest issues was a ride when feeling too ill or having side effects from treatments, Sandi connected with his Oncology Nurse Navigator at the physician’s office. Together, they were able to find a medical transportation vendor that met his needs. Sandi also helped Mr. Y through managing costs, applying for disability benefits, and educating him on home healthcare services.
  • When he was homebound, she also set up a meal service to deliver meals that met his dietary needs.

Mr. Y now better understands his health issues, how to handle his treatment plan, and the importance of being consistent. Sandi helped Mr. Y keep his independence and reduce stress related to his health challenges.

“Although some outcomes are inevitable, our partnership can ease the burdens and enhance the joys of members transitioning through all phases of their healthcare journey,” Sandi says.

Sandi also says Mr. Y had an equal impact on her. Regardless of the particular case, she’s working on, her goal is to help the member in any way she can.

“The impact may be huge or tiny; cost effective or simply humane, but I’m so privileged to work on our talented team trying our best to impact the lives of our members and their families.”