CMSA Today - Issue 7, 2016 - 31


"When a case manager lands on the 'other side of the bedrails'
due to a serious health challenge, she or he may experience that
those same strengths you think you have can be temporarily lost;
or even worse, one can revert to feeling like a complete neophyte
in the 'system' we think we all know so well."
reversal certainly brings to one a higher level of
understanding.
This was the case as my Acute Ischemic Stroke
(AIS) occurred. I tell myself in retrospect that I
should have known better as an experienced
nurse and case manager! I intellectually knew
of "self-care," "work-life balance" and "staying
down" when one is ill. However, I also silently
praised myself for my persistence in the relentless
pursuit of life goals and in the care of others
around me. Then God stepped in and gave me
a warning shot across my bow.
It was a perfect storm for me: overwork,
fatigue, being ill. I was working 80-hour work
travel weeks, finishing my MBA, and sick with
the flu and sinus infection for the previous
10 days. Yes, I had seen my doctor, but the
antibiotics were not working. I added over-thecounter (OTC) cold medicine to keep me going
while traveling. Did you know that over-thecounter (OTC) drugs containing ephedrine,
pseudoephedrine, or phenylpropanolamine
(PPA) increase your risk of stroke? With the
addition of the OTC medicine, the ischemic
event started to slowly flood my boat before
I even knew it was more than a small squall.

778743_VieMed.indd 1

It started with the inability to focus my vision
on a plane in the sky. I thought, "Hmmm...I'm
getting old and need glasses." The next day I
woke up and leaped out of bed to catch another
flight for work. I veered and hit the wall. "What?
My balance is completely gone," I thought. I went
to the doctor and was neurologically examined.
"You're fine," he said. "No, I don't feel fine, but
the doctor says I am?" The next day I woke up
and the left side of my face, tongue, and palate
was numb. "Uh-oh. Better get to the emergency
room right away." I jumped in my car and started
to pull out (which was not a good idea, but panic
presided at that moment over common sense).
"My car battery is dead!" I took a taxi. Angels
were watching over me.
Then the hospitalization. I thought, "OK, I'm
a nurse; I can handle this!" But by day two my
lower lip was trembling. What just happened to
me? The physicians stood in my hospital room
doorway. I said, "Doctor, can you please sit down
and talk to me eye-to-eye on what is happening,
instead of being almost out the door?" The nurse
entered my room, smiled cheerfully and said,
"How are we today?" "I'm not fine, I'm scared;
didn't you hear me? Can you talk to me? I feel

like crying," I thought. After a battery of tests, I
was discharged home two days later on Christmas
Eve. My physicians asked me why it is that I don't
remember what they told me two days ago. I was
thinking, "No, I don't...I was medicated; could you
repeat it please? I am going home alone. Do I get
physical therapy? When? Home health? When?
What will happen now?"
I should know the answers to all these questions
from my nursing case manager experience, but
when you are afraid, fearful, and dealing with a lifealtering event, many of your developed skills seem
to float away like a feather in the wind. I thought,
"Can I be the patient and rely on you to advocate
for me? Ask the right questions for me? I'm not the
strong one now!"
I am grateful that I am in good health without
significant residuals from the stroke. And I would
never wish such an unfortunate healthcare event
upon any healthcare provider. But having been
through such an event is certainly an experience
that has boosted my understanding and lessened
any tendency to ever pre-judge my patients'
reactions to illness. I have learned to listen more
to the psychological effects of illness and bring
to bear the memories of my own experiences to
benefit my patients. My patient, I am here to help
get you through it all, because I know intimately
how it feels. ■
Wendy De Vreugd, RN, BSN, PHN, FNP,
CCDS, MBA, is Director Case Management, Case
Management and Clinical Social Work, Clinical
Documentation Improvement Programs, UC Irvine
Health. To reach out to Wendy, feel free email her at
wdevreugd@ca.rr.com.

Issue 7 * 2016 * DIGITAL

CMSA
TODAY
31
01/12/15 12:46 am


http://www.viemed.com http://info@viemed.com http://www.viemed.com

Table of Contents for the Digital Edition of CMSA Today - Issue 7, 2016

PRESIDENT’S LETTER
ASSOCIATION NEWS
CMSA CORPORATE PARTNERS
Are You Culturally Competent?
Return to Culture – Return to Healing
Appalachian Culture: A Guide for Case Managers
Professional Case Management’s Ethical Quartet for 2017: Part 1, Workplace Bullying and End of Life Care
Diversity of Role Reversal: When the Case Manager Becomes the Patient
INDEX OF ADVERTISERS
CMSA Today - Issue 7, 2016 - cover1
CMSA Today - Issue 7, 2016 - cover2
CMSA Today - Issue 7, 2016 - 3
CMSA Today - Issue 7, 2016 - 4
CMSA Today - Issue 7, 2016 - 5
CMSA Today - Issue 7, 2016 - PRESIDENT’S LETTER
CMSA Today - Issue 7, 2016 - 7
CMSA Today - Issue 7, 2016 - 8
CMSA Today - Issue 7, 2016 - 9
CMSA Today - Issue 7, 2016 - ASSOCIATION NEWS
CMSA Today - Issue 7, 2016 - 11
CMSA Today - Issue 7, 2016 - CMSA CORPORATE PARTNERS
CMSA Today - Issue 7, 2016 - 13
CMSA Today - Issue 7, 2016 - Are You Culturally Competent?
CMSA Today - Issue 7, 2016 - 15
CMSA Today - Issue 7, 2016 - Return to Culture – Return to Healing
CMSA Today - Issue 7, 2016 - 17
CMSA Today - Issue 7, 2016 - 18
CMSA Today - Issue 7, 2016 - 19
CMSA Today - Issue 7, 2016 - Appalachian Culture: A Guide for Case Managers
CMSA Today - Issue 7, 2016 - 21
CMSA Today - Issue 7, 2016 - 22
CMSA Today - Issue 7, 2016 - Professional Case Management’s Ethical Quartet for 2017: Part 1, Workplace Bullying and End of Life Care
CMSA Today - Issue 7, 2016 - 24
CMSA Today - Issue 7, 2016 - 25
CMSA Today - Issue 7, 2016 - 26
CMSA Today - Issue 7, 2016 - 27
CMSA Today - Issue 7, 2016 - Diversity of Role Reversal: When the Case Manager Becomes the Patient
CMSA Today - Issue 7, 2016 - 29
CMSA Today - Issue 7, 2016 - 30
CMSA Today - Issue 7, 2016 - 31
CMSA Today - Issue 7, 2016 - 32
CMSA Today - Issue 7, 2016 - 33
CMSA Today - Issue 7, 2016 - INDEX OF ADVERTISERS
CMSA Today - Issue 7, 2016 - cover3
CMSA Today - Issue 7, 2016 - cover4
http://www.nxtbook.com/naylor/CMSQ/CMSQ1118
http://www.nxtbook.com/naylor/CMSQ/CMSQ0417
http://www.nxtbook.com/naylor/CMSQ/CMSQ1417
http://www.nxtbook.com/naylor/CMSQ/CMSQ0317
http://www.nxtbook.com/naylor/CMSQ/CMSQ1317
http://www.nxtbook.com/naylor/CMSQ/CMSQ0217
http://www.nxtbook.com/naylor/CMSQ/CMSQ1217
http://www.nxtbook.com/naylor/CMSQ/CMSQ0117
http://www.nxtbook.com/naylor/CMSQ/CMSQ1117
http://www.nxtbook.com/naylor/CMSQ/CMSQ0416
http://www.nxtbook.com/naylor/CMSQ/CMSQ1416
http://www.nxtbook.com/naylor/CMSQ/CMSQ0316
http://www.nxtbook.com/naylor/CMSQ/CMSQ1316
http://www.nxtbook.com/naylor/CMSQ/CMSQ0216
http://www.nxtbook.com/naylor/CMSQ/CMSQ1216
http://www.nxtbook.com/naylor/CMSQ/CMSQ0116
http://www.nxtbook.com/naylor/CMSQ/CMSQ1116
http://www.nxtbook.com/naylor/CMSQ/CMSQ0415
http://www.nxtbook.com/naylor/CMSQ/CMSQ1415
http://www.nxtbook.com/naylor/CMSQ/CMSQ0315
http://www.nxtbook.com/naylor/CMSQ/CMSQ1315
http://www.nxtbook.com/naylor/CMSQ/CMSQ0215
http://www.nxtbook.com/naylor/CMSQ/CMSQ1215
http://www.nxtbook.com/naylor/CMSQ/CMSQ0115
http://www.nxtbook.com/naylor/CMSQ/CMSQ1115
http://www.nxtbook.com/naylor/CMSQ/CMSQ0414
http://www.nxtbook.com/naylor/CMSQ/CMSQ1414
http://www.nxtbook.com/naylor/CMSQ/CMSQ0314
http://www.nxtbook.com/naylor/CMSQ/CMSQ1314
http://www.nxtbook.com/naylor/CMSQ/CMSQ0214
http://www.nxtbook.com/naylor/CMSQ/CMSQ1214
http://www.nxtbook.com/naylor/CMSQ/CMSQ0114
http://www.nxtbook.com/naylor/CMSQ/CMSQ1114
http://www.nxtbook.com/naylor/CMSQ/CMSQ0413
http://www.nxtbook.com/naylor/CMSQ/CMSQ1413
http://www.nxtbook.com/naylor/CMSQ/CMSQ0313
http://www.nxtbook.com/naylor/CMSQ/CMSQ1313
http://www.nxtbook.com/naylor/CMSQ/CMSQ0213
http://www.nxtbook.com/naylor/CMSQ/CMSQ1213
http://www.nxtbook.com/naylor/CMSQ/CMSQ0113
http://www.nxtbook.com/naylor/CMSQ/CMSQ1113
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0412
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1412
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0312
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1312
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0212
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1212
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0112
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1112
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0411
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1411
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0311
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1311
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0211
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1211
http://www.nxtbook.com/nxtbooks/naylor/CMSQ0111
http://www.nxtbook.com/nxtbooks/naylor/CMSQ1111
http://www.nxtbookMEDIA.com