At 2:50 p.m. on Monday, April 15, two bombs went off at the finish line of the 117th annual Boston Marathon. Three people were killed, hundreds were injured, and local case managers needed to help deal with the crisis.
When two bombs went off eight seconds apart at the finish line of the Boston Marathon, there were many emergency plans in place. "There's an emergency disaster plan in place for both the city and the marathon itself," says Peter Moran, RN, BSN, MSN, CCM, emergency room case manager at Massachusetts General Hospital (MGH) in Boston. In addition, each hospital has its own emergency process in place.
Not only do case managers have a role to play when inmates are treated at their facilities, but they can also help former prisoners get ready to reenter society.
A death row inmate develops a lump near his breast and is sent to a local hospital for an examination. The physician wants to perform medical imaging to diagnose the lump, but correctional staff won't remove his shackles. It's impossible to perform the test wearing restraints. He returns to the prison without a diagnosis.
Patients who require nutrition support after discharge can be at risk for readmission if their condition isn't managed carefully. They may experience complications from underfeeding, dehydration, and electrolyte imbalances, says Noreen Luszcz, RD, MBA, CNSC, Walgreens Infusion Services (WIS) nutrition program director.
It is an ongoing challenge for case managers to determine whether a patient is more appropriately placed as an inpatient or in observation. Below are some real-life examples provided by Deborah Hale, CCS, CCDS, in the HCPro book Observation Services: A Guide to Compliant Level of Care Determinations.
