Two weeks ago we heard from Nancy Vanveldhuizen, a Paradigm Hero who recovered from catastrophic multiple trauma. Despite losing her left arm, she never lost her spirit and sense of adventure. Stacy Bloemendaal RN, BSN, CCM, the Network Manager who supported Nancy and her family, joins us today to talk about what this case was like from a nurse case manager’s perspective. As the onsite patient advocate, she formed a close relationship with Nancy and helped ensure the best care possible.

Tell us a bit about your nursing and case management experience.

I’ve been a registered nurse for 27 years and have experience in intensive, emergency room and critical care. I have worked in workers’ compensation case management, including catastrophic case management, for 12 years, and have spent the last seven years as a Network Manager with Paradigm Outcomes.

Obviously Nancy was critically injured, but what was it that made the case especially complex?

Nancy had significant abdominal injuries that required multiple surgeries to control bleeding and other interventions to try to save her upper extremity. She almost didn’t survive. It took several months for the abdominal wounds to fully heal, and in the meantime she was undergoing multiple painful wound treatments to try and save her hand and arm.

After several weeks of outpatient treatment, the team felt they could not save her hand and arm. She then had to return to the hospital for amputation of part of her upper extremity. As an experienced Network Manager, I know that was a difficult decision, but she actually has better function of the limb with a prosthetic following the amputation than she would have by saving part of the hand or fingers. But at the time, it was very overwhelming having been in the hospital for so long, getting out and then having to return for more surgery.

Did you and the Paradigm Management Team have to overcome any unique complications?

Continually reopening the abdominal wounds led to complications and slowed her body’s ability to heal. Once she had returned home, I had a difficult time finding a qualified occupational therapist in her rural area who had experience in amputations. I needed to ensure Nancy received the proper help and was prepared to use a prosthetic limb.

What were some of the things you did as the Network Manager to assist Nancy and her family?

When I first met with Nancy in the intensive care unit, I also met her husband who was able to provide an understanding of her indomitable spirit. So when Nancy was able to speak with me several days later her first words were that she was going to get through this, and get back to her life and job. I formed an effective relationship with her and her husband and worked to provide them support and expertise along with education about her recovery path.

I identified and researched the appropriate providers who had experience or training in amputation, prosthetics and therapy within a 30 mile radius of her home, and then facilitated the appointments. I also ensured that the abdominal wound treatment was appropriate so it could be fully closed without infection. I was able to help set up not only the therapy for learning how to use her limb following the amputation (with and without the prosthetic), but also to improve her overall strength and endurance to allow her to return to pre-injury activities. She wanted to garden, ride her ATV and return to work. We also advocated for the appropriate physician oversight so her pain, both physical and nerve-phantom pain, following the amputation was well managed. We wanted to avoid any long term complications and chronic pain medication dependency.

How did you support Nancy’s long-term wellness and ensure the family was poised for continued success?

During our time together, I provided education about what to expect during recovery, identified resources and encouraged her.  Before I said goodbye to Nancy, I made sure she was well established with her primary care physician and a physical medicine and rehabilitation provider. I ensured she had the appropriate medication to manage the nerve pain and was part of a weaning program to reduce medication needs over the next year. I felt confident in her future as she had returned to work several months before we achieved all of the case goals and her family was in the process of building a new home.

What would you tell someone is considering referring a case to Paradigm?

I’ve always been impressed with the team concept of Paradigm. In addition to a Network Manager, a physician is on the team from the beginning to help really understand the full impact of the injury and treatment plan. I also feel that Paradigm does a great job of getting the right treatment early in the injury to reduce complications and get better outcomes.

To learn more about Paradigm Outcomes and how our Network Managers support Heroes like Nancy Vanveldhuizen, visit our website or join the conversation on LinkedIn, Facebook, Twitter, or YouTube.