No question is a stupid question.
And it would be interesting reading, it's just such a broad spectrum of the many things nurses do these days!
From my perspective, I'm a nurse case manager. Official title is LasVegas, RN, CCM. You can see me in a variety of places: hospital, doctor's office, patient's home, medical supply store, physical therapy office, YMCA, Goodwill, library, etc. With case management, our goal is to coordinate the care for patient's with complex issues throughout the healthcare continuum. Those patients may come from a variety of backgrounds: construction worker, teacher, bus driver, cabbie, showgirl, celebrity, prostitute (legal here in Nevada!).
Let me use the showgirl for an example. I'm going to call her BoomBoom. BoomBoom is working at the Crazy Horse and falls off the stage by accident. She falls really hard, compresses 2 lumbar vertebrae. The owner of the Crazy Horse is livid!! That's his BEST dancer!! So, BoomBoom goes to the Urgent Care and gets X-rays to confirm the diagnosis. The Urgent Care doc says, "BoomBoom, stay in bed for a week, take some Flexeril and Lortab for pain, see me in 7 days".
BoomBoom is stressing out because she doesn't know this is a workers comp injury and that she will be paid 66 2/3 her salary while she is disabled. In the meantime, LasVegasRN comes on the scene.
First thing LasVegas assesses is if the initial medical care BoomBoom received was appropriate. 7 days bedrest?? For an active athletic 23 year old? NOT!! LasVegas gets her to a physiatrist - a physician who specialized in rehabilitation WITHOUT surgery.
The physiatrist assesses BoomBoom - ruh roh!! BoomBoom is walking with a limp, horrible pain in her hip radiating into her leg. LasVegas says, "Got ya covered, doc! Already have her set up for a lumbar MRI this afternoon if cool with you?" Doc says, "Cool!". LasVegas anticipated the need for this and already got approval from BoomBoom's claims adjuster.
LasVegas makes sure BoomBoom gets to her appointment that afternoon. LasVegas gets the radiologist's report hot off the press. Oh no!! One of the compressed discs has caused a herniation that's encroaching on an exiting nerve root!
LasVegas calls an ortho or neurosurgeon, schedules a tentative appointment for BoomBoom, faxes the report to the physiatrist and tells BoomBoom she's going to need to go in for a follow-up right away.
BoomBoom comes in, here's the results of the MRI, LasVegas says, "I got your back, doc! Got her set up to see Dr. Fabulous tomorrow!" Doc says, "Damn, you're good!" LasVegas says, "And you know this!!"
BoomBoom sees Dr. Fabulous. Dr. Fabulous says, gee, we need to do a lumbar discectomy! LasVegas says, "I got your back doc! Got approval from the claims examiner for the surgery, when do you want to do it?" Dr. Fabulous says, "Damn, you're good!". LasVegas says, "You better tell somebody!!".
Long story short, BoomBoom has the surgery, starts in therapy right away with a therapist suited for athletes. Checks to see if there is any light duty BoomBoom can do while she is rehab'ing her back. BoomBoom goes back to work for 4 hours a day as a hostess after about 6 weeks off work. BoomBoom goes back full duty and released from care after 5 months.
And that, my friends, is just a small sampling, of the nurse case manager!