sassy3

Thank you Tamara for your reply. I thought 50 patients plus about 10 patients that are on quarterly reports was a big load. I was just curious if that was high, low or average. I work with seasoned CM/DM and some of us are new to this area and we all feel it's high. Just nice to hear from someone else. THanks for taking the time to respond....i will def. check out the article!

Without putting you to sleep...can you give me an idea for TOTAL patient load per month or year for the following situation: -disease specific case manager -high complexity/acuity (cancer patients on active therapy or hospice) -need to provide monthly reports including patient status, medical update, cost savings, education, -every patient requires monthly reports -we are in constant communication with pt -educating, sx management -you have to get claims or other UR/payment/charge info from TPA (no access to system) 50 active patients with this above (abridged version of what we do)..seems like more than enough (in fact it is a difficult load at 50)...what are your thoughts?

I'm brand new at this but an oncology nurse for 15yrs. I work for a private oncology care mgmt program. We do case/disease mgmt...clients could be re-insurer, TPA or even employer. We fall between CM and DM. We approve medical treatment plan for cancer, network status of provider, tons of pt ed on dx, tx, s/e, etc, monitor the pt, assist with changing care settings (ie. Neupogen at home). We complete monthly reports on clinical status, etc and cost savings. I find the documentation of Savings, Cost Avoidance, etc somewhat difficult. Some are cut and dry (hard savings-moving injections from MD office to patient home and they self inject). WHat I find hard is how to my interventions/supports provide savings? Many of us struggle with this. I would love your thoughts, policies, a sample of documented savings or even standards on how you document (soft) savings, cost avoidance,etc. How do you document patient ed...I have heard from other DM forum's that they document as "cost avoidance" b/c you reviewed neutropenia and since the patient wasn't admitted for 2 days for febrile episode that you avoided a $4000.00 in-patient stay. Do others do that? I can't seem to find guidance or references...so any input would be much appreciated. I am searching and searching and need a mentor or some help with this area. We are expected to have cost savings and we probally aren't capturing a savings for all that we are doing. Thanks in advance for any replies.

What a wonderful thought and help. Wish all patients had someone like you. Unfortunately...the generic answer is...it is hard to say. Appetite, N/V, taste changes, aversions ---all change and are individualized. WHat someone likes in the beginning of treatment - they may had three treatments from now. So it can change and sometimes it is a wait and see. Pretty simple tips would be: 1. 1-800-4 CANCER has a pt ed book called "eating hints" that has some great suggestions, tips and meal ideas. 2. Don't make the patient's favorite dish those first couple of days of treatment and after (they tend to experience more N/V and may develop an aversion to their favorites). 3. Must times you want to increase calories and take advantage. if they have a poor appetite and aren't able to eat much...give them a milkshake with carnation instant breakfast for instance so they get lots of calories. Macaroni and cheese, soups, puddings, etc 4. avoid spicy, hot, foods. 5. taste changes are not uncommon so their favorite foods don't always taste the same as they did before. 6. experiment! The patient will let you know what they are craving, wanting 7. Cook family meals for tx days when the pt may not want to cook but it would be help for her family (which will be a big worry). 8. Small frequent meals are better than big huge dinners, etc. Hope this helps. You are a great support to this women and your efforts, gestures will go a long way to help her and her family

Welcome. I'm new to this board but have been in oncology for over 12 yrs. I agree with other posts...the Oncology Nursing Society (www.ons.org) is a great resource for info/ education/ resources/ books---everything. You may want to ask other nurses on your unit if they are involved in a local chapter of ONS. They are a great resource to network with nurses, attend lectures/dinner programs, learn, get lots of freebies (books, references), mentors, etc. My chapter for instance holds a dinner meeting each month at various restaurants and we have speakers (docs/researchers/APN) on various topics related to cancer/therapy, etc. They are free to members and I think $5 for non members to attend. They are great resources for info and they are fun evenings. YOu can search ons site for the local chapter or ask around. Best of luck!

I'm not sure I followed your question but those are part of the panel for genetic testing for breast and ovarian cancer. THey are a blood test to detemine the presence/absence of the mutations. Above all ... before you have a lab or outside company draw blood for these tests...it is highly recommended that you first meet with an APN/Genetics RN/Genetic Counselor to discuss risk, family history, to see if that would be appropriate and then learn about what the test means, results and discuss what you would do with that information, etc... it is about a 3-4 step process that involves education, informed consent, counseling, recommendations, screening...most major cancer centers will offer a "Genetics or Risk Assessment Program". Their are a lot of psychosocial considerations as well. The programs are designed to support and educate you. Plus many insurance companies can be a road block for this and the tests are expense. It is best to be in a supportive, experienced team in approaching this. I can give you some websites that would be great resources for more info, finding a program near you, making the decision about testing, etc.