1305

I currently work for an insurance company as a utilization management nurse. This meaning that I am not directly patient facing, but regularly talk to members/patients regarding their care whenever they get admitted to the hospital and ensuring that they get proper follow up management. A task that I regularly perform are post discharge phone calls, where again, it is sort of a check up on the member to ensure that they have all their proper specialty care follow ups set up as well as assist with concerns and other questions they have regarding their care at the hospital. In this particular happening, I really questioned my sanity... and/or my ability to speak to dead people.

One afternoon as I was going through the members I had to review, I noticed that a member of mine had been discharged two days previous. Long story short, I found that this member had gotten diagnosed with cancer during his admission and wanted to call to check up on him to make sure he was doing okay and answer any questions he had to the best of my ability as well as give him all the resources he needed to get the best care possible. I also noticed that there was a scheduled oncology appointment the day after discharge, meaning the day before today, so okay good I could see how his first oncology appointment went as well. Luckily, I had time right after doing his review to make his post discharge phone call. I got a hold of the member and started my introduction, asked how he was doing, if he had any questions about his new diagnosis and if there was any assistance I could provide. To which he barely heard any of, being that he responded, "Hi, yeah my wife takes care of all my medical stuff." So I got handed over to his wife, which again, I politely introduced myself. Luckily, this time I think I got all my information out so she could do with it what she wanted. She told me that they unfortunately had not been able to make the first oncology appointment. I reiterated how crucial it was for this diagnosis and especially being that it was to establish a plan of care for treatment. She said okay, I'll reschedule the appointment and ended the conversation at that. In my head, she kind of blew me off, but in retrospect she probably considered the previous hospital admission to be sufficient enough care, especially being that the patient got discharged home. I make note of the call and go about the rest of my work. At least this member is at home, with his wife, and is well enough to be at home.

A week or so passes by. Immediate panic. Census change. The member got readmitted, spiraled quickly and fully decompensated ultimately leading to his death at 1305 (military time for 1:05pm) the day before I rechecked his chart. Dang, now I just feel awful. Although I did not participate in the driving care and couldn't physically bring him to his appointment, as a healthcare provider it's a gut wrenching feeling to see the potential of your words dissipate into thin air, into nothingness, especially if you had contact with the person. I felt like even though the member barely spoke to me, I could have made a difference somehow and someway, but that's an entirely other topic about healthcare providers and compassion fatigue. I move on to the rest of my workload and I start putting together my weekly email to our chief medical officer about the current patients that are admitted at hospital facilities. I get distracted thinking about lunch break in 5 minutes and how it is also associated with meeting a new Doctor we will be working with. I get to talking to a coworker about regular office shenanigans, I am just about ready to log off until something catches my eye. Wait, is it? It can't be.... the member. Calling me? I see his name loud and clear ringing on my calling application on my computer screen. My heart beats out of my chest and my temperature rises, thinking about how I just read that he passed and how it could have been my fault and now HE'S CALLING ME ON MY DIRECT LINE?! From...his grave? No no no, can't be possible. Then of course, my more rational mind kicks in. Must be his wife to either just talk through coping mechanisms or maybe has questions regarding insurance. Like I said though, 5 minutes from lunch and a conversation like that necessitates time to discuss ALL the things, a multitude of conversation topics that I would hate to be rushed. So I leave it for after the lunch.

I come back from lunch and there it is, another missed call from the member's number, presumably the wife, and no voice messages. Hmmm, two calls, no voice messages. With my hands sweating, and me attempting to think of all the possible questions the wife is about to ask me, I call back. Ringing, ringing, ringing, ringing *line gets picked up*. "Hi, this is CJ from ____ Health Insurance and I saw that I have a couple missed calls from you, are you needing assistance today?"

*Silence*

Me: "Hello?"

*Shuffling in the background*

Me: "Hello, is anyone there?"

*Shuffling gets louder*

Me: "Hello?"

*Silence*

The absence of voice on the other side of the line echoes through my mind. Okay actually though is the member calling me from his grave? Trying to tell me that I should have done more? Is he gonna haunt me now? I hang up the phone in a frenzy and glance at the time. 1305.