When asked what she likes most about her rheumatology nursing responsibilities at the Children’s Hospital of Los Angeles, Sandra Watcher, RN, states, “I like the collaboration with the multidisciplinary team, patients, and families. Taking complex diseases and making information understandable to patients and families. Helping them learn to live with chronic illness and increase their understanding, normalizing, and living with chronic illness.”
Accurately diagnosing and treating rheumatic diseases can be challenging, but knowing we have an experienced team of rheumatology health and office professionals means the challenge will be met.
Other Team Members
Three other health professionals utilized in a rheumatology practice are the licensed practical nurse, licensed vocational nurse, and medical assistant. The licensed practical nurse and licensed vocational nurse handle phone triage, insurance authorizations for medications, and medication education. Lisa Emig, LPN, at Wellspan Health, enjoys the responsibility of questioning patients about their symptoms, assessing their condition for possible cause of pain, and helping them mange the pain. She states, “having a patient call me back in a week to tell me they feel so much better brings so much satisfaction to my work.” The medical assistant is generally the first team member a patient encounters in a practice setting because they take the patient to the exam room, take vital signs, and review the medication list with the patient.
Another very important part of the rheumatology team is the practice manager and his or her staff. The practice manager oversees all business activities, including budget monitoring, account receivables and payables, banking, insurance, medication and medical supply purchasing, regulatory compliance, facilities, computers, human resources, staffing, training, office staff supervision, and patient relations. The practice manager may discuss staffing, scheduling, insurance issues, or a new administrative implementation like electronic prescriptions or electronic health records with the rheumatologist, NP, or PA. The practice manager’s interaction with the nursing and medical assistant staff relates to insuring that they comply with appropriate work documentation and have the tools necessary to treat their patients. However, a primary interaction for a practice manager is overseeing the front desk and billing staff, where many of the practice problems can arise.
Linda Merritt, RMM, at Arthritis Specialists Group in Utica, N.Y., states, “I work personally with patients that are in need of financial assistance to obtain their prescribed medications, as rheumatology care can become quite costly for patients and the application process for this benefit can be burdensome. If I can help them navigate the system and obtain their medications at a cost they can afford, then I take the time to do so.” Because a practice manager must know something about all aspects to running a medical business, they wear a lot of hats in rheumatology practice. Merritt’s daily challenge and satisfaction is keeping those hats balanced so patients leave the office feeling good about the care and service they received.
Team Beyond the Office
There are health professionals who may not work in a rheumatology practice but are essential to the overall care of the rheumatic patient. The rheumatology practice may refer the patient to these disciplines to assist with rehabilitation, coping, depression, and access to community resources and services. The physical therapist assesses and evaluates the patient, develops an individualized plan of care, provides patient education, and performs specific therapeutic interventions. Therapeutic exercises are used to improve a patient’s muscle strength, joint mobility, and cardiovascular and pulmonary function.
