By Sarah Cottrell
You might be surprised to know that within the busy halls of Northern Light Eastern Maine Medical Center, miracle workers are blending in with their plain uniforms and schedules that stretch out for miles. We got a chance to catch up with Nancy Aylward, RN Nurse Case Manager from Grant 6 Oncology/Respiratory Unit. We learned about the delicate balancing act of her daily nursing duties that make her skills and heart of gold truly miraculous.
Aylward has been in nurse case management for 21 years, but her nursing career stretches back more than 46 years, making her experience and knowledge of patient care incredibly valuable.
“Our main focus is the coordination of care from the time a patient comes in from the emergency room to the time they are discharged,” Aylward explains. “Our role is to determine the level of care for a patient. We help to facilitate tests and everything from imaging to labs and consults, and we help determine the level of support for each patient.”
To understand the complexity of Aylward’s job, it is best to imagine an air traffic controller. When a patient requires acute care, it falls to Aylward to determine what that care will look like and what order they will receive it. She must coordinate with her team, outside agencies and the patient’s family to ensure that every aspect of a patient’s road to recovery is paved as smoothly as possible. And that kind of expertise requires her to wear many different hats.
As a Nurse Care Manager, Aylward has to look at many aspects of a patient’s case to help give them the best possible care. This doesn’t just include connecting that patient with doctors and tests. She also coordinates with patients’ families to understand what kind of support they can offer and deals with insurance companies to make sure a patient can receive the care they require.
“We have different agencies that we utilize daily so that if someone doesn’t have that insurance coverage, and we know that they’re probably going to need that, we can try to help.” That may mean connecting them with MaineCare and other resources to see if they qualify for insurance.
She also connects patients with their next level of recovery, so it doesn’t mean their care ends when a patient is discharged. That may include rehabilitation, nursing home care or heading home.
Knowing how to coordinate care for a patient with an acute health crisis requires Alyward to have a firm understanding of many types of nursing.
“I’ve been a nurse for many, many years, so I’ve done a lot of different jobs,” she says. “I’ve worked in NICU, I’ve done home infusions, a lot of different clinical positions.”
All of those experiences helped her to become an effective Nurse Case Manager.
“If you can understand clinically what is going on with a patient, then you can help facilitate what they need and best determine where they are going to go from here,” she says.
Aylward explains that the field of nursing has changed significantly since her first days back in the 1970s; from the ebb and flow of nursing shortages to the evolution of moving away from hierarchies and moving toward medical teams.
“I think our role in nursing has changed from years back when a nurse was defined by a hierarchy. We don’t see that as we did many years ago. I think we work as a collaborative group much better,” she says. “The transformation over the years is remarkable and has been awesome to see. You know, I’ve traveled all over the country nursing. I’ve seen nursing on the west coast, the east coast. I’ve seen a lot of good things happen in nursing. I think nurses are educated well; it’s just a different world than it was back in the 70s.”
So what is it about nursing that keeps her there? For Alyward, it is all about her patients.
“I think nursing allows you to be part of a medical team, trying to figure out what is happening with a patient as they are coming in and where you’re going to go with that direction of the patient and what the acute needs are,” Alyward says. “It also allows you to work with patients and families and how you can help them go through this crisis, and provide avenues for them to make their own choices because the goal is to make them independent.”
For those thinking about a future in nursing, Alyward has some encouraging insight. She explains that not every nurse is an excellent fit for bedside clinical work, but that’s ok because the field of nursing has exploded over the years, and now there are more paths than ever to find a satisfying career.
“With a degree in nursing, you go toward education, clinical position, administration, public health nursing, research; there’s a lot of different roles that nursing has taken on over the years.”
After 46 years of care, there are a few memories that stand out for Alyward that she will eventually take with her into retirement.
“Thinking back over the years, I worked in the NICU working with the babies and the mothers and families, and watching them,” she shares. “These babies are going through a crisis, and watching them going through that continuum and watching them leave at some point, that follows you and feels good to know you’ve done something good.”
Alyward says that she tries to focus on one good thing that she was able to do to help a family every day. And after 46 years of nursing, many have asked her when she thinks she might retire. But don’t hold your breath because this energetic and motivated nurse is here to stay.
Someday I will retire, I guess,” she laughs. “As long as I like what I’m doing, and as long as I am productive and I can contribute, then I’m always feeling happy about that.”
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