WILKES-BARRE — As National Nurses Week comes to a close, two nurses working for Blue Cross of Northeastern Pennsylvania say the field has more to offer than jobs in doctor’s offices and hospitals.
When they graduated from nursing school, Tammy Hewlett and Jennifer DeMaris never dreamed they’d be working for a health insurance company. But after working with patients in direct care for a number of years, the opportunities at Blue Cross of Northeastern Pennsylvania turned out to be just what they were looking for.
“A lot of people, when they think of nurses, they generally think we work with patients everywhere we go. But I really don’t,” said Hewlett, senior coordinator in quality improvement. “I’m really behind the scenes.”
“There are standards that a health plan has to meet … from quality to access to how we connect with the member,” said Hewlett, of Clarks Summit. “So a lot of my job is making sure that Blue Cross meets those standards. I’m the watchdog for that.”
Hewlett’s department monitors the quality, safety and effectiveness of the care members receive. So doing research and helping develop initiatives to make sure patients are educated about their health are big parts of her job.
One quality measure Hewlett tracks is mammography.
“We want every woman 40 and over to have a mammogram,” she said. “We can see among our membership who has and who hasn’t had one, so we would encourage those women. Not only do we reach out to their providers, but we also reach out to the members and encourage them to have their screening.”
“So you’re the reason I got the ‘Happy Birthday. You’re 40. Don’t forget your mammogram!’ card,” DeMaris said to Hewlett jokingly during an interview last week at the Blue Cross offices on North Main Street in Wilkes-Barre.
While Hewlett deals more with data, DeMaris still works directly with patients — only over the phone instead of in person. As a senior nurse in Utilization Management, DeMaris, of Shickshinny, said she is in constant touch with plan members as they use medical services.
“If it’s an illness or accident or something traumatic that’s happened, we make sure that when they use their benefit, they’re in the best possible place, getting the most appropriate care and able to move on and access those wrap-around services such as rehab and home health,” DeMaris said.
For example, DeMaris said she recently worked with the family of a motorcycle crash victim who suffered traumatic injuries. The family initially wanted to send their loved one to a rehab facility they heard of in Philadelphia. But a Blue Cross nurse made the family aware of Allied Services in Wilkes-Barre and Scranton.
The family visited Allied and found it had services equivalent to the facility in Philadelphia, she said. The patient was treated there, and the family didn’t have to leave the area to visit and offer support.
If a member had a hip replacement, he or she would need to find a rehabilitation center or skilled nursing unit.
“Who has the best infection rates? Who has the best outcomes? Most people don’t know that, but we do,” said DeMaris. “And that’s what we get to do. We make sure that when you use your benefit that you pay (insurance premiums) for and have that right to, that you are getting the best possible care, and that is helping you to achieve your best outcome. And it’s really exciting, it’s a great feeling.”
The women said nursing has a wide variety of opportunities for those entering the field.
Hewlett said she’s been a nurse for 25 years, doing many different types of nursing. Going to work for Blue Cross “was a welcome change at the time,” she said. “The nice thing about nursing is that it’s very diverse. You can come and go into different positions. We could certainly leave here today and go back to the clinical arena.”
“It’s all about finding the right niche,” DeMaris said. “I don’t know where else you can touch so many different people’s lives and make such a difference. It is an amazing opportunity.”
DeMaris, who started at Blue Cross a few months ago after working in a trauma unit, said she keeps a folder of thank-you notes and gifts she has received over the years from patients and their families.
“I only have one that says ‘Thank you for cracking my mom’s chest and doing cardiac compressions on her.’ But I have a whole box full of letters and trinkets: ‘Thank you for finding a phone so I could call my dad and wish him a happy birthday.’ ‘Thank you for washing mom’s hair on Mother’s Day when we came to visit.’ ‘Thank you for making the balloon animal out of a glove so my son wasn’t so scared when he came in to see me.’ It’s those kinds of things” (that help make the job rewarding,) DeMaris said.
“People don’t really recognize a lot of the things that you do,” she said, “but they recognize the care. And that’s what we get to do.”