Patient navigators wear several hats at med center

By By CHRISTINE PETERSON

CASPER, Wyo. (AP) — Tim Troxel's whole body began to ache on the road between Denver and Cody.

He called Annette Clifton, his longtime girlfriend, and said he didn't know if he'd be able to make the drive.

It was Jan. 6, and Annette jumped in her car to meet him. When she walked into his hotel room in Casper, he told her he was glad she came because he didn't want to die alone.

By the next day he couldn't move. His legs didn't work. His healthy, 55-year old body had shut down.

Annette, 64, called an ambulance that rushed him to the hospital. Tim was going into renal failure. He had sepsis, doctors told her. An infection poisoned his blood. They didn't know if he would make it.

She spent hours on the phone with family and friends, sobbing and pacing the Wyoming Medical Center's hallways. Then Annette met Amanda Morton, a patient navigator for the hospital, and made a request.

The couple had been together for 13 years. They owned a house and car. He bought her doughnuts in the middle of the night when she struggled baking a cake. He encouraged her to go back to church.

They'd planned to marry this year, but never tied the knot. Could they be married in the hospital?

"I thought I would lose him," Annette said.

Morton understood. She'd lost her own husband nine years earlier. She knew what it was like to feel helpless.

She spent days figuring out how to marry the couple as Tim sank in and out of consciousness.

As one of six patient navigators for Wyoming Medical Center, it's Morton's job to help make patients and their families more comfortable, whether that is holding their hands and listening or bringing them a favorite food.

Hospitals in Wyoming and elsewhere are increasingly relying on patient navigators such as Morton. They serve as a bridge between a patient and the hospital's medical staff. To people like Tim and Annette, they're angels in bright green coats.

"You think you're tough," Annette said. "But it helps to have someone there."

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The general public expects more out of their hospital experiences, and at the same time health care has become more complicated, said Neil Hilton, vice president for the Wyoming Hospital Association.

Explaining complicated care is one of the reasons for the patient navigator program, said Kathleen Swanson, chief experience officer for the Wyoming Medical Center. It started in May at the medical center.

"We'd always known there was a gap in information," Swanson said. "This helps fill that."

Patient navigators — not to be confused with those of the same name helping with the Affordable Care Act — do everything from bring a cup of coffee to a patient to close the information gap between doctors and patients.

"As it's evolved, their impact on patients' and families' lives are more than we ever knew," she said.

The navigators are paid staff members who go on rounds with nurses, doctors and case managers, sometimes sharing important information a patient may not be as willing to tell someone else. They spend hours with each patient, listening to their stories, comforting them and helping to explain the complexities of medical care.

Navigators email families information about hotels and restaurants as well as what to expect at the hospital. They carry cellphones to be accessible at all hours.

Melissa Trujillo, another navigator, has gone to the store to buy tapioca pudding for a patient. She brought her own computer into the hospital with Skype — an Internet video and phone program — so a mother could talk to her daughter before the mother died.

She and others will check on patients' pets, bring extra blankets and arrange birthday parties.

The navigators take care of the things patients are worried about, allowing them to focus on healing, said Connie Coleman, nurse manager of the surgical unit at the Wyoming Medical Center.

"It also allows the nurses to focus on the patients' health because they know someone else is taking care of those other things," Coleman said. "It's holistic care. We try and take care of everything about the patient, and they close the loop."

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Navigators' backgrounds vary. Morton has been a certified nurse's assistant for nearly 20 years and first worked as a clerk on the progressive care unit of the hospital.

She used to live in Wheatland with her husband and two small children when he was diagnosed with an autoimmune liver disorder. She spent months between hospitals in Cheyenne and Denver. Morton's mother cared for her children while she stayed with her husband.

Three months later, he died.

"I went through all of that myself," she said. "I wanted someone I could unload on and cry and talk about my husband and maybe scream a little bit."

When the patient navigator program opened at the Wyoming Medical Center, she knew she had experience to offer. She chose bright green coats for the navigators because they're cheery and not used by any other hospital staff. It also makes them easy to spot, she said.

Annette remembers the first time she saw Morton and her coat. She was pacing the hallway, talking on the phone while doctors and nurses worked on Tim.

"As soon as she got off the phone, I walked up to her and hugged her," Morton said.

"She sought me out," Annette said. "I realized how much I needed someone."

Morton spent days finding a judge for the ceremony. She cleared the wedding with Tim's family and explained to the courthouse why he couldn't go downtown to sign the marriage license.

Then at 5:30 p.m. Jan. 29, with family and friends surrounding his bed, Tim and Annette married.

Tim can now sit in a reclining chair and talk after a nine-hour open heart surgery and weeks of monitoring. Doctors told Annette that his recovery has been a miracle. She partly credits their wedding.

Morton still checks on the couple every day, asking how Tim is feeling. She bought flowers and a card from Tim for his wife for Valentine's Day. They talk about the Olympics and snowboarding and family.

And before she leaves, she gives Annette another hug.

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Information from: Casper (Wyo.) Star-Tribune, http://www.trib.com

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