Building Therapeutic Relationships Telephonically

By Eric Bergman, RN,

How do you connect when you can’t see and barely know your patient? For telehealth professionals, this is a daily challenge and one that many of us have learned to overcome with careful listening and genuine conversation. As the COVID crisis moved more and more interaction to the virtual arena, a growing number of health care professionals had to learn how to convey genuine caring and therapeutic interaction without touch, eye contact, or, in many case, the opportunity to communicate nonverbally. There are ways to build that true connection and relationship, but it takes new skills and different perspectives.

I work as a population health case manager for a small insurance organization. I have helped to initiate and build our program, which is based on our organization’s fundamental commitment to honor and care for our members as if they were our family. It was precisely this promise that drew me to join the company when I was recruited through my professional network grown by my engagement with CMSA—but that is another story for another day.

Eric Bergman, RN, BA, CCM, is a nurse case manager for a small insurance association serving US government employees through the Office of Personnel Management and a faculty member of Alta Healthcare Consulting. He is leveraging his many years of experience in public speaking, writing, and organizational leadership to engage and support both members of the health plan in their health care literacy journey and professionals in their continuing education. Eric has served on both the CMSA National and CMSA Chicago’s Board of Directors and is a frequent national speaker at case management and nursing conferences.

A big part of my daily job is to identify and reach out to members of the health plan who appear to need some additional support as they manage chronic illness or serious acute problems—meaning problems that are immediate, but likely to resolve. When I call, I offer our members the opportunity to engage with me to discuss and manage their issues. I provide them the insight and expertise I have gained from my years of work as a nurse to help them navigate the health care system.

The work I do is 100% telephonic and is based on building a relationship of trust with them over the course of our conversations. I am able to build these relationships by carefully listening and drawing them into conversation about themselves, their families, and their health challenges. My organization provides me with one of my most powerful tools, the mandate to devote a lot of individual time to each client. I have honed the skills of hearing in the silences and discerning the tone of voice that indicates hesitation or uncertainty, and then I make space to address and support them through that discomfort. I rigorously work to be nonjudgmental and meet our members where they are without preconceived ideas about what they should do or what they need.

I have learned to use the power of conversation to ensure that my members feel heard and understood and to build trust and connection. For example, I met John after noticing that he had a lot of claims for breathingrelated issues, and a pattern of hospital stays and medical equipment claims that suggested he was in a late stage of a respiratory illness that was likely to end his life.

On my first call, I connected with John’s wife who told me briefly that she and John no longer lived together, and she provided me with a new phone number for him. This was a valuable piece of information I filed away to help me understand and meet John where he was.

When I reached John, he had a hard time talking to me because each time he tried to give a lengthy explanation of his situation, he would get so winded he had to stop speaking to catch his breath. I quickly learned that he did not understand how to properly use the oxygen equipment that he had been provided when continues on page 36

Approved for 1 hour of CCM, CDMS, and nursing education credit

Exam expires on December 15, 2023