Compassionate registered nurse with 29 years of healthcare experience, a solid background in chronic disease management, and recognized for providing empathetic support and impactful patient education. Dedicated to improving patient outcomes through strategic resource coordination and strong advocacy.
Overview
14
14
years of professional experience
1
1
Certification
Work History
RN Ambulatory Care Manager
Trinity Health Alliance
Grand Rapids, MI
06.2015 - 01.2026
Offer compassionate support to patients and their families during post-hospital recovery and flare-ups of chronic illnesses.
Engaged and respectful participation in discussions
Complete comprehensive assessments within 30 days of a patient’s enrollment in chronic care management services.
Developed nursing and patient-centered care plans utilizing information gathered from initial assessments.
Provided education on chronic conditions, including atrial fibrillation, behavioral health, cancer, chronic obstructive pulmonary disease, congestive heart failure, diabetes, and hypertension.
Performed a medication review by phone and a comprehensive medication review utilizing pill bottles and assistance from the patient’s pharmacy.
Completed the assessment of community resource needs utilizing the SIOH questionnaire.
Provided support in coordinating DME needs
Collaborated with the patient’s care team to coordinate resources and eliminate barriers.
Conduct follow-up with patients after any medication changes ordered by the provider.
Telephonic assessments of chronic diseases and provider communication regarding changes in symptoms.
Performed transition-of-care phone calls within 1–2 business days following discharge.
Advocacy for patient rights
Empowering patients through education to effectively advocate for their own needs.
Staff Nurse
Trinity Health Hospital
Muskegon, MI
05.2013 - 10.2015
Administered patient care, ensuring comfort and safety in accordance with hospital protocols.
Collaborated with multidisciplinary teams to develop and implement individualized care plans.
Monitored patient vital signs, promptly identifying any changes to enhance clinical outcomes.
Educated patients and families on treatment options, promoting informed decision-making regarding health issues.
Ambulatory Care Manager
Trinity Health Westshore Family Medicine
Muskegon Mi
06.2012 - 05.2013
Preformed comprehensive assessments within 30 days of initial chronic care services start date.
Developed nursing and patient centric care plans based off the information obtained during the comprehensive assessment
Worked with patient on the development of self management goals
Provided patient education regarding the various chronic disease i.e. a-fib, behavioral health, cancer, heart disease , heart failure, COPD, DM, HTN.
Assessed for community resource needs using SIOH questionnaire, medication review, and at each interaction.
Assisted with DME needs and barriers to care
Identified and reported near misses in patient care
Communicated with specialist and primary care provider when concerns were identified.
Provided compassionate ongoing care when patients called with change in symptoms.
Completed telephonic assessment and at times a face to face assessment when patient called or came in with a sudden change in symptoms.
Communicated concerns, changes using SOAP reporting with PCP, assisted with plan development and providing clear and precise instructions to patient using teach back to ensure patient understand of instructions
Transition of Care services with every hospital discharge within 1-2 business days and providing 30 day follow up.
Women's Health RN Care Manager at Louis Stokes Cleveland VAMC Women's Health ClinicWomen's Health RN Care Manager at Louis Stokes Cleveland VAMC Women's Health Clinic