For 17 years, Ron Combopiano has been helping patients at Novant Health New Hanover Regional Medical Center in Wilmington make their way home.
Upon being discharged, some arrive to the sound of silence, no one waiting at their doorstep to shout “Welcome home!” No handicapped ramp that they now need. No food in the refrigerator or pantry. Bedbugs in the bedroom.
It can break the spirit of those who are just recovering from a hospital stay. Not to mention the hearts of those at New Hanover who do their best to help. But here’s the thing about case managers called to this job: They may shed tears. But they keep them inside. When there are crises to resolve, there’s no time to cry.
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“You control your emotions so they don’t control you,” Combopiano said. “I try to use them as a guide to problem-solving.”
Combopiano is one of 70 case managers at 800-bed New Hanover who help patients prepare for life after the hospital. You don’t hear much about case workers outside of health care, but they play a critical role in making sure patients have what they need when they return home and don’t wind up coming back to the hospital. He and his colleagues share his passion and ingenuity, although he’s the only one who gets the job done with a Snickers bar in his hand. He loves sweets. And he loves what he does.
“Ron is always smiling, always has a corny joke,” says Kristy Benfield, the hospital’s manager of case management. “He’s always an advocate for our patients. He always looks for the positive in their situation.”
It isn’t always easy.
‘If I was in your shoes…’
Combopiano, 63, works days on the medical surgical floors. He sees 100 or so patients a week, many recovering from injuries, others from cancer surgery. A meeting in their hospital room to make sure the return home is as smooth as possible can range from 20 to 30 minutes, longer if the situation demands it.
Caring for the sick runs in Combopiano’s family. His wife, Veronica, now retired, worked as a cardiac intensive care nurse for 37 years. The last 13 were at New Hanover. They moved to Wilmington from Sayre, Pennsylvania, in 2003. That’s the winter they suffered through 12 feet of snow. “We said, ‘No! Enough!’” Combopiano said. In northeastern Pennsylvania, he couldn’t do this hard work and unwind at day’s end in a screened-in swimming pool.
Combopiano earned degrees in psychology and social work. But it takes more than a college education to help recovering patients navigate the next leg of an often-traumatic journey.
Many patients, of course, come home to a stable environment. As necessary, Combopiano helps pave the way.
It’s the less fortunate to whom case managers give much of their time and heart. At a regional hospital like New Hanover, which serves large pockets of rural and underprivileged communities, this includes the poor and uninsured who can’t afford home health care or rent a hospital bed. Those who are alone, unable to comply with doctor’s orders about taking their meds. Those suffering mental illness or substance abuse disorder, unable to understand doctor’s orders or refusing to. Ailing cruise ship passengers who dock in Wilmington, want to be cared for and get back on board as fast as they can.
No two cases are alike, Combopiano said. But every case calls for his gifts of patience, motivation, problem-solving and crisis intervention.
He helps connect patients with Medicaid, home health aides, medical equipment and, if necessary, assisted living options. He explains doctor’s orders so a layperson and their family can follow. If a family needs bonding, he’s a mediator.
If a patient loses it?
“They can scream, he’ll stand there. Or his response is ‘I’d be frustrated, too, if I was in your shoes,” Benfield said. “He’s looking for the best in everybody. I’ll put it that way…”
There was the homeless patient who lived in a tent. Combopiano figured out how to get a home health nurse to visit him in the woods. There was a young patient from Asia. He figured out how to get the young man’s mother here to care for him.
No wonder he eats lunch at his desk most days.
‘You have to feel empowered’
This is where Combopiano is called to be.
He’s comfortable in a hospital setting, dealing with illness, heartbreak, frustration and anger. He’s been doing this long enough to know whom to call to get patients what they need. Few can weave their way through a government bureaucracy like him. Rather than shaking his faith, Combopiano said this work strengthens it. He sees the goodness in colleagues who do their best to help others. “You have to feel empowered to help others,” he said. Most of all, he appreciates the opportunity – the privilege – to do his part.
