“As a nurse, you know that every day you will touch a life — or a life will touch yours.” — Angele Rains, BSN, RN
At Axiom Medical, we talk often about the value of having Nurse Case Managers (NCMs) on the front lines of employee health. Most of the time, their work is quiet and steady. They work hard to deliver quality care quickly to stop injuries from snowballing. They get workers back on their feet and guide them safely back to work.
But every so often, there are cases that come along which remind us just how much hangs in the balance. These are the moments when an NCM’s training and instincts kick in, and quality care marks the difference between life and death.
This is one of those stories. In fact, it’s two. Both led by Angele Rains, BSN, RN, one of our dedicated NCMs, whose quick action and careful listening saved lives.
He thought it was the heat. She knew it was more.
The first call came from an employee who was working in the heat. He felt unwell and believed his symptoms were tied to the weather. The employer agreed and requested a routine occupational medicine referral.
When Angele began her assessment, she noticed things that didn’t add up. The pattern wasn’t typical of heat exposure. The answers to her questions raised quiet alarms. The employee, though, brushed off her concern. He was certain it was “just the heat.”
This is where medical intuition, built through years of experience, matters. Angele knew something more serious than heat exhaustion was happening and insisted that the worker immediately seek emergency care.
Angele’s persistence paid off. At the emergency department, doctors discovered a severe blockage in the left anterior descending (LAD) artery—a “widow maker” heart attack. He was rushed into treatment. Without that step, the outcome would have been tragic.
It Wasn’t “Just Muscle Pain.” It Was Blood Clots.
Within this same period, Angele had another call come in. This time the employee had a history of blood clots. The worker believed the pain he was feeling came from heavy, repetitive lifting on the job. It sounded like a strain. He was sure that was all.
Angele didn’t agree. She listened carefully. The story carried risk factors she couldn’t ignore. She advised him to go directly to the emergency room.
Once again, her instincts were right. The employee was diagnosed with new bilateral pulmonary emboli—i.e. dangerous blood clots in both lungs. The worker was placed on blood thinners and referred to a hematologist for continued care. Thanks to her persistence, another life was saved.
Axiom’s Nurse Case Managers are Heroes
These stories, of which there are many, never make headlines. Which is why we are opening a window into what our nurses do on a daily basis. Whether a worker is in South Dakota or South Carolina, Vancouver or Virginia, when they pick up the phone and call Axiom Medical, they are getting care that could define—or even save—the rest of their life.
Our nurses listen well. They also ask the right questions. That foundation is how the right care becomes possible.
Most of the time, the result is reassurance and first aid—sprains, cuts, minor strains resolved without a clinic visit. But sometimes, as in these two cases, the extra questions our NCM’s ask uncover hidden dangers.
Thank you, Angele!
Axiom Medical is proud to recognize Angele Rains for her outstanding clinical judgment and advocacy. In two separate cases, her persistence ensured employees received emergency treatment for conditions that could have been fatal if left unchecked.
Her actions remind us why NCMs are central to occupational health. They are Axiom’s life-saving heroes.