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Interview with Gail Sobtkin a Medicaid Services Nurse

As a nurse, whether you are providing direct care to a patient, educating a new class of nursing students, or teaching a CPR course you are working to improve the health of those you serve.

Nurses can be consultants to an insurance company, pharmaceutical representatives, diabetes educators, or nurse researchers–among a multitude of other roles.

In this post, I interview Gail Sobtkin, RN about her role as a Medicaid Services Nurse in the Delaware Chronic Renal Disease Program. See how her unique experience, combined with a little luck, helped her land this special position!

Q: Gail, can you describe how long you were a practicing nurse and some of the different positions you held?

A: My career began in 1972-73 when I passed the LPN test while attending William Paterson University to earn a BSN degree. I worked as a LPN during weekends, summers and semester breaks until I passed my RN boards in 1974. After graduation, I worked on a hospital med-surg unit for a year then spent the next decade working as an ob-gyn nurse and childbirth educator for a group of doctors. It was exciting and fun to work in that specialty at a time when I was starting my own family.

One of the great things about nursing is the fact that there are many different opportunities that a nurse can pursue and my own career is an example of the flexibility that nursing provides. From the mid 80’s to the late 90’s, I worked in various positions as a community and public health nurse doing home health care, supervising immunization clinics and as a community educator instructing individuals and groups in health issues.

I also investigated infectious disease outbreaks, did case management for acute and long term care clients, and early intervention assessments for infants and young children.

Gail Sobtkin, Medicaid Services Nurse

Q: Where were you working prior to your position as Medicaid Services Nurse in the Delaware Chronic Renal Disease Program?

A: In the year, 2000, I took a position as community educator for the Epilepsy Foundation of Southern NY. For the first time in my career, my job focused on a single health issue – epilepsy and did not involve any direct patient care or clinical skills.

I trained law enforcement personnel, nurses and teachers about epilepsy, seizure recognition and first aid measures, wrote articles for the foundation’s newsletter, represented the foundation at health fairs and helped train new employees (social workers, therapists, job coaches that were employed by the Epilepsy Foundation).

Q: How did you assume this position as a Medicaid Service Nurse in the Delaware Chronic Renal Disease Program (CRDP)?

A: In 2001, my husband and I were planning to move to Delaware (after we could find a buyer for our NY house) and in anticipation of that move I filled out an online application for several job openings that were posted on the State of Delaware Website, knowing it would take several months to be processed. I also applied for a DE nursing license.

Although the Chronic Renal Disease Program was not one of the positions I’d initially applied for, the administrator of that program saw my application and asked me to come in for an interview. The timing felt like it was something that was meant to be- my NY house had just gone under contract and my husband and I were coming to Delaware to close on our new home during the very week I got called in for the interview.

A few days later I was offered the position and was allowed to delay my start date for several months so I could honor my one month notice to the Epilepsy Foundation and also get settled into my new home.

CRDP was a small state program that serviced 350 to 450 low income clients who suffered from chronic renal disease or had a kidney transplant. Eligible clients received free medications, nutritional supplements and medical transportation to and from dialysis and doctor visits.

Q: What responsibilities did this role entail?

A: My primary responsibility was conducting initial and annual client interviews to determine an applicant’s medical and financial eligibility for the program. During those interviews I screened each client for potential eligibility for other Medicaid services or programs to which they may be eligible and made referrals as appropriate.

I worked closely with dialysis unit social workers throughout the state as they were often the ones who referred patients to CRDP. (In addition), I wrote CRDP policy and procedure, worked with the pharmacists when billing issues came up, and transportation services when transportation problems arose.

Q: What did you like most about your position?

A: The fact that the benefits CRDP provided for our clients were literally life saving for them. None would have been able to afford the high cost of their medications or nutritional supplements without assistance, and most wouldn’t have been able to get back and forth for their 3 times a week dialysis treatments without the transportation services CRDP paid for.

Q: What was the least favorable part of the job for you?

A: Writing CRDP policy and procedure. There were many changes to the program from when I started in 2001 to when I retired at the end of 2009. Each change had to be reviewed by committee and published so the public could review it before final approval was given.

Q: How did you use your clinical skills in this role?

A: My position did not include direct patient care, but because I was a nurse and the other workers in the program were clerical or had social worker degrees, medically related issues or questions were handled by me, or I educated staff about them.

Q: What other abilities did you use in this position?

A: As mentioned above, I educated staff about medication or medical issues. In addition, I monitored client’s adherence to their medication and nutritional supplement regimens and intervened through individual client counseling to determine and resolve reasons a client had for being noncompliant.

For example, a client might be experiencing a medication side effect that they hadn’t told the doctor about and after speaking with the client I would address the issue with their medical provider.

I advocated on the client’s behalf when they were being evaluated for kidney transplants or when they had transportation issues or medication access issues (some meds required prior approval).

Q: What advice can you offer to new nurses just starting out in their careers?

A: You are joining the nursing profession at a time of great transition and challenge, but with this challenge there will be new opportunities for nursing leadership and greater independence in nursing practice. The Affordable Care Act will be presenting more opportunities for nurse practitioners and for nurses who increase their skill levels through further education and certification. I encourage you to join the American Nurses Association and stay informed about legislative issues that affect nursing practice and patient care.

Take advantage of any mentorship or preceptor programs that may be offered by your employer and if there is no formal mentorship, reach out to an experienced nurse whose skills you admire and ask if she/he is willing to be your mentor. Fully utilize staff inservice trainings, tuition re-imbursement programs or continuing education programs that are provided by your employer.

Mostly, I’d like to welcome you to the nursing profession. May you have a long career and find a nursing job that fuels your enthusiasm and passion.