Health Dialog Connections

Improving Healthcare Outcomes, One Patient Call at a Time

Beyond helping to treat rashes, colds, and migraines, a call with a nurse can mean the difference between a trip to the ER or a trip to the local pharmacy. Nurses can offer advice to scared parents in the middle of the night, to newly diagnosed diabetes patients who don’t know how to manage their new symptoms, or to those patients who need help navigating the complexities of the healthcare system.

In this series, we spotlight the hard-working nurses who educate, coach, inform, and reassure our client’s members when they need it most. With every patient engagement, our nurses connect patients to the appropriate level of care they need while helping our health plan, provider, and employer clients reduce unnecessary spending and ER visits.

Esther Shapiro Health Dialog Nurse Line CoachMeet Esther Shapiro: From hospice work to Health Dialog, Esther loves making a difference. She’s been a member of Health Dialog’s coaching team for over 11 years and is responsible for helping us deliver high-quality population health management and Nurse Line services to our clients.

What work did you do before Health Dialog? Before working as a nurse coach at Health Dialog, I worked in hospice care, and that was my love and my passion. I also had experience working in oncology, the intensive care unit, the cardiac and coronary care unit, and general medical-surgical care. Having a more diverse background is so valuable in this job.

What appealed to you about being a nurse health coach?

Life circumstances led me to Health Dialog, and the minute I was trained, it was like being at home.

Being in an office setting with a lot of other nurses was appealing. One thing I like most about Health Dialog is the idea that we’re here to guide, educate, and empower people to make the best decisions for their health. I love that.

What is a typical day like for you as a population health management and Nurse Line coach?

I am usually quite busy. Every 15 or 20 minutes you’re talking to someone and making a difference by offering them support. We also follow up with our callers, and most of the time they are so grateful when you call them back. It’s fulfilling knowing that you are making a difference for people. Sometimes it’s interesting the things that people get into—toddlers putting things up their noses, people using ointments on themselves that are meant for babies. You can get really unique stuff. To me, it’s very enjoyable.

I often help people get more clarity around what they need to do and what steps they should take to manage their health.”

What comes up the most when patients call the Nurse Line?

I often help people get more clarity around what they need to do and what steps they should take to manage their health. In fact, people are often doing home treatment incorrectly and that could lead to future complications, and so I often need to clarify what’s the best and safest way to take care of whatever’s going on at home. For example, recently I had someone who was putting peroxide on a wound. We no longer use peroxide, and they were quite surprised to know that this approach is not recommended anymore. We often have to educate people on the benefits of using the latest treatment options, versus sticking to older methods they learned from their parents or grandparents. We always learn more in medicine as time goes by and it’s important that as a nurse, I pass that on to our patients.

How do you stay on top of changes in medical care?

Health Dialog provides timely training that keeps me up to date. We attend monthly webinars and receive tactical “check lists” and “highlight sheets” on a regular basis that focus on teaching us new best practices we can actually use in our day-to-day job. Our training team is really committed to providing ongoing education on the latest innovations in medicine, patient engagement, population health management, and behavioral science, and that’s how we get that continued focus.

When you think about your time as a health coach, what is one of your most memorable stories?

About a year and a half ago we received a phone call to our Nurse Line, and we had to implement an emergency alert for the patient on the phone. This was a man who went to the emergency room for severe pain, and he was waiting and waiting for hours. Long story short, he ended up having a gun and he was out in the parking lot in his car and was threatening to shoot himself. That was an extremely intense phone call. It took a while to get clear on where he was, and then we did dispatch the police out there. It was a long phone call; it was not easy, and we were all quite rattled at the end of the day, but it ended beautifully. The police were able to talk him down (we were still on the phone). We saved someone’s life that day. To me that’s the best kind of memory because I truly helped to make a difference in someone’s life. To hear someone like that—so desperate just because they’re hurting so badly and to be so helpless on the phone…thank god we have ways to get help to people.

“The very first thing that comes to mind [with respect to what keeps me motivated day to day] is making a difference and having that connection throughout the day with the other coaches—knowing that I’m not out here alone.”

Have you had an experience in which you helped someone avoid an unnecessary visit to the ER?

Yes, of course. What comes to mind in particular are parents I’ve talked to about their young kids. They’re on the phone frantic, and their first question is always whether they should take their kids to the emergency room. I would say 90% of the time, that’s not what ends up being the best decision. The big thing that I do with parents who are in that nervous, edgy, and emotional state is to repeatedly say to them, ‘let’s talk about what’s going on, and let’s determine together what the safest thing is to do.’

I had a mother call recently because her infant hadn’t had a bowel movement in 13 hours, and he usually would have a bowel movement every 4-6 hours. There’s a knowledge gap—people not understanding constipation and not understanding the differences between using formula and breast milk. Of course, this required de-escalation. The goal first was to get her to calm down and see that this wasn’t an emergency, and then I needed to give her a few options to try at home, such as rubbing the baby’s belly, putting him in a warm bath, or moving his legs around in a clockwise position when on his back—all proven home remedies.

What keeps you motivated day to day?

The very first thing that comes to mind is making a difference and having that connection throughout the day with the other coaches—knowing that I’m not out here alone. The coaches connect with each other through online chatting. We are always reaching out to each other to just ask things, like where to find certain information. Keeping that community is really important to us. But the biggest thing is knowing that I’m making a difference with people.

What do you enjoy doing when you’re not helping patients?

I love hiking, artwork, being out in nature, and gathering people together.

Thank you, Esther, for your dedication to the Health Dialog cause!




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