Carol Fishman Cohen: Welcome to 3,2,1 iRelaunch, the podcast where we discuss return to work strategies, advice, and success stories. I'm Carol Fishman Cohen, CEO, and co-founder of iRelaunch and your host. Today we welcome Karolyn Diamond-Jones. Karolyn is a registered nurse working in the area of healthcare compliance. She has a bachelor's degree in nursing and a master's in public health, both from Emory University.

Karolyn took a 15 year career break to raise her four children. She rejoined the full-time workforce in 2017 as a case manager in the home hospice and palliative care field. During the COVID-19 pandemic, Karolyn received a certificate in legal nurse consulting and currently works for a large healthcare company in the Atlanta area doing Medicare denials and appeals. In this episode, which is part of our relaunching in medicine mini series, Karolyn will share her experience reentering the field of nursing as well as her pursuit of a legal nurse consulting certificate.

Karolyn welcome to 3,2,1 iRelaunch.

Karolyn Diamond-Jones: Thank you, Carol. I'm very excited to be here.

Carol Fishman Cohen: Well, we're thrilled to have you, and there are a lot of great topics here that your return to work represents, so we want to get into as many of them as possible. Can you start by telling us about your career path that led up to your career break, and what made you decide to take the career break?

Karolyn Diamond-Jones: Originally, I had been a clinical nurse. I had done cardiac and outpatient surgery for many years. Then I got married and took a 15 year break to raise my four children.

I decided I wanted to do some contractual work, probably around 2010, 2011, just taking small assignments here and there with home health, work site wellness, little things like that. We were having financial challenges at home. My husband had a lay off, followed by two more. So needless to say, we were having our own financial concerns at home.

And by 2017, it was time for me to go back to work full time. We needed the income. We had two in college at the time, my twins, and my oldest was just finishing up college. From a financial standpoint, I really needed to dive back in. And so that was the year that I decided to go back to work full-time. It was a trying time for all of us, very stressful, but it was nice that my income was able to help us out as well as provide benefits and keep us going.

Carol Fishman Cohen: And, we were talking earlier, right before we started our interview, about how some people choose to go back to work and some people have to go back to work because of some external circumstance. So you're certainly in that second category. Do you think you would have returned back to work, but it might've taken a lot longer if you hadn't felt the financial pressure?

Karolyn Diamond-Jones: Possibly, yes, very much so. But what was really interesting was I had never been under this kind of pressure before. I mean, the last time that we are under that pressure is maybe when we graduate from college, we take that first job and we're eager to get to work. And so it's a different mindset. Yet when we come back and we choose to go back to work, again, it's a mindset. So this was almost like an emergency type of situation where I had to go back.

And so I really thought long and hard about how I was going to do this because my family really needed it. I had been out for 15 years. I was 55 years old at the time and I thought, "How am I going to do this? I feel like I have two strikes against me. How am I going to pull this off?" I listened to a lot of career coaches online. I did some reading. I also worked on myself a lot. I felt that doing a lot of self care was really important for my mind to just settle and be a little bit more confident and strong. Because when I walked into that interview that day, I had made up my mind when I walked in that I wanted that job and I was going to land the job.

Carol Fishman Cohen: Wow. Wait, hold on a second. Can you take us back, rewind for a minute and tell us how you decided you were going to relaunch into the palliative care field, how you identified this role, and how you even got to the point where you were able to walk into that interview?

Karolyn Diamond-Jones: Yes. And that's a great question. I had made up my mind that, of course, I needed to come back, but in what capacity I was not sure. And I had spoken to other colleagues of mine, other nurse professionals, just bouncing ideas off friends, colleagues, old professors, people that knew me and knew my skill set, and knew also the kind of person I was and personality that I had.

I knew I didn't want to go back to the hospital. My mother had passed away in 2006 from Lewy body disease, and I was really moved by the hospice team. And it was a friend of mine who said, "Karolyn, they did such a great job with your mom. Have you ever thought about going into hospice?"

And that never dawned on me, you never think about that in healthcare. You always think about hospitals and O.R. and this and that. And she said, "You really should consider it." I started looking at it. I started reading up on it. I had some friends in the hospice and palliative care field, and I spoke to them and they said, "Oh, Karolyn, you've got the basic skills for this. You can do this." And I said, "Really?" And she said, "Yes, you have the background because you already understand about adult health and the disease process, and this is just going to be an extension of that. So this might be a really great fit for you." That was what moved me to do this, in that I leveraged what I had to go into an area that I knew very little about only from the receiving end. And I tell everyone, I said, "In my mind it was more of a personal move than a professional move," because I felt it was something that I wanted to give back, in regards to what they had done for me and my family.

It was a good experience. It was a powerful one. It was a solid one. And I was able to leverage my old skills into an area that, again, I didn't know enough about, but I had enough confidence to say, "Okay, you're not walking in empty handed, you have some skills and you will be able to use them in a certain capacity." It's just later and things have changed, there's electronic charting system, there's new medications. The pharmacy world changes daily, always new medications coming out. So I had to learn the medications. I had to take a medication test. They wanted to make sure that I knew how to administer medications, it had been a long time.

Also the state of Georgia many years ago had required that if you had been out of the workforce for, I believe it was seven years or more, Georgia mandates a refresher course through the local community college, which I took.

Carol Fishman Cohen: I was going to ask you about keeping up your license and what was involved in that. So it wasn't a matter of just paying a renewal fee every year, you actually had to take this course. Did you take that course before you relaunched or at the same time while you're already in the job?

Karolyn Diamond-Jones: I took it before I relaunched, because I was also doing some home health assignments. And home health had required that I had my skills up to date and, going back into nursing, Georgia's really strict about making sure that you do take this refresher course, which is a lot of online learning.

And then there's also a clinical involved, where you're actually in the hospital, for, I think it's, I'm going to say maybe eight weeks or so. Where you actually are involved in patient care and you're getting back into that mindset and all of those skills start to come back. You think you forgot something, but you really do remember these things, they're just a little dusty, that's all.

Carol Fishman Cohen: It's really good for people to hear this. So let me just clarify, this course that you took, this is mandated by the state. So it's already set up as an official refresher course to refresh your licensure, I guess, and so there are these online parts, but then there's also a clinical piece.

And so somehow whoever's managing that course then says you have an assignment in XYZ health care facility? You got assigned there?

Karolyn Diamond-Jones: Basically the way it works is Georgia mandates that you have to take this course if you've been out for a certain period of time. And it was interesting because when we first all met at orientation, there were women there, some women were out for 20 years, some women were out for eight years. People were out for 30 years, they needed to come back because their husband was retiring and they wanted to come back, all these scenarios. And so we all had to take this course.

And so it was offered by Kennesaw State, which is a community college here, which has been offering this nurse refresher course for many years for Georgia. And you have the option of taking it in person or online. So that was also another learning opportunity. I had never taken an online course before.

And this is 2009, 2010, around there. So there was another experience I had never had before, online professors, papers, tests, all of that. And then the clinical was linked to the program. They would reach out to me. They knew where I lived, so they would assign me a hospital that was close to my home, and they would give me a choice of areas that I could choose to work in. And then I would have a preceptor there. So I would check off with her certain skills, check in with her once a week, and email her a report of my progress. So they were tracking me clinically that way.

Carol Fishman Cohen: I see. So were you nervous during this time about the amount of time that was going by while you're having to do all this preparation and then still looking for the job, or did you then just start sending out resumes? What was the timeline of the process and what actually happened to lead to you going in for that?

Karolyn Diamond-Jones: I had done the course in early 2009, 2010. I didn't go to palliative care till 2017. Because I had mentioned earlier that places like home health, even if I wanted to step into a very temporary role at a minimum, Georgia said, "You need to have this under your belt before you offer yourself to any employer at any level."

Carol Fishman Cohen: Makes sense.

Karolyn Diamond-Jones: Yes, because my license was current, but they needed my license and this little diploma type thing saying that I did graduate from this program. I am up-to-date. I am current. I am ready to step into the employment world.

Carol Fishman Cohen: So that was kind of the first phase of your relaunch, really.

Karolyn Diamond-Jones: Correct, that was the gateway.

Carol Fishman Cohen: So you started taking these little contract roles here or there. And then, though in 2017, you're getting very serious about it. So did you apply online and get people responding to you? Or did someone recommend you for this role? How did you find it and how did you get to the interview point?

Karolyn Diamond-Jones: I basically had been on LinkedIn. I had really polished up my resume and I was reading a lot of the articles. Remember, we were on a bit of a budget, so a lot of things that I could find free, like great articles on LinkedIn, a lot of reading, a lot of talking to people.

Another thing too is I found that there are really nice people on LinkedIn that are so helpful that actually want to help. There's actually a woman who was on my LinkedIn page, who was a recruiter for some of the larger hospitals in the Dallas area. And she was very, very nice, and we had a really nice conversation on LinkedIn. She was so nice. She said, "Karolyn, if you ever want to talk on the phone about the interview process, or you need any tips for your resume, I'd be glad to help," because she was a healthcare recruiter. So that was another resource too, which was just so nice. I was finding people out there that were really, really kind and generous with their time.

There was also another organization, a Christian organization here in Atlanta, which is a Christian career group through Roswell United Methodist Church. It's one of the largest in the country. And basically they help people come off of a layoff. They help people with relaunching. It's what they do.

And so I went to a couple of free workshops there. I listened to some psychologists. I spoke with someone about polishing my resume. I had practice interview sessions. They had all kinds of little things to help you polish yourself and make yourself a little bit more marketable so that you can actually focus on what it is you want. Only because, when you go out there, there's so much, it can get very confusing if you're not really, really focused on things you want.

And what was really interesting was, this organization had another step to it, another component. What they did was they had the basics, and then once you "graduated from the basics," you could go onto this other part where they basically asked you what your three top companies are.

So you had to do your research, you had to do your homework, you needed to get up there and speak about why these companies, why you would like to work for these three companies.

Carol Fishman Cohen: So, they made you actually speak out loud about it to an audience.

Karolyn Diamond-Jones: Yes, in front of the group. I mean, they taught you how to do an elevator speech, all of that. And how to shrink it down so that you can do it quickly and make your point.

So it forces you to think, and it forces you to really speak about what's important. You have very little time, and you want to get your point across.

Carol Fishman Cohen: Wow. That was very good training.

Karolyn Diamond-Jones: It was. So basically getting back to how I got that interview. I had polished up my resume and I was called in for an interview. And what was in the back of my mind, this is a situation where I'm going to need to sell myself. I need to let them know that I am the woman for the job. I'm the one that's going to be an asset to their company. I walked in and I think one of the things that you can do before you even say anything is to think about the energy that you're bringing when you walk into that room. You want to make them feel that they are so happy to see you, and you're happy to see them. It really is very refreshing when you walk in and the interviewer has a smile on their face. They're happy to see you because there's something that you're doing when you walk into that room.

And when you sit down, storytelling is always really important. I've always found that when you can relate a story, a personal story to an interviewer about why you feel this is important, and I talked about my background very little, because they already had that, but I talked about my personal experience that I had with hospice and palliative care, and how it impacted me, and how I wanted to give back. So sometimes tying something personal to what it is you want really rings true in the fact that it shows that you're here for the right reasons. You're here because this is something that you really, truly want to do, and really speaks to you.

Carol Fishman Cohen: And did you just apply randomly to this job, and then they asked you to come in for an interview? Or did something else happen in between those steps?

Karolyn Diamond-Jones: I had a couple of interviews with a couple of other companies, and it was for the same type of position. But this company was, I don't know, there was something about it.

When you interview for the same position at different places, does the place speak to you? Do you feel at home there? Are you getting a good vibe about the whole culture of the company? And so this was the place that I chose that I wanted to be with.

It was with Amedisys and I really had a great discussion with the director. We related really well. She could relate to a lot of the things that I was saying, maybe her background was similar to mine. But it was a different feeling than some of the other places that I went.

And I think it had to do with, it became more of a personal thing than it did a professional thing. Because like I said, I had related stories to her about my connection and how I felt that I would be able to leverage my skills in this area. They had a couple of other people interviewing for the job, but before I walked through that door, I made up my mind that I was going to get that job.

Carol Fishman Cohen: That's amazing.

Karolyn Diamond-Jones: What was really interesting was, I walked out, I was sweating. I was doing this for my family. I'm like, "I've got to land this, we need benefits, we need everything. Come on, Karolyn, you can do this." And my phone was buzzing and I turned it over. It was the recruiter. And she said, "They LOVED you."

Carol Fishman Cohen: Oh, that is so great! That must've been quite an amazing moment.

Karolyn Diamond-Jones: And she said, "They want to give you an offer." I said, "Well, I'm a little freaked out right now, can we do it tomorrow?"

Carol Fishman Cohen: That is great. Okay. So you end up taking this job and then, is that when you had to learn the new systems and the medications, and you got that training on how to give out medication or track it?

Karolyn Diamond-Jones: No.

Carol Fishman Cohen: Okay. That all happened on the job.

Karolyn Diamond-Jones: Yes. And this was a new world because I had to learn EMR, which stands for electronic medical record, where things are no longer written in charts. Everything is done online. Nurses carry tablets, and that's not something I'm used to doing. Yeah, we have an iPhone and iPad, but as far as using a medical record online or using new software, learning their software, things like learning the whole world of palliative care, which has a lot of legal implications to it, sent me in this direction, because it's a benefit of Medicare part A, and so there was a lot of legal overlap there.

I was learning about the Medicare laws. I was learning about how hospice utilizes those services. And, it was again, it was a career move where I was learning everything from the ground up.

Yes, I was learning new medications I've never used in my life. I didn't know what they were. And also, I was taking care of an age group, most of the patients in hospice are elderly. Occasionally we have people middle-aged, but mostly people that are in their older years. So there were a lot of medications for memory, medicines for Parkinson's disease, or medications for Alzheimers, memory medications, all of these. I knew nothing about them, my background was cardiac. This was all new to me. So a learning curve and how these drugs work. I learned a lot about narcotics and how they're used and how they affect the body.

So there were a lot of opportunities to learn about what was going on.

Carol Fishman Cohen: It's interesting. You mentioned the learning curve because there is such a thing as the learning curve and stages of learning. We actually have a podcast on that topic with Michelle Friedman, so our listeners can look that one up if you want to learn more about the learning curve.

Karolyn, I wanted to get into this transition that you are making and what made you start looking to get the legal nurse consulting certificate? And when did that happen?

Karolyn Diamond-Jones: This happened, so I was doing hospice for awhile, and I had been going through some changes personally at home. My husband and I were separated for a while and we were planning to get divorced. My three older children had already graduated from college and they were off on their careers. My youngest one was about to start college. And so I was thinking about a new chapter for myself and what do I want to do with this new chapter?

And I thought, I had learned so much in hospice. I had learned so much about the laws of Medicare and how they work. And I thought, it would be really interesting to just bring this into something else, but what? I was reading online and I was reading a lot about legal nurse consultants.

And I didn't know what that was. And then I spoke to a couple of colleagues. "Oh, legal... ," somebody always knew someone who did this, "Oh, my friend did that." And so I looked into it and again, trying to keep things within budget. There were a lot of great legal nurse consulting courses online.

There was one that was $3,000, which was really nice, and then some were all the way down to $250. I ended up taking the one for $250, which was offered through a local vocational program here in Georgia, which is also through one of these e-learning portals here, online. What they do as you go on and they ask you where you live, and then the program is offered in several states. And so I signed up to do this. It was a birthday gift to myself in March, 2019. I thought, "I want to learn more. I'm going to take this course." It was six weeks long. It was taught by an attorney whose wife happened to be a nurse consultant.

I was online with 30 other nurses who wanted to do the same thing that I did. They were from all over the country and it was six weeks long. I had assignments and I had tests and I learned a lot about the law in six weeks. And so I had gotten a certificate when I was done, but the pandemic hit and things changed for everyone.

And so, there was no way that I was going to go out and start cold calling with lawyers because no one was hiring at the time. People were locked down, people were quarantined. Things were quiet. And so I thought, "All right, fine. Put this on the shelf and look at it later. Something will come of it just not right now."

So I put it to the side. I went back to hospice. And funny, be careful what you wish for. I was seeing a patient, a lady who had some end stage heart disease, and a very nice family. And her daughter pulls me into the kitchen and she says, "Karolyn, you did such a great job with my mom. I just want to, we all want to thank you." And I said, "Oh, it was my pleasure." And she said, "When you're ready to leave hospice, let me know." I said, "Oh," my eyes wide. She said, "I am the director of recruitment for Pruitt Healthcare." And I said, "Can we talk sometime soon?" And she said, "Absolutely." We exchanged our information, she sent me a request on LinkedIn.

We started talking, I told her about the legal nurse consultant certificate that I had received, and that I was really interested in moving in this direction. And she said, "Karolyn, you know, our compliance department really needs an RN." And I said, "Are you kidding?"

Carol Fishman Cohen: Wow! And also, you didn't even have to interview because she saw you in action. She already knew everything she needed to know.

Karolyn Diamond-Jones: She knew what kind of clinician I was, but she didn't know if I had the skills to start pivoting into the legal world. She didn't know. But what was really funny was the next interview, when I interviewed at Pruitt, and I sat down with my supervisor and I was telling her what I did.

And as I talked, the smile got bigger and bigger and bigger. I said, "Did I say something?" She said, "Karolyn. I'm a legal nurse."

I said, "Oh my gosh, you're kidding?" She said, "No, you're in the right place." I said, "Ok, well that's great!" So she introduced me to our CCO, who is an attorney, spoke with him and some of the other people on the team, and then we had people out in the field. But basically I oversee denials management and appeals for North Carolina, South Carolina, Florida, and Georgia.

We have facilities, we have home health, skilled nursing and hospice in these four states. And so we have situations where there's audits that have to be done, post pay audits for Medicare. And then also too, we have appeals where maybe a payment is trying to be recouped and we need to do an appeal.

So that's where it really gets interesting. I was taught how to write an appeal. And we also do something called an ALJ, which is the Administrative Law Judge, which is actually a hearing that's done over the phone where we actually speak with the judge and give a testimony.

It's very interesting. I have not done that yet. They are preparing me to do that, but I have sat in on a handful of hearings already. So I'm looking forward to doing that and maybe soon, hopefully next year. But it's starting to get really interesting. And it's really interesting too, to tell people what you do because you tell people you're a nurse, the first thing that comes to their mind, "Oh, you work in the hospital, you work in the OR," and I'm like, "No, I work in an area of healthcare that a lot of people don't know about." So, that's another thing too, you just never know where your skills can take you. Sometimes people think, "Okay, I was an accountant then, I need to look for another accounting role."

And that's not always the case. You have that experience, but you can still use that in another capacity somewhere else. And the way I see it is, I've gone from being a clinician, I look back to where I was, I actually wrote a poem about two weeks ago, From Cardiac to Compliance.

My gosh, from taking care of patients after open-heart surgery to writing appeals and sitting in on hearings, it's so different. It's been a really rich journey. So yeah.

Carol Fishman Cohen: So, Karolyn, I'm hearing some themes here. Number one, your positivity. So there's a lot of, "No, it wasn't a bad day , it's just not as good of a day. " And I'm hearing patience with yourself, I'm hearing positivity. I'm hearing that you're a constant learner and you're a curious person, and you look at learning as an exciting process and not something that you allow yourself to get intimidated by.

And I think that's really important because relaunchers can sometimes get intimidated by what they have in front of them in terms of what they need to learn for up-skilling or re-skilling. So any comments on how you kept your positive attitude and encouraged yourself to embrace this opportunity to learn, as opposed to being fearful of it?

Karolyn Diamond-Jones: I think that we all come to the table with strengths and weaknesses. And they're not necessarily weaknesses. Whenever I've done an evaluation for an employer and they always say, "What are your strengths?" And then instead of saying, "What are your weaknesses?" They say, "What are the areas you want to work on?" And I think that's the way it is. I think part of it, it's really based on the messages we tell ourselves and words have such power. Even the words we say to ourselves, when you get up in the morning and you look in the mirror, I heard someone say, "Greet yourself! Say, ‘Hey! Good morning!’"

It's so refreshing to get up. And, it's interesting because given what's going on in the world today, we're really lucky to be here. And I think that's another perspective too, is that our world went through something so horrible and so many lives were lost. I think sometimes we forget the blessings and we forget the good things that we have and we're not as grateful, I think we need to take a step back.

And the other thing too is, we need to remember where we've come. A lot of people always say, "Oh gosh, I had a bad day." "I messed this up." "Oh, I wrote down the wrong information." "Oh, I forgot to do this," or whatever it is. If you look back on where you've come from, it's daunting. It is unbelievable. And sometimes at the end of the week, I'll lay there in bed and say to myself, "I can't believe where I am," when I think about how far I've come, given personal issues, professional changes, all of these things.

I think we really need to believe in ourselves and realize that we really are stronger and smarter than we think. We really know more than we give ourselves credit for. It's just that simple.

Carol Fishman Cohen: This is a great moment to ask you our final question, which you've already been giving advice right there, but our question that we always wrap up with is, what is your best piece of advice for a relauncher audience, even if it's something we've already talked about today? And I know you've already started to give advice, is there anything else that you want to add? It's so valuable and thank you so much for pointing out all of this.

Karolyn Diamond-Jones: Sure Richard Branson once said, "Always say 'yes' to the opportunity and learn to do it later." And I absolutely love that, because he's so right. Take the job. If they offer it to you and okay, maybe it's not your absolute dream job, but take the offer. It's going to get you in the door. It's going to get you started. It's going to boost your confidence. It's going to help you financially.

There's so many positive things that are going to come out of that. And believe in yourself. You want to believe that you can do this. Change your attitude from, "I don't know," "Maybe" to, "Yes, I'm going to give it my best. I'm going to try." Take the risk, take the jump, believe in yourself.

And the other thing too is when you are in that interview, try to show the interviewer that you do believe in yourself, because I think interviewers do sense trepidation when somebody is unsure. So if it's something that you do want, let them know, tell them, "This is something that I've always wanted to do." Because the thing is that if it's something you’ve wanted to do, you're going to work hard, and you're going to be one of their best employees, because you're going to want to give them your best. And I think that's it in a nutshell.

Carol Fishman Cohen: Right, that's a great place to wind up. Karolyn, thank you so much for joining us today.

Karolyn Diamond-Jones: Absolutely. I enjoyed every minute of it.

Carol Fishman Cohen: And thanks for listening to 3,2,1 iRelaunch, the podcast where we discuss return to work strategies, advice and success stories. I'm Carol Fishman Cohen, the CEO and co-founder of iRelaunch and your host. For more information on iRelaunch conferences and events, to sign up for our job board and access our return to work tools and resources, go to iRelaunch.com.

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