Salute to nurses: Profile of Debra Lietz

Bethany Davis, MSN, RN, Clinical Programs Manager, WellMed


In celebration of National Nurses Week, Clinician Insights presents a profile of one of the many nurses whose work is the foundation of excellent care delivery.

With gratitude for the many roles nurses fill in our health care system, Optum Care and WellMed wish you all a happy National Nurses Week.

Seeing relationships between clinicians and patients as crucial to wellness, and with a vision for improving health care delivery for seniors, Dr. George Rapier III founded WellMed in 1990.

The organization is a capitated, full-risk Management Services Organization (MSO) specializing in care for Medicare-eligible patients. 

They provide care for more than 325,000 patients under contracted Medicare Advantage plans. Using the WellMed Care model which adopting the philosophies of the Accountable Care Organization (ACO), WellMed, part of Optum, continuously strives to improve quality and lower cost. 

They have recently been recognized by The Joint Commission, the nation’s oldest and largest health care standard-setting and accrediting body, as an accredited Primary Care Medical Home and awarded the Gold Seal of Approval for Ambulatory Care.

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After more than 40 years as a registered nurse, Debra Lietz found her dream job as a health care manager at WellMed at Boerne. 

Lietz joined the clinic situated in the Texas Hill Country about 30 minutes outside San Antonio four years ago, and has relished the chance to use the full complement of her nursing skills to help keep her patients healthy. 

The WellMed clinical model values nursing care for the many ways it supports the diverse needs of their high-risk patient population.

A day in the life of a WellMed nurse

Debra Lietz’s days are full, and each one brings surprises demanding a nurse’s knack for creative problem-solving. Her morning’s first task is checking to see how the 50-odd clinic members she cares for have fared overnight. 

Is anyone in the emergency room? Has anyone been hospitalized? Lietz’s close connections with the hospital staff mean she knows where her patient is on the trajectory of hospital to home. 

She begins to sort out resources for a healthy transition. From wheelchairs to home care nursing, she makes connections that secure a safe and successful homecoming.

After getting ahead of the curve with the hospital, Lietz checks her schedule and prepares for clinic visits. A steady flow of patients come in for check-ups and care for illness. 

Each one receives her full attention for an individualized assessment that, to the outside eye, might look like old friends catching up. Lietz touches on everything from diet and blood pressure to grandkids and bothersome neighbors. 

“I know my 50 patients extremely well. I know their families, their work, their church,” Lietz says. All these factors have an impact on wellness. By knowing their lives well, Lietz is able to “do everything possible to help keep them healthy.”

Woven in with patient appointments are phone calls from patients, their family members, and other health professionals requiring Lietz’s expert networking and resource-finding abilities. 

Always assessing, Lietz gets right back to a patient with heart failure experiencing shortness of breath. She knows him and can hear the added labor in his breathing over the phone.

She asks if his daughter might bring him in for a weigh-in and possible medication adjustment, by the provider. 

He’s in within the hour, with swollen ankles and a story about a deliciously salty Sunday dinner. He leaves with a prescription for a diuretic, expecting a call from Lietz the following morning to make sure he’s breathing easier.


When time allows, Lietz works on longer-term patient needs: Connecting the concerned children of an elderly patient with depression to social service resources and helping the caregiver of another sort out the details of assisted living.

Knowing each patient lets Debra anticipate needs. 

By placing a “three-days-‘til-you-come-see-me” call to a special patient who benefits from a little extra coaxing, she makes sure he’ll be in to the clinic for a check-up. 

Being aware of those who rely on others for rides gives Lietz the chance to arrange patient transportation to that day’s education session led by a WellMed patient educator.

Lietz taps her extended network of health care colleagues in the community, sharing information that helps them provide better care and gleaning details that inform her interventions. 

A home health nurse colleague is scheduled to visit a patient who, his daughter reports, has been more confused in the mornings lately. Could she make sure the patient is wearing his prescribed oxygen at night?

The day begins to wind down. As Lietz is checking over her handwritten schedule, making sure she’s reached everyone who needed her today, a co-worker taps her shoulder to let her know her “special man” is in the waiting room. 

The patient is a veteran whose PTSD has led to troublesome arguments in the past. Lietz knows him well and has offered the clinic as a safe place. He can come and sit any time he needs a safe place to be. 

Her healing presence is needed, and she goes to sit with her patient, to hear about the issue, to reassure him, and to send him back into the world safe and well.


Holistic nursing care

Each day at her WellMed clinic is a chance for Debra Lietz to show the best of what nurses do. With vast clinical knowledge informing her, she is the listening, healing presence that gets to know each patient as an individual. 

She tailors her care just for them. She knows the details of each life, and how much these details matter. Nursing care of the whole person brings the best possible health for each one of her well-loved patients. 

Nurses like Debra Lietz connect the many parts of the health care system, while always keeping patients at the center of care. Optum Care thanks all of our nurses for the important work they do.

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This publication is informational and for educational purposes for practitioners only. The views and opinions expressed herein are those of the authors and do not necessarily represent the views of Optum Care. The views and opinions expressed may change without notice. 

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