Nurse case managers have many options for specialization. While most case managers handle cases within a certain area of treatment, others choose to take on cases outside their field of expertise as well. For example, a nurse case manager managing one patient’s care after a car accident may also serve the sibling who was injured in the accident but requires a different course of treatment. This choice is often made because the relationship between the two means they will share such things as insurance benefits and social services.
However, most nurse case managers are hired to focus on a particular set of patients or a particular area of practice. Here are some specialization options for nurses who choose case management as their area of service.
Complex, Multi-Disciplinary Cases
Nurses can be employed by hospitals to serve as general case managers, which means that each case they see may have a different medical basis. A nurse case manager may arrive at work on any given day to find the file of a patient who has just undergone heart surgery, is being treated for burns, or has had a problematic delivery. The nurse examines the file and calls in resources from every available area to help the patient with his or her recovery process. This may mean that the nurse must coordinate with doctors, physical therapists, occupational therapists, insurance companies, and social services to ensure that the patient receives help from every possible resource.
Sometimes a nurse case manager needs to take on the role of administrator to direct services to others. While this is similar to task-based case management, it involves a more global approach featuring delegation of tasks to others who can then supply the work needed to manage the case. For example, a hospital might employ an obstetrics case manager who does not actually meet with patients, or only sees them on a limited basis. Instead of managing the case per se, this nurse will assign various other nurses duties to follow through with and help the patient, such as ensuring that the lactation instructor visits the patient before her release and that the patient has access to educational classes about child care.
One of the outgrowths of the healthcare reform movement has been a focus on containing costs. Nurse case managers are still used primarily for health management, but the day is fast approaching when some will specialize in cost management, as well. In this regard, nurses with a background in accounting or business will be highly successful in securing these jobs. Cost containment means that these nurse case managers will be responsible for the rationing of resources to ensure that all patients are served equally and that the hospital or clinic does not exceed its budget for healthcare supplies and services. Nurse case managers tasked with cost control may be asked to make important decisions such as personnel selection and to develop relationships with insurance companies and drug companies to encourage good communication.
Specific Areas of Practice
Some nurse case managers are hired to focus on particular treatments that require a great deal of organization. For example, an oncology or cancer patient may need everything from chemotherapy and radiation treatments to support group help, and family members may also need services that the nurse case manager can help provide. Healthcare is not only about the patient but the patient’s support system as well. Family and occupational issues must be considered in planning long-term care. The areas of cancer treatment, obstetrics, pediatrics, and geriatric care are especially vulnerable to cross-treatment problems, so nurse case managers often focus their efforts on these issues.
What Skills Make the Ideal Nurse Case Manager?
No matter what specialization you choose, a career as a nurse case manager means that you will be given a great deal of responsibility. Strong organizational skills are a must, as you will be handling a great deal of information from a number of different providers and agencies.
Nurse case managers should also have good communication skills not only because they have to communicate with families and patients but because they must also work with insurance companies, social service agencies, nursing homes, and a variety of healthcare professionals such as doctors and other nurses.
Finally, nurse case managers should have great compassion for patients and their families. Even when patients are not completely compliant, it is important to look out for their best interests and talk to them about their options for treatment.