A nurse case manager performs a wide range of responsibilities to ensure that her patients receive a continuum of care. Nurse case managers are usually registered nurses who have at least a bachelor's degree in nursing. Many also obtain voluntary certification from organizations like the Commission for Case Manager Certification or the American Nurses Credentialing Center. Nurse case managers work in a wide range of settings, such as hospitals and medical centers, to help patients throughout the course of their stays.
Coordinating Care Services
Coordination of care services is one of a nurse case manager's main responsibilities. Care coordination essentially involves making sure that staff members meet all of a patient's medical and psychosocial needs. The principal goal of care coordination is to prevent fragmentation of services, says the Commission for Case Manager Certification. For example, a nurse case manager might ensure that a patient admitted for heart problems also receives psychological treatment, if necessary. A nurse case manager consults with all professionals involved in a patient's care to ensure that everyone stays on the same track.
Nurse case managers also often implement service plans. According to registered nurse Margot Phaneuf, this largely depends on the employment setting. Sometimes, nurse case managers with large case loads are responsible only for coordination of care. They might enlist the services of other nurses to carry out care plans. But in some settings, nurse case managers with reduced case loads are also responsible for carrying out service plans. Service plans, or care plans, depend upon a patient's diagnosis and involve a specific set of actions to help address the patient's complaints or concerns. This might include educating a patient about his diagnosis, performing interventions, like monitoring heart or breathing rates, and evaluating a patient's symptoms and progress in treatment.
Advocacy is an important part of a nurse case manager's role -- the "heart and soul of nursing practice," as registered nurse Cindy Zolnierek said in an interview with NurseZone.com. Nurse case managers help address potential problems and concerns for patients unable to do so themselves. For example, they might advocate for their patients with health insurance companies or government health programs like Medicaid or speak up for a patient's needs with other members of the interdisciplinary health care team.
When patients complete treatment at hospitals or other medical facilities, they receive discharge plans to ensure continuation of care. A discharge plan depends on a patient's specific conditions and concerns. For example, some patients might transfer into long-term care facilities, while others return to their normal lives with the assistance of a home health aide. Nurse case managers and other professionals, like doctors, nurses and social workers, collaborate to formulate discharge plans, arrange for required care services and coordinate follow-up care.