What do you do if you're a nurse transitioning from bedside care to case management?

I hope you will have an orientation to know the role you are expected to play. Read about the history, purpose, and value case managers bring to the healthcare system. As I was told in 1988 when I was interviewed for a job as a case manager," Case management is good nursing." We ensure the patients get what they need when needed, in the least restrictive setting and at the most cost-effective price. This has changed a little today, as managed care has streamlined prices, but case managers still look at cost, needs of the patient/family, and available resources for the patient. We are educators and work to empower the patient/family to share their voices and what is important to them.

The biggest change you will face will be moving to a more collaborative and communicative role, with a far more diverse and larger number of patients and staff. Your patient care timelines will be extended compared to bedside. Organization and self-management are vital so find a system that works for you. You will need to be highly adaptable, and able to rapidly change focus without losing track. Collaboration with Social Workers, discharging physicians, Rehab and Skilled Nursing facility persons, DME vendors, and insurance company reps are important. It is especially important to know the distinction between Rehab, SNF and Hospice, and how Medicare, Medicaid, CMS programs, and commercial insurance differ and how they work together.

Use your understanding of clinical workflows and evidence-based care to observe for gaps in care. In this way, you’ll assist your clients in their post-discharge/disease Case management interactions until you can become certified (in so many years of sitting under a CCM).

In my experience before you make the transition from bedside to Case Management, inquire about shadowing a Case Manager or Discharge Planner. This will provide you with a sample of what to expect. Every Organization has different protocols related to dividing and conquering task with Coworkers to be successful. This is the beautiful side of Nursing, there are so many opportunities to explore.

Find a mentor to help you with the transition. Join CMSA, both nationally and any local chapter you can find near you. Finally, "interview" the case managers at your existing work place for their insights

Join an organization that has networking and educational opportunities to learn about case management skills from seasoned professionals.

Based on my conversations with my patients along with my MSN Gerontology Nursing Studies and continued diligence in reading and researching information, I was able to make use effectively my tools and information from work to ensure I lead the patients to the right path that would assure possible help and assistance. This includes social determinants of health that are constantly updated.

I would embrace change. Its the change that pushes us to our limits, to explore more and learn new things. If you dont have experience and you are placed in a situation providing you with the opportunity to lead, just say yes and learn the skills later.

Allow yourself to be a novice, listen, watch and learn from your different preceptors. Understand that you will need time to assimilate a lot of new information, and that you may not always get it right. Anyone willing to learn, and be part of the team will be stronger for the effort.

Things often change rapidly as a denied process suddenly gets approved and you need to move quickly to get the patient care implemented to take advantage of it, especially for discharges and transfers. Expect change and learn to anticipate it. Always have contingencies in mind. A good habit is to ask yourself "What if this fails or is delayed". You don't need to develop a full alternative plan but do have an idea of what your alternatives are, and how the immediate change affects the course of events. Remember you cannot do this alone, learn to depend on and delegate to your skilled teammates like therapists and especially social workers, especially when you must rapidly change directions of care to accomplish the care goal.

When I make my notes for my onsite case manager or social worker colleagues, I make sure that I give them the information that needs to be addressed to effectively provide continued care for the patients especially when they are about to be discharged. I also acknowledge the work that they have done before mine and present them to the patient to provide sense of comfort and security, and the patients will feel that they are taken cared and heard.

Open Mindset: Approach the transition with an open mindset and a willingness to learn new skills and perspectives. Recognize that change can be challenging but also presents opportunities for growth and development. Networking and Mentoring: Connect with experienced case managers and seek mentorship to gain insights and guidance on navigating the transition. Networking with peers in the field can provide valuable support and resources. Transferable Skills: Identify and leverage transferable skills from your bedside nursing experience, such as critical thinking, communication, care coordination, and patient advocacy. These skills are highly valuable in case management roles.

I have joined organizations to learn more from how they use their systems and resources then use this knowledge to practice and make them skills to be successful in providing care for the patients and building common goal with understanding of the present health conditions of the patient toward maintaining better health statuses and outcomes.

Staying patient with yourself is key. Do not be afraid to be a newby. Newby’s ask questions and observe. The basic 101 of nursing is assessment. Without assessment there is no nursing care plan. Continuous learning and building a new network takes time. Be positive when approaching a peer/mentor/leader with questions! Acknowledge what you do not know! Know your why! Your perspective is going to change with your new responsibilities. It is ok to get it wrong, but learn and reassess. Embrace the feedback! Enjoy the journey of providing a different kind of care! Be approachable and your tool kit will expand, then share with others what you found most helpful when you were starting out.

Connect with other CMs through professional organization or CM related CE conferences. Go to CMSA and ACMA websites to find topics of interest Contact CM departments at acute care hospitals. You may be able to shadow a CM or meet with CM leadership.

Be sure to take advantage of being new and seek out a mentor to help you adjust and adapt to the new role and its requirements and duties. Ask plenty of questions and keep good notes. Remember that CM is a very collaborative endeavor, so you may do everything right and things may still fail because some other part of the system broke down. Stay focused on the broader goals, not the tiny details. It will be months before you begin to feel comfortable or competent. Expect that and reach out for help, or just have someone to vent with. Remember to leave time for yourself & self-care. Case Management may not have the immediacy that urgent situations can as a floor nurse, but it is just as vital to the long-term health of your patients.

There is an accrediting system known as Case Management Society of America and they have a network of knowledge to help in your new role but also prepares you for case management accreditation which builds confidence and knowledge about this field. You know more than you think and your bedside skills and knowledge are invaluable. If you pull up their website you’ll see it is invaluable. Your new employer will often support your activity and pay for testing and courses. Employers want you to be case management certified over time. Just some thoughts that helped me transition.

Most important is be the patient advocate first. Meet patient needs first then blend in the family needs. This is not always easy. Building your network for smooth transitions is key.