Running head: ANALYZING A LEADER OR MANAGER ROLE

Analyzing a Leader or Manager Role

Sarah Knoll
Ferris State University
NURS 440

Professor Gabua
November 5, 2014

ANALYZING A LEADER OR MANAGER ROLE

Analyzing a Leader or Manager Role

It is important for nurses pursing higher education to examine the role of nurses in
leadership or managerial roles. A large part of continuing education is career advancement and
for nursing this often comes with leadership type roles. Understanding the impact of leaders and
managers on patient outcomes, staff satisfaction, and nursing as a whole is critical for truly
understanding higher level nursing.
Nurse Case Manager
I chose to look at the role of Nurse Case Manager for the purposes of this assignment. I
interviewed Tracey Hunter, BSN and Nurse Case Manager for Helen DeVos Childrens Hospital.
I have had the opportunity to work with Tracey as a staff nurse, watch her complete her
bachelors degree, and move into this new role. She has currently been working as a Nurse Case
Manager for three years. When I reviewed this assignment I knew immediately this was the role
I wanted to examine. I am able to see a shift in healthcare right now where Nurse Case
Managers are now taking over tasks that were previously delegated to Medical Social Workers
and I thought it would be interesting to look at this in a bit more depth.
Interview
What are the roles and responsibilities of a care manger? According to Tracey, A nurse case
manager acts as the liaison between families and doctor, facilitator of home care services. Nurse
case managers write letters of medical necessity to insurance companies for validate treatments
and services. They draft 24 hour care plans for patients while they are inpatient. They are
responsible for completing state applications for parking stickers and state insurances. They also
identify needs within the home such as safety needs, housing needs, financial concerns, and

ANALYZING A LEADER OR MANAGER ROLE

ensure there is adequate resources such as food and utilities to care for the patient, (Hunter,
personal interview, 2014).
Describe the organizational structure from there perspective of a nurse case manager? Her
description essentially described a hierchial type structure, everyone answers to someone else.
You have your manager and they have theirs, (Hunter, personal interview, 2014). We talked
about this a bit further as we work for the same organization I can also attest to a functional
structure of organization.
Where do you fit in the organization chart? Who do you report to? Who reports to you?
This was a really interesting topic as Spectrum is blurring the lines between what Nurse Case
Managers do and what Medical Social Workers are responsible for. Tracey answers to a
Medical Social Worker who then reports to a Nurse Case Manager.
How do you determine what is Case Management responsibility and what should go to Social
Work? Nurse Case Managers handle all the things described in roles in responsibilities.
Medical Social workers take over cases such as intentional ingestions, suicidal ideations, and
domestic issues, (Hunter, personal interview, 2014).
Why do you think the shift from Social Work to Nurse Case Managers? Nationally it
seems there is a shift in the Model of care. You can teach nurses medical social work things
like dealing with insurance companies, facilitating home needs, etc but you cannot teach
Medical Social Workers the pathophysiology that nurses are trained to work through such as
knowing about certain infections, what they will need at home, or how to teach parents how to
suction their children and ensure their understanding before leaving the hospital. A lot of this
focuses around safety and readmissions. Medicaid will not pay if a patient is readmitted within
30 days of a previous admission, (Hunter, personal interview, 2014)
If you could choose any role to be in since getting your BSN, what role would you see
yourself in? I would definitely not have gotten this job without my bachelors but this is not what

ANALYZING A LEADER OR MANAGER ROLE

I thought this role would be. It definitely burns you out. Im still not sure what my ideal nursing
job is, (Hunter, personal interview, 2014).
Communication and Relationship Building

According to Treadwell and Giardino, the Case Management Society of Americas

(2010) Standards of Practice for Case Management cite case managers as experts in both care
coordination and collaboration, making case management the ideal role for consensus building
and empowerment of the client and care team, (Treadwell & Giardino, 2014, pg. 87). Nurse
Care Managers are resposible for building a rapport and relationship with a large assignment of
patients that changes every day. They also act as an advocate and liason between the care team
and patients. Relationship building and communication are an integral skill required of Nurse
Case Managers to effecitvely complete their responsibilities every day.
Knowledge of Healthcare Environment

The role of the case manager has become crucial to the success of the health
care team. Acquisition of competency and advancement to expertise in the role of
the case manager is a developmental process that involves experience, mentoring,
continuing education, self-reflection, and peer review. Case management, as
defined by the Case Management Society of America (CMSA) Standards of
Practice for Case Management is a collaborative process of assessment,
planning, facilitation, care coordination, evaluation, and advocacy for options and
services to facilitate an individuals and familys comprehensive health needs
through communication and available resources to promote quality cost effective
outcomes, (Brubbaken, Grant , Johnson, & Kollauf, 2011, pg. 170).

ANALYZING A LEADER OR MANAGER ROLE

Tracey pointed out in out interview that this role would not be possible had she chose to
not continue to her education. The world of healthcare is every changing policies and
procedures based on evidence based research and patient safety standards. Continuing
education is imperative for this role in order to stay on top of the latest practice standards.
Nurse Case Managers have such a large spectrum of roles and responsibilities that
without prior knowledge of heatlhcare enviornement they would not be able to effectively
carry out their duties.

Leadership

According to Carr, now, more than ever, Nurse Case Managers are being called upon to
further expand their leadership capabilities and take a more active role in professional partnering
to optimize and ensure the continued attainment of clinical, fiscal, and quality outcomes, (Carr,
2009, pg. 178). I was in awe of the different hats that a Nurse Case Manager has to wear. I
always viewed this role as more of an exclusively educational role. Nurse Case Managers
require leadership skills to perform daily tasks like meeting families and finding out their needs.
They then pass this on to the healthcare team and assist in developing a plan of care that will
meet the patients needs and goals for that admission. Each floor at Helen DeVos has their own
Nurse Case Manager and while there is still a sense of support each floor serves a different
population, therefore, each Nurse Case Manager has to take an active lead, specializing in a
particular area of care, and anticipating the needs of their patients because often patients are not
aware of what their own needs are.
Professionalism

Not only do Nurse Care Managers work collaboratively with patients and inpatient care
teams but they also interact with nursing administrators who are always defining and refining the

ANALYZING A LEADER OR MANAGER ROLE

roles of nurses. According to Carr, The collaboration between nurse case managers and nursing
administration provides a framework for the establishment of a collegial and supportive working
relationship, one that is built on the strength of mutual goals, shared leadership abilities, respect,
and professional loyalty, (Carr, 2009, pg. 181). As the role of Nurse Case Managers becomes
more of a strong foot in the hospital setting and their role is clearly defined, Nurse Case
Managers have the opportunity to work with their up lines to develop and strengthen this role.
One thing that I thought was interesting from my interview with Tracey was the grey line
between Nurse Case Managers and Medical Social Workers. Previously, a lot of the roles and
responsibilities Tracey discussed were strictly Medical Social work tasks so not this shift has me
thinking about how administration will continue to validate each role.
Business Skills

According to Carr, opportunities for collaborative partnerships will continue to present

themselves as the healthcare paradigm continues to shift. During this shift, the demand for highfunctioning collaborative teams will increase. As nursing professionals, it is important to note the
similarities and differences in our respective practices, foster communication, and build upon our
shared roles to strengthen patient care delivery, (Carr, 2009, pg. 181). Nurse Case Managers
cross paths with many different disciplines in order to effectively person their every day job
responsibilities. Healthcare is a business like any other, opportunities will present themselves
and Nurse Case Managers are presenting themselves with a large spectrum of skills, thus making
themselves much more marketable in a competitive field.
Conclusion
Nurse Case Management is a specialized are of nursing requiring skill, collaboration, time
management, and extensive nursing knowledge in order to successfully perform all roles and
responsibilities. Nurse Case Managers are often learning as they go to determine the needs of

ANALYZING A LEADER OR MANAGER ROLE

their patients and how to meet those needs in a timely manner. This section of nursing is an
integral member of the direct care team as well as a valued member of the nursing leadership
team. Although, this role is relatively new in some hospital settings, the role is defining and
refining to meet patient care needs.

ANALYZING A LEADER OR MANAGER ROLE

References
Brubbaken, A., Grant , S., Johnson, M., & Kollauf, C. (2011). Reflective practice: a framework
for case manager development. Profession Case Management, 16(4), 170-181.
Carr, D. (2009). Collaborations in Leadership: The Nurse Case Management and Nursing
Administration Connection. Professional Case Management , 14(4), 178-184.
Hunter, T. (2014, September 21). Nurse Case Manager. (S. Knoll, Interviewer)
Treadwell, J., & Giardino, A. (2014). Collaborating for Care. Prefession Case Management,
19(2), 86-92.