So what do nursing case managers do???
Specifically there are many facets to the answer to this question. In general, nursing case managers are pro-actively involved in many different situations throughout the day. They may provide a patient or family member with information clarification from the physician, may ensure approval / certification of services by managed care organizations, or negotiate home care services with an agency. There is a much varied scope of functions and activities that the nursing case manager provides which increases their challenge for ensuring that high-quality and cost-effective care gets delivered to his/her patient/client. The case manager may be scheduling a test while trying to resolve delays related to tests or procedures. The various roles are important for timely patient care delivery and outcomes. The various responsibilities and roles of nurse case managers and their ongoing planning and prioritization of the tasks to be completed require them to be astute in time management, which is integral to the effectiveness of the role as a case manager. Nursing case managers spend a great deal of their day coordinating and facilitating patient care activities and expediting the completion of tests and procedures. They also ensure that results of the tests and procedures are available within a reasonable turn-around time which is an important function in reducing / eliminating delays and variances in patient care activities. In collaboration with members of the health care team, the nursing case managers help patients move smoothly through the health care system to decrease and help eliminate confusion, frustration, and the feeling of "falling through the cracks." The nursing case manager is constantly working to prevent fragmentation and eliminate duplication in the provision of healthcare services. The nursing case managers pro-active timely intervention when a patient’s condition changes enhances the outcome of care. Nurse case managers function as patient care advocates and managers through facilitating use of resources to what is required to achieve the desired outcomes. Another function of the nursing case manager is the role of negotiator/broker of care, being instrumental in getting necessary tests and procedures completed on time, negotiating the best resource / treatment plan possible with the health care team and patient. Nursing case managers also negotiate with health care agencies for community services, home care, needed support to assist patient’s at home; they negotiate with managed care companies for approval of the patient’s hospitalization when recommended by the physician, the need for durable medical equipment, or the necessary services needed. The nurse case manager works a liaison role between the patient / patient’s family and the health care system. The nursing case manager strives to establish rapport to help facilitate the implementation of the plan of care. The nursing case manager keeps the patient and members of the healthcare team involved in the treatment plan. The nursing case manager constantly informs involved members of the plan of care, tests and procedures, appointments, etc. which makes them the best means through which the care is advocated, negotiated, agreed on, facilitated, and coordinated.