By Deborah Taschner, MSN, RN, CMGT-BC

It all started with sleeping in the car. No, we weren’t homeless. We were in the middle of moving overseas. My brand-new military husband had failed (see “poor planning skills”) to get a hotel room for us. Our apartment was littered with boxes. No bed, no couch, nothing. So, we slept in the car. Granted it was only one night, but the seed had been planted. The learning for case management had begun.

When I think back over my career in case management, I can remember when I first became interested in the career field. It didn’t start while I was working inpatient. Sure, I wondered whatever happened to my patients after they were discharged. Didn’t the families take care of them afterwards? No? Home health? No? Were there any home discharge fairies flying around with their magic wands?

I first ran across the term “case management” in a CEU offering I had found in a professional nursing journal. The job description included taking a patient from a lower level of health to a higher level of health. Case Management was comprised of not only nurses, but social workers. In this article I read that there were emergency rooms that had one of each! Where were ours hidden? When I was up on the floor picking up patients while I was a circulator in surgery, I did catch sight of these elusive people. I wondered how they got their patients from “point A to point B” safely. This was a hand-on-chin pondering moment.

Then it hit me! This was my “aha” moment. I had been able to manage people, household goods, carsick dogs, carsick guinea pigs (yes, she got car sick) from point A to point B without incident. In fact, I had been able to manage to do this six times, including once overseas and back. How did I come by this future marketable skill, which could be defined as planning? The United States military.

How did this correlate to case management, though? I was born into the United States Air Force. My father was active duty and we moved. I never worried about how we got from here to there. My mom handled it. Plus, I never planned on marrying anyone in the military, but then I met my husband. After we married, we received orders to Europe. Remembering the way my husband handled our first move leaves much to be desired. From then on, I made it my mission to ensure our future moves were never botched again due to poor planning. Very poor planning.

After moving to Europe, there I was, a fresh, bright-eyed, semi-new nurse who was certain the base hospital would be tripping over itself wanting my nursing services. Shortly after that, I learned there were ten nurses, including me, who were in our squadron, minus three that were active duty. This was not a one squadron occurrence. This marital pattern was replicated in the other three squadrons on base, as well. The base nursing population was glutted, leaving me professionally gutted. I needed to remain relevant in my profession. If I didn’t find something, I would certainly lose my skills. Enter “Welcome Baby.”

Welcome Baby was a program developed by family advocacy to assist young parents with parenting their children. It was both refreshing and exciting! I was helping patients with my new planning skills. I was making a difference. Little did I know, this was my first foray into case management.

Further connection was made after my initial “aha” moment. I was finally able to put it all together. Case management takes a patient from a lower level of health to a higher level of health, using periods of care coordination. This was parallel to me moving my family from one place to another, assessing each component in the moving plan, ensuring we arrived safely with ourselves, our belongings, and our carsick pets.

Little did I know that a series of life occurrences would lead me to the best career choice I have ever made. My background training via the United States Air Force has been invaluable to me. While I did not learn everything about case management through the military, I have learned a plethora of valuable information regarding case management through my nursing career. I have made contacts in the medical community that I was able to incorporate into the military case management practice where I currently work to this day. Working as a case manager, I finally feel my relevance in this career called nursing. Bliss!

Oh.  And we never slept in the car, again.

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Bio: Deborah Taschner has been a nurse for over 34 years working in NICU and surgery, but fell in love with case management. She currently works at a small military treatment facility. With her husband, Taschner has raised two boys and now enjoys two daughters by marriage, two beautiful granddaughters, one aggrandizing grand-cat, and two goofball grand-dogs.