By Pat Stricker, MEd, RN
Have you ever wondered how your life would be if you had not decided to be a nurse or to transfer to a case management position? I think about that often. I was in high school and on my way to becoming a teacher. Back then there were not nearly as many career opportunities open to women other than being a teacher, secretary, librarian, or nurse. Since I loved children, I decided teaching would be my chosen career. And I also thought the hours sounded great! After all, teachers worked “short days” (9am – 3pm). I never considered they had a lot of other work to do, e.g. lesson-planning, preparing tests, grading them, etc. I also liked the idea that teachers did not have to work week-ends and they had summers off. Sounded perfect to me! (I was a bit short-sighted back then).
However things changed when a friend asked me to go with her to a high school future nurses meeting. I really had no interest, but I went just to keep her company. However, I found the topics very interesting and started to investigate further by going to a few more meetings with her and decided this was the type of job I wanted. The hours would not be nearly as good, but the position itself was so enticing and the opportunity to help others would be very rewarding.
My initial goal was to be a clinical nurse caring for patients in an office or hospital setting for the rest of my career. And remember, back then there were not that many positions for nurses outside the clinical settings. However, over the years a variety of different types of nursing positions were developed. Some examples include, but are not limited to, working as an RN in: a specialty area, community health nursing, visiting nurses, public health, school nursing, nursing homes, outpatient surgery or care centers, telephonic nurse call center, retirement and assisted living facilities, occupational health, healthcare insurance company, sales and marketing for clinical programs and products, informatics, quality, clinical technology, and case management.
My journey also led me to various practice settings. I started working in an Internal Medicine office for four physicians (still thinking of having weekends off). I then worked in visiting nurses, medical-surgical acute care, labor and delivery, emergency department, triage telephonic call center, CM organizations, and for a technology company. Along the way, I also received a Master of Education degree, so I was able to work as an educator in some of these settings, which was my original “imagined” career before nursing. So I was able to work in both professions.
As my experience level grew, so did my career advancement - from staff nurse to leadership roles as project manager, manager, director, consultant, and vice-president. All of these roles, settings, and leadership positions rounded out my career and made it very rewarding.
Another thing that I loved about nursing was that I could determine a schedule that worked for my family and me. When my children were young, I worked nights in the Delivery Room part-time, so I had time to be at home with them during the day and did not have to arrange child care. I was tired a few days a week, but that was okay since I had more time with them. When they were in school, I chose roles that were Monday through Friday days, so I was able to spend evenings and week-ends with family. This made me happy in my professional life and my family life.
As my children grew, I was able to work on some challenging and rewarding projects: telephone triage training for the U.S. Air Force clinical staff in Alaska and Japan; setting up a new CM/UM call center in Puerto Rico; implementing a new telephone triage program using protocols and computers (something very new for all of us at that time); and development and implementation of a new Care Facilitation program in the United Kingdom. This was their name for a new concept for them - - a Case Management program. These projects required a lot of work, thinking out-of-the-box, and traveling, but they were wonderful experiences!
It sounds like I had a lot of jobs, but I was never looking for new job because I was not happy with my current position. They were just new opportunities that seemed to be exciting and right for me at the time, so I chose to do something different. Where else can you find that kind of autonomy and stability, yet remain in your chosen profession?
As I look back on my years as a nurse and case manager, I realize that I could not have chosen a better career path or one that I enjoyed more. Becoming a nurse allowed me to work in multiple roles with a variety of experiences without leaving my profession - - nursing. I had no idea at the time I chose nursing (60+ years ago) that there would so many types of roles available in the future.
So why am I telling you this? I hope you have been able to see that some of this may apply to you also. If you are a new nurse just starting out, keep these things in mind and know that you have choices ahead of you on your nursing path. And if you are a nurse who has been on the path for a while and are beginning to feel that you would like to do something different, look around and think about what role would make you happy. Hopefully it will be somewhere in the Case Management area, as there are a lot of rewarding roles (quality, reporting, analysis, implementation, education, auditing, etc.) that need to be filled. Remember, you have the ability to manage your career to make it truly meaningful for you.
As for Case Management, the nurses in the Care Facilitation program in the U.K. were defined by their leadership as the “glue” that keeps the CM process together and the nurses defined themselves as the “oil” that keeps the whole process moving! Whether you want to consider yourself as “glue” or “oil”, I think they were right. Case Management is the perfect role in a great profession!!
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Pat Stricker, MEd, RN spent the last thirty years working in the clinical care management field in directorial and senior management positions. She has been responsible for development, implementation, and operations of: care management application systems; education and curriculum programs for staff and clients; call center operational programs; clinical implementations and clinical sales and marketing support for triage, utilization, case, disease, and population health management programs. She also worked as a consultant in the United Kingdom, implementing a Care Facilitation (case management) program for the National Healthcare System. Most recently she worked for TCS Healthcare Technologies, a case management software system provider, as Senior Vice-President of Clinical Services. Pat was also a longtime monthly contributor to the CMSA newsletter, as well as the author of articles for other nursing publications on topics related to care management and healthcare information technology.