By Colleen Morley-Grabowski, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM
Nancy Skinner often describes the transition to case management as a "poof, you're a case manager" event. The journey was almost inevitable, though still surprising.
As a nurse, I loved bedside care. I felt I was born to do this; it took me long enough. But once there, I bloomed! I always prided myself on providing the best possible care for my patients while they were in the hospital. But every time I discharged a patient, a question lingered in my mind: What's next for them? How are they going to be able to manage after discharge? I'd push the wheelchair down the hall, worrying if they had the support they needed to follow their treatment plan, manage their medications, and navigate the next steps in their recovery.
This wasn't just a professional concern for me—it was personal. I saw firsthand the complexities of managing care as the older sister of a chronically ill sibling. My brother was in and out of the hospital throughout our childhood, and I often wondered how my young parents, barely in their twenties at the time, were able to juggle the endless appointments, treatments, and decisions. They had no medical background, yet they somehow navigated the overwhelming system while caring for my brother's complex needs.
Years later, as an adult and a nurse, I found myself in a similar position when my own child faced health challenges. Even with my training and a few years of experience as a nurse, I felt overwhelmed and ill-equipped to manage the many details of his care. I had more knowledge than my parents did at the time, but the complexity was still there—multiple doctors, medications, appointments, tests, and the emotional toll of caring for a chronically ill child. It was a stark reminder of how complex this process can be, even for those with a healthcare background.
I became a case manager by pure chance. A nurse friend reconnected with me and told me about a new position she had recently taken in managed care (thanks, Marguerite!), so I applied. An excellent supervisor took a chance on someone with ZERO experience and hired me (thank you, Rogelio!). If you know anything about me, you know I jumped into the deep end headfirst.
That's when I realized the profound importance of case management. I had always been the nurse who cared about what happened to my patients after they left the hospital, but now I understood the actual value of having someone to help connect the dots. I wanted to be the person who could support families like mine—those navigating the healthcare system with no roadmap and feeling lost and overwhelmed.
Becoming a case manager allowed me to take my nursing skills to the next level and opened up a new realm of possibilities for how I could truly impact patients' lives. At the bedside, my role was primarily focused on the immediate needs of my patients—stabilizing them, ensuring they were ready for discharge, and providing them with the best care possible during their stay. However, I often felt that my involvement ended too soon. What about after they left? Did they have the resources to manage their condition at home? Would they understand their medications and follow-up appointments or know how to get help if they needed it?
As a case manager, regardless of the setting I was employed in, I realized I could be the one to fill that gap. I could follow my patients through the entirety of their healthcare journey, from hospitalization to home, and ensure that they weren't just dropped into a system they didn't understand. I had the opportunity to help families coordinate care, access community resources, and navigate the insurance maze—all of which are critical but often invisible aspects of recovery. It was about more than just ensuring they had what they needed for discharge; it was about preparing them for life after the hospital, setting them up for long-term success, and preventing unnecessary readmissions.
Case management is about advocacy—advocating for patients who don't know what questions to ask, who don't understand their care plans, or who are overwhelmed by the complexity of their situation. It's about continuity—making sure that no matter where a patient is in the healthcare system, there's someone looking out for their best interests and helping them transition smoothly from one stage of care to the next. It's about collaboration—working with doctors, nurses, social workers, and therapists to create a cohesive plan that addresses not just the medical side of things, but the emotional, social, and financial challenges as well. And most importantly, it's about ensuring that no one falls through the cracks—that patients and their families are not left to figure things out on their own.
For me, case management became more than just a career. It became a calling—a way to use my own personal experiences and professional skills to help others through some of the most difficult and confusing times of their lives. It's about being the advocate I wish my family had when we were navigating my brother's care, and the guide I needed when my own child was facing health challenges. It's about making sure that every patient and family has someone in their corner, helping them manage the complexities of care, just as I once did. In this role, I can ensure that patients don't just survive—they thrive, empowered and supported through every step of their healthcare journey.
National Case Management Week 2024 is October 13-19—Get ready to celebrate the heroes of healthcare—our Case Managers! This year’s lineup is packed with FREE CEs, including bonus October webinars, live networking events, amazing prizes, and so much more! Register Here: https://cmsa.org/about/national-cm-week/
Bio: Dr. Colleen Morley-Grabowski, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the Immediate Past-President of the Case Management Society of America National Board of Directors. She has held positions in acute care as Director of Case Management at several acute care facilities and managed care entities in Illinois, overseeing Utilization Review, Case Management and Social Services for over 14 years; piloting quality improvement initiatives focused on readmission reduction, care coordination through better communication and population health management. Her current passion is in the area of improving health literacy. She is the recipient of the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020) for her work in this area. Dr. Morley also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her 1st book, “A Practical Guide to Acute Care Case Management”, published by Blue Bayou Press was released in February, 2022. Dr. Morley has over 20 years of nursing experience. Her clinical specialties include Med/Surg, Oncology and Pediatric Nursing. She received her ADN at South Suburban College in South Holland, IL; BSN at Jacksonville University in Jacksonville, FL, MSN from Norwich University in Northfield, VT and her DNP at Chamberlain College of Nursing.