By Nancy Skinner RN, CCM, CMGT-RN, ACM-RN, CMCN, FCM

I recently had hand surgery. Post-operatively, my hand was enclosed in a braced dressing that extended from mid-forearm to my fingertips. Because of the restrictive nature of that dressing, I was unable to perform common activities such as dressing, cooking and even the keyboarding necessary to write this blog.

Being a somewhat independent individual, I did not ask for assistance much of the time. That independent streak caused me to become extremely frustrated while trying to perform simple tasks. Sometimes, I was so discouraged that I was poised to give up or even compromise the integrity of that dressing just to achieve the task. Today, I am counting the days until I can finally have the dressing removed and regain function in that affected hand.

During this period, I found myself focusing more on my challenges than on the tasks I could accomplish. I forgot to celebrate the things I was able to achieve, simple things like helping colleagues prepare for certification, providing an educational program via Zoom and taking the dogs for their two-mile walk each day. When I began to look at what I could do rather than the obstacles I experienced, my levels of frustration eased, and my post-operative journey became less challenging.

The inability to overcome barriers and the feelings of frustration that I felt reminded me of my experiences as a “baby” case manager. In 1985, I was a clinical nurse and one day I was “poofed” into a case manager. I received no specific onboarding or education about the role I was cast into, but instead, I was advised that case management was a simple role and that I should be able to “figure it out myself.” I was told my primary goal was facilitating the patient’s timely and efficient movement through the healthcare continuum with a significant focus on the judicious use of healthcare dollars. Throughout those early years of my case management practice, I was challenged by a lack of case management-specific education and by a scarcity of “tools” and resources to assist me in guiding my patients towards the successful achievement of their desired healthcare goals. I often focused more on the things I couldn’t achieve rather than the small successes I assisted my patients to gain. At times, I questioned whether I could ever become a professional and skilled case manager.

Born from that frustration as well as a need and desire to become a true patient advocate, I learned there was a group of case management colleagues who had come together to support the practice and the diverse group of healthcare professionals who had embraced that practice.

Their commitment to the professional practice of case management gave birth to the Case Management Society of America (CMSA). CMSA became the one organization that sought to “facilitate the growth and development of professional case managers across the full health care continuum, promoting high quality, ethical practice benefitting patients and their families”.1

With membership in CMSA, I networked with other case managers to share challenges and celebrate successes. When I felt frustrated, I reached out to other members for support and guidance. Through strong collaborative efforts, we, as case managers, began to be recognized as an essential element of healthcare delivery not only in the United States but across the globe.

Over the years, CMSA has provided me not only with networking opportunities but also:

  • Standards of Practice for Case Management, which became the foundation for my practice
  • Educational opportunities through both on-site and virtual programs
  • National and local conferences with events that offered an ability to interact with exhibitors to learn more about available services or treatment options that might benefit my patients
  • Public Policy initiatives

While these member benefits have served to enhance my practice, the greatest value of association membership has been the consistent support of colleagues and friends. They have provided a helping hand when I have been frustrated with an inability to advance the quality of care my patients required. They provided a helping hand when I needed information regarding resources that might enhance my patient’s ability to be even more successful in their healthcare journey. They have provided a helping hand when I felt I was not making a difference for my patients and when I questioned my abilities as a case manager. They also provided a helping hand when I was a patient rather than the case manager.

As we wrap up our celebration of Case Management Week, it is important to remember that everyone needs a helping hand sometimes. Please take a moment to celebrate your individual practice of case management. Realize that although we may not be globally heralded as key members of the healthcare delivery team, we are the heart, if not the very soul, of that team.  We represent the helping hand that many of our patients need.

Throughout my practice, I have partnered with hundreds of patients, their families and their caregivers. The most memorable of those interventions have not been successful because of dollars saved but rather because the patient/case manager collaboration included a helping hand – a helping hand to obtain a wig for a 5-year-old child who had alopecia and didn’t want to be the only one in school without hair — a helping hand to facilitate travel across country so that a patient could experience his final days surrounded by friends and family, and a helping hand to provide patient-specific educational resources so that a patient could understand their diagnosis and the value of adhering to their prescribed treatment plan in order to achieve the best possible health outcome. These small actions absolutely reflect the very foundation of case management, which is patient advocacy. For without that focus on advocacy, there is no case management.

If you ever question the ability to be a patient advocate or are frustrated with the “tasks” you can’t achieve, your case management colleagues are there to offer a helping hand.  Reach out to them through professional organizations nationally or locally. Reach out through social media and know that there is always a “wise and seasoned” case manager to answer your questions and provide a helping hand.

Finally, if you ever question your value as a case manager, please consider this quote from Dr. Suess, “To the world you might just be one person; but to one person you might be the world.” For so many of our patients, that is the true value and worth of each of our case management practices.                

Reference: 1.

Bio: Nancy Skinner RN, CCM, CMGT-RN, ACM-RN, CMCN, FCM, has been a case manager, Director of Case Management and an international case management educator. She was named CMSA’s National Case Manager of the Year and she has received CMSA’s Lifetime Achievement Award. She is also a member of the inaugural group of case managers designated as Case Management Fellows (FCM). She is currently developing a Facebook Group to facilitate greater networking among case management professionals.

Recordings are available for multiple CM Week events, including webinars. Access them here:

Thank you for celebrating Case Management Week with us!