Nursing Case Management Essay

Registered nurses play a vital role in the health care system of the United States. Within the nursing field, there is a seemingly unlimited number of routes and opportunities for nurses to serve. A specific route a registered nurse can take, is case management. Ethical and legal issues are ubiquitous in many health care settings, case managers have to work within the health-care reform legislation limits, within HIPPA limits, and within their own moral limits. The key is to find the boundaries and excel within those limits. Case management nurses serve a particularly important role as they use their medical knowledge, management skills, and interpersonal skills in order to meet their patient’s multidimensional needs.

Case management is

Nurses in this field wrestle with privacy, confidentiality and quality of care challenges while staying within the limits of health-care reform legislation and HIPAA compliance. It’s essential for case managers to behave and practice ethically, adhering to the code of ethics that built their professional credential. It is vital to be aware and to practice the five basic ethical principles; beneficence, nonmalfeasance, autonomy, justice, and fidelity. Case managers should hold themselves accountable for practicing these five principals. Case managers need to recognize that their primary obligation and role is to their client/patient and that the decisions and actions they make should reflect their purpose of serving the patient (Case Management Society of America). Respective relationships with coworkers, employers and other professionals should be demonstrated. It’s inevitable that laws, rules, polices, insurance benefits, and regulations that may come in conflict with personal ethical principles, but in these situations, case managers are bound to address it to the best of their ability and seek appropriate consultation that will aid in the correct and well researched decision. Finding the appropriate boundaries and limits is the key to operating within the scope of a case manager’s

They specifically define case management as “…a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s health needs through communication and available resources to promote quality, cost-effective outcomes,” (Case Management Society of America). Established to formulate a plan that allows a patient to navigate the healthcare system smoothly, case managers coordinate between the patient, their family members, the healthcare team, insurance companies, communities and many others (Moreo). Chris Gibbard, a case manager at Avista Adventist Hospital, said that the priority is to reduce their patients’ amount of time that they spend in the hospital and to work as their advocate on the hospital side of the situation. The key is to focus on the whole person and the delivery of care. The roles and functions of a case manager go well beyond meeting the hospitals requirements and goals and delve deeper into truly working for their client’s