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Medical care plans are outlines or summaries of the types of medical care and treatments that patients should receive. Case management nurses help create these plans with several things in mind. First and foremost, a care plan is based on the type of injury or illness a person is suffering from. Medical professionals creating care plans will also take a patient’s medical history, including allergies and risk factors for other illnesses, into consideration when creating care plans. Other aspects that may help determine a patient’s course of treatment include their health insurance plan, prognosis, and the needs and wants of both the patient and their loved ones.
Individuals who wish to become case management nurses will often specialize in one area. Generally, case management nurses are more prominent in specialties that require patients to receive long-term care, such as those with chronic illnesses or long-term care needs. If you choose to work as a case management nurse, for example, you might work with patients who have cancer, diabetes, AIDS, Alzheimer’s disease, heart disease, physical disabilities, and debilitating mental impairments, to name a few. However, there is also a place for case management nurses in medical specialties that do not deal with just chronically ill patients.
The duties of case management nurses are diverse and somewhat complex. On the one hand, these nurses are required to keep the patient’s best interests in mind at all times. On the other, they must also keep in mind the limits of medical science and the bureaucracy of the facilities in which they work.
First, a case management nurse will usually assess a patient and consult with other medical professionals such as attending physicians. From there, the medical team can devise a care plan based partly on the patient’s medical problems and history and partly on the patient’s wants and needs and his loved ones.
Since a “one-size-fits-all” approach to treating patients is not feasible, each patient’s care plan will differ. Because of this, a case management nurse must consider a patient’s medical history when creating an effective and safe care plan. For example, some patients are allergic to or may have had a bad reaction to some substances, and therefore can not be treated with certain medications. The wants and needs of patients will vary greatly as well. Some patients, for instance, may have other obligations that make scheduling treatments and doctor visits somewhat difficult, while others may have limited means of transportation or mobility issues. Planning a medical treatment plan around the patients’ wants and needs greatly increases the effectiveness of the plans.
It is also often up to the case management nurse to inform and support each patient throughout the course of their treatment. They might keep them abreast of different treatment options, for example, or inform them of various resources they might employ during their medical care. This type of information and support enables patients to be more proactive about their medical decisions.
Medical care plans are periodically reevaluated by case management nurses and other members of the medical teams. Case management nurses must stay on top of any changes in a patient’s condition or lifestyle that will affect treatment. If changes are made in a patient’s condition or lifestyle, the case management nurse will often need to update the case management plan to reflect these changes.
Although there are no stringent guidelines for becoming a case management nurse, the majority of employers will look for a few basic things before hiring a case management nurse.
The first step you must take to become a case management nurse is obtaining the right education and training. Generally, you must first be a Registered Nurse (RN) before you can move up. This usually involves getting your nursing degree and passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
Extensive experience in a clinical setting is not always required, but almost all employers will restrict new hires to those with hands-on, case management experience. This usually involves at least two years of working with patients in a clinical setting.
Finally, not all case management nurses have to be certified, but certification will certainly help your chances of getting hired for this position. A couple of agencies offer case management nurse certification, including the American Case Management Association (ACMA) and the American Nurses Credentialing Center (ANCC). Obtaining your certification in this area usually involves completing several hours of classroom education, practical training, and clinical experience. Once you’ve completed all of the requirements, you will then be eligible to sit for a case management nurse certification exam.