1. Owen, Mindy Susan RN, CRRN, CCM

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I am writing this column from my home in Parkland, FL, where we have lived for the last 18 years, supporting the community, and enjoying the benefits of a quiet middle-class town, voted one of the safest in the nation. Just 2 weeks ago, our town was rocked to its core with another fatal school shooting. But the young people who survived have been an inspiration, with one even articulating it best by saying, "It is their time to change the world." This may be the beginning of their legacy, and as I sit here, I pray that they will make it so. Their passion, commitment, and total desire to make this world better reminds me of my younger days, starting out as an RN and wanting to always focus on how to improve patient care, provide a listening ear and support, as well as improve myself and my clinical skills to always work at the top of the Standards of Practice.


Early in my career, I had several mentors who would encourage me to challenge myself, stay focused on my practice, and be the best I could be. They saw in me what I did not. I think about those mentors all the time and reflect on how different my career may have been without the support, direction, and knowledge that they provided as I walked my path. Part of their legacy was in their great ability to mentor, listen, and be a role model as an RN. Giving of themselves to better the profession, helping young practitioners as they develop, and modeling the standards of practice were a gift to those of us who were lucky enough to practice alongside of confident and caring professionals. I think about that often and strive to emulate those professionals today and every day of my career. This gave me confidence in my ability as an RN, as well as confidence in stretching myself, as opportunities presented themselves in front of me.


As I moved into the second stage of my career, gaining "clinical maturity" as a medical-surgical nurse, a Neuro-ICU RN, and a director of Acute Neuro Rehabilitation, I began to explore what else an RN could do outside of a facility setting? As a National Board member of ARN (Association of Rehabilitation Nurses), a colleague encouraged me to contact a company that employed nurses to do "disability management." I was told by this company 32 years ago that it was developing a program called "case management." I asked the company to explain it, define it, and share with me any information it had. The response was "we are not really sure what the program will entail, but we think you would be really good at it." Yikes! I left puzzled, but when offered the opportunity to be on the ground floor of designing, developing, and implementing the model, I took a leap of faith and decided this is where my skills and my career were taking me.


I never thought of a legacy at the time. I was just putting one foot in front of the other, trying to learn all I could, be present all the time, do the best job I knew how to do, and hopefully be part of building the best program to serve patients and clients at the time and for the future. The diversity in those colleagues who also took the leap was our skills, knowledge, and education. At the time, we did not see it; we saw only the struggle, but it brought forth the best foundation we could establish. Not thinking about a legacy, but thinking about how could we develop a program that would be sustainable going into the future of health care? None of us had a crystal ball, but all had a passion and desire to improve the process of clinical and fiscal accountability for all we served.


Case management, many will argue, has developed into an advanced practice. It has taken more than a village to embed case management throughout the health care landscape. The twists and turns have been many, and today we still hear, but to a lesser degree, "What is case management?" I have said many times to colleagues that I will do my best to define case management as a process that is patient-centered, a valued member of the interdisciplinary team, and with a skill set that focuses on encouraging the plan of care to be patient-driven through a nurturing and listening health care practitioner that is focused on the right care, at the right time, and in the right place, for the patients being served.


Thirty-two years ago many of us jumped into case management, because we saw an opportunity to decrease fragmentation within health care, use our clinical skills to provide advocacy and support to patients and families, and be the conduit within the health care system. Naive, maybe, but at the time, and looking back, it was a worthy goal to strive toward.


So, today, as I am now the "older" RN case manager and reflect and look back on my career, I hope I have contributed to the practice as a supporter of always being the best case manager one can be. Never settling, but embracing change and working for that change to improve the process and the role case managers play in the holistic, patient-centered plan of care: Always staying true to the role of advocate and being a role model as a professional.


Recently, a dear colleague and friend Ellen Fink-Samnick received the Distinguished Alumni Award from the University of Buffalo. She asked in her speech "What is your legacy"? This question came at a time when our community is grappling with this horrific tragedy and sharing stories of some of the victims' legacies that are being defined way too soon. We are all reflecting on how a legacy can make an impact today and for future generations. We will all leave a legacy, in our professional careers and our lives: What will your legacy be? It is a question Ellen asked, and I am pondering. I hope my legacy will be one of collaboration, encouraging lifelong learning and listening. And a legacy of always striving to improve the process and the practice of case management for generations to come.


I would welcome hearing what your legacy will be?