1. Sefakis, Audrey BSN, RN, CCM

Article Content

Having a daughter in a baccalaureate nursing program has certainly opened my eyes to several things that have changed since I was a nursing student. However, one thing is certain-we are still not great at nurturing our young and providing students with the opportunity to see all that the nursing profession encompasses (e.g., research, forensics, quality improvement, teaching, case management). This is not an issue that only affects nursing students; a similar challenge exists in social work and other clinical professions. We work in rewarding practices that offer a wide variety of career options, but we must ensure that students are at least aware of these options. To ensure case management's survival, we must begin to spur interest in a case management career path in order to increase the number of candidates, as well as to attract candidates earlier in their respective careers.


This begs the question: How do we introduce the case management practice to young people in high school, college, and/or earlier in their career path? In looking to academia for support, both nursing and social work curricula are already full; adding a dedicated case management course is highly unlikely. However, case management could be introduced as part of a larger topic that is already covered, such as care coordination and/or health care financing. These inclusions would be adequate for raising awareness but would not provide hands-on experience, nor would it offer network or mentoring opportunities. We need to do more and here are a few ideas.


Professional organizations must do more to create opportunities for proactive outreach. Conferences, educational institutions, and employer settings offer opportunities to connect with people regarding the rewards of embarking on a case management career path. Sending enthusiastic speakers to schools and universities, engaging the public at career fairs, and participating in Student Nurses Association and/or National Association of Social Workers events are just the beginning of what can be done with a little focused planning.


Case management employers must also bear recruitment responsibility by fostering career interest in who will potentially be job candidates. Internship programs allow firsthand observation and working experiences, as well as the chance to apply theory and skills learned in the classroom. Interns acquire meaningful skills and knowledge to help them thrive after graduation. Companies that sponsor internships understand this is an investment in their own future.


Where employers are concerned, although there are limited job opportunities for students in clinical settings, there is an alternative worth serious exploration: summer internships. Invaluable experiences gathered during internships include shadowing a case manager, completing department research, participating in projects, conducting time studies, and performing administrative duties. These assignments shed some light on the experience, knowledge, and skills needed to become a case manager. Offering these experiences also allows organizations to network to schools and recruit new talent into their ranks.


An internship presents the opportunity to establish a one-on-one relationship between an experienced case manager and someone considering such a career path. The intern-preceptor relationship is extremely important and warrants careful planning and execution to ensure success. This requires dedication by both parties to undertake a nurturing and positive experience. The preceptor must be allowed sufficient time to devote attention to the intern and his or her learning goals. This helps make sure that the experience is meeting their expectations as well as those of the organization. A preceptor serves as a mentor and a trusted adviser who provides support and keeps the intern's best interests and experience goals as priorities. Although it may not be the intent of the internship, a positive experience could turn into a lifelong informal mentor relationship.


Experienced case managers develop great skills such as time management, transition planning, motivational interviewing, and critical thinking. It is time to share this wealth of knowledge and abilities that may not be apparent to an intern more focused on developing clinical expertise. The focus of an internship should combine work/projects and dedicated case management observation and interaction. The preceptor should be prepared to impart and demonstrate essential case management information, including definition, work process and settings, standards of practice, qualifications, quality measures and outcomes, and charting a career path to enter the field.


We have begun an internship program in my workplace and allot summer funds in our budget specifically for this purpose. However, if this is not feasible, some schools allow students to participate in unpaid internship programs. Until recently, we have not specifically targeted nursing or social work students for these positions. Moving forward, we need to think more about the future of case management and developing new talent to join our ranks. Our interns work in a variety of departments within our health plan and gain exposure to areas such as government affairs, legal, quality, pharmacy, sales and marketing, medical affairs, utilization management, precertification, provider performance, and contracting. They gain a variety of important perspectives in these departments that ultimately enhances their understanding of the health care system and their own self-management skills.


I challenge you to brainstorm the development of case management recruitment and activate just one of your ideas through to fruition. Through your own professional network or at your workplace, gather together a motivated group of like-minded colleagues to consider the possibilities. Start by compiling an ideas list. The most important thing to keep in mind during this initial phase is to NOT start critiquing the ideas. Don't allow yourselves to get bogged down in the "why nots." The possibilities are limitless. Your idea list might look something like this:


* Connect with student nurse and/or social worker organizations to discuss opportunities.


* Introduce the internship concept in your workplace.


* Introduce the internship concept at your local CMSA chapter and collaborate ideas with the national chapter.


* Personal invitation to students and the newly graduated to attend a case management event.


* Network with vendors to discuss recruitment opportunities.


* Outreach to alma maters to discuss partnerships.


* Outreach to employers to discuss internship possibilities.


* Investigate grant funding opportunities.


* Hold a fundraiser or host a GoFundMe initiative for internships.


These are just a few ideas to get you started. Be creative and positive when brainstorming. Once the group decides the list is long enough, get to work on critically analyzing the pros and cons of each opportunity. Be fair and open-minded as you consider the operational and financial feasibility as you begin to pare down the list. This process leads to the elimination of and/or merging of ideas until you reach a point of having three to five possible projects. At this point, pick just one project to develop and launch ... then get to work in making it a reality! No idea is too small; the sky is the limit!


Case management has been begging us to actively engage in new talent recruitment for years. The opportunity to ensure case management's long-term sustainability depends on all of us. Go for it!