Q&A: Case managers in unfamiliar roles

Q: At times, case managers with nursing backgrounds are being asked to fill in and assume patient care roles during the COVID-19 pandemic. What should case managers do if they do not feel comfortable they can succeed in the roles they've been assigned?

A: This is a fair concern. A challenge arises when a professional is rusty or not proficient in current aspects of clinical patient care, says Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, of EFS Supervision Strategies LLC in Burke, Virginia.

"Nurses who have not worked at the bedside for years can lack expertise in using their skills, as in starting IVs [or] giving meds, if not also reconciling the current age of technology. The fear of risk of potential harm to clients and themselves is real," Fink-Samnick says.

There are several strategies case managers can deploy if they find themselves in such a situation.

Be direct. It's always a good idea to provide something in writing expressing your concerns. Additionally, case managers can request a meeting with hospital leadership and human resources to discuss the issue.

“Everyone is in reactive and emergency mode at this time, and fearful,” says Fink-Samnick. “Cool heads prevail, so case managers should still try to discuss the situation with their leadership or contact human resources.”

Be aware of the hospital's needs. In the case of an emergency declaration or disaster situation, it is legal for hospitals to assign staff to areas of need based on licensure and experience. However, if an employee is truly being asked to practice outside the scope of his or her licensure, the hospital and case manager should find a better way to make use of the individual's skills.

Suggest alternatives. Case managers have diverse skill sets. If a case manager is being utilized incorrectly, there is surely another area in which the case manager can contribute.

“Try to itemize to your leader how valuable you can be for either a specific population or vulnerable nursing unit,” says Shawna Grossman Kates, director of case management at RWJBarnabas Health in Tom’s River, New Jersey.

For more information on case management's role in the COVID-19 pandemic, see the May issue of Case Management Monthly.