Socialization of Nurses in Case Management

Human Resources -- Performance Management and Organizational Effectiveness Nurse socialization can be significantly aided by case management. The inclusive, team-oriented, patient-centered approach to case management develops powerful dimensions of the nurse, the nurse-patient relationship, the healthcare team and the healthcare environment. Unfortunately, the traditional patriarchal system found in current healthcare militates against this most effective development and usage of case management. One way in which nurses learn their roles and functions in the healthcare system is through Case Management.

For example, through Newman's model of nurse case management, the nurse can: review the totality of circumstances; focus on the "caring and commitment" aspect of service; learn and honor a patient's choices and goals; assist the patient in reaching educated decisions; raise the quality of care while reducing costs; expand his/her work with patients to assist them in settings outside the nurse's set service area; and employ a team-oriented approach to care (Butts & Rich, 2010, p. 460).

These aspects of nurse case management can assist the nurse in developing powerful dimensions of the nurse-patient relationship, such as: "pattern recognition" of the client in all applicable medical/social settings and of illness as a "way of life" while assisting the patient in making informed choices; "rhythm and timing" of the nurse's most effective presence and letting go, according to the needs and abilities of the nurse and patient; "opening of the self to the client" by using his/her self to serve all the patient's needs; "mutual growth" of both the nurse and patient through the processes of growing, learning and sharing; "choices" by learning and honoring the patient's decisions; "beginning and ending" by thoughtfully arranging visits with the patient, knowing and respecting the time for letting go at each phase and possibly ultimately letting go altogether (Butts & Rich, 2010, p.

460). Clearly, this comprehensive use of case management by the nurse individually and as a team member leads to effective assumption of the nursing role, as the nurse is increasingly able to learn and honor each patient's circumstances in order to render the most effective and service. The current patriarchal, male physician-focused nature of the healthcare system militates against the nurse socialization espoused in Newman's approach to case management.

Newman's approach celebrates and thoroughly uses the whole-human and often feminine characteristics that best develop the case management dimensions of pattern recognition, rhythm and timing, opening of the self to the client, mutual growth, choices and beginning/end (Butts & Rich, 2010, p. 460). Meanwhile, the current patriarchal system, constructed by men and assigning high value to masculinity and low value to femininity (Butts & Rich, 2010, p. 177), tends to devalue the traditionally "feminine" characteristics (Blackford, Dec 2003, p. 241) that make Newman's patient-focused case management model possible.

Furthermore, the team approach and rightful empowerment and importance of nurses in policy-making and patient advocacy (Butts & Rich, 2010, p. 58) are antithetical to the male-centered patriarchal culture of current healthcare (Kavanagh & Knowlden, 2004, p. 310). In sum, nurses are moving toward a stance of inclusion while the traditional patriarchy maintains a stance of exclusion. This obstructive and exclusionary patriarchal system continues to dominate the healthcare system (Blackford, Dec 2003, p. 238), though nurses have made effective inroads through intelligence, dedication, determination, and the greater power wielded by nurses' associations. 3.

Conclusion Case management can greatly assist nurse socialization by assisting nurses in learning their rightfully expanded roles and functions in healthcare. For example, Newman's model allows the nurse to review, focus, learn and honor, assist, raise care quality while reducing costs, expand, and employ a team-oriented approach. This assists in the development of powerful dimensions of the nurse-patient relationship, such as pattern recognition, rhythm and timing, opening of the self to the client, mutual growth, choices and beginning/ending. This inclusive and thoughtful use.