Professional relationships and power dynamics between urban community-based nurses and social work case managers: advocacy in action. Prof Case Manag 2009;14(6):312-20
Date
11/26/2009Pubmed ID
19935349DOI
10.1097/NCM.0b013e3181b5de1cScopus ID
2-s2.0-73949084278 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
PURPOSE: The purpose of this study was to explore how community-based case managers interface with their clients' healthcare providers and other community organizations as a function within their advocacy efforts. Case managers previously defined advocacy as occurring at individual, organizational, and community levels. The relationships they attempt to develop and maintain are consistent with case management ideology, yet this is a complex process to ensure care for vulnerable populations with many medical and socioeconomic needs.
PRIMARY PRACTICE SETTINGS: Community-based case management settings.
METHODOLOGY AND SAMPLE: In-depth qualitative interviews with a total of 20 nurse and social work case managers working in public housing, university-affiliated community nursing centers, local parishes, and community ministry.
RESULTS: The case managers in this study reflected on how they interface with their clients, other healthcare providers, and community organizations on behalf of their clients. They reflect on the importance of trust and communication to facilitate this process. The advocacy work of case managers is influenced by the setting, others' perceptions of their knowledge and expertise, and power dynamics. Their ability to effectively advocate is greatly influenced by the strength of the relationships they forge.
IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: Advocacy for vulnerable clients is influenced by the existing relationship between case managers and their clients' healthcare providers. Case managers need to be persistent in their interactions with other providers to ensure that their clients have access to valuable community resources. Clear lines of communication should be established between case managers so that there is clarity around roles and expectations in service provision. Case managers should also participate in the mentoring of future health professions students so they may learn the application of advocacy work in community settings.
Author List
Young SAuthor
Staci A. Young PhD Sr Associate Dean, Associate Director, Professor in the Family Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Case ManagementCommunity Health Nursing
Cooperative Behavior
Focus Groups
Humans
Interprofessional Relations
Nursing Care
Patient Advocacy
Qualitative Research
Social Work
Urban Population