Colleen Morley, DNP, RN, CCM, CMAC, CMCN, ACM-RN, had a successful career in credit and finance before deciding to go back to nursing school. Two weeks after getting her associates’ degree, Morley began working at Mount Sinai Hospital, where she stayed until making a move to Little Company of Mary Hospital, continuing to work in Acute Care, Oncology, and Pediatrics. Working 12-16 hour shifts with three children to take care of, Morley found herself longing for the set hours that came with her previous career. Fatefully, it seemed, an old coworker reached out to her with news of a position that could deliver such a schedule. “She called me and said, ‘I found the perfect job for you. It’ll bring your business and nursing career together. It’s 9-5, Monday through Friday, no weekends and no holidays.’ So, I said, alright, tell me more.”
Learning the position was in telephonic case management for a major health insurance company, Morley still had questions. “The interviewer explained case management to me by asking, ‘Did you ever have a patient in the hospital, and you wonder why they’re still there, or why they even got admitted in the first place?’ I described a patient I had that fit the description perfectly, and he said, ‘Precisely.’ Two weeks later, I had the job.” Morley stayed at Blue Cross Blue Shield for about five years. She was promoted three times within the first 18 months, ultimately becoming manager of the Utilization Review Department serving every state except Illinois.
Educating fellow health professionals
In 2009, Morley found herself looking for a new opportunity due to a company-wide reduction in force (RIF). “That really pushed me to go outside of my comfort zone, so I decided to go back into acute care. I parlayed my inside knowledge of insurance companies into a case management director job, where my major goal has been to educate the rest of the care team about what case management is and how we can help.” Morley is currently the Director of Case Management Services for West Suburban Medical Center and also runs her own business, Altra Healthcare Consulting, where she offers education to nurses, case managers, social workers, and other health professionals. She also currently serves as Secretary for ANA-Illinois, President for CMSA Chicago (Case Management Society of America’s Chicago chapter), and director on CMSA’s National Board.
Morley writes extensively on several subjects, including health literacy, and is publishing a book on acute care case management early next year. “I’ve got a team of about 23 contributors helping to put together a sort-of guide for someone just getting into acute care case management. Normally, there’s not much training, and you just get thrown into it to learn on the job. So, this would be a useful resource for people to get the practical training and guidance that a certification exam doesn’t necessarily test you on.”
Advocating for patients
Case managers act as a sort of liaison between patients, care team members, hospitals, and insurance providers to ensure everyone is satisfied—most importantly, the patient themselves. “It is a different kind of nursing. But everything boils down to what is best for the patient and what the patient needs/wants. It’s a gigantic concept and huge assessment to ensure we’re not only looking at the patient while they’re in the hospital; we’re looking at what happens to them after they leave. It’s one of the reasons I got into case management. I was always that nurse who wondered what happened to the patient after they left.”
A concept near and dear to Morley is health literacy and patient education. She recalls several times when she has witnessed failure in these areas, among them, an example both deeply personal and, at the time of this interview, incredibly recent. “My mother, who was an ICU nurse for 38 years, has a lot of medical conditions, including Graves’ disease and Crohn’s disease. I visited her in December of last year and made an emergency physician appointment that I attended with her. I watched the medical assistant perform a medication reconciliation, where she looked through my mother’s box of pills, matched every bottle to what was on her screen, and clicked ‘taking’—not once asking a single question to verify that was the case. The night before, I had discovered a bottle of Synthroid that was filled in September but was still full. It turned out, in July, the doctor told my mother she could stop taking a steroid she’d been given for a Crohn’s flare, but she misheard. Instead, she stopped taking the Synthroid for her Graves’ disease, and not taking the Synthroid for four months was significantly bad. Despite monthly appointments, nobody put two and two together because they were focused on one disease or another and not the big picture.”
Morley continues, “So when the doctor entered, I emptied the Synthroid bottle on the table and asked how she could possibly be taking these when all of the pills are still here, and how could they not make sure something this important was being taken care of? I was told, ‘Well, she’s a retired nurse. She knows what to do.’ We changed doctors two weeks later and had a diagnosis of stage three Parkinson’s disease almost immediately after that. That was eleven months ago, and my Mom died yesterday. I can only wonder what the outcome would have been had somebody been paying better attention and caught that earlier, had someone done a better assessment and considered the changes a patient may be going through and their health literacy at the time, instead of just assuming.”
The possibilities are endless
Morley’s journey in nursing has been anything but traditional. Asked if she would do anything differently, she says, “I would have loved to have started in my nursing career earlier. But that being said, some personal growth had to happen. Things happen in life for a reason. If I started in nursing school straight out of high school, I probably wouldn’t be doing what I’m doing now because I wouldn’t have met the people I needed to meet to create that personal growth.”
She offers this same insight to her fellow nurses, “Be open to what the universe is trying to show you. Nursing is an incredible profession. It’s unlike any other career out there, and the possibilities are endless. So, keep yourself open to those possibilities, and don’t pigeonhole yourself into something you think you should be doing.”
Morley believes continuing to learn and staying connected through associations like ANA-Illinois offers a multitude of benefits. “Never stop learning. Just because you’ve always done something one way doesn’t mean there isn’t a better way to do it. Staying engaged with professional education and personal development keeps your practice current and enables you to take care of your patients the best way you can. It allows you to explore new areas, connect with people, and learn how to do things more effectively.
“I learned a lot in the past year and, here’s Mom still teaching me; God bless her. I’m sitting here writing the dedication page for my book right now, which is dedicated to my mother. If it wasn’t for her, I wouldn’t be a nurse, and if I wasn’t a nurse, I wouldn’t be doing any of the cool things I’m doing now.”