Defense Date


Graduation Date

Fall 2008


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Gladys L. Husted

Committee Member

Mary Ann Thurkettle

Committee Member

Anthony P. Mannarino


nursing case management, nurse case manager role, hospital case management, role perceptions


The purpose of this study was to gain a better understanding of hospital based nurse case managers' perceptions of: (a) their role in today's rapidly changing healthcare environment, (b) practices and other factors that contribute to role success, (c) sources of role frustration, and (d) opportunities to enhance future role success and satisfaction. The study is significant because efficient and effective hospital based nursing case management benefits patients/families, nurse case managers (NCMs), hospitals, insurers, and the community at large. As the emic point of view of participants was highly desired, a qualitative descriptive design using focus groups method was selected, and six research questions were developed to achieve study goals. Because the main objective of the study was to gain an understanding of the NCMs' perspectives of their role, Role Theory was used as the organizing framework. Underlying propositions of Role Theory (Biddle, 1979) supported the use of the focus groups method as the researcher was interested in the perceptions of a group of NCMs in the context of a particular setting rather than an individual's sole experience or perceptions. Study participants (n=11) were recruited from a purposive convenience sample of NCMs working at a 600+ bed, not-for-profit, inner city academic medical center in a Mid-Atlantic state. The focus groups were conducted using a semi-structured interview guide to stimulate discussion and ensure study goals were achieved. The focus group method was the ideal research methodology for the study. The participants were very open, enthusiastic, and willing to talk about their views and work experiences related to the research questions. The goals of the study were achieved with two focus groups due to saturation of the data. The focus groups were audio-recorded and verbatim transcripts produced. A rigorous transcript-based data analysis strategy was used. The verbatim transcripts, detailed field notes, and debriefing session notes were all used as sources for the data analysis; however, the transcripts were the primary source. Following data analysis procedures outlined by Krueger (1998c), 31 themes and 19 subthemes emerged from the data. Direct quotes from participants were provided to support the study findings.