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Job design for nurse case managers. Intended and unintended effects on satisfaction and well-being.

As managed care expands, nursing case management is becoming increasingly widespread. Yet little is known about the characteristics of the case manager job and its effects on nurses' workplace well-being. This study investigated hypothesized differences between the characteristics of nurse case manager and staff nurse jobs, including both intended positive and unintended negative effects associated with changes incorporated in the nurse case manager job. Nurse case managers reported significantly higher levels of autonomy, job identity, feedback from agents, and collaboration with physicians than staff nurses; however, they also reported higher levels of required interaction, role conflict, overload, and ambiguity. These findings have important implications for nurse case manager and the organizations that employ them, in relation to job design, career/candidate selection, and orientation and ongoing development.