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Strategies to Support Realistic Expectations in a Complex System

14 Aug, 2025 Anne Llewellyn

                               
Case Management Focus

Healthcare can feel overwhelming, especially when someone is suddenly thrust into it after an injury or life-altering diagnosis. The system is often fragmented, confusing, and intimidating. Nurse case managers play a vital role in easing this burden. By guiding injured workers and their families, they help reduce complexity and foster realistic expectations about recovery, treatment, and outcomes. In this article, I’ll share practical tips nurse case managers can use to support this process.

  • Initial Education & Orientation
    • Take time to explain the healthcare process, timelines, and roles of different providers.
    • Work with the healthcare team to clarify what recovery may look like
    • Work with the injured worker and the team to set short-term vs. long-term goals.
  • Transparent Communication
    • Use plain language to describe medical conditions, procedures, and limitations. 
    • If you are an onsite nurse case manager and accompany the injured worker to a doctor's appointment and other team members ' appointments, look for signs that the person may not understand what is being said and ask the person speaking to explain things if they are not being clear or talking over the injured worker's understanding. Ask the injured worker if they have any questions. This will engage the patient in the plan of care.
    • Address misconceptions early to prevent unrealistic hopes or fears.
  • Goal Setting with Milestones
    • Collaborate with the injured worker and family to set achievable goals.
    • Break down recovery into phases with measurable progress markers. Celebrate progress, even if it is small progress. 
  • Emotional Support & Validation
    • Acknowledge the emotional impact of injury and change, and encourage the injured worker to share their feelings. 
    • Offer empathy while gently guiding expectations toward what’s medically and practically feasible.
  • Coordination Across Providers
    • Ensure consistent messaging from doctors, therapists, and insurers.
    • Prevent conflicting advice that can confuse or mislead the injured worker and the family. Onsite nurse case managers can do this by repeating what the doctor said and what will come next. 

Regular Check-ins & Reassessment

  • Revisit goals and expectations as recovery unfolds. Reset and add new goals as needed. 
  • Be proactive in adjusting plans based on progress, setbacks, or new information.
  • Advocacy & Empowerment
  • Help families understand their rights and options. Encourage them to let you know if they have questions. Let them know they can come to you for assistance when things are uncomfortable or strained. 
  • Encourage injured workers to participate in care decisions, fostering confidence and clarity. 

I hope these tips help you set realistic expectations with your patients and their families. What strategies do you use? Feel free to drop me a note to let me know. You can reach me at allewellyn48@gmail.com 

Have a good week! 

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    About The Author

    • Anne Llewellyn

      Anne Llewellyn is a registered nurse with over forty years of experience in critical care, risk management, case management, patient advocacy, healthcare publications and training and development. Anne has been a leader in the area of Patient Advocacy since 2010. She was a Founding member of the Patient Advocate Certification Board and is currently serving on the National Association of Health Care Advocacy. Anne writes a weekly Blog, Nurse Advocate to share stories and events that will educate and empower people be better prepared when they enter the healthcare system.

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