Dilemmas of caring in a corporate context: a critique of nursing case management

Nursing case management is widely acclaimed within the nursing literature as a form of advanced practice, beneficial for both clients and payers. However, case management programs involve potential conflicts between client goals and system goals, especially in relation to for-profit managed care systems. Early nursing discourse tended to minimize those conflicts, but more recent literature has begun to address role conflicts and ethical challenges. Feminist and critical-theory perspectives are used to examine nursing case management in the contexts of capitalism and sexism, thereby illuminating recurrent dilemmas within the profession. The ability of nursing case management to resolve those dilemmas is questioned.