Marge Groom introduces the reader to the needs of treatment and prevention of pressure ulcers for patients in hospital and long-term care facilities. She provides background in the development and the treating care of pressure ulcers. She directs the reader to an understanding of pressure ulcers as means to prevention. The team approach she states provides the best patient care to control and cure pressure ulcers, based on her experiences. She advises that from wound care, to nutrition, to physical therapy, the team can make a meaningful difference in the incidence of pressure ulcers, while improving the health and physical comfort of patients in their care.

John Lowe asks the readers the question: "What are the specific factors preventing the injured or ill worker from resuming full work duties?" Once he has our attention, he sets the stage for his discussion: "Impairment Versus Disability." His discussion starts by quoting the American Medical Association: "the relation between impairment and disability remains both complex and difficult, if not impossible to predict." John goes on to examine impairment and disability as it applies to return to work. He concludes by stressing that the most effective return-to-work outcomes for injured workers is the result of a team effort among all parties to a case.

Nancy Lewis shares with the reader her recent experience in developing a continuing education presentation on the topic of "Wounds, Healing, and Diabetes." Nancy explains that this routine assignment became a subject of considerable interest, and is an area of legitimate concern. First, she defines the three broad categories of diabetes diagnoses. She outlines the numerous physiological consequence of this disease. To better understand diabetes diagnoses, she discusses in depth the process of "healing a wound." Nancy now points out an approach of treating diabetes on a personal basis; by increasing healthy eating, and adding to this increased exercise on a routine schedule. Nancy concludes and gains the reader's attention by stating, "One key to reversing this very serious situation is education." She now challenges the reader to consider, "We as professional case managers can exert a major influence as teachers."

Marcy Tigerman presents the reader with the question; "How can an effective case manager take step back from being a lifelong 'doer' and refocus on becoming a 'cue-er' for enhanced success?" She directs the reader to realize that getting the job may not be enough. Take it to the next level; empowering our clients to actually become more independent in complex health care situations. We should be guided daily by advocacy and autonomy that are underlying case management values. Marcy now asks the question, "Have I stopped, focused, and truly explained what options my patients have in these situations." Read this article and see how you measure up to Marcy's time-tested convictions.

-Frances Snowden, BS, RN, CRRN, CCM

Contributing Editor