In July 2021, I donned my cap, gown, and hood and officially received my doctorate: the capstone of my professional career and a gift I gave myself. Looking back, it was a long time coming and yet, as a lifelong learner, I know that timing does not really matter. I achieved this goal because it mattered to me.
My professional story began in 1969, the year I graduated from high school and started college with the intentions of becoming a doctor. But I had already met the man I would marry and faced the same dilemma as so many women of my generation: How could I balance a marriage and the long road through medical school? My decision seemed logical at the time: I switched to nursing school so that I could complete my education quickly.
After graduating from nursing school, I did go back to get a bachelor's degree but had no ambitions at that point to pursue any further education. I had other priorities at that time, including putting my husband through school so that he could pursue his goal of becoming an architect. I left nursing when my children were born and stayed home until they were school age. Then, in early 1990s, I returned to the workforce.
By that time, I had been away from bedside nursing for 6 years. Although I wanted to use my knowledge and skills, I could not see myself going back to hands-on nursing. That is when I heard about a job as a case manager. Although I knew almost nothing about the field of case management, I was hired and spent about a year settling into my role. Quickly, though, I found my passion.
Case management allowed me to use my knowledge and skills to help people as they navigated the complex and often confusing health care system. In acute care, many of the clients I worked with were in crisis or close to crisis and needed someone to educate them so that they could make informed choices. Problems often arose that could not be solved with obvious solutions; instead, I had to get creative to see what services could be provided that were not specifically covered by insurance plans.
In June 1993, the first certification examination was administered to the inaugural class of Certified Case Managers (CCMs), and I was proud to be one of them. Over the years, continuing education for me was never merely about collecting the necessary credits to stay board-certified as a CCM. More than credits, I wanted to stay relevant in a rapidly changing field and add tools to my case management toolbox.
As I moved into supervisory positions, my peers often had master's degrees, although I did not at the time. I can remember a discussion of whether a master's degree should be required for anyone who wanted to become a director, and I could see the value of an advanced degree. I returned to school again and earned my MSN in health care administration in 2005. At the time, I thought my advanced studies were done.
Making the Leap
A few years later, however, I was working for an organization that was affiliated with a university and supported nurses in getting doctoral degrees. It was an online program, which made it appealing to me, but I was not at the organization long enough to get into the program. I changed jobs, and for nearly 10 years after that, continued to toy with the idea of pursuing a doctorate.
In 2017, I left acute care to take on the Chief Industry Relations Officer (CIRO) position with the Commission for Case Manager Certification, the next evolution in my career. I had already served as both a volunteer commissioner and chair of the Commission while working in acute care case management, so joining the Commission as staff was a logical transition. As CIRO, I work closely with other organizations across the care continuum to support professional certification, while also engaging in training and other professional development of case managers.
Then, in 2018, I attended the Association for Nursing Professional Development conference. Walking through the vendor exhibit hall, I stopped at the booths of several universities that offered doctoral degrees in nursing. This time, I did not just toy with the idea of pursuing my doctorate; I decided to go for it. I applied and was accepted into a program that began in October 2018.
My educational journey mirrors the demographic information gathered in the role and function studies conducted by the Commission for Case Manager Certification. Among the participants in the 2019 field survey, 80.62% of them held a bachelor's degree or higher-nearly a 10-percentage-point gain from the 2014 study. The breakdown among the survey respondents was 46.79% with a bachelor's degree, 32.24% with a master's degree, and 1.59% with a doctoral degree. The increase in advanced degrees supports the continued drive toward professionalizing case management and the importance of building one's knowledge skills and abilities to help advance the practice and its contribution across health and human services (Tahan et al., 2020).
Although I cannot speak to the motivation of other case managers who have pursued advanced degrees, for me it was all about attaining a goal I had set for myself. I'll admit it: For the first 4-5 weeks of the doctoral program, I would look in the mirror and say to myself, "I thought this was a good idea-Why?" I had not been in school for 13 years and was among the oldest students in the program. As overwhelmed as I felt in the beginning, my studies ignited my passion. I quickly saw that there was so much more to what I was doing as an educator and trainer, especially how I could elevate what I shared with others by expanding my knowledge and incorporating research and new information. It was one thing to share my truth, and quite another to have the data to back it up.
Listening to the Data
When I received my master's degree, I always cited data in the projects I completed for my boss but never considered myself to be data driven. With my doctoral studies, though, I became much more passionate about data.
My CIRO role at the Commission has always emphasized data, especially the findings of the role and function studies conducted every 5 years to determine the knowledge and essential skills required for professional case management practice. In addition, the study findings inform the content of the CCM certification examination.
My newfound love of research and data also recalled something a chief operating officer in acute care had said to me years ago: "Without data, all we have is an opinion." As my doctoral studies took me deeper into the data, I gave up my opinions and sought out knowledge that informed my thinking and enabled me to be of more help to others.
Lifelong Learning
Looking back on my professional journey and pursuit of advanced degrees, I sometimes regret that it took me so long. Because I cannot change the past, though, I can only assume that the timing was right for me. I share this perspective because there are undoubtedly other case managers out there who are thinking of going back for an advanced degree. And if anyone reading this column wonders if it is too late for them to pursue a master's degree or a doctorate degree, I am here to assure you that it is not.
What matters most is passion, which is the key ingredient in anything we do. I am reminded of that each time I look at a paper I tacked on a wall in my home. It is a quote that never fails to inspire me, even though I have no idea who said it: "It's a beautiful thing when a career and a passion come together."
When we are passionate about what we do, we are naturally driven to learn all we can. We keep moving forward, and that, in turn, keeps our passions ignited.
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