In celebration of Nurse Care Manager Month, we sat down with Ellen Rathke, RN, BSN, CCM, a Neonatal Intensive Care Unit (NICU) Care Manager for Mass General Brigham to learn how she supports families during some of the most vulnerable moments of their lives.
We learn how her work helps parents navigate the emotional, medical, and practical challenges of having a child in the neonatal intensive care unit and beyond.
Q: How did you get involved with this work?
I was a NICU nurse for between 25 to 30 years. Now I use that experience to help parents navigate the multi-faceted challenges of having a child in the neonatal intensive care unit and beyond. I like doing this because I’m able to educate — not only around the diagnosis, but around how to advocate for the child — and how to be the parent you need to be.
Q: Do your cases have many similarities?
Most of the babies I work with are premature, but not all. Some are full-term infants with complex medical conditions, and others have genetic or cardiac issues. Regardless of the diagnosis, every family needs support—not just medically, but emotionally and practically. To answer your question, no two families are the same. Every family’s experience in the NICU is different, each has its own needs and challenges.
Q: How do you learn about these cases, and how do you reach out to new moms?
Most of my cases come through transition-of-care systems that alert me when a mother delivers. I reach out during the postpartum period. I ask about their recovery, NICU status, breastfeeding, postpartum visits, and more. I stay involved until I know mom and baby are both on stable ground.
Q: How do you get the conversation started?
I always ask new moms about their delivery experience because it can be a major source of emotional pain. If the birth was traumatic—like an emergency C-section—I provide space to talk through it. Some moms are ready to move beyond it quickly. Some are not.
Q: How important is it for you to help with that?
A big part of my work involves supporting parents, especially mothers who feel overwhelmed or guilty after a difficult delivery. If the mom is struggling, I refer them to behavioral health services or support groups to help prevent or treat postpartum depression. Emotional support is key during this time.
Q: In what way can a Nurse Care Manager working for a health plan support a mom in a way the hospital cannot?
My work may start during pregnancy, or in the NICU, but it may continue even after the baby is discharged. I’m not associated with the hospital, and that independence is valuable. I provide a space where moms can speak openly without feeling like they're talking to someone who's part of the hospital system. It creates trust.
Q: How is trust created in that way?
Parents feel comfortable speaking openly with me without feeling like they’re talking to someone representing the hospital. I’m here for them. It's important for parents to feel informed about their baby’s condition and to understand the ups and downs, especially with very premature infants. I can help explain what’s happening, and a key part of that really is helping them process the experience and feel confident moving forward. They don’t always feel comfortable sharing that with hospital staff.
Q: Does your role working for the health plan influence what counsel you give?
Yes. I make sure families know how to use their insurance-covered benefits, and all that is available to them. Just one example (of many) is lactation consultant benefits. I can help them get access to specialty formulas or feeding supplies when needed. I make sure they know their options and how to access them.
Q: What’s your role post-discharge?
Leaving the NICU is a huge emotional milestone. It can feel overwhelming—parents no longer have 24/7 nurses at their side. They're suddenly on their own and expected to manage complex care at home. I help them process the NICU experience and support them emotionally as they settle into life at home. I also help with practical needs—ensuring they have postpartum follow-ups, navigating breastfeeding challenges, accessing behavioral health services, and preparing for pediatric visits.
Q: What’s the most important thing for these parents to know?
Children with complex medical conditions may need coordinated care, referrals to specialists, and more. So, managing care and knowing how to advocate for your child is critical. It’s a huge part of what I do. Doctors may see a healthy baby on the surface, but they don’t always know what’s happening at home. I help parents feel confident in sharing those details and ensure they speak up when something doesn’t feel right.
Q: What’s a tip for doing that well?
I encourage parents to jot down any concerns before a doctor’s visit so nothing important gets overlooked. We’re talking about things like feeding difficulties, sleep patterns, or developmental concerns. I help them build confidence to speak up and ask the right questions.
Q: What tips would you give any newborn mother or father?
Learn how to be an advocate, ask questions, keep notes about your concerns, and stay informed. Make sure you have your patient portal set up. And make sure you have your health plan member portal set up – all your benefits and everything you can access is found inside that portal.
Where do I find it?
Mass General Brigham’s patient portal is found at patientgateway.massgeneralbrigham.org
Mass General Brigham Health Plan’s Member Portal is Member.MGBHP.org
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