Acute Rehab CM Frustrations

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    I just started a job as an RN Case Mgr at an Acute Rehab. Previously all my experience was in acute care at hospitals. I pretty much like it, but I find the rehab patients so much more difficult to deal with. I tell them things and they agree and then I find myself changing everything because family members become involved, etc. One patient I had wanted very much to go home. Was to go on Lovenox. I checked the price and it was to be $1500. He told me THREE TIMES that it would not be a problem as he was in an accident and his lawyer was advancing him money. I kept telling him he would need to get this right away and not miss a day. He agreed. Well guess what? The lawyer didn't advance him money yet as the patient assured me. I documented everything well and was told not to worry about it, but I do! Coworkers said if he says he doesn't need help, just move on. I called to check on this pt and he said he has an application which he will fax out on Monday and is sure he will qualify. I reminded him I told him the price and how he assured me the lawyer would come through. Ugh! Then, another family was totally rude when I was bending over backwards for them. I don't need to tell an experienced CM about that - we've all dealt with it.

    My question is how do I stop worrying about my job? I want a life when I go home. How do you deal with the stress and just shut work off? How would others deal with the Lovenox situation? How do you deal with d/c'ed patients who call you after they leave?
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