Any cons toward accepting a UR position and leaving bedside? - page 2

by Heartyournurse 8,669 Views | 17 Comments

Good evening! I just wanted to get any UR nurses or CM nurses out there that can share their thoughts on this different type of nursing? Any pro or cons? I haven't heard anything bad about this specialty yet in this websites.... Read More


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    Case management can be done by a third party company working with insursnce companies, with assessments being done via telephone. I just learned of this. One company is RSA. Im just now learning about case management being a new grad. I have a former classmate who works there as a new grad. I only want to keep this in my back pocket though while looking for clinical nursing to get that experience.
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    Yes, to be a case manager you need clinical experience on which to base your management decisions.
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    Thanks for the info!
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    I think times have changed...you dont necessarily need to have clinical experience to become a case manager. It also depends on the setting of a CM. For example, you can go into workers comp or work with other insurance companies who need CM. As it is, its tough getting jobs as a new grad. If you have a business background like I do, have worked in corporate for 10 yrs, I think I would be a good fit for CM. Its an old school thinking that a new grad must work in a hospital before they do anything else out in the field. If you cant get anything in a hospital and you have an opportunity to work as a CM or LTC or Home care, might as well take the job, get experience and move forward. I am tired of constantly people trying to grill in our heads, Oh you must work in an acute setting before you do anything else...if you have a background in something that can help you be a better nurse in another area, then definitely apply. I am getting more calls to do CM or Home health care jobs vs. hospitals. And to be honest, I am not too keen about bedside nursing. I like the business/problem solving side of it and probably will go off and go into technology/informatics because thats been my background. Good luck and do not give up...
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    While you don't need to work in a hospital at the bedside specifically, you DO need some type of experience dealing with patients, whether that be in a wellness center or LTC or clinic or hospital is largely irrelevant. My first job was at a federal health center and I did a little of everything from QM to CM to pt triage. It is naive and arrogant to believe that you have graduated with all you need to be an effective nurse. The sad reality is that nursing education has been up in arms for years with debate of what curriculum should include and even whether postgraduate residencies similar to physicians should be required because there is simply not enough time to teach a nursing student EVERYTHING they need to be an effective nurse. Hospitals orient new grads for 8-12 wks or more just to start on a basic med surg floor, sometimes up to a year for certain specialties, just to do "bedside care." To be an effective CM, you need to understand not only the modalities of disease but what's actually being down "out in the field" these days because in the 3-4 years it takes you to finish school, the treatments you've learned about can change. In addition, you need to have a firm understanding of the structure and hierarchies of medical institutions to effectively navigate your clients through the system and there is no better teacher than experience. Frankly, you cannot learn everything out of a book and like it or not the cornerstone of nursing is health CARE.
    To me, informatics and healthcare technology are areas where your nursing background might be a plus but not a requisite. The primary field isn't nursing IMO, it's informatics/technology
    Mijourney likes this.
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    sweetnurse786 you must be a student or a new grad? Having clinical experience never becomes "outdated" or passee. It is plain old...neccessary...... to actually becoming a real nurse. Doctors are not allowed to practice in any area of medicine without having completed a residency. And the same principle goes for nurses. Textbooks and the limited scope of clinicals cannot teach you about evidenced based practice, critical thinking, and the impossibly infiniate types of cases that will come through the doors of a healthcare facility. This seems to be a significant point of confusion for people who are considering a career in nursing, nursing students, and new grads. I don't know why they are not more clear about this during nursing school, or just create a formal nursing residency structure, so more people actually understand this, before they are in too deep into the career choice, or career change.

    I am an RN, BS, BSN, MBA currently also completing a second masters in health informatics. I teach health information technology at a local college, had 15 years of IT experience a BS and an MBA and a couple director level titles under my belt before I went back to school and became a nurse. I went through 8 years in the medical corps of Air Force reserve at the age of 35, to make the career change into nursing. When I went out into the civilian world as a new grad nurse nobody gave a DARN about any of it... at all. As far as they were concerned I just fell off the back of the turnip truck and could not even apply a band aid without being a liability, until I completed a year of orientation and preceptorship in real live patient care. I tried every last route to find a job. I was rudely awakened to the fact that 2 years in the Med/Surge/Tele/Oncology towers of a major hospital was the ONLY thing that got my nursing career going. I of course had to work 3-11 and night shift those 2 years, because there was a 5 year wait list to get on day shift from nurses that had already been there 5 and 10 years before me. Then another year working psych/LTACH/SNF through agency to round out skills. ONLY after I had this experience, did I land a job as a Senior Application Analyst on and EMR implementation/design project in the IT department of a major hospital system. Only after slaving in that for 3 years, did I finally start to get looked at for Case Management positions in this hospital system, alongside most other CM's that had MSN, MBA or MA degree's and averaged 25 years clinical experience at the likes of Yale Medical Center , Cleveland Clinic etc.

    My sincerest advice is get in a hospital new grad program or nursing home as fast as you possibly can after graduation, and just get the inevitable over with and out of the way as fast as possible.
    Mijourney likes this.
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    Quote from sweetnurse786
    I think times have changed...you dont necessarily need to have clinical experience to become a case manager. It also depends on the setting of a CM. For example, you can go into workers comp or work with other insurance companies who need CM.
    Oh, no, you can't. They want you because you have experience with patient assessment, terminology, collegial relationships with physicians and therapists, negotiation, and more, and there isn't a new grad on the planet that has that.

    You absolutely have to have solid clinical experience to be a case manager. If you want to do work comp case management for a TPA, a solid background in ortho, neuro, and rehab will be invaluable, because many work injuries involve those.

    "Solid" doesn't mean, "I took care of a TKR my third semester."
    Mijourney likes this.
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    One of the basis for nursing case management is that you provided care as a nurse. I agree with previous posters who state that their careers in case management got off the ground only after direct patient care experience. How naive is it to go into CM thinking that you can assume a high level of expertise without real world practice. You not only utilize the nursing process in CM, but more importantly, you use clinical judgement when patients or families report medical problems and concerns. Clinical practice is a prerequiste for clinical judgement and advanced critical thinking. Trust me, you will not want to be caught with the proverbial pants down when a crisis occurs with one of your CM patients.
    MBARNBSN likes this.


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