Anyone else getting SLAMMED with patients?

Specialties Case Management

Published

Specializes in CCM, PHN.

I wish there were ratio laws to protect CM nurses.

We are understaffed and overworked to the max since ACA onslaught of new patients enrolling Jan. 1 in the health plan I work for. Our max for patients per CM RN supposed to be 65 and we are all carrying caseloads well over 100 and have no extra help.

I'm spread so thin I'm worried if this is even safe.

Any thoughts?

Can't they hire LPN/LVNs to do some of the tasks that could be delegated and do not necessarily need the expertise of an RN? For that matter, it would seem that straight out administrative assistants could do some of the purely 'clerical' tasks. Not necessary to hire a lot of people, just enough to make a dent in the workload.

Specializes in CCM, PHN.

We have admin partners that do all the clerical tasks. And no one can keep up. Why do we put up with this?

You are probably just like most people lucky enough to have a job, somewhat cautious, to avoid jeopardizing that job.

Specializes in CCM, PHN.

I don't feel lucky at all. I go home crying every day. I wish I had a different job. And a better quality of life. As long as I'm in nursing that won't happen.

Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.

Oh my gosh, I was thinking about this very same thing the other night!!!! I was slammed with about 8 patients all at once in the ED as soon as I walked in to get report. Also, I live in a ratio state where, basically, I am the only nurse that works in my ED that has more than 4 patients at a time. It is frustrating to say the least!!! I never had time to take an actual break that shift, but it did not matter, I have no one to break me even if I had the time. Also, when I was working the floors (prior to the ACA) I had 40+ patients (covered two units) and had to discharge several to SNFs, HH, and provide for medications via pharmacies outside of my hospital etc. all while the bedside nurses had no more than 4 patients at once.

We need protection too! If we miss anything, it is our bottoms and no one else! What gets me is the fact that management seems to think that we can be everywhere at once! So if something hits the fan, the only explanation must be that we were doing nothing at the time and just allowed something bad to happen or we are reckless and missed something simple because we are incompetent!

It is getting so bad, that some of my friends who are CMs too and I have contemplated going back to bedside even if it is only PT or PD to give ourselves a break. The pay where I live is a lot better, the bedside nurses are protected by unions and ratios, and they get to take breaks! In fact, I have to deal with my phone going off all shift, while the bedside nurses can turn off their voceras to eat, use the bathroom, and stare at the wall at different points during his/her shift.

In the meantime, I am actively seeking employment in a different nursing specialty to assist me to further my career goals. I have gained a lot doing what I do as a CM but I feel it is time for me to move on! I will, however keep my PD CM job when I find a promotion because it is good pay and I do not have to work very many shifts a month to stay in good standing...

Apply criteria ruthlessly. Nothing pares down your caseload faster than denying services.

Specializes in CCM, PHN.
Apply criteria ruthlessly. Nothing pares down your caseload faster than denying services.

I'm not in UM, I'm in CM.

Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
I'm not in UM, I'm in CM.

Some CMs do both. My guess is that d'cm does both.

Specializes in LTC, med/surg, hospice.

Wow, I had no idea it was like that in case management. I was looking into a couple of CM positions at my facility but I see I would definitely need to ask a lot of questions. From the job descriptions, it appears the CM would be responsible for UM as well.

I work in a health plan and we also have noticed increase since the new year. We are hiring "engagement coordinators" to make the initial calls and cull out the members that are going to want to work with a CM. Our patient demographic is largely geriatric with many health issues and in rural area that requires long drives to the clinic and hospital. I agree, nursing is not for faint of heart and even a clinic job can cause you to have sleepless nights.

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