conflict in hospital case management

SummerGarden, BSN, MSN, RN · Nov 20, 2011

just had an interview today for hospital case management. a lot of their questions revolved around "what would you do if a coworker yelled at you or what would you do if a doctor won't listen to you". what would you do if a patient or family member were angry? they told me i needed to have "thick skin". they said they have to deal with conflict alot. why is there so much conflict in cm? is this normal for cm.

all professions, where one must deal with the public and work in a team requires one to have "thick skin". in addition, in order to be a good nurse case manager you need to be comfortable with your nursing knowledge and skills set. for example, you will need to assert yourself and influence the discharge planning team because despite what anyone says (including the docs), you are the one leading the show. if you are a new nurse, i think you are going to find this job difficult to do unless you are properly trained to be both a nurse and a case manager.

paperclip4 · Nov 20, 2011

Thanks for your comment.

kellenl · Mar 28, 2012

Case Managers deal DIRECTLY with DON and MD a lot. A precert nurse may tell you that an insurance company had denied or partially noncerted a hospital stay and as the CM you will have to go tell the charge nurse or doctor to get the patient out of the hospital. YOU will be the one to take the brunt of the agression from these people!!!!

jenniferelliott · Mar 28, 2012

You must be confiedent in your nursing experience and be able to stand up to doctors, nurses and grumpy patients. The people are ill and a lot of times you are the middle man and have bad news for them. Example: A patient is in the hosptial after having a colon resection for cancer. The doctor may want to start initial chemo before they are discharged from the hospital You find out from the precert nurse that the insurance company does not pay for the chemo drug the MD is ordering. YOU will be the one to have to go explain to the family and tell them that if they choose to get the treatment they will be financially responsible.

MomRN0913 · Mar 28, 2012

In my experience when there is too much emphasis on how you handle coworkers with bad attitudes, it's usually because th hiring managers are very aware their staff has "extra" bad attitudes that have driven others away.

Yes, you need to stand up to MD's, family members, and so both in case management, push for certain levels of care and so on and so forth, and there are times in every position you need to stand up for yourself, but when that empoyer keeps stressing it...... worry.

I interviewed for a position once where they just kept asking me and giving me scenarios about nurses with attitudes and how you handle them. That was what the interview was based on It was a charge nurse position. I didn't get the position, but after that interview, I didn't want it! I then met some people late on who worked at this particular facility and yes the attitudes and bullying were as bad as I thought it was.

Go with your gut.

d'cm · Mar 31, 2012

"Why is there so much conflict in CM? Is this normal for CM."

In some institutions conflict defines the job. In hospitals where the attending physician is an independent practioner who is paid for every time s/he sees the patient and the hospital is dependent on their admissions, the case manager's mission":to assure that the patient progresses through the continuum of care and is discharged to the least restrictive environment" is often in direct conflict with the powers that be. Make sure your Director has your back before you stand up to any MD's. Personally, after years trying, I found it mission impossible and would never consider a hospital based case management job again.