Jun 4, '13 by MBARNBSN Guide
I have only worked in a Hospital setting, so hopefully others can answer your question with experience in both settings. In any case, hospital CM is not a stress free job. It is not just the learning curve (which is about 1 year plus, but orientation is not 1 year plus), it is also the fact that it is similar to bedside nursing. You must move fast and make things (discharge planning and UR) happen fast. There are barriers to discharge that you are responsible for with each of your patients and no one else. Also, you may or may not be on the same floor/unit every day. Many times you must be able to work different type of units with different nurses, doctors, etc. due to staffing.... I can go on, but reality is that the hospital setting is not organized necessarily compared to other environments and it is definitely not easier. In fact, the turnover rate is pretty high in the hospital setting. The only setting I have known with a low turnover rate for Nurse Case Managers is Public Health.
Their focus is totally different (population based rather then individual based). Some have a case load of individuals or organizations, but they do not perform UR and they have no pressure to move patients/organizations to the next setting of care with resources in place. Those nurses perform assessments and make referrals similar to the rest of us, but they implement interventions that are completely different. Which is why they do not actually call themselves Case Managers, but rather Public Health Nurses. Good luck!
Last edit by MBARNBSN on Jun 4, '13