Cons: If you are a Discharge Planning (D/C) Nurse only, you will be dealing with a lot of stress associated with bedside-drama because you have real patients and families and are actively involved with the big picture of the Medical Course of tx as well as the discharge plan. If you are Utilization and Review Nurse, then you will be in a cubicle or on-site to review charts in order to get your company paid. This can be tedious and stressful depending on environment and management style of the company. If you are both (A D/C Planner and a UR Nurse) you will be combining the two in a very stressful way. In other words, this is not an easy specialty.
Many come to this specialty with very wrong ideas of Case Management. There is a lot of business politics and laws to follow that if you do not take learning them seriously, you will not be efficient or perform well in this position. You may even get yourself into trouble. If you only want to be a Case Manager to get away from bedside nursing, but you do not want to learn the specialty as you would train for a new position in the ER, ICU, Psych, etc., then you will proably be one of those that leaves within a year. As is the case with any specialty in Nursing, this specialty is not a good fit for every personality!
Pros: This specialty is expanding its numbers because of changes in Medicare and Medicaid laws. Also, many jobs are well paying (comparable if not better paying then floor positions). The more work experience and certs you have, the more valuable you are to companies! This is in stark contrast to bedside positions, where the more experience you have, the less likely an employer will hire you, promote you, reward you out of fear of having to pay more for your skills and work experience. Plus, the CMs that are good at his/her job, are the ones that know the ins-and-outs of their job. Unlike bedside nursing positions, where popularity (not skills or knowledge) equals the better Nurse on the floor.