Long hours/no life

[Camino77]

I left bedside about 4 years ago because I was a single mother of a young child and I needed stable hours/mon-fri "daycare" hours. I got a work at home job with a large insurance company doing UR and liked it for a few years. . . however the last 6 months the work load has gotten larger and larger and LARGER. Not just for me - all of the UR nurses are feeling it as leadership piles more and more work on us (new projects, priorities, meetings, spreadsheets, tasks, documentation) PLUS we are on a hiring freeze and nurses keep quitting so our assignments grow and grow. As our assignments grow, so does the amount of work they expect us to do. Plus. . they have added mandatory weekends.

So, my Mon-Fri 8-5 job has turned into a Mon-Fri with some weekends job that is typically 7-6 with no lunch and occasional late night after my son goes to bed or 5am scrambles to do reviews. It's not just me - it's all the nurses. In fact, I'd say I am one of the "faster" ones who actually work less. I have one coworkers who constantly works until 10 or 11pm.

I talk to friends at other insurance companies and find that this has become more the case in the past year.

Is this just the new insurance norm? My boss is someone who equates long hours with being a good and loyal employee - she jokes about seeing one of us on-line at 11pm.

Also, because there are so few nurses currently, it is very hard to get PTO and if you do get PTO, you are expected to completely finish all your work before going on PTO and that can be very hard when you have 25 pended cases!

There is a wee part of me who misses those 3 12 hour shifts. . .my son is older now and I now share custody which makes things easier. . .tell me I'm crazy to even think about returning to bedside. I am one of those nurses who actually loved bedside/hands-on but got burnt out by all the new "patient is client" attitude. My old hospital also went thru a big upheaval at the time that I left and let go tons of veteran nurses. It was becoming very toxic.

Sorry for the long post. . .I just feel lost as a nurse these days. And now I am working more than ever and seem to be tired and stressed all the time. I guess I'm just looking for others who have experienced this. . or at least understand. I keep exploring options for my next nursing career transformation but am wondering if I am just chasing an empty dream.

[SummerGarden, BSN, MSN, RN]

I was one of those nurses who stated I was not ever going back to the bedside when I became a CM and I allowed every certification to expire. However, when I wanted a promotion, case management became a dead-end career/job. I was not able to move up due to lack of positions, the few openings being very competitive, and lack of leadership experience on my part at the time. So, I went back to the bedside.

I received an entry-level (ANM) position in Telemetry (front-line managers where I worked can be pulled into assignments and can often cover breaks due to being short staffed), so I cannot write that you are crazy returning to bedside nursing for the reasons you wrote. On the other hand, I kept my CM position per diem for many years because I wanted the option to jump-ship if the reasons I left bedside nursing the first time came up again.

I finally gave up my CM position recently. Although the reasons I left the bedside have come up again in spades because I am an assistant nurse manager, I have grown to prefer the negatives/cons of bedside nursing to those of case management. In addition to what you have written and I have experienced, case managers can work long hours and put in a lot of work just like any other nurse, but not be viewed as hard workers by other departments, not be viewed as nurses (???), and not have opportunities to take off because no one can cover them. Not to mention some case management departments are not even run by nurses or are run by nurses with very little years of work experience in any area of nursing! But I digress.... to reiterate my above point, the pros to bedside nursing are overwhelmingly heavy on the side of having nursing career choices and seeing nursing career progression compared with opportunities of a nurse case manager. Good luck! :)

[Been there,done that, ASN, RN]

Read your contract. Work your 40 hours , or report this mess to your state labor board.

[NurseMegP, BSN, RN]

You could always look at doing CM/UR for a different company? I work as a UR nurse for a smaller MCO and while the CMs and claims analyst people here are busy, we're fairly steady in what we do in UR. Probably what I do now is a lot like what you did starting with your current company. I would really suggest looking into a different company if you want to keep the M-F hours but there are maybe opportunities for you in some of the other nursing "auxiliary" fields like informatics or research. I think about going back to bedside but the consistency of my schedule now (830-5, no weekends or holidays, ever) is incredibly important to me. I hope you find what works for you!

[Ageless99]

This is the new norm.

Nurses that think they are leaving the bedside for a less stressful job and better hours are in for a surprise. It's just different types of stress. The hours are still long and it's 5 days/week. Unless you get lucky and work for a smaller company.

It's hard to get time off because of short staff, it's hard to transfer/move up because of short staff, and so on.

[blushpink, BSN, RN]

Thank you for sharing and I understand the stress. I have been working for a small CM company for almost five years. I have about 30 to 40+ cases. When I ask not to get assigned to new patients, I am told that I have the smallest caseload in the company. I work overtime each month, and I am struggling to submit all my documentation before the deadlines. After being in the field all day, documentation would have to take place either late night, early morning or some weekends before patients or insurance adjusters blow up my phone or inbox. I am getting burned out with patients who do not take the initiative to better themselves or their situations. The more they whine, the more is handed to them on a silver platter. There is barely a work-life balance as I feel that I am on call 24/7. The only driver, to be honest, is the generous pay. I sometimes think about returning to the bedside parttime, or perhaps starting an entrepreneurial venture since I am already an independent contractor. I hope to save enough money so I can go for the latter.

[Lili Watson]

I totally agree with you, Nursing is one of the most demanding profession and on an average, a nurse spends 12+ hours a day within the medical facility. Running around to save lives, assisting the paramedical staff and doctors, and helping patients with their everyday needs. Nurses are doing great work for people around the globe. I have read many articles on nursing life that how much stress they are getting during duties, how hard their lives are and they totally deserve respect and honor. For those who want to know more about nurses lives, I am sharing some links for them,

Pulse Uniform Article on Nursing Life

Ameri Tech Article on Nursing Life

[angel337, MSN, RN]

You are not crazy to want work life balance. They know many nurses want the no weekends, no holiday schedules that the typical insurance job has, so when one nurse leaves its not hard to fill the position. Also many of these jobs are work from home, I still do it and it helps with retention but the downside can be working all the time. I have learned how to cut it off.

Do what is best for you and your family.