[Suzy2]

I am wanting to transition into case management nursing this fall. I have been a tele nurse for the last 2 years and have a bachelors degree in special ed w/5years teaching previous to nursing. I would love any input on the pros and cons of case management nursing. Also, is the pay less, more or the same as floor nursing? Any input would be greatly appreciated

Suzy

[Mijourney]

Hi Suzy. Do you know what type of case management you want to focus on? There are different types depending on what a particular employer's vision is regarding the utilization of case managers and depending on what the need is for the population at hand. There is case/disease management. Some do a form of case/utilization management. Others do a form of case/discharge planning. Then there are are other case management hybrids as well as a few purebreds. When you begin investigating and interviewing for positions, you need to ask the potential employer what their case management focus is on.

I believe the case management consultants are those who call their own shots on what type of case management services they'll provide. That's the positive for being a consultant. The challenge (I wouldn't call this a negative) is that you have to really network. The other challenges are that you have to be really creative to get the tools you need for your client as well as be assertive to get the compensation you want.

The downside with working for an employer is that their brand of case management may not jibe with your views of how clients should be serviced. You also are stuck with utilizing the tools provided to you by the employer for the client. If you work for an insurance company, for instance, the program may be set up where there's not alot of room for out of the box thinking like with consulting. Traditionally, as in a hospital setting, their focus is on utilization and coordination of services. In the hospital, there may be a little more room for creativity because some hospitals do have social workers that work with the nurse case managers.

I'm sure others can give you better insights on your concerns.

[kTIE]

The Pro's:
You have alot of opportunities to work in very different settings, insurance companies, hospitals, medical groups and private. Your hours are mainly 9-5 and if you choose to, you can work weekend. The pay ( in california ) is about 35-40 per hour based on experience. It is " out of the box" thinking because you need to evaluate the patient, living situation, financial situation, social situation and plan accordingly with taking into consideraton the clinical picture. It is an independent position in that you need to critically think and plan for approx 14-28 patients ( the average I have had to case manage in the hospital setting ) alone ( or with assist from a social worker ) on a floor and plan for patients. It is collaborative in that you work closely with all disciplines ( P.T./ S.T. , social work and the bedside nurse ) to provide care.

The CONS:
You follow the directive of whomever employs you and usually you are maintaining the fiscal side of healthcare. So you are responsible for bed days, and need to be the "bad person" to the physicians and others who see you as a "discharge planner" of sorts and "throwing the patient out" when you are trying to manage the patient with the appropriate resources. There are couple of 12 hour positions but most are 8 hour ...meaning 5 days a week. There is a different stress in your manager or other superior is looking at your " cost vs.benefit".

Hope this helps