[susanmary]

I'm at a crossroads in my life/career & feel ready to make a change from being a med-surg floor nurse (often charge with full assignment) to a career that affords me a better quality of life. Thinking about case management. Any insight? Pros/cons? What are the major issues dealing with worker's compensation & disability? Do you feel you are able to be your patient's advocate in your position? Stress level? Was it a good choice for you? Why?

Thanks for your input.

[renerian]

I do case management in home health but I still see patients. I will check and see what people say to your question. Good thread.....I am at a crossroads too.

renerian

[LasVegasRN]

When I was completely burned out with doing bedside nursing in the hospital, I asked a discharge planner what she did exactly, and if she enjoyed doing it.

I left bedside nursing 11 years ago and do not regret it. Being a case manager has affored the opportunity to work regular hours (although some companies may require some "on-call" stuff) and no longer worry about working weekends or holidays. It was a great transition in that I still had contact with patients and could help them obtain the care that they needed and still utilize my nursing skills and knowledge fully.

It seems that physicians now have a better understanding of nurse case managers and their role in helping them to provide care to their patients and act as a liason between them and the payor source.

Some of the cons is having to work with clients with a long period of time. With workers comp, the time it takes to resolve an injury may take YEARS. At some point you may feel you have exhausted all your resources to help the client and it gets frustrating when you see the client developing a "disability mentality". In those instances, it's helpful to have someone else review your case to give you a fresh point of view or a "reality check". We're human, and sometimes we need a breath of fresh air to help us along every now and then.

With case management you are not just restricted to workers compensation. There are case managers doing discharge planning in the acute care setting, long-term care setting, dialysis units, home health (like Renerian), group health, and independent organizations like PPO's, IPO's and TPA's.

You also have the ability to specialize in different areas. You can obtain a certification in case management. If you enjoy work-place disability management you can specialize in occupational health nursing. Those are just a few.

All of your nursing background gives you a firm foundation to build as a case manager and grow into almost any area you find interesting.

I did disability case management for 8 years and utilization management for 3 years. It's not hard to find your niche.

[LasVegasRN]

Oh, yes, you asked about stress.

I found the stress to be much less than working in the acute care setting. Gone were the bytchy bedside attitudes. In case management, you work like an independent contractor of sorts. People aren't going to come behind you and criticize the way you gave a certain medication, or the condition of a patient's room, or why you didn't finish an admission when you were scheduled to leave 2 hours ago. It's not the same at all.

You're going to be doing 90% of your work on a computer and learning to use different programs. Your going to be responsible for your own case load and you won't always have someone looking over your shoulder. In my opinion, the best kind of case manager is one who is goal-oriented, can think quickly on their feet and has the ability to be very creative and open-minded in their problem-solving.

Stress may come from the frustration of trying to get a patient/client something you really feel they need to help them recover and their insurance does not cover it. Stress may come from trying all you can do to get your client the best medical care for their condition and they fail to participate. Stress may come from a physician that is "burned out" with taking care of patients with chronic pain issues and he/she just blows them off.

The reward is learning how to work around these barriers and get a good outcome.

Every job has it's stressors. The degree the stress affects your ability to shine, in my opinion, is all in how you deal with it.

[ryaninmtv]

I am a refugee from patient care and have found my way to case management. I am glad I made the change. There is stress but it is a different kind of stress. I deal with an inbox and voicemail now rather than call lights and codes. I enjoy developing relationships with the clients and am not now completely burned out on nursing. The hours are much better also with a family as I don't work any weekends or holidays. Some nurses have a hard time transitioning from the clinical setting to case management. I felt at home the first day. Hope this helps.

[RNCM]

Having been a critical nurse for 10 years and getting into the emotional burnout thing, I tried something different and went into Case Management in the early 1990's.
It is a decision I have never regretted (well once or twice.... )

I have found a niche for myself in Hospital - based case management and I love it!

I get plenty of contact with patients and family members, and I feel that I have a direct and positive impact on their lives and health.
I no longer dream (or have nightmares) about patients when I sleep, but I still get the satisfaction and the warm fuzzy feelings for which I entered the nursing field.

There IS life after ICU nursing, and Case Management is a good way to go!

[EXOTIC NURSE]

Las Vegas RN you got me interested in case management when you told me that is what you did and I have been looking into it every since then. I am basically looking to relocate to Nevada in which I private messaged you and let you know that ....and I want to look into case management positions. I am not close to doing it right now as I want to complete my BSN first then I will look into it.

[LasVegasRN]

It's a great field to be in, Exotic. The BSN is definitely a plus! Nevada is very good to case managers and believes strongly in our value.

[EXOTIC NURSE]

That is great !! I am so excited again.....about this subject......thanks LasVegasRN you have been very helpful on this subject.......I am looking forward to relocating to Nevada but I will be visiting there again soon in October maybe I can get a chance to meet ya ........who knowsssssss!!!!!!!!!!

[lynnintn]

I have been a W/C case manager for about 5 years; I enjoy it! I work out of my home for a national disability management co. I find it is never boring, I enjoy the travel, and I get to the see the results of my hard work.

I recommend W/C case management to anyone burned out from hospital nursing. I worked critical care for 5 years before switching to case management. I am taking the CCM exam in October, and then will begin working on my life care planning certificate. Luckily, I am in a state where case management is mandatory if the injured worker has been hospitalized, has been off work for 8 weeks, or medical bills exceed 10K. So the work is plentiful here.