mclennan, BSN 17,510 Views
Joined Sep 25, '06.
Posts: 747 (58% Liked)
I am a case manager RN. I also have a good relationship with my hiring manager and know why she hired me so here ya go:
1. BSN. Most medical groups, insurance co.s, hospitals get better reimbursement and accreditation if CMs have BSN.
2. Some experience in Public Health, health teaching, discharge planning, chronic condition management or something along those lines. Lots of states offer PHN licensure to BSNs whose program curriculum included community/public health that meets requirements. If you can get it, get it. My hiring manager, and 3 or 4 other CMs in my department were PHNs for some years before becoming CMs - she says that pretty much nailed why they hired me. Highlight any nursing experience in which you developed therapeutic, long term relationships with patients and followed them through chronic illness. Any telephone triage expertise or training is valuable too.
3. Get certified as a CM either by the Commission for Case Manager Certification or the ANCC Case Manager Board Certification. I cannot emphasize this enough.
4. Be prepared to sit in a cubicle all day calling patients, to wear business clothes, to earn salary instead of hourly, and go to lots of meetings. It is a far cry from working the floor, the clinic, or 12 hours in scrubs. And it's not always better, it can be just as crazy busy, complicated, stressful and the grind of 9-5, M-F isn't the paradise you might think. We have had a couple of CMs who came straight from inpatient, bedside shift work nursing leave after 5 or 6 months because they missed working with patients and having those 3 or 4 days off a week. And, they missed overtime pay.
5. On the upside, it's very autonomous, independent work that actually uses nursing theory heavily, and really sharpens your critical thinking skills. Docs love us. Patients love that they don't have to come to as many appointments and have a go-to advocate. Case management is gonna be a big thing, it saves everyone money and increases patient satisfaction scores big time. And, the pay is great IF you have the experience and certification!
Hope that helps and good luck!
The point of research is to gather data to test theories. Research findings are disseminated into practice and policy. The best researchers are those who develop theories and data collection methods based on and informed by their knowledge of the practice their research will impact. Get some practice under your belt to create a credible foundation as a researcher.
Plus, most nurses are bitter, cynical and clever. We will detect your inexperienced, ivory tower dreck a mile away. When I read published research I can SMELL the academic hack who never wiped a butt or flushed a line like rotten fish. Trust me on this one. Go work.
Reminds me of when I volunteered at an AIDS hospice (well it was a group home, but in the 90s we didn't call it a hospice even though that's what it was) and cared for this wonderful man. He was 6'4 and near the end, he wasted away to only 100lbs. or so. He spent a lot of hours sitting in a deep bathtub of warm water, nothing else was very comfortable for him. One night I asked him if he'd like anything to eat or drink and out of the blue he said, "you know what I'm craving? A big, day-glow fruity island cocktail. In a big glass, with the little umbrella and garnishes and a straw. Ice cold. I miss sipping drinks like that on vacation."
Well, of course there were several men in recovery at this place and alcohol was banned. At first I thought, I'll figure out how to make a virgin drink like that for him. I called my uncle who was an ex-bartender in his 60s. I'll never forget it. He said "to heck with that. Let's make this man a proper drink." I stopped by his house the next day and there he had a whole setup, a Thermos with the drink in it, and a hurricane glass packed with fruit, umbrella and straw. He even wrapped it all up in a box so I could smuggle it in.
I did. I arrived & found my patient in his bath, candles lit & music playing as usual. Got a huge container of ice from the machine, and locked the door behind us. I took out the glass, iced it and poured the drink. It was a hideous bright blue and loaded with rum. I fixed up the garnishes and umbrella and gave it to him. I have NEVER seen such a blessed out look on a human being's face!
After only 5 or 10 minutes I could see the blue drink coming out of him in the bath water. His GI was so destroyed that almost anything he consumed was passed so quickly he couldn't absorb it. I didn't say anything. I let him enjoy the cocktail. He finished about half, then handed it to me and said "you finish it. I insist." (I was not a nurse then and an off-duty volunteer). I pulled up a chair next to the tub and settled in. We sat there a long time, talking about our favorite vacations and wild times. I very stealthily changed the bathwater until it was clear again.
He died about a month later. At the visitation I tucked the little cocktail umbrella in his suit pocket and kissed him goodbye.
During my BSN I got a full ride, merit-based scholarship. That took care of tuition, books & school fees. To pay rent & bills I worked part time as an EMT and CNA, drove a junky old truck, ate rice & beans, gave up booze and going out. Milked the HECK out of every student discount I could get and let my mom treat me to shopping at Target & Costco. (I was 30). Reduced my car insurance down to the bare minimum. Babysat & pet sat for friends. Bought NO clothes, shoes or jewelry. Climbed stairs in my apartment building for exercise instead of gym membership. Had the same crappy, taped-together old flip phone all thru school.
Had to put an unexpected hospital visit for kidney stones on a credit card but I paid that $3000 off long ago.
Be resourceful! Apply for EVERY darn scholarship you can even if you don't perfectly fit the criteria! Look into employer tuition reimbursement! Federal Nursing Loan Repayment program! Work study! Beg family!
It CAN be done!!!
Lifelong atheist here and RN, I put my patient's and their family's needs ahead of my own, always. If it is important to THEM that I join their prayer circle or participate is something religious/ceremonial, it's not gonna kill me or "turn" me to join in, pretend to pray, and just play along for 5 minutes. If it brings them comfort, keeps the peace, and soothes the patient, GREAT. That's my JOB. I can close my eyes and hold their hands and think about my grocery shopping list. Or meditate. Or be thankful I get 5 minutes to stop and breathe deeply on my busy shift. Sometimes (GASP) I even tell them I am honored they asked me to be included. Come on, don't make a bad impression of us atheists, we have a rough enough time as it is. Be the mature, enlightened, polite atheist and put your patients first.
I just started the MSN in Nursing Ed Oct 1st. Here are my impressions, pros & cons:
1. Pro: one of the few accredited, well-regarded NON-PROFIT schools out there that isn't out to suck up Pell/Fed financial aid
2. Pro: designed to be SO easy and user friendly, a monkey could pass with a degree
3. Pro: high Mormon quotient on staff in SLC, so SUPER friendly customer service
5. Con: all grades are pass/fail so there's no GPA and your credits won't transfer to most brick & mortar/terminal degree programs that aren't WGU. True story. Very sad. Think hard about if you're going to pursue more schooling after WGU and where. WGU at this time provides a "letter" to schools explaining their "pass=B" policy but most won't accept that, they want letter grades and GPAs. BEWARE of this. I hope they modify this practice sometime in the future, because when all these WGU students decide they want to get DNPs and PhDs at non-online schools they'll be essentially SOL.
6. Con: the quality of writing from other students is pretty atrocious. Painful, sometimes, to read the message boards. And, as it is in most of our sad society, people have a propensity to use the boards and assignments to a) brag about themselves b) talk a lot about their religion. It gets tedious. I don't really give an R.A. about your decorated military service, your many sparkling professional achievements, your children or your church. Just write what the assignment is asking and get it over with.
7. Con: many scholarships won't fund online degrees. This might change, but there are growing pains in the academic world caused by the advent of online education. Scholarship entities are struggling to keep up. I had a heck of a time begging for money, because so many refused to fund online degrees. I thank the vulture-capitalist, for-profit schools for that, *cough* U of Phoenix *cough* DeVry *cough* what?
TONS of students doing WGU are also parents, so a lot of their stuff panders to that. It's keenly felt by us non-parents, believe me. If you aren't "struggling" with or "juggling" work, school and kids you won't be able to identify with about 99% of other students. I wouldn't point this out if it wasn't always presented as if these people deserve medals for their choice. Sorry, you chose parenthood, work and school. You're no more special or stressed out than anyone else. It's great you belong to a big club and have people to talk to, but remember not everyone is the same. I sometimes wish WGU didn't sell themselves so hard on that angle!
Have you looked on the IHS website?
Why do you want to work for the IHS?
I took an IHS scholarship and worked for them for 4 years. WORST experience ever. It ruined me financially, made me hate nursing and broke my spirit. It's a backward and corrupt government agency that runs an archaic health care system that is underfunded, outmoded, and mostly exists in extremely poverty-stricken rural areas. The jobs are low pay, high stress and very, very depressing and understaffed.
Keep in mind they practice preference of hiring Native candidates first. And they have a ready-made pool of candidates from the scholarship obligation program they are required to hire from by law.
I cannot imagine why anyone would want to work for this agency unless they are obligated to by contract. If you are a non-Native person who just wants to "help the poor Indians" you won't last 5 minutes in an interview or on one of these reservations. Trust me on that.
Still don't see why the Op is so upset. I'm the type who loves to help people, but don't give a flip if they don't want me to help them. Many times, people want to figure the thing out themselves. And ya know what, they often do! They also will tend to run right up over you and succeed. And there you are sitting by yourself looking at your beautiful narratives, wondering if you should wallpaper your bedroom with them, or would that be too much awesomeness that you wouldn't be able to sleep?
Thumbs up to you and a high five, OP. I have been a BSN/RN for 6 years now, and done bedside, case management and public health. I HATE all of it. The last 3 years I've really spiraled downward into total hatred for the job. I'm cursed with being really good at it - I'm always a patient favorite, and have never received a bad review. But I'm so over it.
I'm starting a new job in two weeks doing case management, and have already decided if this doesn't re-ignite some hope and passion for this profession I'm done. I'm gonna try for a year, and if I still hate it, I'm headed for grad school to teach nursing. I had an awful nursing school experience -and if I can do anything, at least I can help avenge my experience by being a good teacher.
Why do I hate it?
1. The obvious: the health care system is broken. Horribly. And I'm sick of being a part of it.
2. The bubble is going to burst, folks. Nursing salaries are going to take a nosedive. Of this I am certain.
3. The quality of schooling and therefore quality of nurses is in the gutter. I can't believe some of the people I have worked with. How the hell do half these dopes graduate? They can't spell and can't speak clear English. I don't get it. I don't want to be lumped in with people like that.
4. I have worked with "under-served" populations for way too much of my nursing career, and their sense of entitlement and demanding services they don't need has embittered me and ruined my faith in this profession forever.
5. I like animals and machines more than people.
One other thing. It's so sad how we who hate nursing & want to leave have to keep that such a secret, or that ANYONE is shocked by something like that. Nursing is just a vocation, an occupation, a profession. No profession should completely define a person. YOU ARE NOT YOUR JOB. You are a human being, first and foremost. Nursing is not the noble, altruistic, self-sacrificing job it used to be. Sorry, Charlie. Florence Nightingale is DEAD.
Some people end up hating it, just like some accountants end up hating their job. A nurse leaving the profession really should not be judged so harshly, it doesn't mean she's an uncaring, cold, uncompassionate person. In fact, it's probably the opposite. Too many nurses who hate it STAY in the field and make everyone's lives - their co-workers, bosses, patients, and their own - MISERABLE. So kudos to those who bail when they know they need to. I wish you all the best of luck.
Any time you sign your name you automatically put "RN" & the date/time after it, especially when tired after a long shift, I did this at the DMV and had to do it over.
Here in L.A., my co workers and I used to try and guess which SSRI/NRI/benzo the plastic-surgeried ladies we saw on the street were on, "she totally has Zoloft face. OMG, that blonde one has Xanax eyes. Lookit, Paxil face AND fresh Botox!"
Carry box of gloves in car in case of Good Samaritan situation. And I sometimes try to log on my computer at home with my work logon.
Powerlessness. Some is perpetuated by the systematic forces, and unfortunately, some is perpetuated by nurses themselves.
I think every nurse aged 55+ who has had this happen should all get together somehow and write a letter/synopsis/report about their collective experiences. Publish it professionally, and send it to unions, professional nursing organizations, nursing media, the AARP and prominent nursing leaders asking them to address this issue!!
It is happening far more than what's reported. I understand the generational shift that's affecting all professions generally. I understand the complications this presents to management. What I don't understand is the total and utter lack of training, preparedness or mechanisms in place to deal with the widening age gap in the workforce. I have seen managers, time and time again, prioritize the bottom line over the value of experienced nurses. Rather than develop constructive ways to utilize their knowledge - or learn new techniques to effectively handle the conflicts between older and younger employees, they'd rather just fire them, or worse, passive/aggressively pressure them out by making the work environment so uninhabitable they have no choice but to quit. It's not just happening in nursing. It's happening everywhere.
That being said.....oldsters, my advice to you is to keep up with the changing technology, be tech-savvy, and don't be a high maintenance chestnut. Just do stuff the new way they want you to, stop clinging to paper and old protocols. Don't eat your young, and don't perpetuate the old stereotypes. Don't give those managers any excuse to start honing in on you. Every time I've seen an older nurse get canned it almost ALWAYS starts because of these issues. I hate to see it go down that way, but I find a lot of older nurses are so stubborn about learning new things, they practically invite the scrutiny that starts the process of termination. So stay flexible, stay informed, learn that software without complaint and nurture those youngins! You are our ROLE MODELS!
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