Dialysis or case management?

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    Hi everyone! I'm at a crossroads... I've been a nurse for 2.5 years and have been blessed with two job interviews? One for case management willing to train and one for dialysis willing to train in an outpatient center. I need some advice and pros and cons if possible. I work in an LTAC and need to get out, looking for something different and that can offer me more. Please help, thank you!!
  2. 7 Comments so far...

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    I can't really say which is "better", per say, but I was a Case Manager for hospice and enjoyed it very much. I was able to spend time with my patients and families, however, the paperwork is massive... and changes frequently! Dialysis, I am JUST going into myself, as an acute in patient RN. From what I have been told, it is a very autonomous position with a great deal to learn.
    I think it will be fantastic!
    I wish you the best of luck with whatever path you choose!
    pma5 likes this.
  4. 1
    Quote from calliou
    I can't really say which is "better", per say, but I was a Case Manager for hospice and enjoyed it very much. I was able to spend time with my patients and families, however, the paperwork is massive... and changes frequently! Dialysis, I am JUST going into myself, as an acute in patient RN. From what I have been told, it is a very autonomous position with a great deal to learn.
    I think it will be fantastic!
    I wish you the best of luck with whatever path you choose!
    Thank you so much! Good luck with dialysis!
    calliou likes this.
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    By the way, which position gets paid more? Thank you!
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    I have worked dialysis for many years. I say it depends on your personality and what you enjoy doing in nursing. In my point of view dialysis is very fast paced,and stressful. In chronic dialysis, you will be supervising technicians, learning how to perform various dialysis procedures, lots of patient interaction, tons of paperwork. It's a highly regulated area so you will learn about compliance, infection control procedures and regulations, and managing patient outcomes to satisfy medicare guidelines. There is some disease management of patients with end stage renal disease because patients need good follow up in order to meet medicare requirements for reimbursement to dialysis facilities. Also, you should love technology because you will be working with dialysis machines, water quality testing..... Many of the outpatient or chronic dialysis facilities are owned by private for profit companies so you will be part of cost cutting initiatives such as counting supplies, performing in various capacities to reduce need for additional employees.
    pma5 likes this.
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    Thank u so much marisette! I will definitely keep that in mind
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    Is it case management hospital or case management hospice? They are very different. Case manager hospice is very hands on with the patient.You visit the patient and you are their primary nurse. Case manager in the hospital deals with insurance companies and charts to make sure the patient gets billed correctly etc. There may be on call involved with with both, but it is more likely with hospice.
    Dialysis outpatient is nice because you have a routine down and your own techs that can do a lot in an outpatient setting.You are also not on call. Inpatient Dialysis requires on call, most likely no techs and crazy unpredictable workday. But it pays very well.
  9. 1
    Most dialysis jobs are the same.


    Case management varies widely, not all CM jobs are the same. I am a CM and LOVE it. After 6 years in other areas of nursing I've finally found my niche! And no, I don't deal with billing or insurance companies or any of that. I manage patients who are post-surgical discharge. I meet them & their families in the hospital at d/c to review their post d/c treatment plan, meds, DME, f/u appts, home health plan, and whatever needs they will have once they leave the hospital.

    Then I call them at home anywhere from 2-6 times over the next month to check on them, conducting a short interview, chatting and answering questions. I serve as their go-to person for any issues they're having. If they need an appointment I can get one for them, if they have symptoms or complications I make sure they get seen, I straighten out their meds, communicate with the docs, make sure everyone is on the same page, make referrals, and whatever else it takes to make sure they heal up, recover well and don't go back to the hospital. My company has social workers, home health, and specialists available as resources and clerical workers do all the insurance stuff.

    I'm salaried, M-F, 9-5. I have a cute little office with a desk and computer, a company cell phone and I wear business clothes. When I meet patients face to face (in one of our clinics) I wear a white coat. I work on my own for the most part, which I love (soooooo done with the whole "teamwork!" thing) but have a cool boss and other CMs I can always ask questions.

    Keep in mind positions like these might require 2-5 years experience in some sort of population-based nursing like Public Health, or in ambulatory nursing, following patients with chronic conditions. You HAVE to be good on the phone and have a bubbly, yet assertive personality. It takes being outgoing, fearless and a little obnoxious to really work the "system" in order to advocate for your patients! But I love being that resource for them, they love having someone who will help them and fight for them if needed.

    Also, you have to be fast and down with technology. We use an EMR and iPads and smartphones every day. Lots of CMs have big caseloads and you will have to be quick, nimble and efficient to get what your patients need so you can move to the next one.

    This kind of case management nursing is NOT for introverts, slow people who are scared of technology, shy mumblers, bitter ex bedside nurses or new grads.

    Pay varies. I have BSN, 2 ANCC Board Certifications, (in ambulatory and CM) a previous BA in an unrelated field, 6 years experience in I.T. before I was a nurse, 6 years experience in Public Health, ambulatory clinic and home health nursing, and I'm working on my MSN. I make around $50/hr and have potential to move up.

    Case management is going to be a HUGE thing as the medical system tries to save $ and move more toward a preventative medicine model.

    And yes hospice/HH CM is a different game entirely.

    Good luck to you!!!!
    NRSKarenRN likes this.


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