Anyone NOT case managing???

[RN1263]

My first home health agency didn't have the field nurses case manage and I loved it, then I switched agency's and had to case manage and couldn't handle it. I became the admissions nurse for awhile then got ill and had to quit. Anyone NOT case managing? Seems like every other agency wants case managing nurses and I don't know what to do now?....

[Kyasi]

My agency has both administrative nurses who do case management and field staff nurses. The field staff do weekly med fills, dressing changes (short visits) or they do direct patient care for mostly disabled children. We are a Medicaid only agency, so we write PA's to care for kids when they are at school (there aren't enough school nurses to deal with the many issues some of the kids have at school, such as GT feedings, meds, seizures etc. or if the child isn't in school we provide care for them while the parents are at work. We also provide Respite care for the families on Medicaid Waivers.

K.

[caliotter3]

I only work as field staff on extended care cases and wouldn't do otherwise at this point. There are many RNs who do this, but most of them do home health extended care shifts here and there in addition to their hospital jobs. You don't have to do case management or nursing supervisor jobs if you don't want to. The problem might be finding field staff jobs in your area. Check with all of the agencies to make sure they do or don't have field staff jobs for RNs.

[anticoagulationurse]

When I started HH the Case Managers were field nurses. We worked in pairs with one RN to one LPN and had territories. They changed the model to where nobody works in designated teams or areas (now everybody goes everywhere) and there are Case Managers that work at the office. I believe it allows for a generally higher case load since the CM's are no longer seeing patients and the RN field nurses are no longer bogged down with faxes, calls, etc.

There are benefits and draw backs to each model. Personally I prefer this model because I am a field nurse and don't get stuck with the tedious things that can follow me around for a week, as they did when I was CM/field nurse. But, with this model, there is no patient continuity whatsoever which is terrible. However, I do feel if all nurses are charting correctly and going by the care plan, there is no reason quality of care needs to suffer for lack of continuity.