Can't believe the difficulty hiring CMs

SummerGarden, BSN, MSN, RN · Apr 8, 2013

Try to make sure the filter (if your HR uses filters) is not accidentally disposing of the more experienced Nurses resumes by being set incorrectly. Also, does the job description state "entry-level Nurse Case Management position"? Sometimes experienced bedside nurses who want to change over may not apply because he/she may think that his/her lack of CM experience will not allow their application to be considered. Plus, if your pay is good for a Case Manager in your area, is it also good for a bedside nurse in your area too?

One hospital I work for has entry-level positions open for CMs, but the bedside nurses would take a huge pay cut if he/she accepted the position and so are not interested. On the other hand, another hospital I work for pays comparable to bedside nursing positions. Thus, that Department gets more bedside nurses applying (the last time we got close to a 100 applications) compared with experienced nurse CMs despite the fact that the job description posted listed the position for experienced Nurse CMs. Good luck.

NurseAmie · Apr 9, 2013

Why does a CM require an BSN, or even a any RN? Aren't there policies in place that determine the follow through care, and how to arrange it, and who to contact, and what company is in sync/in the program, of any patient based on pay sources, etc? I wouldn't think CM involves much autonomy, so this sounds strange to me. I can't imagine the need for a college degree, really, even, from what I've experienced.

SummerGarden, BSN, MSN, RN · Apr 9, 2013

Why does a CM require an BSN, or even a any RN? Aren't there policies in place that determine the follow through care, and how to arrange it, and who to contact, and what company is in sync/in the program, of any patient based on pay sources, etc? I wouldn't think CM involves much autonomy, so this sounds strange to me. I can't imagine the need for a college degree, really, even, from what I've experienced.

NurseAmie, what have you experienced? Have you worked as a Nurse Case Manager or have you just watched us from the sidelines thinking you have what it takes to do our job without any experience working in this specialty?

I have worked as a Case Manager in Social Services prior to nursing and I am working as a Nurse Case Manager. In both cases having a college degree was more than needed!

In the case of Social Services techs and others that I have worked with who do not have college degrees, do not have a clue as to the psychosocial needs of patients. They act more like an uneducated neighbor who spent time watching too much Jerry Springer trying (clumsily) to solve the problems of clients with no understanding of boundaries, professional behavior, or appropriate solutions to support clients/patients.

On the Nursing side I use my clinical judgment with every client too. First I perform assessments (where no one signs off on my assessments given I am a RN) that includes reviewing charts, speaking directly to patients and family members, and speaking to the patient's IDT and outside agencies. Further, I have a lot of autonomy intervening and advocating for patients. For example, I do not just do things (perform tasks) because some Doctor tells me to do so. I question orders that need to be questioned. In addition, I know the laws, policies, and understand insurance requirements that will affect my patient's access to health care and am able to guide my colleagues, outside agencies, and patients to make the optimal choices.

As for why we need a BSN, I have taken a Nurse Case Management course that was very intense during my RN-BSN program unlike the curriculum offered during my ADN program. However, I doubt that is the reason for the BSN. As the OP has already pointed out in another thread (https://allnurses.com/case-management-nursing/lpn-degree-sociology-826395.html), new regulations and policies throughout health care around the country is requiring the nurses to have a BSN, ergo a BSN is becoming the norm.

BTW, I am glad you asked the questions you asked because it helps to assist other nurses who do not understand Nurse Case Management either. On the other hand, because of nurses who do not understand this specialty, many employers do not want to bother training experienced Nurses to be Case Managers. Many Nurses new to this specialty have an attitude, where they do not want to accept the learning curve and/or work hard to support patients and clients because they were under the wrong impression that Nurse Case Managers are not really working as Nurses and/or that we hardly work.

mclennan, BSN, RN · Apr 9, 2013

Why does a CM require an BSN or even a any RN? Aren't there policies in place that determine the follow through care, and how to arrange it, and who to contact, and what company is in sync/in the program, of any patient based on pay sources, etc? I wouldn't think CM involves much autonomy, so this sounds strange to me. I can't imagine the need for a college degree, really, even, from what I've experienced.[/quote']
Wow. Are you flipping serious? What an insulting and totally ignorant thing to say.
My company requires BSN, MSN preferred, and a bonus if you have or pass the CCM exam and become Board Certified. Our requirements used to be 2-3 years experience beside AND population/ambulatory care, but we've had to change that. Now we're asking 1 year experience, and the pay and benefits are ABOVE market rates that most bedside nurses get paid, based on credentials and experience. A qualified candidate with CCM cert will start at $50/hr.
Case Management Nursing is serious business that requires a strong background in skilled nursing, good knowledge of CURRENT pharmacology, critical thinking about patients in a holistic approach using the nursing process, ability to navigate insurance companies, policies and laws, and education/experience with patient advocacy/education, social resources and preventative/community health. We will not hire very young and inexperienced nurses. This is an intellectual job that requires maturity and education. It is not clerical. It is not secretarial. It is not for LVNs. It is not technical.
Research has proven many times over that unnecessary hospital admissions and re-admissions drive health care costs up for everyone and contribute to higher mortality rates. Case Management helps prevent that and helps patients with complicated or chronic conditions manage their care.
It's also a relatively new concept and too many agencies and companies have half-baked CM departments that aren't founded on research or EBP. Protocols for CM are still in development with accreditation agencies and insurance companies.
What I do, what we are hiring for, and what many companies will begin requiring are highly educated, well-credentialed, Board Certified, mature, experienced RNs as CMs who can coordinate every aspect of a patient's care and serve as clearinghouse, sentinel and qualified communicator between all elements of a treatment plan. If you know anything about health care, you know that involves insurance companies, UM, teams of doctors, specialists, pharmacies, other nurses, hospital administration, social work, DME, community agencies, municipal services, ombudsman, SNF/LTC, hospices & rehabs, families, DPOAs, POLSTs, lawyers, approvals, denials and appeals, medication assistance programs, home health, other CMs, MAs, TONS of complicated policies and protocols and of course, the patient. The job of the CM is to make sure all these components are talking to each other, understand each other, are within compliance, and following the treatment plan. And an ability to clearly document ALL of it using good writing skills, nursing judgment and proper medical terminology.
IT DEFINITELY REQUIRES MUCH MORE THAN A COLLEGE DEGREE.

wincha · Apr 9, 2013

Tried to send you a PM but your mailbox is full. Is your position telephonic that you can work from anywhere? I am a certified case manager and am considering a change currently.

KelRN215, BSN, RN · Apr 9, 2013

Why does a CM require an BSN, or even a any RN? Aren't there policies in place that determine the follow through care, and how to arrange it, and who to contact, and what company is in sync/in the program, of any patient based on pay sources, etc? I wouldn't think CM involves much autonomy, so this sounds strange to me. I can't imagine the need for a college degree, really, even, from what I've experienced.

Is this a joke? My Case Management job is the most autonomous job I've ever had. Why wouldn't it involve autonomy? What is your experience that leads you to believe you don't need a degree to do the job?

mclennan, BSN, RN · Apr 9, 2013

I agree - to add to what I wrote above, I do 99% of that work TOTALLY on my own. I do have a team of clerical staff to assist with paperwork, but I have contact with my managers usually only to request time off or clarify a policy. Most autonomy I've ever had in any job I've ever had in 25 years of working!

KelRN215, BSN, RN · Apr 10, 2013

OP, here are my thoughts... how is your ad worded? I have seen MANY Case Management jobs advertised on Craigslist that are rather vague and don't give the name of the practice/company. I've seen these same jobs advertised since probably last year. They all say something like "We are looking for a Case Manager to join our growing practice" or something like that. If I don't know the company and can't look it up, I'm not going to apply for the job. I don't want to waste my time and theirs if I find out it's somewhere I would never consider working. What part of the country are you in? Is it a place with a lot of experienced nurses looking for work?

cardiacrocks, BSN, RN · Apr 10, 2013

May I ask what state this job is in? Where is the hospital? Gesh, wish I lived where ever you are, because, I have almost 2 years experience and 2 Bachelor's degrees. A BSN and a B.A. with psychology as my major. I'd love to have this job. Hoping to go back for my Master's this fall too.

salvadordolly · Apr 10, 2013

Where I live, there are a lot of experienced CM's, but they have many years experience and their CCM. A lot of them don't have their BSN though. We had to drop that requirement to get some more applicant. This is home health though.

mclennan, BSN, RN · Apr 10, 2013

This is a large, multi-state medical group. Not a hospital. Not home health. Not an insurance company. Not some mom and pop place that would ever advertise on Craigslist. The postings are on our website and we've taken out quarter page, full color professional ads in nursing journals and magazines. We've ran booths at job fairs. We are based in SoCal. It's a great job and place to work.

It pains me to read all these posts about even experienced nurses not being able to find work, and good BSNs burnt out on floor nursing - while we have these wonderful positions wide open. It doesn't make sense!!!!!