Case Management - Typical?

[featherzRN, MSN]

Just started as an inpatient case manager - it's my first shot at it, so I'll be several months in orientation/training.

Just curious if my new job is a typical case management job. The nurses have a caseload of 25-30 or so patients with UR reviews/faxing to insurances done daily (medicare three times/week). They also handle all d/c planning and placements, including SNF/Dialysis/etc (generally this is 5-8 patients a day needing placement or other major d/c needs). The nurses are so busy trying to d/c and place patients while trying to write initial/concurrent/final reviews on every patient and attending family conferences that it seems no one has time for lunch, breaks or even to get out 'on time'. I am hearing we may get assistants at some time in the future, but for now all faxing, calling, etc is done by the CM. It also requires weekend rotation and working on holidays.

I don't mind 'busy' but I am a little leery of 'crazy and stressful' , especially since the pay is similar to that of a clinical staff nurse and is much less than my 'other' clinical position (which is being held for me in case I decide to come back :) :)).

[traumaRUs, MSN, APRN]

That is pretty typical in my large teaching hospital for the floor case managers. However, our social workers just started doing some discharge planning and that has helped with the workload. I work in the ER and most of my time is spent with discharge planning and true case management of our chronic patients.

[Bibeau1]

The average case load ( best practice ) is 20-30. You have identified what every other Case manager has noted. There just isn't enough time for every thing. One suggestion is to look at your case load. You do need to see all managed care patients ( pending on how may days you get from the insurance , ie days approved ) . Your medicare have to be seen w/in 24 hours of admission then every 3 days depending on intensity and severity. If you do your d/c planning on day one . That is..... have an active home care and /or snf/ rehab plan in the works as early as possible then the d/c should go much smoother . That means documenting what the plan is to inform the doctor / staff on day one, That way there is NO question the direction that this patient's going. also place what ever forms you know the Doctor will have to sign and /or complete prior to the d/c . that way you won't have to chase him/her down when the pt is ready for d/c . It will decrease your work load tremendously . Hope this helps .......