Case Manager to Bedside

[QTNurseBSN]

Do any Case Managers out there ever miss the hands on patient care that you use to provide in the hospital. I work in Case Management, not in the hospital, so it does not consist of Utilization Review or Social Work. I do more of assisting the doctor and maintaining the client's charts and other secretarial, NON-NURSING things. I love not having to work weekends or holidays, even though it didn't really distress me that much when I worked in the hospital setting. I do miss having my days off during the week, since I work Monday-Friday. I do miss the multi-tasking and nursing skills that I did in the hospital. I have tried to find PRN jobs in the hospital so that I don't lose my skills, but not much luck. I know some people would love my job and I try to think of all the reasons to stay, but I do miss patient care. Have other Case Managers felt this way? What did you do to fill that void or did you return back to the hospital?

[SummerGarden, BSN, MSN, RN]

I fill the void by working as a Case Manager in the hospital setting. I do not miss bedside nursing because I am exposed to it every day. I work directly with patients and families and intervene by the bedside when necessary. Although I do not perform nursing tasks as a bedside nurse any more, I participate in the decision making process of the patient care to include collaborating with the doctors and other health care team members so that my patients are able to discharge from the acute care setting in an appropriate time frame for the patient and to the appropriate setting with the appropriate equipment.

In addition, I assist in moving the patient along the continuum of care while in the hospital setting, which assists in discharging the patient in a timely manner. For example, if one of my patients is not able go home because he/she was not able to be scheduled for a diagnostic on time, I intervene and find a solution to the problem. Another example, if I have a patient who needs an ISO room when one is not available, I work with the inpatient team to move or transfer patients in order to prevent a delay in admission.

As a Nurse Case Manager in the hospital setting, I find that most people (to include most Nurses), do not understand the job of a Case Manager. Most do not understand that a hospital Case Manager is more than a Nurse who sit in an office (I don't have an office), charts or read charts all shift, and who only pops his/her head out of the office once-in-a-blue-moon to perform Social Work (I am not a Social Worker, thus I do not perform Social Work).

Therefore, I suggest that you become a hospital CM. If after performing our job for at least one year you still want to go back to bedside nursing, than you will at least have the connections in Nursing Leadership to gain an interview! We (hospital CMs) work closely with hospital leaders (Nurse Managers, Charge Nurses, House Supervisors, etc.) along with other health care team professionals, so networking is not difficult to do. Good luck!