Case mgmt vs utilization review

SummerGarden, BSN, MSN, RN · Nov 9, 2014

Hi!
Both sound intriguing but would like to know opinions of those who may have switched paths later in their career.
Thank you!

Switched how? Switched from bedside nursing to CM/UR? Or switched from bedside nursing to CM/UR then back to bedside nursing?

I can give an example of both...: I went from bedside nursing (like just about every nurse you will run into) to CM and UR. In fact, I work as both because I work for two different employers. I started out as CM nurse then transitioned to a UR only nurse for one employer and work as a CM where one of my duties includes UR for another employer. I have no intention of going back to bedside nursing.

However, I know of three nurses that switched from bedside to CM and back to bedside nursing without problems. Two of the three never gave up a PT bedside job so they had their foot in the door to go back to bedside if they did not like CM, which is the case. The one that managed to transition without keeping a bedside PT job did so because of the connections she kept and the relationships she kept with her former employer. Thus, when she decided that being a CM was not for her, she went back to her former employer without problems.

FYI, the turnover rate for Nurse CMs new to the specialty if 1 year.... If you can make it past your first year and be fine with this job, the chances increase that you will not wash out and only get better. Good luck...!

tjjox · Nov 9, 2014

MBARNBSN,

Thank you for the reply! I was an OR Tech for 25 years, and went to nursing school the last couple years. I went into the OR because I do like the OR a lot...but I didn't realize how different being a nurse vs. tech is. I'm still fairly happy, but am done with my BSN next month.

i feel this is a great time to try out something new and different. I am going to stay contingent in the OR just to keep my foot in the door. it seems there are some who truly love cm and ur. So I'm just trying to get a feel for how others that have gone through such a change are doing.

Thank you you for the input.

Been there,done that, ASN, RN · Nov 13, 2014

If you are being offered training in both specialties.. you are the only one that can weigh the pros and cons.

Personally, I feel working from home trumps everything.

angiewdm · Nov 21, 2014

I LOVE utilization and case management; I work in utilization management at an insurance company. It is a lot different than other types of nursing, as you don't directly work with other patients. It is very fast paced (it is our busiest time right now); but you can somewhat plan your day, which I like. You can make a difference, but it's behind the scenes. I was able to help an agency yesterday get home health services for an actively dying patient who did not want hospice--they didn't realize they could do that. We had someone call in a month and a half stay for inpt mental health...not the right level of care for that patient...