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Confused about case management, please help

Nurses   (540 Views | 12 Replies)
by Guest716906 Guest716906 (Member)

1,314 Profile Views; 43 Posts

Hello, 

I was just wondering. I was a med surg tele nurse for 4 years, and I have been a hospice case management nurse for 8 mos now. I do a ton of wound care, incontinence care, foley insertions, enemas, heavy lifting, etc. I am totally burned out. I want a nursing job requiring little to no hands on patient care, non bedside. However when I ask other people what I should look for, they say case management. My question is, how is my case management job different from other cm jobs? Should I apply for another cm job, since I already have 8 mos experience under my belt? Thanks! 

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108 Posts; 3,532 Profile Views

Hospital based case management RNs help coordinate the patients transition from inpatient to their next phase of care. (I am not one, so I'll leave the details for somebody else to explain). They do not perform clinical patient care. 

Edited by MelEpiRN
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FacultyRN has 13 years experience as a MSN, RN.

117 Posts; 817 Profile Views

It sounds like you are the clinical nurse assigned to manage a caseload of patients - similar to home health.

Traditionally, case management refers to coordinating care - helping patients access appropriate resources, ensuring appropriate levels of care in hospital and out, getting needed referrals, dealing with insurance issues, preventing avoidable readmissions, etc.

Your job title is misleading, in this case. 

Do you have strong organization, communication, and interpersonal  skills? Your clinical background could be very beneficial in a true case management role.

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43 Posts; 1,314 Profile Views

WOW! thanks for that response. I agree that the job title is misleading.. I do feel just like a clinical nurse in the hospital again only without extra help at patients homes, I'm driving all the time, and on top of it dealing with medical care and coordination, insurance and billing issues, etc. This job is way too much. I will apply to other case management jobs and see how that goes. I love the critical thinking part of my job, and educating patients and families. Hate the hands on nursing care. 

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CharleeFoxtrot has 7 years experience as a ADN, RN.

629 Posts; 8,138 Profile Views

2 hours ago, FacultyRN said:

It sounds like you are the clinical nurse assigned to manage a caseload of patients - similar to home health.

Traditionally, case management refers to coordinating care - helping patients access appropriate resources, ensuring appropriate levels of care in hospital and out, getting needed referrals, dealing with insurance issues, preventing avoidable readmissions, etc.

Your job title is misleading, in this case. 

Do you have strong organization, communication, and interpersonal  skills? Your clinical background could be very beneficial in a true case management role.

With utmost respect, Home Care/Hospice RN jobs are frequently entitled "case managers" because they are in charge of the team (PT, OT, SLP, home health aides) on the "case" and represent those cases at IDT meetings. If you do a quick search of the term "RN Case Manager" on a job website such as indeed dot com you'll see what I mean. 

That is one definition of case management.

Of course that is a different thing from inpatient case management as you noted, or what I do as a care manager in a primary care setting. 

But I totally agree the OP's experience both inpatient and outpatient would be very valuable in obtaining a "true" case management job. That combination of experience is how I ended up in my current job.

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17 Posts; 567 Profile Views

I am a case manager at the hospital where I worked in Ortho/Medsurg for 3 years.  I love it!  I work with the same doctors and many of the same nurses, help patients and families, work 8-4:30 M-F and no hands on care.  I enjoy going to work every day.  The bulk of the work is discharge planning.  We set up home health, rehab to SNFs, help people apply for medicaid if they need long term care and help the hospital by efficiently getting all of this in place by working on it as soon as a patient arrives on the unit by doing an initial assessment.  I could go on, but this is just a quick summary.

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43 Posts; 1,314 Profile Views

Ryamanell: that sounds perfect for me. I would love that. I looked online, wasn't seeing many hospital cm jobs. I applied to 2. Do you think they would hire me with 9 mos hospice cm experience?

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13 Followers; 4,056 Posts; 31,309 Profile Views

I feel like the kind of position that might interest you is referred to as care manager/care management RN around here, with a description similar to what @rymanell posted above. So make sure to include those search terms in your searches.

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Katie82 has 25 years experience and specializes in Med Surg, Tele, PH, CM.

569 Posts; 4,850 Profile Views

I am a case manager, and your job is definitely different from mine. I work for the State as a CM to the Medicaid and Medicare population. I love my job, but do no direct patient care. If one of my patient needs home care, I call Home Health and order it. Not sure why they label your job case management, but keep the title. It will help you get your foot in the door if that's what you decide. I work on my own with guidelines, but very little direct supervision. If I have questions, I do have a supervisor to call, but really feel as though I am part of a much bigger team. 

 

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43 Posts; 1,314 Profile Views

@Katie82 That sounds like a good job. So you work for an insurance company? My question is, how did you get into that job? What kind of prior experience did you have? I have 10 months in to this job but I am about to put my 2 weeks in. My back hurts too much from all the heavy lifting and I am working unpaid overtime finishing charting. Do you think 10 mos of experience in my current job could get me another job as a case manager? 

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Katie82 has 25 years experience and specializes in Med Surg, Tele, PH, CM.

569 Posts; 4,850 Profile Views

I have had two jobs with Medicaid. The first was with a Managed Care Organization hired by the State to administer their Medicaid patients. We had a very large CM staff. The second is in a different state working for an Agency operated by the State to Case Manage their MA patients. It varies from state to state, but most have MA case management because it has proven very successful in containing costs. Insurance companies also like to use case management as a means of assisting their members. Can be a bit challenging from time to time, but there is no other job I would rather do. I had ten years of Public Health prior to that, and while I never considered myself a CM, I found that many of the tasks I routinely performed were, in fact, case management. 

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17 Posts; 567 Profile Views

I was a med-surg nurse for about 3 years with a BSN and a prior degree in business which wasn't really relevant to getting this job.  The hospital system I work for is hiring mostly RN's for case management right now and we are referred to as RN Care Managers.  I know they do require a BSN for RNs.

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