Frustrated

TheCommuter, BSN, RN · Jan 30, 2016

I recently left the specialty hospital setting after five years to become a case manager. To tell you the truth, I'll be perfectly fine if I never perform direct patient care ever again. The hospital setting is not all it is cracked up to be.

Many hospital nurses would love your hospice case manager job. It is flexible, autonomous, and respected. You've got a good thing and don't even realize it. It boggles my mind why someone would want to leave a nice CM job to bust their butt, sling bedpans, push a med cart and fetch HS snacks in an inpatient setting.

4boysmama · Jan 30, 2016

Many hospital nurses would love your hospice case manager job. It is flexible, autonomous, and respected. You've got a good thing and don't even realize it. It boggles my mind why someone would want to leave a nice CM job to bust their butt, sling bedpans, push a med cart and fetch HS snacks in an inpatient setting.

as a hospice rn case mangr, I agree with the above that it is a flexible, autonomous and (mostly) respected job. But....I do my fair share of butt-busting and bedpan slinging. It's not a cushy desk job. It's a whole lot of direct patient care, and often in situations where you've got zero people around to help, and no supplies/resources. That said, it's the best job ever and I couldn't imagine doing anything else! :)

Editorial Team / Admin · Jan 30, 2016

Just remember that while the grass may look greener on the other side, sometimes it's because it's being "fertilized" more often.

MPKH, BSN, RN · Jan 30, 2016

You said you love your job--that's something not many people can say. The grass isn't always greener and looks can be deceiving. However, if you really want a hospital job, try gaining some experience in a LTAC facility. Or just keep applying to hospital jobs.

**NickiLaughs, ADN, BSN, RN** · Jan 30, 2016

If you really want a hospital job, go to long term acute care. Many of those pts are hospital pts who just are going to keep being very sick. They even have mini ICUs. I know several people who worked in one and were able to get in a hospital a short time later.

You will encounter art lines, central lines, cardiac drips, run codes, etc

and these facilities tend to be more willing to hire those without acute experience.

i can't say I'd transfer from your gig to a hospital gig tho.

bosslady47 · Jan 30, 2016

Thanks for reply and the information. I think I'm just more tired of people telling me What im doing "isn't nursing."

Libby1987 · Jan 30, 2016

Thanks for reply and the information. I think I'm just more tired of people telling me What im doing "isn't nursing."

It's not relevant to acute care experience. Nothing we do in home care, I've been a very high functioning home health case mgr for years, adequately prepares us for acute care nursing. As much experience as I have, as much as I'm respected by my peers and providers, I would face plant in acute care without intense orientation.

Acute care nurses aren't prepared to hit the ground running in home health either. It takes about 6 mos to get them anyway near independent, and then longer to become as productive as we'd like.

Doesn't mean anything other than employers are looking to provide less time and money training people without relevant experience.

Why don't you you go into home health case mgmt where you will see a broader patient population and potentially make more money?

nutella, MSN, RN · Jan 30, 2016

I recently left the specialty hospital setting after five years to become a case manager. To tell you the truth, I'll be perfectly fine if I never perform direct patient care ever again. The hospital setting is not all it is cracked up to be.
Many hospital nurses would love your hospice case manager job. It is flexible, autonomous, and respected. You've got a good thing and don't even realize it. It boggles my mind why someone would want to leave a nice CM job to bust their butt, sling bedpans, push a med cart and fetch HS snacks in an inpatient setting.

A hospice Case manager job is hands on and bedside nursing - NOT a desk non direct care position!

The title is confusing but it is a position in which a RN manages a caseload but provides direct patient care!!!

And those jobs are not necessarily relaxed, the agency I worked for had a case load of 18-22 and pushed it to 28 cases (some of them palliative and perhaps one visit every 2 weeks or so but still).

nutella, MSN, RN · Jan 30, 2016

as a hospice rn case mangr, I agree with the above that it is a flexible, autonomous and (mostly) respected job. But....I do my fair share of butt-busting and bedpan slinging. It's not a cushy desk job. It's a whole lot of direct patient care, and often in situations where you've got zero people around to help, and no supplies/resources. That said, it's the best job ever and I couldn't imagine doing anything else! :)

You are very right! Not to mention the "emergencies" and "pronouncements" that get added ...

The title case manager is somewhat misleading as I got the impression that not only the agency I worked for but every other agency around was mostly abusing nurses.

Caseloads up to 28, non clinical staff trying to bully RN into taking "another visit" - when some already had 6 or 7 visits for a 8 hour day and so on.

The work itself is great - gratifying and real nursing for sure.

But like is so many other areas of nursing nurses get just used and burned out.

ThePrincessBride, MSN, RN, NP · Jan 30, 2016

I don't understand the problem. You love your job, it pays well, and it has GREAT hours (no weekends, no nights, no holidays.)

Hospital nursing is overrated, and I say this as an acute care nurse. Nurses at the bedside seem so unhappy compared to those away from the hospital and in desk jobs/non-clinical work. Turnover is high. Nurses rush towards jobs like yours that have limited patient contact. This isn't to say your job is cushy but...the stress pales in comparison to what bedside nurses have to put with everyday.

I would stick with case management if I were you. While I enjoy working in the hospital, it has some downsides and can wreck havoc on your health.

nutella, MSN, RN · Jan 31, 2016

I don't understand the problem. You love your job, it pays well, and it has GREAT hours (no weekends, no nights, no holidays.)
Hospital nursing is overrated, and I say this as an acute care nurse. Nurses at the bedside seem so unhappy compared to those away from the hospital and in desk jobs/non-clinical work. Turnover is high. Nurses rush towards jobs like yours that have limited patient contact. This isn't to say your job is cushy but...the stress pales in comparison to what bedside nurses have to put with everyday.
I would stick with case management if I were you. While I enjoy working in the hospital, it has some downsides and can wreck havoc on your health.

Again - a hospital case manager is a HANDS ON job. Your desk is in the car and you document with a laptop. While you manage a case load and are responsible for "case management" it is not NOT a desk job at all. I am not sure what you mean by "limited patient contact" - as far as I know it is direct patient contact each time you visit a patient, which is several visits a day.