Hospital CM, d/c planning vs UR, Working w/families

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.

I just interviewed for a CM position at a community hospital. Caseload is 14-15 for discharge planning, they have separate UR dept although would occasionally need to cover some UR as well. No assistants as far as faxing/referrals.

I am much more interested in UR than d/c planning, and I don't love the idea of working w/families with unreasonable expectations, which I know is part of the job (I have been part of those families so I know what it's like on both ends). I much rather enjoy chart review and talking w/other professionals, but I am looking to get my foot in the door. I have outpatient CM experience but my direct care experience is in outpatient/clinic and acute psych; all of the UR or combo CM jobs I have seen in my area require at least 2-3 years of med/surg. I figure w/the hospital CM experience I could eventually transition to UR, since they would train me on it and I would be doing it from time to time. I'm also interested in clinical documentation review/improvement.

I'm worried I would be setting myself up for frustration as far as the family piece. I don't really like working w/families, to be honest. I do think I would learn a lot, though. I liked the manager and her manager.

Thoughts?

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I have been working as a hospital CM for about 6 months now. My background is finance/banking, then nursing school and med surg nursing for 2 years. I love the CM job. My caseload is around 11 or 12 patients and it is mostly discharge planning.

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Specializes in Ambulatory Case Management, Clinic, Psychiatry.

Dorky question, but what is a typical day like for you? Did you like med surg nursing? Just curious.. What do you spend most of your day doing/what is the breakdown like (calling facilities/companies to set up services vs meeting w/patients or families vs talking w docs/team)? Thanks in advance

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I worked on a joint replacement unit with some medical patients mixed in too. I did like it until the nurse patient ratios became unsafe, often 6 patients. I also worked 12 hour shifts, mandatory on call, and every 3rd weekend. I really wanted a more normal work schedule and am finding this much healthier for me.

I think I probably do all of those things equally. It is really a great mix. I am finding the facilities and service providers, such as IV abx and O2, are really helpful and know how to help me get the correct orders from the doctors. The doctors really appreciate what we do, as length of stay is very important to their jobs. I love being with patients, which is why I went into nursing and I am finding that I have more time to spend with them in this role when I want to.

Every morning around 10am we have interdisciplinary rounds where all the disciplines discuss each patient and their needs. I enjoy this and I feel like I add a lot to their care.

I love that I can go to lunch and actually enjoy it. I also leave right at 4:30 every day.

I hope this helps!

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