How do you like case management nursing?

**NickiLaughs, ADN, BSN, RN** · Oct 16, 2012

It's incredibly boring. I'm honestly trying to go back to floor nursing. If you don't mind a desk job with a lot of typing, you might like it. There are different areas, I'm in utilization review, where the hospitals have to "prove" the inpatient stay was necessary and warranted. It's not hard, but it's busy work. I know there are more people who are involved in the transitions of care end, I only do a little bit of it. What I've learned is many patients aren't compliant and we can't force them to be. That's the problem with our system being broke. The drug addict with 63 ER visits is probably not going to change.....

SummerGarden, BSN, MSN, RN · Oct 17, 2012

Cons: If you are a Discharge Planning (D/C) Nurse only, you will be dealing with a lot of stress associated with bedside-drama because you have real patients and families and are actively involved with the big picture of the Medical Course of tx as well as the discharge plan. If you are Utilization and Review Nurse, then you will be in a cubicle or on-site to review charts in order to get your company paid. This can be tedious and stressful depending on environment and management style of the company. If you are both (A D/C Planner and a UR Nurse) you will be combining the two in a very stressful way. In other words, this is not an easy specialty.

Many come to this specialty with very wrong ideas of Case Management. There is a lot of business politics and laws to follow that if you do not take learning them seriously, you will not be efficient or perform well in this position. You may even get yourself into trouble. If you only want to be a Case Manager to get away from bedside nursing, but you do not want to learn the specialty as you would train for a new position in the ER, ICU, Psych, etc., then you will proably be one of those that leaves within a year. As is the case with any specialty in Nursing, this specialty is not a good fit for every personality!

Pros: This specialty is expanding its numbers because of changes in Medicare and Medicaid laws. Also, many jobs are well paying (comparable if not better paying then floor positions). The more work experience and certs you have, the more valuable you are to companies! This is in stark contrast to bedside positions, where the more experience you have, the less likely an employer will hire you, promote you, reward you out of fear of having to pay more for your skills and work experience. Plus, the CMs that are good at his/her job, are the ones that know the ins-and-outs of their job. Unlike bedside nursing positions, where popularity (not skills or knowledge) equals the better Nurse on the floor.

momswann · Oct 20, 2012

I took a CM job in April and I absolutely love it. Now, I realize it's not for everyone. If you love the clinical aspect of nursing, you may not like CM. I like it much better than floor nursing. I feel that I make a difference in patient's lives, without the stress of floor nursing under bad conditions. When I'm with a patient, (either telephonically or in person), I'm with that person. There are not call bells, phones, physicians, aides, etc, tugging on my coat tails. I work with a medicaid population and do everything from discharge stablization to chronic disease management. My population goes from peds to geri. Love it.

Cehurstrn · Jul 7, 2013

I am looking into an opening at our hospital for a CM position. At my previous job I completed clinical reviews with various insurance companies and loved it. Although frustrating at times when services would be denied, to win an appeal or to get approval the first time was always thrilling. It made me feel like I was being a true advocate for my clients. What's the typical case load like for hospital case managers? Or what's a typical day like? I would imagine it would be interesting with the various floors within the hospital. I have been a RN for 3 years and I have my BSN. I plan to start my master's next year part time for Family or Women's Health NP. I have worked primarily psychiatric and behavioral health including detox from alcohol and substance abuse. I also worked in a setting that primarily treated eating disorders and secondary diagnosis. I have not worked floor nursing for meg surge but I worked eith differing illnesses because of complications from behaviors or medical issues that then triggered mental health issues, including for example RA, lupus, DM, dialysis tx. I have also worked with pregnant patients.

skimtnrn · Oct 23, 2014

Do you still work as a CM for Medicaid?

momswann · Oct 24, 2014

I love it! Pm me if you have specific questions

tjjox · Nov 9, 2014

Hi!

i just joined this site. I'm an OR nurse and am looking for a change. I have been looking at case management vs. utilization review. The cm job is for an insurance co with good history and benefits, and you may work from home eventually. Ute is office job with a fairly rough drive downtown. I'm looking for some insight from those of you with experience. I appreciate any info you can share.

terry

nursechris1 · Nov 24, 2014

Catherine, our expected caseload during the week is 1:25. On the weekends, it's closer to 1:40. The thought is that there is less to do on the weekends, HAHA. The only thing we don't do on the weekends is fax clinicals to insurance companies. We have people in our department called Case Manager Associates, but it appears they are phasing them out. The do a lot of the discharge work, making the referrals to facilities, agencies, etc. The nurses do the initial face to face on every new patient along with doing UR , ULTCs PASRRs and when we have time, review the chart to make sure the patient meets criteria to stay. Some days the job is good, other days it's hell. I work on Neuro, and we frequently have patients who are difficult to place. Otherwise, we deal with the same things the floor nurses do: working with difficult families, difficult doctors. For me, I don't feel like I make a difference. I used to be a hospice nurse, and I really felt I was doing something to make a difference. I did that for about 10 years. It was an emotionally taxing job though.

Latina619 · Mar 6, 2015

I love case management, but I'm not going to lie! It's very challenging! I work in a very busy LTACH, and there are days when I feel so overwhelmed that I start to wonder if I'd be better off going back on the floor...I suggest you shadow a CM for a day, that Will give YOU better insight into case management and whether or not it's for you..good luck!

d2504 · Mar 29, 2016

I'm interviewing for an LTAC case management nurse tomorrow. Can someone provide some insight into how I can best prepare? I have been floor nursing for 2 1/2 years, the past year in Icu and the previous year and a half in tele. I've always felt I wanted to work in coordination of care and think this is a great way into what I want to do, and something I'd be good at. I am not a traditional nurse and came into the field about ten years later than most, coming from a sales and marketing field, so my people and communication skills are very intact, but I worry this position will be a bit much for them to trust me to handle, given my relative inexperience compared to "seasoned" nurses.

Murse901, MSN, RN · Apr 7, 2016

I didn't read any of the other comments. Honestly, I didn't even read much past "I'm a new grad".

Not trying to be harsh, but slow it down. You don't need to consider case management until you have several years of experience under your belt. You need to be a strong nurse with excellent critical thinking and negotiating skills, and those things come only with time on the job.

Edit: Didn't realize this was a necro-post. I was replying to OP, not to those that rose the thread from the dead.