Nurse CM Reality Check

[Raisin08]

Hello all,

I've been about 6 months at my job in an outpatient clinic as a nurse case manager and it seems a much different role than that of the hospital cm.

First, I work as part of a clinical team of several MDs and mid-level providers, and all total the patient panel I serve as sole primary Nurse totals over 1800.

I am starting to feel spread too thin- and with so much to do for so many people, its simply impossible to meet all my patient's needs and expectations for follow up calls and care coordination.

Could anyone with a similar position or experience compare notes with me? Is this situation standard? Also, are there any standards of care regarding patient panel size for outpatient CM's? I cannot find any.

Thanks!

-Spread like bean dip in Beantown....

[CaseManager1947]

Well.... I don't have your job, but I do case management. I can't imagine trying to case manage 1800 souls. You don't say if this is disease specific or what, but MAN, that sounds like a daunting proposition. A little more info may be helpful to someone trying to help you. Do you have to set up services, follow-ups, or what???

[Raisin08]

Hello, Thanks for responding CM1947.

My Providers are mostly Infectious Disease specialists/PCPs and a large proportion of my patients have HIV/AIDS.

So I do a lot of phone triage for folks, often with compromised immunity and coordinate follow-up, routine appointments, medication refills, referrals, paperwork for assistance and services, etc.

Recently we lost a Nurse CM and a decision was made not find a replacement for the position, however new Providers are joining our clinic and the morale among the nurse staff is very low.

In addition I have been an RN less than a year and have never worked in an out-patient office. I cant find any information about what the norm is in this part of the industry so it is difficult to gauge how it compares to the workload of other clinics.

-Raisin

[CaseManager1947]

Again... I think 1800 people is too many for one person to effectively manage... especially high risk, problem prone folks that you describe... IMO, but as I said, I don't manage this kind of case load... I cry when I get to 30 people in the acute setting, But, we are setting up rehab, home health etc. A different perspective.

[dria]

that sounds like a heck of a lot. it's comparing apples to oranges, but i work telephonic, and start to get a little nervous when my load exceeds 100.

i guess it all boils down to the level of need for those 1800, and exactly what you are doing for them. the key that i see is that you are starting to feel overwhelmed.