Nurse with disabilities and case management

Been there,done that, ASN, RN · Apr 11, 2014

Hospital case management could be too physical for you. What is your background?

Look into insurance companies, especially where you can telecommute.

Start by searching "work from home" on this site.

RN010101 · Apr 11, 2014

Hi Been there,done that,

Thank you for your reply. My background is mainly QA. I tried to also apply for insurance jobs, but didn't receive any calls (presumably due to my lack of Case Management experience). I'm just not sure what to do, since I've been looking for a CM position for a long time. Thanks to God, a hospital hired me, but now I am scared if I can physically handle it. How much physical activity is there in CM? Is it possible to sit once in a while?

mclennan, BSN, RN · Apr 11, 2014

I sit all day in my job as a CM, except when I am asked to cover an inpatient CM's job once in a while or meet a patient/family on the unit which is rare.

Huh. I'm always surprised at how little people know about CM nursing!

RN010101 · Apr 14, 2014

Hi mclennan,

Thank you for your reply. Can you tell me more about your typical day as a case manager? Thanks!

SummerGarden, BSN, MSN, RN · Apr 18, 2014

I sit all day in my job as a CM, except when I am asked to cover an inpatient CM's job once in a while or meet a patient/family on the unit which is rare.

Is this a joke? I think the poster was serious in asking his/her question.

OP: A typical day inpatient is not "sitting all day" waiting for someone to ask for help. An efficient case management program requires nurses to start his/her day with a case load that have assigned MDs. There is rounding with the doctors, staff, and patient/families (sometimes this means more then one meeting).... Also, there are new admissions, new assessments, old issues, concurrent issues that can cause a delay in care (so you must be proactive and intervene using your nursing communication and nursing critical thinking skills), UR/UM, arranging for DME, arranging for discharges (complicated ones), and above all you must be constantly and consistently communicating with all the players involved with your patients. Thus, be prepared to be on the phone (cell phone) all day along with have to walk your unit and possibly others to meet with support systems, IDT staff, and vendors to get equipment, services, and/or placement.

On the other hand if your program is ineffective, you might be sitting all day waiting for someone to talk to you... in which case, bring a book.

mclennan, BSN, RN · Apr 18, 2014

If you read what I wrote carefully, you'll see I said I sit all day ***EXCEPT*** when covering for the inpatient CM. Next time you want to rip on someone's post, maybe actually reading it might be a helpful first step.

I sit all day making up to 30 calls a day to post-discharge patients and also manage a queue of over 80 patients all on schedules for calls at different times depending on their treatment plan and needs. I also conduct about 12-15 pre-surgical interviews a week, attend meetings, care conferences with families and spend a lot of time on the phone with doctors offices, SNFs, ALFs, DME agencies, insurance companies, social workers, home health and hospice agencies, and hours and hours on the phone with families and our utilization dept. So YES I SIT ALL DAY but doing important work and coordination of care TELEPHONICALLY. From a DESK. At which I SIT. *EXCEPT*, again, as I originally stated CLEARLY, when I am asked to cover for the inpatient CM, then yes, I am running all over the hospital. Thanks.

SummerGarden, BSN, MSN, RN · Apr 19, 2014

If you read what I wrote carefully, you'll see I said I sit all day ***EXCEPT*** when covering for the inpatient CM. Next time you want to rip on someone's post, maybe actually reading it might be a helpful first step.

I did read your post. I saw the "exception" but it still did not make sense until you wrote this post. So thank you for the clarification. In the future, be clear.

mclennan, BSN, RN · Apr 19, 2014

In the future, read more carefully. Thanks.

nurseprnRN, BSN, RN · Apr 23, 2014

When I was a hospital-based CM I was on my feet almost all day, going from floor to floor, visiting patients, sitting in conferences c hospice, running to the ER, and on and on. I did about an hour-plus on the phone with care coordination for discharges, but many of those were short and sweet owing to relationships I cultivated carefully. So, for example, I could call Shady Grove SNF and say, "Hey, Linda, can you take ... " and Linda would trust my assessment, and the lady would be in the ambulance in an hour or two. "Mary Ann, can you come see a gentleman for a hospice admit? 2pm? Great, thanks so much, see you there." And I had to chart on all these people, which meant some sitting down (usually...not if there wasn't a chair in the nursing station, though :)). Or I might find myself in a medical records cubby for a whole afternoon chasing down documentation for reimbursement issues.

I had a bad knee for about 6 months during that job and I would sometimes find a quiet alcove and just pull myself together because it hurt so bad.

I think that as the difference between the above posts illustrates, the range of physical work a "hospital CM" job could entail is pretty broad. Ask.