There is no shame in nursing. The shame lies with the first fool that turned a humanity service into a profit making business. It's the "just business'" attitude that has ruined nursing. People will always need us. The cold hearted, political, puffed-up greedy fools at the top leave a bad taste in everyone's mouth.
UR keeps the numbers but case management meets the needs. If you do all you can do in meeting a patient's needs, all that they qualify for with their payor source or all that you can find "ou there" to help them if there is no payor source. Then you have done case management. Work with the doctor in getting them transferred or release in a timely manner. Call all MD's involved to coordinate discharge. Call reviews to insurance companies. Make time for family questions. That about it!!