sweetie01

I don't believe we are allowed to discuss pay, but I believe they pay the same rate for all RN's in the same geographic area. I'm in NC, so the HEDIS nurses here probably get less than those in California and New York. I would also ask them how the pay structure changed from last year. I'm sure they would be glad to explain the change to you. I'm not thrilled with the new pay structure, but I have no doubt that I will be paid on time. Never had a problem with that.

If you are talking about I have worked for this company for the last 2 years doing HEDIS and another project. I have not had any problems with them. This year they changed the HEDIS pay structure. I'm not sure how I'm going to like it, but I'm going to try it. Hope this helps.

Brenda, The Ocala area is nice. The SW area of Ocala, where Marion Oaks is located is very nice too, low crime. I can't remember specifics about Marion Oaks. I do remember that the properties looked alot nicer on the Internet, than when we actually drove through. We drove around for about an hour. I'll ask my Dad, but you can't go by his opinion. He's really become a snob in his old age and really got on my nerves when we were looking at houses. It's not like he has any money, so I don't know why. LOL! Gotta love him! Send me a private message, so I'll remember to ask him.

When I used to get really frazzled and stressed and felt like I could never catch up, I would stop what I was doing for 5-10 minutes and make a list of what needed to be done. It really helped me organize and prioritize and put me back on track, so I wasn't just running around like a chicken. I seemed to accomplish everything much quicker when I did this. Of course I always started off with a list like someone else mentioned. But just like everyone else, got tons of discharges, transfers, and admits and would have to stop and make new lists throughout my shift. Good luck!

Brenda, I have considered moving to Ocala for years, my dad still lives there. Did you actually go and see Marion Oaks or are you just looking from the Internet? From the internet we liked the prices and it looked really good, but didn't like it as much in person. This was a couple of years ago. Haven't checked it out lately. Never really looked for work, so don't know much about the hospitals. Good luck! Sweetie01

I know the job description does not list the hiring managers name, but I would call HR and ask or call the switchboard and ask to speak to the CM supervisor/director or whomever you can get a hold of. Or you could just ask one of the CM's you probably see every day on the floor. Talk to them, get more info, see what they think. I've applied for plenty of jobs and gotten them without having all the specified requirements. Some hiring managers go strictly by the posted job posting, but many don't. I'd talk to the manager to get a feel for what they are looking for before I put a transfer request in. That way your not rocking the boat and then find out CM would never hire you in the first place. All they can say is no. If they tell you to try in a year and you apply then, at least they will remember you and know you are eager, persistent, and motivated. Good luck! Sweetie01

I have permanent restrictions that also keep me from patietn care sinc 2000. The restrictions you list seem too restrictive. What do you think of them? Do you feel they actually reflect what your restrictions truly should be? If not, I would work on getting them changed. Did they actually do a thorough assessment of your limitations? I can't remember what it was called now, but they actually sent me for a 4 hour series of tests. I walked and squatted and reached and bent and did manual and gross dexterity tests. Not until then did they set my permanent restrictions. Of course this could work for you or against you, but I don't see how your restrictions could get any worse. I have worked Corporate Compliance, coding, consulting, in-services for medical device companies, chart review, and now case management. And I only graduated in 97. With all your nursing experience just think what you can do! One thing you can do right now is get into doing HEDIS chart reviews. That is if you are able to drive to Dr's offices and do chart review. The rest you do from home. Alot of companies are hiring for this temporary project right now. Usually lasts from Mid-Feb until Early May. Depends on the company. It's really easy, any nurse can do it. If you are interested in doing this, don't delay. Go to monster.com and any other job search site and put in keyword HEDIS. Good luck!

It should get better. I was always real nervous and kind of shy with the patients. The biggest single thing that helped me through nursing school was working at the hospital as a Nursing Assistant. Even if I could only manage 1 shift a week. It made a huge difference in my comfort level with the patients and clinical. I didn't have to worry how to give a bath, where the linens were, or how to call dietary for a tray, etc... In my state you could do foleys, trach care, remove IV's, dressing changes, etc. as an NAII. I should add that I worked Prn and because of this I was able to work on a bunch of different floors as a Nursing Assistant. I started on one floor and then would just call the nurse manager on whatever floor I wanted to work. This helped me to decide what type of nursing I wanted to do when I graduated. Good Luck! Sweetie 01

This is very common. I would not worry about it. I would mention it to my preceptor and maybe in report to the other nurses one day. I'm sure they would be willing to let you get the experience. Good luck!

Thank you everyone! We do not have access to the chart, but we do have a log that we document on. It has notes on all the patients that come through the admitting office on that date. We do document all of our interventions and calls here. It sounds like I should call the doctor on some of the less obviously acute patients if I have concerns first before I send to ther ER. I will just have to make it clear that I can't treat the patient, just watch them to make sure they don't get worse. If their in obvious distress, I'll still assess them and document, but I will just send them to the ER. I'll keep nagging my Managers for policies and/or protocols for what we are doing. I'm still not sure how we were hired to do case management, but are now assessing and triaging pt's. That's healthcare, be flexibe or move on I guess. I also talked to someone on the Board of Nursing at length today and gave examples of pt's I'd sent to the ER and why. She told me that I was doing what was right for the patient and to give myself a break. This made me feel better. One problem I also have is that I determine the patient needs to go to ER and triage tells them to sign-in, but you have 8 patients in front of you. Of course the patient doesn't want to sign in and wants to go back to the admitting office. It does no good when I explain that I can't treat and that the ER can get you back immediately and theres a doctor there if you need help. I can't force the patient to sign in, so I have to take them back to admitting. This scares me, but I guess all I can do is monitor to make sure they don't get worse and call the doctor, making sure to document everything. An example is a pt in admitting with dx of angioedema, no sob, resp and VSS, no obvious swelling, but complaining of difficulty swallowing. Didn't feel comfortable leaving in admitting until the patient got into resp distress. Triage told him he had a bunch of people in front of him, so he wouldn't sign in. I stood with him in the ER going round and round about why he needed to be in the ER, until a bed was ready. The triage nurse was no help. My manager actually agreed with me on this one when we discussed if after the fact.

Thank you for the replies. Let me try to clarify. I am an RN. I guess I'm feeling uncomfortable because I have not done patient care in years and neither have any of the other Case Managers. None of us has been trained in triage. We were hired into positions that did not require patient care and now we seem to be doing triage. Sometimes our manager supports us sending a patient to the ER and sometimes she doesn't. She usually disagrees when she does not feel the pt was not acute enough to go to the ER. The problem is that she will not clarify what we are supposed to do with patients that have stable VS and pulse ox 97% that are complaining about SOB, all of a sudden doubling over with abd pain, etc... She disagrees that they should go to ER, but yet she tells us if pts are in distress they need to go to ER. She may not consider that distress, but I do. I was always taught you treat the patient if they have complaints. If i were on the floor, I would call the doctor and let him know what was going on and let the doctor decide what to do. I could call the doctor in this situation, but I can't treat. I don't feel comfortable having someoe sit in the office that is symptomatic, wheter it be objective or subjective on the patients part. We don't have any policies or procedures or protocols to guide us at all. I keep explaining how imporatant it is to at least have policies and protocols to follow, but she doesn't think we need any. I have many concerns about this. #1- none of us has done pt care in a long time. #2- none of us are trained in triage #3- we have no policies or protocols to guide us. Am I just being paranoid because I haven't done pt care in a long time? I feel at the very least we should have protocols. She doesn't think this is triage. Any advice, even if to tell me to relax would be appreciated. Sweetie 01

I am a Case Manager in Bed Management. When patients come in for admission we often do not have a bed available immediately. Patients often wait an hour or more for a bed. If 3 patient are waiting on the only available bed, we determine who gets it first, based on diagnosis, orders, assessment. Our Manager expects us to assess the patients. She has even provided us with a BP cuff, thermometer, and pulse ox. We have been told that we are NOT a treatment area & we can't treat patients. We have been told that if a patient is in distress, we need to get them to a bed immediately ( if appropriate) or send to ER. The problem is that when we do send symptomatic patients to the ER, our manager does not support us. Also, none of us are trained in triage. We have explained our concerns to the manager with no results. What is my liability in this situation? Is this triage? Am I worried about nothing? Any advice would be appreciated. Sweetie01

I am a Case Manager in Bed Management. Initially our role was to Interqual direct admits to determine if the patient meets Inpatient or Observation criteria. We then make recommend what unit the patient should go to. The bed specialist then gets the bed. Our role has also expaned into what I consider Triage. When patients come in for admission we often do not have a bed available immediately. Patients often wait over an hour for a bed. If 3 patient are waiting on the only available bed, we determine who gets it first, based on diagnosis, orders, assessment. Our Manager expects us to assess the patients. She has even provided us with a BP cuff, thermometer, and pulse ox. We have been told that we are NOT a treatment area & we can't treat patients. We have been told that if a patient is in distress, we need to get them to a bed immediately ( if appropriate) or send to ER. The problem is that when we do send symptomatic patients to the ER, our manager does not support us. Also, none of us are trained in triage. We have explained our concerns to the manager with no results. Even if someone has normal VS and pulse ox of 98%, but is complaining of SOB, i feel they do not need to be sitting in the admitting office waiting for a bed. I can't do anything for them. They need to go to ER or room, as far as I'm concerned. Now maybe if I had been trained as a triage nurse, I would be more comfortable with this, I don't know. What are we supposed to do with these patients? Questions: #1- Is this triage? ( I belive it is) #2- Am I assuming care of the patient when I assess them or even ask are you having chest pain, etc...? (I believe I am) #3- What is my liability? Thank you! Sweetie01