springfieldrn

We have all new staff in our department after our hospital was sold and the long time nurses did not want to continue under new ownership, so, Question regarding UR. We do not use Interqual at my facility and turn in our clinical review's based on "criteria" formualted by our hospital corp. We do not have a format for the UR we send in, we all do it a bit differently but get the info. to right people. I am wondering how other folks do their UR. Same format for all? Wing it? Template? Also, do you seperate your case management and UR nurses or is that job combined? If it is combined what's your average case load like? Thank's

3 months into case management myself and LOVE IT!

I am going on two months as a Case Manager in a 100 bed hospital. The question you posed that I feel I can repsond to is the one about making difficult decisions. This has been the hardest thing for me. I see alot of uninusred folks with chronic conditions, homeless dual dx, seniors with substandard living situations among many other situations. There are times I can't fix it, change it, materialize a solution or find a miracle. Do I try very hard? Yes. Is it frustrating? Yes. Do I make a difference most of the time? Yes. Do I miss the bedside? NO. I love being able to interact with pts, nsg, docs, facilities and families. This job is never easy or boring and I love it. Good Luck

I just had my one month anniversary in case management and love it! I have a background in patient care and administration. I love being back with patients, families, drs and nurses in a team enviroment. The con so far? The never ending FAXING! Overall I love it.

Take an ad out for your services and try Craigslist.

When I did primary nursing we had 3 patients. I really liked it, I felt I had more control over my day and knew my patients better. More than 3 patients? I wouldn't do it.

My contracts always specified not to work "in competition" with ,,,,, You should definitely check your contract carefully.

I just go about getting ready what I can quietly. I have been able to intervene with patients on the floor before they became symptomatic and thank the powers that be that I listened. Over time I have learned how to present my feelings to the doc in a way gets my point across without making me feel akward.

Core Measures are here to stay. As already stated they are part of reimbursemnt, as in if we don't prove we provide the standard of care for the dx the hospital may not get fully reimbursed, which translates into a paycheck, or lack there of.

I laughed out loud reading your post. If you choose nursing your sense of humor will apprecited by many. The days of being a human forklift are for the most part over. There are many new lifting devices and the culture of not asking for help is dissipating with a couple of new generations coming on board who don't equate asking for help with weakness, like I and many of my cronies were raised with. I find new nurses with life experience wonderful to work with. Best of luck to you.

etoh withdrawl last etoh ingestion 3days ago.

Sprinfield Oregon has two hospitals with openings and is hiring new grads.

All of the per diem, agency and travel jobs I have had required the hospital new employee and nursing orietation. As far as orientation to the floor when I got my orientation sheet completed I was done. Every place is different of course. Maybe you could ask the new manager if the orientation period could be flexible.

Nurses yelling at eachother and demaning eachother is nothing new! Not that it's ok by any means. Whether you put her on tele and gave O2 is not the point in my opinion. If you are being treated in that manner again I encourage you to put a stop to it at the time by saying something like " if you can't gear down and talk to me civilally don't talk to me at all and we can take it up with the manager". If you have to physically walk away do it. Involve the charge nurse. The days of nurses bullying eachother needs to end. In years past we have had the reputation of eating our young. Don't let someone else's bad behaivor determine your future.

yes you need your RN before MSN.