Jump to content

Boog'sCRRN246 RN

Utilization Management
Member Member Nurse
  • Joined:
  • Last Visited:
  • 784


  • 0


  • 13,450


  • 0


  • 0


Boog'sCRRN246 has 10 years experience as a RN and specializes in Utilization Management.

I am a Certified Rehabilitation RN and recently obtained my Accredited Case Manager certification. I am currently working in Utilization Management. I am a Regional Supervisor over three facilities for my hospital system's Utilization and Denials Management department. 

Boog'sCRRN246's Latest Activity

  1. Boog'sCRRN246

    Don’t want to take care of people anymore...

    It's certainly enough to at least apply. It all depends on the culture of the company you are applying to whether they feel you have enough relevant experience. My department (hospital-based your) used to have LPNs doing Utilization Review; now the required education level is a BSN, with preferred education being an MSN, and at least 4 years of RN experience. Personally, I think wanting an MSN is a little excessive, but I'm not the one determining that for my facility.
  2. Boog'sCRRN246

    Don’t want to take care of people anymore...

    Since you don't seem to be a new nurse, I would recommend looking into a Utilization Review position. I haven't physically taken care of a patient in over three years, but we do ensure that they are taken care of financially, which is a huge thing. The last thing a sick pt wants is unexpected out-of-pocket costs from a hospital stay.
  3. Boog'sCRRN246

    Utilization Review Nurse

    Currently, there is no specific nursing certification for Utilization Review/Management. My department recognizes the ACM-RN and CCM certifications once you've worked in the specialty for 1-2 years.
  4. I think you missed the part where the OP stated they had three years of ED experience and at least some Outpatient experience. For my department, Utilization Management, that would be enough to at least get an interview. I also wouldn't have reinforced the UM idea if OP had no nursing experience. As for a crisis situation, most recently we were exempt from having to offer anyone up for the COVID labor pool because we were considered essential to the health system as far as ensuring payment from contracted payors for services rendered. Having a UM plan is part of CMS's Conditions of Participation so it would have to be an unimaginably catastrophic event to depart from that. A person doesn't have to be in love with patient care or deal with patients to be a nurse. There are so many behind the scenes nursing positions that are non-bedside. What a person does need is a willingness to get at least some experience with patient care (as awful as it may be) before making the jump.
  5. I second the Utilization Management suggestion. I'm regional supervisor over three hospitals in my health system and have not had to deal with a patient/patient's family in almost three years. We do make decisions that affect patients, but we are partnered with our hospital care coordinators who handle the face-to-face encounters. My team literally sits in a cave-like office (or at home for the time being) all day reviewing charts and paging doctors.
  6. Boog'sCRRN246

    What is it like in your hospital right now?

    I don't understand this either. In the last two weeks, my hospital removed the mask requirement for those who had not gotten the flu shot and told everyone else if they were not involved in direct pt care and seen wearing a mask that they should "be prepared to answer why they were wearing it." As of this morning, they started handing out masks to anyone who enters the facility (currently only staff and very limited visitors) and they are NOT mandatory to put on. This was after creating a form letter on Friday letting people know where mask donations could be dropped off. To me, if we are to the point of having to accept mask donations, we have no business just handing them out all willy-nilly. They should be reserved for staff with direct pt contact.
  7. Boog'sCRRN246

    New Grad-Insulin

    What happens when you have a brain injury patient that requires a 1:1 sitter? Does the tech get pulled to sit with the patient leaving you to fend for yourself with the rest of the patients? Brain injury patients can be extremely unpredictable; throw a psych diagnosis on top of that and things can go downhill fast. You'll get the med pass down eventually; what you should be concerning yourself with is how safe you're going to be once you're off orientation. Do you have previous experience working with brain injury patients? It's not really something you can pick up in only three weeks. Is there a system in place for you to call for help if necessary? I don't mean to be negative, I'm just thrown off that a brain injury floor is only staffed with one licensed person.
  8. Boog'sCRRN246


    When I was a Rehab floor nurse, my co-worker was floated to...wait for it...the CATH LAB and expected to fully take over the duties of the off-going nurse.
  9. Boog'sCRRN246

    New Grad as a Clinical Liaison

    This job is about so much more than just clinical skills. It also encompasses the "boring" and "political" side of nursing - paperwork, insurance auths, Medicare/Medicaid regulations, etc. Would you feel comfortable denying a patient for admission to your SNF because they would be better served at a different level of care, such as IRF or LTAC or even home health? Would you then refer the patient to that level of care? The SNF Clinical Liaisons in my area wouldn't dream of doing any of that because it would hurt the bottom line of their employers. To me, that is where the difficulty of the position lies.
  10. Boog'sCRRN246

    Sabotage? Failed by 0.1%

    And who paid you to come on here and attack everyone who offered opinions you didn't like? Also, you are sorely mistaken if you think people go into nursing because they are "money hungry." That is just laughable. Education is one of the ONLY businesses where the customer is NOT king. You pay for the privilege of LEARNING and learning requires personal responsibility. You don't waltz into a classroom and demand things just because you were stupid enough to take out ridiculous loans. What happened to the days when a student actually held themselves responsible for their education and didn't expect to be spoon-fed everything or given unlimited attempts just because they paid to be there? And you're absolutely right, we are affiliated with nursing schools - the ones we've all actually graduated from.
  11. Boog'sCRRN246

    What Did You Get For Nurses Week?

    We got a hand-held, battery-operated fan. The fan blades have an LED panel that lights up with the company motto, but the motto is too long, so the fan dies before you can see the whole thing. My co-worker and I also got to chase the ice cream cart down the hall, then go back to our office to get our badges to prove that are, in fact, RNs, even though all RNs wear the same color at my hospital. After that, the cart pushers had a debate in front of us as to whether or not we "qualified" for the ice cream since we are case management RNs, not bedside RNs. So, all in all, a typical Nurses' Week.
  12. Boog'sCRRN246

    New RN, leaving after 6 months unprofessional?

    In my experience, and possibly due to where I am located, traveling for recreation is thought of as frivolous and if you're not working yourself to death six to seven days per week, you're not contributing to society. I feel like this is an underlying theme of American culture. I read articles all the time where a person is just out on a Saturday night, gets in some kind of trouble, and the first thing someone says is "Get a job," or "I was in bed at that time b/c I have to WORK in the morning." Americans are very much obsessed with work, work, work and complaining about not getting a vacation. Also, when it's hard to get just one or two days off because your manager is constantly having to justify positions, the thought of extended travel is laughable (not my personal opinion, just what I'm used to hearing).
  13. Boog'sCRRN246

    How the mind works: Domestic Violence

    Stockholm Syndrome. Look into it.
  14. Boog'sCRRN246

    Sedatives and Stroke

    Reducing blood pressure with antihypertensives in an acute ischemic stroke decreases perfusion of brain tissue surrounding the area of initial insult. Reducing BP reduces the MAP, which can result in a larger area of ischemia. Sedatives are typically used with patients experiencing anxiety and agitation related to the stroke. It is not uncommon for stroke patients to receive benzos, antipsychotics, and antidepressants. As you can see, one class of medication has the potential to do much more and longer lasting harm than the other.
  15. Boog'sCRRN246

    want to join MSF, what's the best way?

    So I will admit that I do not have a clue as to your actual question, but from looking at their website myself, I am seeing an extensive list of requirements, one being that nurses have THREE years of relevant experience, including one year of management type experience. Just wondering if you had seen all the extra requirements?
  16. Boog'sCRRN246

    Kicked off unit when Joint Commission arrives

    Even if you are just on the unit doing CNA duties, you run the risk of being cornered by a JC surveyor and asked questions for which you will likely not know the answers. Count yourself lucky - most hospital employees don't even want to be around for TJC.