nursingosaurus

I don't know how much time I will have to contribute to this post as I have several things going on right now, but I was recently diagnosed with Fibromyalgia. I don't know how if I am in the right place in terms of this forum, or if I should be on another forum, but I can for sure say one thing: fibromyalgia is debilitating. Over the past 13 years I have almost always had a vague sense of fatigue. Sometimes the fatigue is much more than vague and feels heavy, as if several people are standing on my shoulders and my upper back. I do not understand it. I've been to the endo, several of them-- while I do take medication for thyroid and hypothyroidism has made me feel awful in the past, it has been under control for quite some time. This feeling is different. When I have a fibro flare, as I have heard it called, it feels as if my entire body has come down with the flu, has been hit by a truck, has gone through a bumpy rollercoaster ride. Sometimes the episodes happen when I haven't slept well and sometimes they happen for no good reason at all. I recently had a one and a half span where I actually felt, on a scale of 1 to 10, ten being the happiest I could ever be without any symptoms or pain....I felt at about an 8. My symptoms were minimum. I have no idea why or what I did other than I took some different vitamins which now seem to do nothing for me. Maybe it was the initial surge of the vitamins getting into my system. I really don't know. This entire beast is a mystery and I am struggling to understand it. How can my bones, muscles--my entire body hurt-- for no reason? I am not overweight. I am not underweight. My diet has not been perfect but I eat a very good amount of salmon, fruits, veggies, and I stay away from sodas and fast food. I don't eat white bread and I have been making a concerted effort to stay away from foods that will give me an instant sugar rush. As I am writing this, I am trying to get through a vague fibromyalgia episode. Bones and joints and muscles all over are aching; I have taken my neurontin, I have stretched and gone walking several times today for work breaks, I have stayed hydrated with water and the only sugars I have had have been those found in the fruit I have eaten today. I will try and continue this later, but right now I must get back to work. I no longer do the kind of nursing that involves direct patient care. I did it for about 6 years. It was AWFUL on my body. I know that I sound like a wuss and I know that many nurses did floor nursing, ICU nursing, night shift nursing for their entire career. I've had several tell me to "suck it up, and do what they did," but they're also older now and having a terrible terrible time with their bodies. I can't say that there is a direct correlation between that and years of floor/ICU nursing, but I can say that if my body already feels like it has gone through a rollercoaster ride without a seatbelt, then I don't think moving heavy patients and the heavy physical work involved in patient care is for me. I wish it was. For the past four years I worked in an OR setting where most of our patients were not able to work, were obese, and had about ten other health issues going on. I feel as if my body aged about twenty years during that time. I am thankful for the experience I gained from that job and I am thankful I had that job to begin with. Now I am in a position that is the exact opposite-- I am not moving around all day. It feels almost like a dream. It doesn't seem real. But with it comes its own set of issues. Sitting in a chair all day is also a nice way to get stiff- it is the total opposite end of the spectrum from my past job. So...here I am, at a newer job, thankful for the opportunity but trying to find balance. (PS-- if this entry is in the wrong place, please let me know and I will go put it there instead. thanks!)

Hi, I am an RN Case Manager. I know that there are various associations for RNs to join, such as the American Nurses' Association, and I am aware that there are a variety of associations for specialized nursing practices. My question is this: Which case management society --nation wide-- is the best and most appropriate for nurse case managers? I have been doing searches but it just pulls up certifications over and over again. I plan on testing for my case management certification but at this moment I just want to join a nurse case management association. Regarding case management associations- does it have to be one that is FOR nurses? Or can it be for case managers in general? Thank you to anyone who can recommend the most highly respected case management/nurse case management association for an RN case manager to join.

Thankyou for your help, you're likely correct!

Hi, I just accepted a job with aetna doing in office case management (non traveling!!!) I am not sure what software we are going to be using but is there a place online where I can get some exposure/use with some of the popular case management softwares, such as milliman? thanks!!!

thank you for your perspective, it is appreciated. I am already the bad guy at my job because patients get really mad if they not maintained NPO / having a driver prior to surgery even though they were instructed ahead of time. I've worked with an EXTREMELY frugal person for awhile now so I guess I am used to "omg save money." I hope this place I am going to is not bad though...I am going to keep what you wrote in mind. thanks!

CE DIRECT!! thanks, I really appreciate it. I was looking for something along these lines. I am sure it will be very helpful so thankyou very much.

THANK YOU!!! (tried to post a reply via my phone earlier today) but it evidently didn't go through. I checked out glassdoor and briefly looked at careerbliss......I've browsed through lots of the case management threads and will do so again to see if anything new has been posted. I appreciate your suggestions, thanks!

I recently was hired to work for aetna as a case management RN. I don't have formal case management experience (as in the actual job title) from any other jobs but at my current job I do A LOT of case management duties. I have been at my current job several years so starting somewhere else is scary but it is something I must do. It'll be an in office non traveling position. Can someone give me advice on how ti prepare? Is aetna a good company to work for? Tell me everything please, even the bad!

Thanks for the info!

I have a job right now as an RN.... but I am trying to transition to utilization management or Case management..... several interviews but all "not selected." Helpless feeling

That is all such great, insightful and helpful advice. Thank you so much!!!!! I am printing it all out right now and going to read it over and over, and write in my own thoughtful comments after thinking about the answers thoroughly. What kind of questions specific to utilization review can I be expected to be asked? What kind of UR questions should I be asking? Can someone give me an overview or example of the process of Utilization Review nursing? Interview is tomorrow!!!! THANKS AGAIN!!!!

Hi all, I some how managed to obtain a Utilization Review RN interview a few days from now. 1. What kind of questions should I expect to be asked and how can I prepare for them? 2. What kind of questions should I ask them? 3. Are there perhaps any resources out there I can find --on allnurses.com or the internet in general? I have done plently of searches but perhaps using incorrect keywords. I'll take any help or advice I can get, such as DRG codes I might need to know, and so forth. This if for an HMO that focuses on pediatrics, and works with medicare, CHIP, etc in a large sprawling city. Please, your answers are appreciated and may even help someone else other than me! Thanks!!!

Thank you for your insight, and I have noticed the same thing. Can't give up though!!!!

I have roughly 4 years of clinical nursing experience, with some indirect case management, insurance verification and discharge experience. I applied and interviewed for a job which said ,"ENTRY LEVEL CASE MANAGEMENT" but upon arriving they said they would prefer that I had some case management experience. 1)I'm so confused about this, but that's a different story entirely. 2) How do I break into case management? 3) How do I break into utilization review? 4) Is there some place on the internet, perhaps even on this forum, that gives a good run down of UR and CM, such as steps involved and what not? I appreciate any and all help you can give me!

GOOD QUESTION! I completely HATE bedside nursing....I work in day surgery now, and people sometimes are so freaking gross that I can barely stand it. I know that sounds really awful but...I just am burnt out on direct patient care. Maybe after a break from it I will feel differently. I have asked some people how they feel about case management and they have turned their noses up at it....discouraging, but, the people that turned their noses up at it are the people who truly enjoy direct patient care, so that might have something to do with it. I hope you (and I) both are able to get some answers. I am looking at CM as well as UR, too. Best of luck to you!

Wow, I am so sorry that happened to you. I am so sorry someone was such a jerk to you. You are absolutely right. I really have kept all of this inside for so long. I have been so embarrassed about it for so long, like I was a failure or a horrible nurse. When it was all happening I couldn't believe it. It felt like a horrible dream. Temporarily losing my ability to write (something I love).....going through a horrible separation then divorce...then fired??? The worst thing about it was that this hospital had been a placed I LONGED to work at for so long. I had yearned to work there, and when I got the job I was so desperate for it (my ex basically told me I had to get a job or else) and so happy to be working there that I just....couldn't believe it ended up that way. It feels good to talk about it and receive encouragement!!! I have grown enormously....I really feel like this job helped me "grow up" in a lot of ways. I appreciate the advice and will follow in your footsteps. THANK YOU!!!

well, it has to do with a lot of things. 1. I am concerned about the direction that my employer is going. There have been some decisions that concern me that they have made regarding personnel, behavior of physicians/staff, etc. 2. We have another location about thirty miles away. They can't seem to make their staff show up to work, so they are always calling me up there. It's quite far from my house, I don't get paid for the mileage, and when I do go up there....all the remaining staff makes fun of the place where I work (the place sending them help!!!) 3. I make about 8-10 an hour less than most other nurses with my experience. I know it isn't about the money necessarily, but----here's the thing--- I am making what an LVN makes yet I am an RN. No offense intended to LVNs or LPNs, it is just I worked really hard to become an RN..... 4. There is zero, zero zero room for professional growth. 5. I have a coworker trying to sabatoge me; they didn't hire her friend three years ago, but they hired me instead....so she has had it out for me ever since. She has destroyed my files, pointed out my mistakes in front of patients and doctors, talked poorly about me to patients....it really is incredible. YET, the person who has the final Say in all of this LOVES her, so she gets away with whatever she wants. I have told some fellow nursing friends about her behavior and actions....they were surprised she was still employed. When it comes down to it: I put a smile on my face and do my job. I keep a positive attitude while I am there. I try and ignore/deal with the BS and just focus on providing quality nursing care for my patients. That being said.....as I asked originally....am I doomed because I was fired one time three years ago?

I would go with UT Arlington. The fact that TWU can't give you a straight answer is a big indicator of how completely messed up their RN-BS program is. I had high hopes for it as well; I am in the last week of my last semester with them, and I honestly wish I had gone somewhere else. Their program says "100% online" but what they DON'T tell you is that during your last two nursing classes you will be in clinical. I can't remember what the hour requirement was for one of the classes, but the very last class requires you to do clinicals for 90 hours!!!! Let's just say that I nearly had a nervous breakdown this semester when it came to working my full time mon-fri job and then doing clinicals on the weekend. I truly wish I had gone somewhere else....

I have found myself at a place in my life where I feel pretty hopeless, or at the very least, very very discouraged about my future in this profression. My first job as an RN was in 2008. I was hired off-cycle- most hospitals where I live have their new graduates start in Jan. or June so that they can be part of the "new grad" classes that go on for about six months. I graduated in Feb. of that year and started my job in April. I was hired for a floor/unit that I really didn't want to do, but I was desperate for a job. I was hired for pediatric med-surg. Let me be the first to say that this and ICU are not my favorite parts of nursing; I find all the noise, machines beep, and all that to be very overwhelming for my already anxious mind and heart. Whatever, I took the job anyway because my husband was pressuring me. During the course of my training on that unit, my first preceptor was having her own marital problems and was burnt out. She decided she did not want to be a preceptor anymore, told our bosses, and then un-assigned herself from the hospital's preceptorship program. I was then placed with a rather good RN who had NEVER been a preceptor, ever. She never had attended any training on how to train or teach...NOTHING. she was just sort of assigned to me. Let me also say that during this time I was diagnosed with some major hand/arm issues that rendered me with extreme difficulty in writing. I am a part-time writer, yet, my effective writing skills were completely shut down. What took me usually ten minutes to write ended up taking me 30 minutes. During this time at this hospital, my unit manager left and moved out of state, and my unit director was fired. Also during this time, I found out my husband was cheating on me.....we began the separation and early stages of the divorce during this time. I never ever EVER talked about it at work, I always kept it separate and never wanted to let it carryover to my job. We were supposed to have weekly progress meetings per the unit new-grad policy, but whenever I showed up to them.....the clinical education person or my manager didn't show up. This happened quite a bit. One day my preceptor and I were floated to another unit. At about 9am she went to a meeting, then came back and told me that the interim-manager needed to talk to me. I went to my home unit, where my interim-manager was located and some lady I had never met was in the office. She was evidently on call for our interim-unit director, who was on vacation (imagine! taking the position as an interim-unit director and then going right on vacation! geez.....) The first thing she said to me was--and I will never EVER forget this-- "I have made the decision to release you of your nursing duties." No hello, no good afternoon, NOTHING. I was shellshocked, absolutely caught off guard. They never really would give me a reason except that I was not a good fit for the unit. Right after this happened (July 2008) I had surgery to correct the issues with my hands and arms. I was then offered the chance to work in an ICU at a very busy community hospital. I was so, so so traumatized from the experience with my first nursing job that I felt off-kilter the entire time. The patient acuity and pace of the unit was not for me, and I made the decision that I would try another area of nursing within nursing. So, that is pediatric med-surg and ICU that aren't for me. Is anyone keeping count? I am :/ I was hired for a day surgery center to be a peri-operative RN in december 2008. I have now been there three years. I have an excellent record at this job I have been at for three years-- a good attendance record, and I have learned a lot and grown so very much. The environment is the complete opposite of hospital nursing. I am one of two nurses in our center, and I am cross trained to run a radiology machine. I am their infection control person and their safety manager. I do A LOT for this company, but, I am ready to move on. This has been a very nurturing envvironment for me; this is the kind of place where some people go to work and stay there forever. I am now looking to make a change, but the VERY traumatizing events from my first job STILL haunt me. I still feel worthless. I still feel scared, hopeless, like no one will want me. Is this normal? I know that given my anxiety, medical surgical nursing and ICU aren't for me. I don't care for ANYTHING to do with those specialties anyway, so ....that is fine. I am looking at case manager, utilization review....I have even thought about being a nurse liaison. I am friendly, outgoing, and work hard. I am very dedicated. I just feel so hopeless. Has anyone else ever been fired or let go from a nursing position? Like I said...it happened over three years ago, but I still feel terrible about it. Am I screwed for the rest of my entire career because I was fired from ONE Place that I wasn't supposed to be hired for off-cycle anyway? My career wasn't supposed to be this way when it started three years ago. :/ Has anyone else ever gone through a few nursing specialties before they found one that worked for them? Please help me, I appreciate any advise, kind words, or explanation of similar life events that another successful RN went through. Can anyone suggest any jobs that might be a good fit for me?

Hi all, I am currently a day surgery nurse where I work in a specialized environment, assisting the doctor and staff in fixing dialysis patients' dialysis access. I have been here for three years and previously had a (brief) time in pediatric med surg and then a few weeks of an internship in the ICU. Suffice to say, I HATED bedside nursing (it really just isn't for me...no matter how hard I try to make it work, it never has been a good fit for me). Anyway, I ramble-- I am looking to make a possible career change over the next year...maybe sooner. Can anyone give me a candid opinion on what it is like to be a utilization review nurse? What about the job do you like? What about the job do you hate? Do you spend time on the unit floor, or do you work behind a desk all day? I appreciate all comments....I want to know the awesome, the good, the bad, the ugly, and the really ugly (stuff no one tells you about re: a job because they don't want to be mean). THANKS!

I read this post a long time ago....and think about it often....I actually thought about this post quite frequently when I took a job out of nursing school at the bedside (pediatric med-surg) that I really just could not stand. It was a horrible fit for me but everyone kept telling me you "need the medical surgical experience as a a new nurse no matter what." I thought that I would like the faster pace of the ICU a lot better, but no, I actually hated it MORE. What I learned about myself is that a)the things people say such as "you must get medical surgical experience or else!" may be advise with good intentions, but it may not be advise that really applies to everyone. I, too, have anxiety issues and I have been doing work for school on a medical surgical unit. Something about the patient acuity and the 10000000 things happening on the unit really make me feel like my head and heart are about to explode....so I can feel for you. A lot. ***I originally came to this post because I wanted to know what you decided to do with your career...if you stayed with nursing or went elsewhere..... can you update us if you don't mind?*** I truly send your way the best of wishes and hope you are at peace with your career choices, whatever they may be.

PS- lots of credit and admiration to ANYONE who is a medical surgical nurse and actually likes it. Working directly at the bedside IS NOT for me....some people have the very stringent belief that without any exceptions, the nurse should always get a lot of medical surgical experience before going to another area. It seems that such a stringent "always should" point of view is too inclusive and does not account for the fact that many people such as myself might have learning disabilities and that another area of nursing might work better for them. Regardless of where you find yourself, I wish you much success ...NEVER GIVE UP!!!!

I have to agree with the member who wrote that it might be a bad fit. However, as a relatively new nurse (it will be four years for me next year), I can most certainly understand the need to take a job because it is all you can find. I had to do the same thing and sadly it did not work out for me, but I changed jobs and now have been at the same place for three years! It is working directly with patients in the day surgery setting....it is tough, and I actually am in the opposite position as you.... I want to take a break or at least try something different from direct patient care, and Utilization Review is one of the things I am looking at. Please tell me what you find out, and most importantly, keep looking for other jobs that might be a closer match to what you desire to do! Good luck!

Round 2-- HEY again, thank you-- I was able to receive the private message with the link but when I clicked on it, it said it was not a valid link. What is the name of the book or article and maybe I can find it? I would PM you back directly but since I am not an upgraded member I can not. Thanks again and I am so grateful for your help and willingness to help me in such a genuine manner!!!!

No but I tried something very similar. However, I will try that exact string of words. I actually have my preceptor for clinicals involved because I thought I was out of my mind because I couldn't find this. Also, my own instructor can't find this simple statistic. CRAZY huh? I am not sure if I am able to receive a private message because I am not an upgraded member. Do you know if that is that case? Again thank you so much! Your help and kindness is appreciated!