heathert_kc

I have been a case manager for UHC and a state ISP program and passed my CCM in the last testing window, but was recently had a recruiter reach out regarding a position in a rural critical access hospital. How night and day different are we talking? Actually excited about the opportunity to branch into something different, but worried the learning curve will be too great.

I am in the same boat (only in CM for a few years considering higher education) and agree the CCM is probably #1 requirement I see preferred, plus it is easier/cheaper/faster than Obtaining a masters degree. But if pursuing a masters is the plan, look at schools/options/what is most practical for you— I am a firm believer in looking at the cost benefit analysis of an debt you are considering and if you aren’t 100% sure this is what you want you probably want to wait a bit. MSN with an emphasis in leadership and management is probably what I have seen the most ??

It was a pay bump for me too. I am not doing inpatient CM and have a salaried position. I previously worked for UHC, who started me salaried, then changed everyone over to hourly (that corresponded to our salary divided by 52 weeks then by 40, the number of hours we work in a week) so there was no change on pay only that we had the possibility of OT when things were crazy. It was sooo funny the social worker CM thought this was a slap in the face, the nurses either shrugged with indifference or were happy with the change. Interviews and whole hiring process isn’t just about trying to get someone of offer you a position but rather seeing if there is a mutual fit. I feel like people forget that, as the applicant (the one saying ??‍♀️Hey hire me, or the one in need of a job/income/etc) people often feel like they are subordinate, lower than this huge corporation considering employing them. It really is a 2 way street— you need a livelihood and they need our skills and dedication. I would explore your options and see what is out there and what the salary or hourly rate is like in your area.

I was wondering this too. I have been in case management for a few years and working on getting my certification now (delayed due to testing/class cancelled), but as my husband and I are soon ?to pay off our mortgage it may be something fun to do when so have more flexibility. I see assignments but was wondering rate of pay? How it compared to other specialties? One different aspect is that hospitals tend to still do 5/8 hour shifts- which makes exploring the area a bit more difficult. Hope someone has a real answer for you.

I was an LPN in LTC for 4 years, as an RN I worked Ortho (minor back injury scared me away from bedside nursing), I was a clinical supervisor for a home health company for 2 years, then took a case management job for an insurance company... I just feel unfulfilled ? I do paperwork but it is super busy, working from home is distracting and there is never an escape from work. I have been thinking about making a change, be it go back to school for something totally different or some different nursing field. What are the pros and cons of psych nursing? Why do you love it? Why do some not? It’s hard to jump in head first, nerve racking as I have kids and a husband and right now I provide insurance.

I can certainly relate. I have great co-workers for the most part, but management which has always been questionable has had some recent changes and it is so frustrating. New DON was never a floor nurse, no real in service or meeting of the minds in months. Things are changed on a whim and communication is horrible... Telling one nurse on one shift doesn't mean we now all know, responsibilities are simply shifted from those who aren't doing them, or not doing it properly, to those who are competent. Concerns aren't taken seriously. The ADON they hired is related to several staff members (though that breaks company policy) and she has zero experience in management and is unprofessional at best. I am dreading the job I have been at for more than 4 years I have to have insurance for my children), but am afraid of the demon I don't know (any possible new job). I feel stuck, though I know I'm not the only one second guessing my future here.

There is a difference in staffing between day and night shifts, so is this on night shift?? If so I would say that is not far out of the range of what is normal. Did they say that is the max, 6 pt per RN? Because that may mean the majority of the time you have 4-5 but have to be capable of carrying 6 in the event they are short staffed or at full capasity. The number of tech/aids/LPNs they have matters too, some hospitals train support staff to do a lot more than VS and baths/toileting. As stupid as this may sound to you right now, I think new grads are at an advantage to work an a challenging environment at first. Because in learning you are capable of handling that, you then have confidence you can handle anything. I have been an LPN for nearly 3 year in a very nice skilled nursing facility, but as a new grad RN I have decided to start at a very fast paced acute rehab hospital, just because I know I will not fully delevelop my nursing skills if I work in a cushy, suburban ltc facility for the next five years. And god forbid, I lose that job or if my family relocates and I have to work at a 'real' nursing home, not sure I could manage. I love it where I work now, but it is not expanding my horizons. Just keep in mind that there are lots of other nurses who do it and manage just fine. Nursing is definitely a tough job. You have to start orientation without such ideas in your mind and all those pre-concieved notions that you have and just be open to learning and taking in the experience. Even I start 'class' orientation tomorrow, and am nervous. Hearing older nurses talk about the old days of nursing is even scarier. Relax, breath, and be confident; You can do this!

That's what the doc said. 'Lift is okay, just do it properly and get help when needed; No being superwoman. You will probably be more careful with any of the isolation pts than the other nurses considering, just NO CMV pts.' Yes, that is what I ment I am not gauranteed a job after maternity leave, which is a scary situation, new baby and bills to pay but jobless. I don't mind moving on in time from any position if it is necessary or a better deal for me and my family (that's just the way of the worlds anymore) but would hate to be forced to and feel the pressure of needing to find a job right away despite being a busy new momma. Thank you for your input. I am going to talk with my hubby, think I will give them a call tomorrow and just go to this interview for the telephone based office gig, you never know...

Thank you, Congrats to you as well! You made some great points and gave me a lot to think about.I have never used FMLA and haven't done much research yet, not sure why but I was thinking it required a minimum of 6 months employment, but you are right it is one year. So I think the office/phone job is out. My current job does not offer paid materity though luckily I was smart enough to opt for short term disability, which give me 60-70% pay for 8wks (vag delivery) or 12-13wks (c-section). I do live in an 'at will' state, but I want to be fair to them. I mean, nursing is a small world. I was hired because they are adding one nurse to each unit, so they need at least two full time RN for each day and night, plus some. I was considering at least asking her if they might be able to utilize me one shift a week or something, while keeping my current job, which only requires me to work an average of 30 hours per week in order to be considered full time and get full benefits. So that I would still be an opportunity for me to get a little experience, a foot in the door, and a little extra something on my resume. Of coorifice there is no telling whether they would go for that but it is worth a shot, right?

I was really happy to get offered a job in an acute rehab hospital, as I wanted something more acute. But the week before my orientation I failed to have my monthly and took a pregnancy test and sure enough...POSITIVE! I have been married several years with no children, as I just finished my RN in December and my husband is set to finishing nursing school (his 2nd degree) Dec of this year, we are excited! The excitement died down a bit as it is very early in the pregnancy, and all I can think about is how the director who interviewed me talked about how busy, fast-paced and crazy it is. Plus looking at the information they gave me, the insurance will not go into affect for another 2.5 months and 2-3Xs what a pay now in LTC and will only increase when I add a baby, my current employer is Catholic funded so insurance covers whole family: you, spouse and as many children as you can have with no extra cost. Plus she said they have a lot of isolation patients and there is heavy lifting, so I have a call out to my doctor about that. But I am suddenly less excited about this job offer, Is it do-able?? Safe?? If I wait until early next year I won't be a new grad any more. Then just as this realization came to me I was called about a telephonic contract to hire position for a medical research company, I interview on Friday. It is not exactly what I want but is less active and stressful. I do not need either as I currently work in a great snf that is not too hard and I have been there nearly 3 years, mostly as an LPN, though I am starting to feel burned out there. I have yet to hear back from any large accute hospitals I have applied to, and I can not bank on that happening in the next two months, before I start to show as I have been applying for the last 4 months. I am just really confused and don't know what to do?? How would I even take back my acceptance of the position?? can I request part time or PRN if my OB says it is okay?? I really did not want to tell anyone as it is so early.

Oh to work in such a place, where anyone can be fired for not doing there job.... jk they just don't take things seriously and management is too lax, not that everyone walking on egg shells is better, but in time I think things will correct themselves as far as management is concerned, with families complaining and problems not getting fixed. I think you guys are right. I definitely think that I could do a little more praising, though I generally have a good and appreciative relationship with most of the aids. More follow up may help as well. I am meeting with the DON this week. So we will see how that goes. I just start thinking if I don't do it, it won't get done so I do so many 'CNA tasks' (not to down such tasks, I was a CNA not too long ago) that my own work suffers and I am exhausted.

I am a new RN in my mid-20s, though I have been at the same facility as an LPN for 2+ years, a CNA for 2 years before that (though at a different place). Because I was in school last semester I had to transition to working primarily weekends. I work mostly nights, and some evenings. Night shift on weekends, one day in particular, is a real makeshift crew. On that night one aid is a relatively new CNA (scares me to death she wants to be a nurse) ,she has an attitude and is down right lazy. She fell asleep while the other aid was on break!! so basically I was the only one on the floor Needless to say I was not happy. The other one is a bit older, and been doing it a bit longer but still lazy!! There is a resident who is at the front of the hall and he cannot remember to use his call button and he whistles when he needs help, though I explained to them that that is so and so and when he does that he is trying to get someone's attention, he whitles and they just sit around. When they are busy doing rounds call lights are all but ignored and in the morning I leave an hour earlier and am very busy with med pass, but the idea of prioritizing is so foreign. I had a meeting with the DON, we drafted a list of espectations for them to sign, little that has done. The very same day half were broken: the men they get up were not shaved, a motion alarm not being heeded led to a resident having a fall and skin tear, the break room was a mess, and she fell asleep. This was this past week. I thought I was about to have a panic attack, I mean I help out more than probably any nurse, but I am coming to the realization that I cannot do it all! Compaining to management does little or nothing. I had my ADON (who is less tolerant of bs, though has little power, unfortunately) to print me extra write-up forms. I wrote them both up, but the young ('I know how to do my job') with an attitude girl refused to sign so of coorifice the other one followed. The DON wants us to meet and talk about it, but I really am not interested in working that shift at all. In fact the idea of going in next week as me anxious. I am not usually short tempered, but the frustration is making me act like someone even I don't like. I take my work personally and I work my tail off only to hear countless (legitimate) complaints about my shift/ staff. I used to trade one of my shifts with another nurse, when it was convenient for one of us and she has since told me that she cannot take my shift any more because she, who has been a nurse a lot longer than me, cannot handle my staff... I am feeling so discouraged. I used to truly enjoy my job, but now I am considering just resigning. Not sure if that is a rational thought or me being overly emotional. Don't know what else to do.

The fact that you take your job personally shows you care. But this tends to be the type of individuals who do no call no shows, those who call in all the time, have countless 'family emergencies', car break downs, mysterious illnesses, or simply 'I can't make it', etc. It certainly should be grounds for dismisal, though that all depends on the policy at your facility. My facility is horrible about sticking to there own attendence policy, which can be frustrating. From my experience every no call no show I have ever had was a person who should have been fire a long time ago, not my opinion, but if our attendence policy had been followed. I mean if god forbid I were in an accident and/or in a coma or extreme circumstances I would hope my job would excuse me. So there has to be some discussion, but for those who are notorious for being unrelible, show that they obviously don't want to work there, and that is how I see it. You gotta look at your policy and speak up when it is not being followed, remind management that it is you and all the other staff members who suffer as a conscience.

Thanks for the input, I appreciate it and I hope you are right!! Either way I am up for the challenge, just a bit nerve racking to start something new.

I worked as a LPN for 2.5 years in ltc; it was a beautiful new facility and relatively cushy compared to most nursing homes (ratio 16-18 pt per nurse on day/evening, 1:32-34 on noc, with 4-5 medicare at the most, only one gt, rarely one IV) or so I am told, I have never been a nurse at any other snf. Finished my RN bridge in December and despite the last 3 months of applying everywhere my only more acute job offer I have had is a small free standing rehab hospital on the acute unit. I have not yet starting, job offer is pending my background check and physical. But I was told there is a great deal of online simulations and then a minium of two weeks training on the floor, but that could be extended if I needed. There are 14 beds on the unit if I remember correctly, and they are hiring an extra nurse so that there will be 2 on day and night. I will be working noc 12hr shifts. I am really nervous, it is a short stay facility with most patients in and out in 10-20 days. That means lots of admissions, and I am told they have pretty high acuity: trachs, complex drsg changes, g-tubes, IVs, etc. Any advice for making this successful transition in to a faster paced environment?? I would really appreciate it.