sboet

Haha Joe NightingMale, I totally agree. It ebbs and flows. Some weeks I want to drop out of existence, other weeks I think I have it pretty good. And I agree, part of the reason I like this job is because I'm good at it. I'm also getting comfortable with my population (peds neuro) and becoming more knowledgeable and (shockingly) INTERESTED! To be honest, I chose nursing for the stability and the general idea to help humanity. Come to realize improving humanity is a different thing than direct interaction with individuals you can't always help, especially with Medicaid. I really should have been an author of philosophy or something, wandering the natioanl parks, thinking all day, but hey I also wanted to have some stability, a family, and to maybe not live in a storage unit for the rest of my life. This job can suck, but my worst day here is better than an average day in the hospital, for me. Anyway, glad you are adjusting :) Wish you well!

Sorry for the late response, but I had to comment. I am currently an RN Care coordinator for a company that manages the medical care of complex special needs children on our Medicaid plan. They basically get assigned to our "network" when a physician has referred to us because we offer a clinic and care coordination. It is solely telephonic and currently our ratio's are about average 270 patients: 1 nurse. The caseloads are split by primary diagnosis, ie neuro caseload, endocrine caseload, etc. The job, like you stated above, really involves minimal nursing skill and mostly organization of services, submitting authorizations for meds and DME, answering phone call after phone call from disgruntled patients (parents), and spending a preposterous amount time reassessing their eligibility financially and medically. We all feel that this is a glorified clerical job with a touch of nursing and a touch of social work, as someone said before, it almost feels that a trained clerical person could do this job and just call the nurse or social worker a couple times a day to ask a specific pieces of advice that could really just be Google'd. Also as you said, one of the most difficult parts of this job is the lack of clarity in all aspects, from defining who exactly our provider are from day to day or what exactly we are supposed to do with basically everything that comes in, as things seem to change daily. ALL and I mean ALL of our training was based on the word-of-mouth of other care coordinators. Everyday consists of an anonymous chirp from the cubicles "Does anyone know of a ___ specialist in __ town? ...Wait for someone to yell out "I referred to Dr. XYZ a couple months ago, but I heard he might not be taking the plan anymore. I'm not sure, but I'll drop off this torn up post-it note with his office ph# which may or may not be out of date/inaccurate because I got it from another care coordinator 5 years ago who has since quit." Or most infamously, a flat out "No, there are no providers. They will have to travel at least an hour." Then comes the 5 minute self-talk to prepare for the total frustration you will encounter one you call Mom and tell her, like a blowhorn being set off directly in front of your face. The lines are innately blurry and those who require clear guidelines and precise direction are constantly stressed out and frustrated at this job. Despite this, I am actually relatively happy with my job. I am by nature very go-with-the-flow and able to work with a lack of direction (actually stifled by rules in general) and to be honest I do not take this job seriously. I take the needs of the kids seriously, but not the total lack of organization of the system. I look at it, shrug my shoulders, and move on fairly quickly. I don't spend much time fighting a system that could never be changed by a single peasant such as myself, nor do feel the desire to. I do what I can in the scope of whats available and I often find it to be a scope I must constantly define and redefine myself. With this, I do feel very autonomous in my job, yet also very connected to my co-workers because we all work together trying to define this undefined system. I am coming to see that although first and foremost, the system sucks, it is a difference in personality that decides whether or not someone can handle this job and whether or not they will be likely to dread Monday mornings. I rarely dread going into work. I sometimes even look forward to it-- to see whats going to happen, what we'll discover, what kind of BS will happen, what kind of weird phone calls I'll get, what I'll learn, etc. Those who come in expecting clarity and direction are constantly fighting a battle that they never win, and therefore they get burned out repetitively, every single day. Anyways I just wanted to post this to let you know you are not alone! Lack of clarity, glorified "complaint hotline" as we call it, billing representatives, etc all play a much more frequent role than that of an actual registered nurse, and we get paid significantly worse than those in the hospital, BUT it is not the hospital, I get to decorate my cubicle, M-F with all weekends off, salaried, rarely have to see a patient, never have to touch them, I really can ignore calls until I'm READY for them (unless urgent), I am not micro-managed, and there really is a whole lot of comedy in the chaos, if you can see it. Good luck!

I am graduating with my BSN from Florida in May (next month). I really want to move out west preferably Oregon but I am not opposed to either CA or WA. Can anybody tell me what the job prospects are for new grads? Thanks