Should I stay in case management or go?

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Nobody, wants to answer this thread that I posted in Career advice section, so I thought I would post it here. Any advice would be appreciated. I have done worker's compensation case management for almost 4 years. I was a med-surg nurse for 3 years. I have an okay job it pays about $25/hr. I am autonomous in that I can arrange my schedule around my family and I work out of my house. The down side is billing. You have to show credit for your time spent. It is hard at times to work 8 hours and show credit for 8 hours so doing 12 hours of it is next to impossible. I am at a point that I am so tired of working M-F and having no time off. I have two kids and it seems that the weekend is here and gone before I know it. I can not imagine spending 20 more years working M-F. Truthfully, case management is a M-F job. I figure that I could possibly go back to the hospital working every other weekend 12 hour shifts and work a few extra shifts a month during the week and make the same money for less hours at the hospital. I thought maybe eventually I would do agency if holidays and money became a problem. I am not sure how I will react to going back to doing hands-on nursing either or 12 hour shifts or nights. I am considering going back and doing ICU and maybe considering going on th CRNA school. Who knows maybe I am dreaming. I have a friend who is a CRNA and loves it. Does anyone know the good and bad about being a CRNA? I am not sure what is the right path to take or how to find it. Am I crazy to leave M-F 9-5 shift to go back to nights and 12 hour shifts? I thought about picking up some prn work to see if I would like the hospital again. However, I am hoping to get hired. Agency would not hire me because I have not done hands-on nursing in the past 2 years. I just thought if I tried prn work while keeping my job I might have a better idea. I just do not want to give up what I have and go back to the hospital and say "why did I do this!" I have what most people would love to have but I am burnt. How do you get past it. If I go back to the hospital, I would have more time off. But, will I get burnt on 12 hour shifts too! Too many choices! Any advice would be helpful. I am 30 and feel I need to either poop or get off of the pot. I have also considered home health. Can you do 12 hour shifts doing home health? Is it autonomous? What are the good and bad about home health and ICU?

I really do like case management overall, but how do you get past being burnt!

You might try something similiar to case management like disease management. I don't think you have to worry about billable hours in disease management on a regular staff nurse level. There's usually abit more flexibility in hours. I know nurses that work part time in that field.

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take my word for it, disease management is extremely boring and most of the people you are calling at home, to educate, really don't want to talk to you. As far as work comp case management? I have only been doing it for four months as an onsite nurse and I gave notice today! I absolutely hate billing for time, I hate dealing with the adjusters. Conversely I love the patient contact even if it is just to meet with them during an appointment. I was also promised I would be able to work from home, and after four months that has not even been mentioned yet. I should have gotten that in writing when I was hired; that I would work from home by such a date. It's too late now. Also, the people that were training me were two of the crabbiest, rudest, most arrogant nurses I have ever met. All I was ever told was that I needed to please the adjusters.

I worked both hospital and home health before I went to work comp case management. I have to say I made the most money in home health. I got time and a half for over time.... I wouldn't go back to the hospital unless it was in a specialty specialty department; I don't like the 12 hour shifts too much. I think if you are married with a family and your spouse can keep the kids when you are working then 12's are fine. They are a little much if you are single and you have a kid getting home from school at 3 p.m. and you don't get off work until seven.

One thing we have as nurses is choice. You cannot say that for any other profession. Find something you like and jump in. You are still young enough at thirty to become a CRNA; go for it. I am heading back to home health, where I was the happiest. Good luck!!

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take my word for it, disease management is extremely boring and most of the people you are calling at home, to educate, really don't want to talk to you. As far as work comp case management? I have only been doing it for four months as an onsite nurse and I gave notice today! I absolutely hate billing for time, I hate dealing with the adjusters. Conversely I love the patient contact even if it is just to meet with them during an appointment. I was also promised I would be able to work from home, and after four months that has not even been mentioned yet. I should have gotten that in writing when I was hired; that I would work from home by such a date. It's too late now. Also, the people that were training me were two of the crabbiest, rudest, most arrogant nurses I have ever met. All I was ever told was that I needed to please the adjusters.

I worked both hospital and home health before I went to work comp case management. I have to say I made the most money in home health. I got time and a half for over time.... I wouldn't go back to the hospital unless it was in a specialty specialty department; I don't like the 12 hour shifts too much. I think if you are married with a family and your spouse can keep the kids when you are working then 12's are fine. They are a little much if you are single and you have a kid getting home from school at 3 p.m. and you don't get off work until seven.

One thing we have as nurses is choice. You cannot say that for any other profession. Find something you like and jump in. You are still young enough at thirty to become a CRNA; go for it. I am heading back to home health, where I was the happiest. Good luck!!

Thanks!

I am really considering going back to the hospital and get my ICU experience and after a year then think more about what is really right for me. At least at that point, I will have some ICU under my belt, which is required for CRNA. I am considering NP too. I can always try home health in the future as well. I just don't want to keep sitting on the fence and a few years from now I decide to pursue CRNA and I do not have ICU at that time. Plus, I hear CRNA is going to a doctorate level program with more schooling. I am hoping to get in before that happens, which means I better start getting the wheels turning now. I do not see myself staying working for hospital long-term. But at least, ICU will likely prepare me for any new step and I can always go back to case management.

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how do I know if I'm cut out for nursing....I am interested in the field of nurse anethesist ....is there alot of blood and guts in this field...thanks.

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Thanks for the advice too! The only problem about the ICU route is I will probably have to jump ship to do it. THey are not likely to train me to work prn. I figure I could do med-surg prn a few months to see if I like the shift work and if so do ICU for a couple of years and then make a decsion regarding CRNA or NP. I keep having this feeling that I will not know unless I leave. I guess I can always go back to CM. But, I like working out of my house so much and hope if I do decide to go back that I can get a job out of my house again. I must say I do like field better than TCM. You get a better insight and I enjoy the travel.

Dear aaac,

I guess I'm backwards from your situation. I'm currently doing telephonic disease management and work from home ( 4 10hr days) and I'm considering leaving for an in-office M-F worker's comp case managment position. I'm only leaving my current job because my company is going down the toilet so to speak. I'm devastated to have to give up my home-based job. I live in Atlanta and the commutes are terrible. No less than 1 hr each direction to work. That means I'm basically putting in 10-11 hours for work everyday of the week. But, there are no home based CM jobs here in Atlanta that I can find. Perhaps you can give me some advice. I think I may be offered another CM position working with indigent/medicaid population. The hiring manager said it was old-fashioned case managment with careplans, etc. Do you think I would get better experience as a case manager working with WC or medicaid? Good luck and thanks in advance for your help with my question.

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Can't anyone get time off during the week from your jobs? I have no experience w/ home or office case management, but I do Care Coordination at a hospital; it combines some Social Work, Case management, and utilization. I thought I would miss 12 hrs shifts, but I don't at all. We cover weekends on a rotation so get 2 days off whenever we want, to make up for it. It's nice because you can take a couple of 3 days weekends, a 4 day weekend, etc.

I live where there's Daylight Savings time, so really feel like I have quite a bit of time off even after work. And our hours are very flexible. We put in our 8 hrs and stay available by pager til 5:00 pm. If we need to leave early/come in late, we can make it up over the week by coming in early/staying late, whenever. The job has it's hectic moments but I have no desire to go back to the bedside fulltime. PRN might be ok. But being a single parent, I don't want to mess w/ planning childcare, after school activities, etc around 12 hr shifts again. Seemed like the only way I could make afterschool programs was to work mostly weekends.

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Specializes in OB/MedSurg/Home Health/Case Mgt.

I work hospital case mgt. and have done so for the past 8 yrs. What are job responsibilities in workers comp? What is a typical work day like? How many hrs a day do you spend? How many clients do you have? What kind of home-office setting do you have? AND, how do you get started in workers comp? One more.....are you covered with personal health insurance thru your company?

Thanks,

susan

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how do I know if I'm cut out for nursing....I am interested in the field of nurse anethesist ....is there alot of blood and guts in this field...thanks.

Honey ,nurse anesthetist is all blood and guts, it's SURGERY. You may not be doing the cutting but you have to watch.

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Talk about the grass being greener. I work monday, thursday and friday 12 hours in ICU and look forward to the day I can transfer to our case management office in the hospital.

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