I have been offered several case management and one RN position and I have no idea which to accept that will put me on the best path to being a FNP. I want to be an outpatient clinic FNP when I am done with school in 2 years and the jobs I'm offered right now are in hospice as either a case manager or an RN. Pay is almost the same and I am being offered the exact same flexibility, travel area, etc. Everything about the jobs is the same except the responsibilities and I could use some advice on what you think will set me up best as a future FNP.
I do want to add the CM job is hourly and the RN one is a flat rate per appointment- anyone have experience in how these differ?
Last edit by mary.thomas on Jun 8
: Reason: more information
If you are planning on being a FNP - I think hands on / direct care would be the preferred experience and is most applicable to that path.
That's a tough call. While there is no doubt working at the bedside offers important knowledge of patient care, care managing will give you more insight into the provider world and the complexities of care. Is the care managing position strictly desk work? Or is there active patient assessment/evaluation involved? If the latter, I would highly consider the care manager role. While I had years of experience as an RN before my FNP, one of the best jobs I did was as a in/out patient pain care manager which I did the last 2 years of school where I could help establish protocols and plans for complex patients who needed a range of therapies and had multiple co-morbid conditions to consider in decision making.
I work full-time nights in a male prison. I do hands on care. Sometimes more than when I worked on a med-surg floor in a hospital. I've done wound-vacs, Pleuro-vacs, IVF, tube feedings..wound care since working in this prison.
I'm currently working in hospice, and I'll be starting a FNP program in the fall. If the company you'll be working for is anything like mine, I'd think the case manager job is more in line with what you want to do. As the case manager, I am the point person for my assigned case load of 20 pts. I do weekly (or more) visits with my patients, assess and provide direct patient care, wound care, cath changes etc. as well as am the one responsible for making sure the patient has everything he or she needs. This means ordering supplies, managing prescription refills and obtaining C2s from the physician, contacting the physician for order changes, coordinating care provided by my HHA and other disciplines, and that's just the start. The RNs that are not in a case manager role are utilized to do admissions and assist with patient visits, so they provide the hands on care but they do not have all the paperwork attached, and they report to the case manager.
I find it odd that the CM job is hourly, because most of us are salaried. That's because our employers know we put in hours above and beyond the 40/wk we are "assigned." I also know that working per visit has perks as well. Once you're used to doing patient visits, and if you're very efficient, you can really make bank fitting in a bunch of visits in a day. If you have any questions about hospice in general, feel free to PM me!
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