Transitioning from the bedside

Hello all,

I've been lurking and reading others' CM experiences and I'd really like my fellow nurses input, sorry for such a long post!

So, I have been interested in getting into case management. I've been an RN for 4 years, with progressive hospital experience (floor, stepdown, ICU) and also a year of outpatient concurrently (clinic, FQHC). I was also a CNA for 6 years before I got my RN, so between the two, I've been wiping butts at the bedside for 10 years. I'm nervous about leaving the bedside because I tried clinic work 3 years ago and left because I wanted to "get my hands dirty" and at the time I'd only worked on the floor for about a year and had less clinical experience, which, of course, I was anxious to get. Now, 3 years later, I'm considering leaving the bedside again. This time, of course, I have more experience, so I'm hoping I don't miss it. However, I've only been in the ICU (my current position) for about a year and a half, and I know that for something to have real substance on your resume, you should hang out for at least 2, especially as a new specialty (critical care). But to be honest, other than neuro (my specialty), I have no interest in trauma/ER/critical care. Really, I've always said I never wanted to just be a hospital nurse (no disrespect if that's your thing), I always wanted to do something more. I feel that as a hospital RN you really get treated like such a replaceable commodity and I don't like being treated as "one of the masses" forced to do the happy "customer service" tap dance for management, families, etc....Honestly, being a nurse in the hospital is the only profession I know with baccalaureate prepared professionals who get clocked and reprimanded for being 1 minute late...sometimes I think I was treated less like a kid when I worked at McDonald's as a teen .I'm hoping CM will be a little better getting out of the hospital hierarchy but, I am fully aware that "the grass is always greener"...Another concern is that I've noticed most CMs seem to be a little older, so I'm wondering if I should take this as a sign in itself...but again, my situation is unique in that most 28 year old nurses probably haven't spent 10 years doing bedside care already..

So, I had an interview with an insurance company for a "Concurrent Review Nurse" position. It went really well (the manager and director literally both told me so separately afterwards), and (Lord willing), I'm thinking I'm going to get an offer from them next week. They said they would be able to match what I make on night shift at the hospital, which was surprising and great news as I thought I'd have to take a pay cut for this "prime shift" position. Also, after I get comfortable with the job, I can work from home 1 to 2 days a week, with the possibility of transitioning to full work from home eventually. I'm a newlywed, and we'd like to start getting trying to get pregnant within the next year, so I figure that this job would be much easier on me then working the floor with a big ol' belly...not that that is a determining factor, but it is a plus.

I like the idea of still being able to use my clinical expertise but in a more comprehensive "big picture" manner..and the fact that there are so many work from home opportunities. I like working on my own and this seems like it would be a more independent (although, apparently from some of these posts, not necessarily more autonomous) role without the constant dependence on peers to help you like on the floor (I guess depending on your unit). Don't get me wrong, it's not that I'm not a team player and/or won't help out when needed, I just prefer to work independently.

Also, one last thing...my ultimate career goal doesn't have much to do with any of the above, lol. I want to be a practitioner (NP) providing both traditional and alternative (holistic, complementary) therapies. I'm actually in the process of applying for an adult health NP/MSN program and would be working towards that while working. I'm dazzled by all the niches in nursing and want to try and learn as much as possible before I get a master's though.

So, now that I've spilled my soul (sorry if I jump around, I just had a lot to get out)...What do you guys think...Should I do it? What are some of your experiences transitioning from the bedside? Did you miss it? How did you cope? Are there any younger UM/CM nurses out there who care to share their experience?