R.N. Nurse Medical Case Management

Medical Case Management

R.N. Nurse Medical Case Management client fees are generally $50 - $75 per hour. The Nurse case managers pay is subject to individual pay scale varying by employer.

Oh, he's doing so well. I think he'll be released today", said the floor nurse.

What that means to 'Bob' & his family is no more 'medication pump', no more nursing assistance, no more medical staff to answer questions, no ER a button away ..

The Case Manager's job is not to 'play pretty music' .. it is to first ensure the client understands the medical plan and then we allow the patient client to optimize their specific rehabilitation.

A Case Manager's job is not to ignore the medical condition's vocational impact .. it is realistic assessment & appropriate goal setting as determined by the interdisciplinary health-care team.

R.N. Nurse Case Management files are generally 'post acute'.

Can be pre-procedure. Kidney transplant / heart procedures / and other such planned for major medical procedures.
& even then, it is more to prepare clients for the post procedure situition.

The RN Case Manager sees the 'post acute' patient client & family up close & personal.
- RN Case management files are generally for the first 6 - 12 months post injury / incident.
- It is during this 6-12 month 'post event period' .. post injury .. that hard facts will be realized & hopefully dealt with in a meaningful manner.

The US Army, US Marine Corp and the US Department of Veteran Affairs are in need of Nurse Case Managers.

There is a huge need for Nurse Case Manages to assist injured Iraq & Afghanistan veterans.

To contact the VA regarding Medical Case Management careers: 1-800-949-0000

The patient client family's real ordeal begins with post acute release from the hospital.

.. family burden .. loss of function .. pain .. uncertainty .. loss of income .. medication side effects..

Injured Workers and their families have real expectations and needs.

Appropriate exercise, proper rest & planned nutrition ( intelligent lifestyle? ) are required for personal optimization.

In addition to timely acute medical treatment, injured workers and their families are entitled to the establishment of appropriate medical & vocational goals by the interdisciplinary health-care team.

An injury can potentially change all aspects of a person's life: personal function, health, lifestyle and vocation.
An Injured worker's role as a provider has possibly been removed .. human function lost .. standard of living may decline .. homes lost .. families destroyed .. not a pretty picture!
Objective vocational assessment, as well as the medical plan assessment, of the work related injury or condition is critical.

Pre-procedures doctors are huckster salesmen .. selling the procedure often with promises not born out by statistics.

The idea that "all doctors" are honorable people is so 19th century!
21st Century doctors are corporations.
Often it is a case managers role to ask 'hard questions' of medical providers.
- + it is the 'squeaky wheel' that gets the attention ..
- & MY GOAL is the medical team's appropriate focus & attention on my client's medical plan.
- Clarification of the medical plan.
  - Make sure every one involved is clear as to the specifics of the medical plan.
  - Communication between all members of this interdisciplinary team must be open and complete in order for the medical providers to be objective with the injured worker and cooperative with the employer.
  - Make sure the doctor has the diagnostic / therapy reports, discuss the relevance.
  - Make sure the therapist knows vocational requirements and establishes an appropriate therapy plan.
- Realistic assessment of the injury & rehabilitation potential are vitally necessary for the injured worker's successful return to a fully functional life.
- Doctors often present a 'rose colored' outlook .. a rosy outlook often not supported by facts.
- Question the doctor in the presence of the patient client.

Often there is not a 'bright future' .. & the sooner the client addresses the realistic future the better for all. An Injured worker's role as a provider has possibly been removed .. human function lost . standard of living may decline .. homes lost .. not a pretty picture, but a real one.

Very often work related incidents are life altering.
A lifetime of education / work / promotions / seniority .. all gone in a 'medical instant'.
From respected work place producer to a '40 year old has been' in community college classes with 19 year old freshmen.
Happens every day .. could happen to anyone of us!

Ask the hard questions. I go in to each appointment with pre made forms & ask the same 'base set' of questions at each visit + any specific questions regarding my clients care plan. The patient client hearing me ask the questions is positive.

Dates .. future procedures .. diagnostics .. possible diagnostics .. time frames.
If the client raises an issue with me, I address that issue to the medical provider in the presence of the client.
The patient has the same information as I.
- If the client 'forgets' I emphasize the relevant issue at the next medical appointment.
  - Patient clients often have selective memories.
- I review the clients diagnosis with him & provide visual aids when possible.
The case manager's client is the injured worker, the case manager should always ensure the the client is fully informed of all options.

If vocational retraining is the ultimate reality it should be addressed as early as possible in the medical plan.

Often injured workers stubbornly refuse to accept this reality.
- I would too!
Address this critical issue as often as possible at client appointments with doctors & therapist.
- If the client is agreeable, discuss with family members.
The opinion of the case manager does not matter, it is the opinions of the medical care providers, docs & therapist, that matter.
Expose your client to medical reality from the medical team as often as possible. Good or Bad.

Use any good news for motivation .. a part of the case management file is client motivation!

I often get calls from out of state Nurse Case Managers. I always share all local information.
This can be an incredibly rewarding career.

medical care is an area in which globalization benefits the individual

Have yen to travel? TESOL / TEFL can be a good career choice.