Critical Path Network: Create an environment where CMs can thrive
Critical Path Network
Create an environment where CMs can thrive
Increased caseloads, high stress can cause burnout
If you want to recruit qualified case managers and retain the ones you have, you have to create the kind of environment in which caring nurses want to work, Catherine Mullahy, RN, BS, CRRN, CCM, suggests.
"Case managers want what every employee wants — mutual respect, a collegial environment, and the ability to make a difference. Stress is a big factor. If the department is crowded with files everywhere and it looks like chaos, people aren't going to want to work there," adds Mullahy, president of Options Unlimited, a Huntington, NY-based case management company.
Finding good case managers is more of a problem now than ever before, as the shortage of registered nurses has intensified, Mullahy points out.
"The nursing shortage is to the advantage of nurses. Everybody, regardless of the health care setting, is having problem finding good nurses and keeping them," Mullahy says.
Historically, case management positions have been attractive to experienced nurses because they typically were a Monday-through-Friday job.
"Hospital case managers didn't work on weekends or on the evening shift in the past. That has changed, particularly with the number of people who can't get to the hospital to pick up their family members during the day but can get there in early evening hours," Mullahy says.
Case managers in all settings are experiencing the same thing — increased case loads, increased stress on the job, and the feeling that no matter what they do, they are not making a difference," she adds.
Because of the critical nursing shortage, some hospitals are paying bedside nurses more than an experienced case manager can make, Mullahy says.
"While money is a factor in any job, many nurses may not be the primary breadwinner in their family and may be willing to take less money to work in a less stressful environment," she points out.
Employers need to look at creating the kind of environment that attracts nurse case managers, she says.
If you are offering a high-stress, high-volume job with a lot of telephoning calling and little patient interaction, you may find it difficult to attract qualified case managers, she says.
"When I talk to colleagues about interviewing for a new position, I suggest that they need to interview the employer as much as the employer needs to interview them," she says.
Job assets
Here are some job assets that case managers are looking for:
- a reasonable caseload;
- a professional environment;
- the ability to attain continuing education;
- support for attending educational conferences;
- cost-sharing for certification.
If you want to keep the staff you have, be careful about insisting that your case managers work long hours, she suggests.
"In professional categories, a certain amount of overtime is expected, but some case managers are expected to work overtime and are not given compensatory time off. Employers may abuse a nurse's affinity to not leave the patient in the lurch," she adds.
Consider splitting shifts or allowing job sharing to retain experienced case managers who have young families at home, Mullahy suggests.
Providing a shift for working moms who can come in at noon and work until 8 p.m. could attract highly skilled case managers who can't work 9 a.m. to 5 p.m., she says.
"The more flexibility you have with working hours, the greater capacity you have to attract staff," she says.
Job sharing is another possibility, she suggests. If two nurse case managers share the load on a unit, it gives them the flexibility to work on a shift that suits them.
RN case managers went into nursing to work with patients. They are likely to burn out quickly if the majority of their job involves paperwork or computer work, Mullahy points out.
"If they don't have much interaction with patients or family members, their job is not going to satisfy their desire to make a difference to people. Nurses like that kind of collaboration and feeling like they are making a difference," she says.
Make sure that the management of your hospital understand the value of case management and act accordingly to provide your staff with the salary, benefits, and recognition they deserve, Mullahy says.
If case management positions are being cut and other positions at the hospital aren't, it's possible that the case managers haven't done a good enough job of articulating what value they bring to the organization, she says. "If employers understood the value of case managers, they'd add more of us instead of cutting back."
Hospitals are faced with a shortage of resources, a shortage of money, and increasingly complex patients, and that's where case managers can be a tremendous asset, she points out.
"Case managers assist with better management of patients across the continuum. They expedite discharge and follow the high-risk patients beyond the hospital. Case management can demonstrate real value to the hospital administration," she says.
If you want to recruit qualified case managers and retain the ones you have, you have to create the kind of environment in which caring nurses want to work.Subscribe Now for Access
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