A Day in the Life as an RN Case Manager: Hospice Edition
I started a new role about four months ago and would love to share my roles and responsibilities. Being a case manager has opened new doors I’ve never seen myself walking through. I’ve learned a ton in just a short time and I’m excited to see what the next four months have in store for me. If you're considering starting a new role but the fear of the unknown is stopping you, hear me out. DO IT. I promise you will be so glad you did. This blog will cover my day-to-day roles and responsibilities as a case manager.
What is a case manager?
Let’s start with the basics. A case manager is defined as a health professional. They collaborate, plan, and evaluate the patient’s goals and outcomes. Case managers work with other team members to help coordinate the patient’s care. The team includes nursing assistants, doctors, nurse practitioners, nurses, and families. A case manager's responsibility is to assess, plan, and advocate for the patient. They must ensure that the healthcare team follows the patient’s wishes. This responsibility may differ from day to day. Some common job duties of a case manager include:
Assessing the patient for necessary care
Coordinating care with the healthcare team
Colloarbating with social workers to aid in resources for the patient
Facilitating transfer of care from one location to another
Advocating for the patient’s rights and dignity
Case managers are an essential part of the patient’s healthcare team despite the environment they work in.
Are hospital case managers truly distinct from case managers in the field?
The care coordination is still the same despite where you work with some differences. A case manager in the acute setting handles the discharge planning of the patient. Case managers are typically registered nurses. They ensure the patient gets proper care and coordinate the care plan. As a hospice case manager, I must plan and deliver patient care. I also provide palliative and emotional support to the patient and family.
Some other job roles include the following:
Performing a nursing comprehensive assessment every 15 days to stay in compliance.
Weekly nursing visits to ensure the plan of care is being met.
Administering medications and evaluating the responses.
Educating patients and families on the Hospice philosophy
Collaborating with the doctor or nurse practitioner to ensure the patient’s needs are being met.
As you can you see working as a case manager in the field versus the hospital is similar. We both maintain exceptional planning and coordination of care for the patient and family.
My work schedule with timestamps
Before I get into how I managed my caseload, let me explain a little more about my position. As a hospice case manager, I manage care and advocate for my patients’ specific goals. This could be as simple as managing the patients’ pain within two weeks. I work a salaried position from 8 am to 4 pm Monday through Friday. What I love about being a hospice RN case manager is the flexibility I have in my schedule. On my team, I get about 15 patients that I need to see a week, so I divide my patients up as I see fit. This could be based on location, patient preference, and my schedule. Some days are lighter than others depending on STAT calls or the patient's status. Being salary, I do not get overtime. So, it helps me delegate tasks and ask for help which is a struggle for me even after 7+ years of experience.
Let me give you a quick rundown of my work day.
7:00 am: I do inner work such as reading, exercising, or meditating.
8:00 am - 8:15 am: Read the morning report. The report covers deaths, the providers on duty, new admissions, transition alert patients, and patients in Inpatient units (IPU) patients. It also informs us of patients in the hospital. After my report, I give my patients an estimated time of arrival. I give myself about an hour and a half window.
8:15 am: Attend the morning huddle via work phone. My team manager will discuss team-specific needs and ask if we need additional help. ( I love this so much). After the meeting, I get ready to leave to see my first patient.
10:00 am-1:00 pm: I see my scheduled patients. I check for any new changes from last week, vitals, and head-to-toe assessment. Then I order supplies and medications. If I need to consult with the physician or NP, I will do so during the visit. I also update the plan of care and set patient-specific goals with an achievement date of two weeks. Finally, I review the medication list with the patient or family and print out a new list every month.
1:30 pm- 3:00 pm: I finish up my work tasks. I enter a two-week summary notes of my patients for the upcoming team meeting.I also take this time to work on upcoming recertifications.
3:00 pm-4:00 pm: I stay close to my area so if one of my patients needs me for any concerns or STAT calls I’m available. By 3:45 pm, if I don’t receive a call from my patients or the call center, I enter my mileage for the day and head home.
This is my schedule on a good day. This is without patients needing a higher level of care visits. Depending on my schedule, I can start my day earlier or later. For example, on Mondays, I have two assigned patients, whereas on Thursdays, I have four patients to see. Each week brings a different set of responsibilities and challenges to the table. It’s imperative to look out for those clues when assessing my patients.
How I organized my tasks for the day
I handle my workday by prioritizing who I will visit first based on their health status. Sometimes, a patient may be dying. They will need daily visits, not a weekly one. I also use sticky notes for admin tasks. This includes emailing the team's admin assistant and following up with the pharmacy about a medication. I need to note that despite having an organized schedule, this can change instantly. Staying positive and open helps me get through the day. When I am stuck and need help, I ask my co-workers or email the scheduler. I never feel like I’m working alone, and that’s the best part of working for hospice. The support is unimaginable and I’m happy I made the switch.
In a nutshell
A case manager is a health professional. They help the patient get excellent, cost-effective care. Hospital and hospice care managers coordinate care and advocate for patients’ wishes. Case managers are an essential part of the patient’s team. I managed my work tasks by prioritizing and asking for help when needed.
FAQ
What is a case manager job description?
A case manager's job is to provide clinical support to the patient and family.
What is the case manager's role and responsibility?
A case manager must assess the patient’s care needs, facilitate care tranfers and advocate for the patient’s rights and dignity.
What are the types of case managers?
Case managers have different roles and duties depending on their job. Common case management roles include legal, hospital, health insurance, and home health.
