With all the jobs that have gone virtual during the pandemic, it’s easy for anyone in nursing to feel a little left out. Nurses have dealt with nerve-racking census surges on and off for the last two years while other professions have stayed safe, cut out commutes, and regained work-life balance. Where’s the justice in that? It’s no wonder why so many dedicated and nurturing people, well beyond their wit’s end, are thinking about getting out of nursing.
Though we’ve put together some tips on how to recover from nurse burnout, there is one way you can keep on helping people while reclaiming much needed work-life balance: pursue one of our remote nurse care manager positions.
These types of positions are the solution to nurses wanting to work remotely, but what do they look like in practice? And what do experienced nurses who enter these positions love about them? We took some time to speak with Merritt, one of our nurse care managers, to provide you with some answers before you apply for these types of positions. Her role is just one example of a case manager position and others will differ in their responsibilities and structure.
w3r Consulting: Hi Merritt! Thanks for taking some time out of your day to speak with us. What was your transition like to care management?
Initially, I was doing both case management and care management at the same time. This is a part-time position. I only work twelve to four, Monday through Friday. From nine to noon, I was doing home care out in the field as a case manager. So, I would put on my scrubs, get dirty and barely get back in time, still with goo all over me, to log in.
My experience with hospice and home care required more hands-on activity, taking responsibility for everything from the get-go of their care to make sure they had all the medication and all their treatments. If they had any services, I would order them. It was a lot of support and a lot more responsibility. As a care manager, I oversee the services and make sure members have things, but I don’t have to acquire them. Comparatively speaking, the care manager position was a vacation once I logged in.
I started transitioning out of home care around the time COVID began. I said I think I just want to do care management from home. It’s wonderful. I was out there working for six months during COVID, but not anymore.
w3r Consulting: What does your typical day look like?
Every day is a little different and that’s what I love about it. I am a department of one right now since I am working as part of a pilot program. The purpose is to reduce rehospitalizations. Because it is a pilot and it doesn’t have all the bells and whistles of integrated care management for the people who have the Medicare Advantage Plan, I have a lot of flexibility and leeway since I’m basically building the program as I go along. It’s up to me to think outside the box and find workaround pathways to get the job done even though I don’t have all the support of offering different disciplines like dietary support or social work or pharmaceutical expertise.
I have my tasks, and a lot of them are the initial reaching out stages to see if members are interested in the care management program. In general, people are overwhelmed with junk and scam calls, so they are reticent to answer their phones. When I do have an individual who agrees to go forward with it, I have 100% success.
Once they have been engaged and we have a care plan set up, we go through the different items that the computer generated as problems based on how they answered the intake and the assessment. Usually, the traditional workflow after you open the case is to do follow up one, two, and three before you close it. I do follow ups until all of the goals are met or the crisis is averted or they no longer need my emotional support. When I initially set the plan up, I include the label “may use later” for certain goals, and I go back to see if I really can do that for them. I figure, it’s a free benefit for them, and I want them to be a satisfied customer.
I have a supervisor and a boss who are wonderful and very supportive. They have basically given me carte blanche to run the program as I see fit. My position is a unique situation though. However, I love thinking outside the box, overcoming challenges and hurdles to get the job done ultimately.
w3r Consulting: So, not everything is one size fits all?
Exactly. I have a member right now who is non-verbal and her mom needs the care. She’s not technically one of our members, but I do a lot of emotional support for her because her daughter has end-stage MS. Everything falls on the mother’s plate. So, my job is to support her and that will be ongoing.
w3r Consulting: What other types of ailments, conditions, or traumas are you helping people with?
I work with a wide variety but that is based on occurrence. For example, I am working with my second member who has Ehlers-Danlos syndrome, which is a rare but horrible genetic disorder. That’s one where I’m surprised that I’ve had two cases in the last six months. It’s a debilitating disease.
The first type of Ehlers-Danlos breaks down your whole vascular and causes a failure of just about every organ because the blood supply to it is being cut off. The other type is characterized by hypermobility because the joints just don’t support you, because you are so double-jointed, and the ligaments and tendons are stretched out. These individuals need a lot of emotional support as well. I have a secret weapon to take care of and provide counseling for people in these situations.
w3r Consulting: It seems like creative problem solving is right for this role. Are there other traits that are essential for this type of role?
Extroversion! I did door-to-door sales when I was younger, and I’m not afraid to put myself out there and get clients and contacts. It takes a bit of that initiative to get around people who are hesitant and apprehensive. You have exactly 15 second to metaphorically get your foot in the door on the phone.
Nurses in this role need to be empathetic and truly compassionate. Putting yourself in the other person’s shoes, particularly when they’re facing depression and everything is falling apart at the seams. A lot of that might reflect on the ways they interact with you: they might be short-tempered, crabby, or they just don’t want to deal with you at this point in time. You need to understand their situation and, not push them but work with them and try to work into their program as best as you can.
w3r Consulting: Did you have certain assumptions about care management before getting into the role?
I love that question. When I was in homecare, I always thought that nurses who worked for insurance companies are basically put out to pasture, and they go to the cube farm. I wasn’t quite ready to go to the farm yet, and I looked down on those who did. I thought, “Oh my god. They went to the farm. That’s it, they’re done, they’re a wash up.”
So, I got phone calls from one of the recruiters who worked for w3r, and they presented this part-time position. My recruiter convinced me to give it a shot, and though I was very hesitant, I begrudgingly said okay. I’m so glad I did because it’s the best job ever.
Thank god this type of job exists. Now that I have a bum ankle and it’s hard to navigate these stairs and constantly ice it, I’m much safer where I am. I have greater respect and appreciation for these remote positions. COVID has raised the awareness of working remotely, and more people are open to these positions.
w3r Consulting: Do you find that working remotely allows you to create a healthy barrier so you’re not taking on people’s trauma?
Yes, I would say so. When you see people face to face, it’s a lot harder to have that objectivity and not cross the boundaries. I was a notorious boundary crasher. In this role, I exclusively communicate over the phone. That’s by design. So many members don’t have the video capacity, so we don’t even go there. Truth be told, I’ve gone on to make friends, and I love these people so much.
w3r Consulting: How do your stress levels compare to your former positions?
When I was a wellness nurse, the hours were later and later and later. They didn’t want to compensate me for all those hours. They expected me to get 12 wellness visits in eight hours. The expectation was totally unrealistic, but they didn’t care. It was all about getting the reimbursements and the sweet numbers so they could get reimbursed and make up for other deficits with these hospital groups.
At hospice, the work-life balance is the main challenge. When you get the calls at three in the morning, you’ve got to go out and do that death visit, and then you have to be ready to work the next day. Some companies give you the day off if you’ve been up all night, but not all of them do. You’re waiting for that call. When you get home from a death visit, do you sleep? No, because you’re waiting for the phone to ring again. There are few agencies that actually have a dedicated on-call staff. In general, they don’t care if you crash and burn, as long as you make the visits. If you die, we’ll get another one because you’re just a unit of production. That’s all it is.
I’ve had horrendous experiences with some companies and that’s why I so greatly appreciate this situation because I’ve paid my dues.
w3r Consulting: With the transition, is it a more permanent fit? Would you go back to hospice in the future?
For me, once you taste care management, there’s no going back. It’s been a very sweet fit, and I love it. I love the convenience of working remotely. The commute I have is from the living room to my study. The only hazard I face is turning my ankle on the carpet. That’s about it.
I love all the time I have reclaimed by not having to commute. The work itself is wonderful because I call up people and have a chat like we’re having now. We have fun, we cry, we laugh together. We do it all. At the end of the day, I feel great about a day’s “work,” so called. And I don’t have any work-related stress. Who can say that?
w3r Consulting: Thanks for the time, Merritt, and keep up the great work!
Want to learn more about how to work remotely as a nurse? Check out our latest opportunities to see remote nurse care manager jobs that can restore the balance in your career.