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Should an RN working as a utilization management nurse feel undervalued because she cannot find work in a hospital?


Dear Donna,

I have 10 years med/surg/oncology experience and haven’t worked as an RN in 10 years. I have tried to get back into nursing and it’s been a nightmare. I took a refresher course and all it did was drain my wallet. I have applied at hospitals, nursing homes, hospice, home care, dialysis, you name it.

One nursing home called and hired me and it’s been the worst experience of my life. Being responsible for 25 acute and long-term residents is unsafe and not for me. I am sorry I left in the first place but know now I can’t go back. It’s sad because I was a
good nurse.

I was lucky to get a job as a utilization management nurse at an insurance company. It appears I will always be at the insurance company. It is good pay and the hours are great but I am still sad nursing didn’t work out. We were told the profession values our experience but I feel it is not true. The profession values a BSN.

Feeling Undervalued

Dear Donna replies:

Dear Feeling Undervalued,

I hear your frustration, but I am glad you at least found a nursing job. And while a BSN has become standard for hiring in many hospitals, it is not as much an issue in other areas of healthcare. There are many nurses without a BSN working at home care, hospice, outpatient hemodialysis, etc. The fact that you have been out of nursing for so long is more of an issue for the hospital (and some other) markets. You are correct when you say a refresher course will not make up for lack of recent hospital experience. The hospital job market for nurses ebbs and flows. It all comes down to supply and demand. Right now there is an abundance of nurses with current hospital experience to fill those slots. All that may change in the next five years.

You say “nursing didn’t work out” for you. You are still very much working as a nurse, even if not in the setting you envisioned for yourself. Keep in mind there are many ways and places to make a difference and have a positive impact. I have worked both in utilization review in a hospital and for an insurance company as a nurse. I never doubted I was contributing in a significant way to the overall delivery of good quality care.

Since you apparently still desire to have more direct patient contact, I would suggest you start by volunteering in an outpatient/ambulatory direct care setting in preparation to eventually make the transition. Look for volunteer opportunities as a nurse in your local public health department, even if it’s giving flu shots for now. You also could volunteer at a free clinic or the American Red Cross. These positions will not qualify you for a hospital job right now but may help you acquire a more suitable position in this same general area. And since care is permanently shifting out of the hospital and into the ambulatory care setting anyway, you’ll be moving in the right direction. The entire landscape has changed. Read “Nursing – A new paradigm” to get an overview (

Best wishes,

By | 2014-10-09T00:00:00-04:00 October 9th, 2014|Categories: Blogs, Nursing careers and jobs|0 Comments

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