Karen* is a nurse who has something in common with countless other RNs — she has a disability. She is no longer able to lift, stand for long periods of time, or do repetitive work like typing. She is eligible to collect disability benefits, but she would prefer to keep working. She has always been a bedside nurse and is depressed because she can no longer work at the bedside.
Her primary care provider had cleared her to do less physical work so as a last-ditch effort, she attended my “Career Alternatives for Nurses” seminar to learn about other options.
“A friend encouraged me to go, but I was not optimistic,” Karen says. “I felt hopeless. Then, when people introduced themselves at the seminar, I was surprised that several other attendees also had disabilities. You always think ‘poor me’ and assume you’re the only one. I realized I’m not alone, and that helped.”
At the seminar, Karen became intrigued by case management, a specialty she knew little about. She had assumed that nurses either had to have experience or had to be certified in case management to get a job in the specialty. She learned that even though some employers may prefer someone with prior experience in the specialty, any nurse can learn how to do case management and many companies (including insurers) are willing to train. She also found out that certification is not necessary to get started.
Karen was reluctant to consider working for an insurance company because she always viewed them as the “enemy.” But when she heard about the benefits of working in this type of company (regular hours, holidays and weekends off, great health care benefits, pension plan, etc.), she perked up. Additionally, she saw that while case management has a cost containment component, it also provides an opportunity to help patients get healthy, well, and stable – and stay that way.
Karen decided to attend an open house sponsored by a local managed care company. She felt intimidated walking in, not knowing what to expect. But after meeting several nurses who had worked there for many years and learning about the extensive training program offered by the company, she agreed to interview for a position. Karen opted not to focus on her physical limitations during the interview but did ask questions about the nature of the work and the workday to be certain it met her physical needs. She did mention, in a lighthearted way, that she was looking for less physical work and wanted to use more of her brain and less of her back. Karen was offered a full-time job with good pay and great benefits, and she happily accepted it.
Now, as a case manager, Karen works independently and has her own caseload, so she can sit or stand when necessary and take a break when she needs to. She was surprised at the degree of nursing knowledge and experience she was able to apply to this specialty. In fact, she had to bone up on so many illnesses, diagnostic tests, conditions, current treatment modalities, and medications that she feels she has developed a broader base of knowledge than she has ever had. What’s more, she has phone contact with patients, service providers, and equipment companies, which she enjoys. This allows her to develop long-term relationships and get to know patients, family members, and providers.
I advised Karen to join the Case Management Society of America and the American Association of Managed Care Nurses. She was reluctant to do so because her personal funds were low at the time. I explained the many benefits of belonging, including the education, networking, and opportunities for personal and professional development, and stressed that she couldn’t afford not to join if she wanted to be successful in her new specialty. She was delighted to learn that her employer was willing to pay for her membership in one professional association, so she paid for the other and joined both.
After one year, Karen has adjusted well to living with her disability, has had some improvement in her physical condition, and is an experienced case manager.
“I really thought my nursing career was over when I became disabled,” she says. “Even when first considering case management, I saw it as primarily administrative work and not too challenging at that. Boy, was I wrong! I now realize you don’t always have to use physical skills to be a nurse; my nursing knowledge is just as important and valuable, if not more so. I make a difference in my own way now, and I’m a proud and productive member of the nursing profession.”
*Name has been changed.