I recently saw a picture with an accompanying quote, “Remember: Nurses are like icebergs. At any one time, you are only seeing about one fifth of what they are actually doing.”

Thinking back to my orthopedic days, this is quite accurate. But, the world of nurse case management is an even more incognito way for nurses to help others outside of the stereotypical hospital shift, and, without people even seeing what is involved.

Floor nurses in the hospital take care of patients while they are admitted. Hospital nurse case managers work on discharge planning and coordinate with the floor nurses and the physicians to ensure the patient is taken care of once they leave the hospital.

Not only do they deal with insurance approval and other communication that may be stressful to a patient but they also provide a smooth transition for the patient from hospital to home. They do this by arranging home health, physical therapy, medical equipment such as walkers or crutches. This ensures the patient is safe to be home and recuperate in the best way possible.

When the Army relocated my family, I began searching for this type of work. Not only was it another way to assist patients in their recovery, but the hours are a more typical 8 a.m. to 5 p.m. schedule. Nurses who work in a ward have to volunteer for their share of night, weekends and holidays.

A nurse case manager position can often require years of previous experience. Even as a new nurse, I was able to earn a Nurse Case Manager position outside a hospital with a worker’s compensation management company, which allows me to do the same type of work, but on a smaller scale.

Here, I am still helping the patient recover after an injury. However I work strictly over the telephone with patients who become injured at the workplace. I help coordinate follow-up visits and care for the patient, as well as communicate with the providers and the employers to keep their recovery plans as streamlined as possible. I take all this information and communicate it to the insurance adjusters so that the claims can be taken care of and the employees are back at work in an efficient amount of time based on their injuries.

The range of injuries varies from simple, uncomplicated and reported but not treated injuries to severe injuries that may require surgery or physical therapy, resulting in my following them for a much longer time period.

As a former orthopedic nurse, if a patient with a shoulder injury rolled up to me on a bed, I know what to do for them. Since this is strictly telephonic, I have been learning the “under the water” part of the iceberg side of this type of nursing. Dealing with their visits, incident reports, diagnostic orders and even surgery reservations, I am still able to aid them in their recovery but from an entirely different angle than what I originally learned.

I am also fortunate enough that this particular company allows me to work from home. I was thrilled at this option and thankful that I literally stumbled upon such an amazing opportunity that allows me to be flexible for my family and still have the satisfaction of having a career helping others. I’m only two weeks in, but I’m thoroughly enjoying helping patients from this side and I look forward to continuing to learn more about nursing “on this underside of the iceberg.”