Is being a utilization review nurse stressful?

For example, a nurse may feel that a patient should have access to a particular treatment on compassionate grounds but that the patient is not eligible for the treatment, based on the specifics of the patient's case and the policy of the hospital or insurance company.

A utilization review nurse examines patient cases if the hospital feels that a patient may not be receiving the appropriate treatment.

For example, a doctor might recommend hospitalization, but the utilization reviewer might feel that the patient does not need to be hospitalized, and it would be better to discharge the patient to free up a bed, save the hospital money, and save money for the patient as well.

Utilization review nurses also review situations like requests for medical imaging studies, the use of certain medications and treatments, and recommended medical procedures. Hospital nurses may also be concerned about whether or not patient cases meet the standards for reimbursement by insurance companies.

All of these aspects of the job have real-world consequences, making the role of a utilization review nurse extremely stressful.