1. Powell, Suzanne K. RN, MBA, CCM, CPHQ


The fast pace of change in the health care environment can lead to stress and burnout. Case managers are acutely susceptible, as they are often the front-line "go to" professionals expected to solve all problems. Some tips to decrease negativity and increase resilience are discussed.


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While driving home from a tough day at the hospital, lamenting that I want the magic bullet (or fairy dust) to decrease case management stress and burnout, a radio clip caught my attention. Van Cliburn, one of the most noted classical pianists in our lifetime, had died. In the 1950s, when schoolchildren had weekly air raid drills, hiding under school desks in case the Russians attacked after the successful Russian launch of "Sputnik," Van Cliburn became a symbol of hope when he won the coveted Tchaikovsky Competition in the Soviet Union.


As I listened to recordings of his performances, I was struck by the utter beauty of his playing and lamented, "What if I took the music road, instead of the nursing road I chose?" Certainly, no one can "burn out" playing music! I was also struck by another thought: How could I have misjudged his performance so inaccurately when I heard him play in the 1970s at a live performance? What I remembered about this concert was thinking how "robotic" he sounded. I was wrong (I must have been wrong!); this was not what I was hearing on the radio in 2013. This pianist had an intuitive command of music, channeling his emotions through the keyboard as a master!


Then, like an immediate answer to my quandary, Van Cliburn's life tale unfolded. It seems that in the 1970s, he suddenly quit performing. Although no one knows why for certain, the widely held belief is that the pressure of performing, the critics' sharp tongues, stage fright, and his own perfectionism had led to burnout.


Putting two and two together, if it can happen to musical "greats," what can be done to help case managers who are being consistently audited; expected to be all things to their employers, the patients, and others; to decrease readmissions and the rate of insurance denials; to be a discharge planner who pulls out miracles for safe patient discharges with no resources and massive needs; and the list goes on.

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In an effort to pull together a bit of hope, I have borrowed some tips from one of this month's authors, John Jude Reynolds. In 2007, he wrote an article titled, "Negativity in the Workplace: Whether Its Origin Is Organizational or Personal, the Problem Must Be Addressed." Some potential words of wisdom follow (Reynolds, 2007):


1. Do not get "hooked" by a negative employee or coworker. Stay focused and remain professional.


2. Encourage coworkers to confront negative behavior and to let their coworker know how that behavior makes them feel.


3. Set the expectation that negativity is inconsistent with the values of the organization. Name it! Confront it! Expose it! And be honest in admitting to working to remedy systemic problems-such as persistent staffing shortages.



I have also asked Ellen Fink-Samnick, the Energizer Bunny(TM) of Professional Resilience(C), to, in David Letterman fashion, give our readers, "Ellen's Professional Resilience(C) Top Ten for 2013":


10. Seek support from colleagues, peers, and professionals


* Engage with a mentor(s) to empower your aspirations


* Seek reinforcement from peers


* Reach out to colleagues to validate your intentions and actions


9. Give yourself permission to take control and shift gears to regain objectivity


8. Find fun ways to release frustration


* Silent Meows and/or Primal Screams


* Reflection time


* Engage in a favorite activity


* Dance like nobody is watching!


7. Think of Teflon:


* Stay attuned to boundaries


* Don't let the tough stuff stick!


* Anticipate & LET THINGS ROLL OFF!


6. Value vs. de-value your professional self


* Take opportunities to educate others about your value to the process


* If you can't advocate for yourself, nobody will do it for you!


5. De-connect to re-connect


* Take "tech-free" time-outs!


* Re-engage with the rest of your life!


4. Turn off that professional switch!


* Make it a ritual when you leave work


* Have peers who are Not in the biz


* Set limits for yourself plus others


* Just say no to peers and family members when asked for "Professional Advice"


3. Take 10:


* 10 seconds: to process and breathe


* 10 minutes: when unsure what to say or do


* 10 hours: when it's time for a day off


* 10 days: when it's time for vacation


* 10 months: It's time for a new job


2. Pay it forward:


* Set an example for the next generation of professionals by prioritizing your individual needs as readily as those of your patients.


* Tell at least one colleague a day how valuable he or she is!AND #1 is.......


1. Professional resilience yields personal POWER!


* Grounding your professional value strengthens your personal core



October 13-19, 2013, is National Case Management Week. We are important. YOU are important. While you are taking care of the patients we serve, remember to care for yourselves and use this wisdom from our fellow colleagues. Celebrate you!




Reynolds J. J. (2007). Negativity in the workplace: Whether its origin is organizational or personal, the problem must be addressed. American Journal of Nursing, 107(3), 72D-72G. [Context Link]


case management; resilience; stress