1. Treiger, Teresa M. RN, MA, CCM, FABQAURP

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Since early 2020, we have been struggling to keep our collective heads above an untenable workload waterline. If it is not a capacity issue, it is shifting priorities that keep us hopping. For others, especially those working in the workers' compensation sector, jobs were temporarily or permanently lost. My private caseload was affected because of face-to-face contact restrictions. I used videoconferencing with those who were comfortable with technology, but some complained that it was just not the same. Corporate clients put anticipated projects on hold to redirect case management staff members to more pressing work. Regardless of our work setting, the last year has affected us all.


I found myself in a new territory of having a little bit of time on my hands. I could only spend just so much time on my treadmill, so I decided to do some nonacademic reading. One book that I found globally applicable was The Mindful Athlete: Secrets to Pure Performance by George Mumford. Published in 2015, this book was aimed at sports-minded individuals. Still, as I scanned its content, the use of the term superpower caught my attention and reminded me about the many case management events I attended featuring that exact theme. As I took a deeper dive, I began drawing a few parallels that I will share with you.


Mumford shared his own story and what brought him to mindfulness was pain. His early years were difficult, and surviving life was his goal. Substance use became a way to dull the troubles, and his subsequent recovery required that he walk through the pain rather than continue to avoid it. Ultimately, he leveraged his education, formal and otherwise, to develop his philosophy of performance improvement. Whether an athlete or case manager, we can all benefit from his wisdom and look at how we can improve through the lenses of mindfulness, concentration, insight, right effort, and trust-Mumford's superpowers.



Mindfulness is the moment-by-moment awareness of thoughts, feelings, sensations, and one's environment. Being present and in the moment are other ways to describe it. Athletes apply mindfulness during gameplay by being in the zone. Case managers do so through conscious effort to help clients move through their episode of care or illness. Our achievement of mindfulness is when our knowledge, skills, and abilities allow us to fully engage in each client's present rather than run between the spinning plates of one crisis to the next.



Our work environments tend toward being a series of distractions in the form of phone calls, emails, meeting requests, and a host of other activities. For me, the pace creates frantic energy that is wholly counterproductive to my ability to do the work itself. I have cultivated a practice of focused breathing with the aid of setting hourly reminders that thump on my wristwatch. These mini respites help me concentrate amidst the disarray going on around me. Mumford refers to it as Awareness of Breath (p. 101). Although breathing is not a conscious effort, purposeful concentration on slow and regular breathing is a simple way to redirect me. It helps me get things done effectively and efficiently rather than continuing a downward spiral of frustration or anxiety. As a positive force, concentration has brought me to a place of what I refer to as process consciousness.



I know my abilities as well as my limitations. I realized many moons ago that I was not the expert at all things case management. That said, I firmly believe that I have the intellect to figure things out. That is a habit of thought. Habits become reality. When I used to think that I could not do a particular task, I failed. Taking a methodical approach to examining my reactions and actions allowed me to understand critical causative details and reshape patterns that I was not consciously aware I had developed. Mumford talks about the blueprints as a basis of our biopsychosocial operating systems. Reprograming myself was a substantial undertaking, but it was worthwhile because I let go of so much baggage that I had not even been aware of until I took the time to look within.


Right Effort

The concept of putting effort into the right things forms the basis of right effort. When faced with a care transition, I found myself making the situation a lot more complicated than it needed to be. My labors were misdirected and time-consuming, but I had already invested so much time and effort into a course of action that I could not possibly change course. That is where I was very wrong. It is seldom too late to make a course correction, but perhaps the most valuable lesson I learned was that of getting out of my own way. Mumford refers to "be still and know." It may sound counterintuitive to work driven by deadlines, but spending a few minutes in quiet consideration about what I am doing saves me hours that I would otherwise have wasted on the wrong effort.



Who or what do you trust? Do you trust yourself? Do you trust that you have the knowledge, skills, and abilities to perform your job safely and effectively? Do you trust that you will do the next right thing regarding your clients, colleagues, family, and friends? Does your trust allow you to function in a place of vulnerability, knowing that you will see any given situation through to its conclusion? I arrived at a place knowing that I could either fear or embrace challenges-be they related to work or life.


Mumford talks about paths of fear or achievement and having the confidence to be open to the next thing that presents itself. When I developed confidence in myself, I began making decisions based on all the superpowers I cultivated. The synergy of mindful, focused effort partnered with belief in myself helps me perform effectively, efficiently, and with the best intent for positive outcomes.


So, let me ask you-Which superpower are you ready to work on?