East Bay Getting to Zero

East Bay HIV/STI Case Management Manual

Section 9: Self-Care & Preventing Burnout

Section Navigation:East Bay HIV/STI Case Management Manual

Author: Damon Powell

As a case manager, you are constantly being pulled in a thousand different directions at once. You try to be present and available both emotionally and physically for your clients. Many of us know all too well the feelings of exhaustion and burnout that can result from constantly pouring so much of yourself into others. Many of us have accepted these periods of burnout as a natural part of the terrain. 

But it doesn’t have to be that way. Devoting time and space for self-care is essential. Running yourself into the ground until you are either physically drained to the point of sickness or suffering mental breakdowns is neither sustainable nor necessary. As you pour into others, you must also find ways to release the daily stressors and replenish yourself physically and psychologically. No one can pour from an empty cup!

Self-care is a win-win for everyone. You are better able to maintain your well-being and momentum, your agency and community benefit from you maintaining a calm and consistent presence, and the clients in your care get your best consistently.

In the sections below, we will present various ideas, strategies, and practices you can use to take care of yourself.

Self-Care:

Is It Ethical?

Research now indicates that self-care is more important than ever for case managers and those who provide direct services to clients. The current evolution of work culture to a more hybrid model has made it even more difficult and essential for case managers to practice self-care routinely. When you regularly split work time between the office and home, leaving the stresses of the day behind once you clock out can be extraordinarily difficult. 

This new way of working makes setting boundaries between the personal and professional an essential part of maintaining a healthy and safe environment for you and your clients. Studies have shown that many hybrid workers end up working longer hours at nontraditional times when working from home. With higher caseloads and longer, nonstandard hours, self-care is essential. The anguish of caring for and supporting others along with often helping to bear their burdens can quickly lead to apathy, compassion fatigue, and rapid burnout. 

Taking time to find and maintain work–life balance under these circumstances is an ethical imperative that will benefit both you and those you serve. You owe it to yourself and your clients to set firm boundaries and take the time out you need for renewing yourself physically and psychologically. 

Know Your Limits:

Establishing Healthy Boundaries

Healthy boundaries are paramount in our efforts to prevent burnout. Now that more case managers are working within a hybrid framework, establishing and maintaining clear boundaries between the professional and the personal is paramount. If you are consistently experiencing intrusive thoughts about professional tasks, projects, or clients outside of work hours, you may be on the road toward burnout. 

Boundaries are the guidelines and limits we set in order to let others know what we are comfortable with (professionally or personally). These limits and guidelines must include specific actions and behaviors that clearly define what we consider to be intrusions into our personal or professional lives. In order to set these boundaries, we must do some inner work to get clear on what we need to protect our mental and physical well-being. 

Once we have taken the time to reflect on these needs, we are responsible for communicating these guidelines in a clear, firm, non-threatening manner to those around us—be it friends, colleagues, supervisors, or clients. This may look like being clear with clients about when it is acceptable to reach out or when they can expect to hear from you, letting colleagues and supervisors know that you do not expect to field questions or review materials while on lunch, or any other limits you feel are necessary to protect your physical and mental energy. For case managers this is a necessary first step toward separating our personal and professional lives in a healthy and sustainable manner. Clear boundaries set the foundation for avoiding burnout and increasing your professional longevity!

Making it Work:

Practical Tips for the Home and Office

Now that you understand the need for self-care, as well as how to recognize burnout and clearly articulate your boundaries, it’s time we shared some practical tips on how to engage in routine self-care and avoid burnout. 

It takes a friend to be a friend

As case managers, seeking and offering support from supervisors and colleagues is a must. This means you should actively pursue opportunities to participate in peer support groups, mentorship opportunities, employee assistance programs, and other support networks where you can speak openly and honestly about your tragedies and victories as a case manager. These networks are your first line of defense against feelings of isolation and a place to obtain advice, share strategies, and give and receive emotional support. You can include friends and family members in this network if you are able to do so without violating any rules around confidentiality. 

Another benefit of networks is the opportunity to sharpen and hone your skills through continual learning. Networks are the perfect environment for ongoing professional development in a field that is constantly evolving and transforming. Many networks also offer opportunities to participate in ongoing education, training, developing the latest best practices, and mentorship experiences that will build confidence and competence while you add new skills to your resume. 

Fostering a Healthy, Supportive Environment 

Spending half your time working from home does not negate the need for a healthy working environment. Don’t be afraid to advocate for yourself and others regarding workplace policies and procedures that don’t promote wellbeing or redundancy. Speak to your supervisor and others in the chain of command about the need to update organizational protocols or workplace systems that could be more efficient for case managers or clients. This may include the need to discuss or adjust unrealistic caseloads, cutting out non-essential meetings, or establishing regular times and days for updating case notes in order to prevent burnout and ensure that quality care is being delivered to each client.

Sometimes, creating a healthy and supportive work environment will mean integrating new or better technology. Upgrading systems or installing new technological tools can often increase efficiency and productivity in ways that relieve stress. This is particularly true for technology that reduces paperwork, cuts down on administrative tasks, or prevents constant emails and notifications that can keep you stuck at your desk. 

The Personal Supports the Professional

Just as the stresses of work can leak into your personal life, things from the personal sphere can have serious effects on your professional performance. Studies indicate that consistently applying self-care in your personal life can help you develop high levels of resilience, which in turn helps with challenges in every area of life.

The list below is not exhaustive and should serve as a starting point from which to build a solid foundation of practices that you can integrate into your lifestyle and use as needed. The more tools we have in our toolbox, the better equipped we are to handle situations that arise in our personal or professional lives. 

Some of these self-care strategies could be:

  • Getting physical – Regular physical activity is essential for stress relief and mental and physical health. This could include taking a walk at lunch or going to the gym a few days a week after work. Anything that gets you moving is important.
  • A healthy diet – Proper nutrition is important to your overall health, physically and mentally. Sugary and/or highly processed foods can affect mood, not just physical health. Eating regularly helps to maintain consistent blood sugar levels through the day so you can avoid becoming “hangry” or irritable. This also means making sure that you stay hydrated by keeping a container of water near you most of the day.
  • Sleeping it off – Getting good, consistent sleep each night is integral to your overall wellbeing. Make sure you establish a regular sleep schedule and actively address any barriers that are preventing you from sleeping for 7–9 hours each night.
  • Having some fun – Make sure you plan time for any hobbies and interests you have. Don’t cancel or delay your vacations because of high workloads. Actively pursue time with friends and family to avoid isolation. Make a joke or two with colleagues at the office. Make time for the people and things that light your inner fire. 
  • Going higher – Regularly engage in practices like mindfulness meditation, tai chi, yoga, deep breathing, worship, connecting to nature, or other activities that promote inner peace and contemplation. It is important to feel connected to something greater than ourselves, whether it be the universe, collective consciousness, God, your inner being, etc. The label isn’t what’s important; it’s all about the connection.

The key to developing resilience lies in commitment and consistency. Self-care can never be a “one and done” set of practices we check-off from our to-do list. We must identify practices that work for us and commit to engaging in them consistently. This way, over time they become integrated into our worldview, so that they become automatic habits or ways of being that support the varied ways each of us navigates through life. 

Self-Care is Self-Compassion

Practical self-care tips

Commitment and consistency must be accompanied by self-compassion. The concepts and strategies above will only work if you commit to using them consistently on a long-term basis. This is the most efficient path to developing deep-rooted resilience. It is this resilience that will allow you to maintain balance, avoid burnout, and provide compassionate care to those you serve.

None of the above is possible if you are not willing to extend the same grace and compassion to yourself that you regularly offer to your clients. The more you work at soothing and caring for yourself, the better equipped you are to offer those same gifts to others. Self-care isn’t selfish or self-indulgent. The only way we can truly care for others is if we have first taken the time to learn how to deeply care for and accept ourselves. None of us is perfect, so we must cultivate the habit of being gentle with ourselves.

Celebrate the wins, manage your time and energy, be grateful, and look for the positive in yourself and others. You are the only person that you ever truly live with—so make the relationship a great one!

References: 

Author

Damon Powell, Ph.D., has been serving in the HIV/AIDS community for almost 20 years. He has served in a variety of capacities as a Counselor, Advocate, Case Manager, Program Manager, and Activist in all three Bay Area counties (Contra Costa, San Francisco, and Alameda). He currently serves as the Project Director for Primary Care At Home, Incorporated, in Oakland, California.

Section 10: Professional Growth and Opportunities for Case Managers