EXECUTIVE SUMMARY
Case managers need to maintain optimal communication skills, and one way to do this is to make sure they’re mindful of their own stress levels and emotional health needs.
- CMs can focus on mindfulness, which is a strategy for being in touch with one’s own work stress, and can be accomplished through meditation, yoga, and other activities.
- Self-talk can be negative and defeating, so CMs should be aware of it.
- Motivational interviewing and other practiced communication skills help facilitate better rapport with patients.
Case management takes place in a fast-paced world where communication is the fuel that keeps the engine running. As such, case managers might take a look at their own communication skills and strategies to see if they need a tune-up.
“There are so many calls that have to be made in a day and so many cases to get sorted out and to hold in your mind,” says Claire Casselman, MSW, LMSW, psychosocial intake case manager at the University of Michigan Comprehensive Cancer Center in Ann Arbor, MI. Casselman spoke about strategies for patient encounters at a case management conference on Nov. 10, 2015, at the Michigan State University College of Nursing in East Lansing.
“So what are some skills and strategies that we can bring with us to work each day — not only in the global sense as case managers, but also on a more micro level of what happens in the moment?” she says. “We need to take a two-pronged look at what keeps us at our best and what we call upon to stay in the moment with the patient or in this situation.”
Casselman offers the following suggestions for improving communication and mental readiness:
• Focus on mindfulness. “It’s an overexposed term that is a very practical way of being self-aware during interactions — whether you’re on the fly, and monitoring what your body is telling you at any point in time,” Casselman says.
Each person should make sure they’re taking opportunities for time out from work stress. Moments of mindfulness can help them replenish their brains, contributing to fitness and balance, she explains.
Exercise helps with mindfulness, as do yoga, tai chi, and meditation.
“I practice meditation and yoga, which I know shifts my brain chemistry into that place that is restorative and helps to clear my thinking,” Casselman says. “Simple breathing exercises, journaling, mindful meditation, yoga, and tai chi are the things that increase our breathing and increase the release of helpful chemicals, and they also generate community and connection with our colleagues and peers.”
Mindfulness is not luxury; it’s essential for one’s professional mental health: “If we really want to be effective and stay in the game for the long haul, then we have to protect our finest resource, which is our self,” Casselman says.
Time is not the obstacle that people believe it is, she adds.
“I’ve met plenty of people with kids at home who’ve built these activities into their daily lives,” Casselman says. “It’s not necessarily taking a lot of time; a mindfulness practice can be accomplished in 5 to 10 minutes a day.”
• Notice your inner voice. It’s important to be aware of self-talk, which affects mood and motivation.
“Our own self-talk can be soothing and comforting, or it can be harsh and very critical and demanding,” Casselman says. “Make sure you’re getting enough sleep, exercise, and are soothing your inner critic.”
The first step is noticing one’s self-talk, she notes. “A lot of us run on autopilot every day and don’t have an awareness of how hard we are on ourselves.”
Once aware, a case manager should identify the beliefs behind negative thoughts and rationally check those assumptions, asking if that is really what you think, Casselman says.
“The question is, whose voice is that? Who am I channeling right now? Usually I can back that up to a parent, teacher, or significant adult in my life,” she says.
If a CM notices that the self-talk suggests feelings of stress, then it might be time for a breathing exercise, she adds.
• Build calming moments into the day. “Preparing yourself for your day includes building in calming moments,” Casselman says.
One difficult phone call can set a negative tone for the day, so case managers need to re-collect themselves with calming moments at those kinds of times. This strategy begins before heading for work, she says.
“Start with an intention for the day, saying, ‘No matter what happens today, I am going to — fill in the blank: eat a healthy lunch, walk for 10 minutes, go outside for 10 minutes,’” she explains. “The cues help to remind yourself how to manage [stress] during the day.”
Casselman keeps something in her pocket that serves as a touchstone; touching it is soothing and alleviates worry. “I have a physiological reaction to it.”
Case managers also can build calming moments into their interactions with patients through learning to partner with patients and evolving to guiding them rather than directing them, she says.
• Use practiced communication skills. Motivational interviewing and other communication skills help improve the case manager’s relationship with patients, she adds.
“Help them feel like they are your partner in this, as opposed to your being the person who says, ‘Here’s what you do,’” Casselman says.
The goal is to obtain a patient’s buy-in and clarity: “If they feel like their needs aren’t being heard, then they’re less likely to have buy-in,” she explains. “The care manager is asking the patient what the patient needs so the person feels like a partner with whoever is on the other side of the bed or desk.”
A good start is to ask patients what they hope for their health outcome.
“Often, the answer is what we expect to hear, but sometimes we’re missing something,” Casselman says. “They might have a desired outcome that doesn’t seem to fit with our need to get them services in the home or whatever it might be.”
The strategy is to start the conversation from the point of how the patient frames the problem and what is utmost in importance to the patient in this situation, she adds.
“Now we can understand the patient a little more, and we’re listening for and hearing in the patient what the patient is motivated to do and try,” Casselman explains. “With that information, we can figure out how to connect the patient dots with the provider dots so that we’re not handling it in a prescriptive fashion.”
Case managers make it their goal to make a connection with patients where the patient is. “If we do that, we’ll say, ‘Do you think that will help you with your largest concern? How will that help?’”
Following this strategy might take a little more time up front, but it can save time down the road and reduce the chance of the patients returning to the doctor to complain that they heard some information from the case manager that they don’t understand, Casselman says.
“It won’t work for everybody, but if we can invest in assessment and relationship-building outside the gate, then it creates a connection to patients and increases the chance of a buy-in,” she adds.
Case managers need to maintain optimal communication skills, and one way to do this is to make sure they’re mindful of their own stress levels and emotional health needs.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content