Happy One-Year Anniversary to Me!

As of tomorrow I will have been working as a case manager for exactly one year. In one year I have learned more through my hands on experiences with clients than a text book could have prepared me for. In the spirit of reflection and commemorating my anniversary, here are ten things I have learned, realized and gleaned from my first year in the field:

1. You can't "fix" everything. As a case manager, your job is to support, advocate and provide services. As long as you are doing everything you possibly can, you have done your job. It is human nature to want to go above and beyond, and most times we find ourselves doing that. Even when we have gone above and beyond, sometimes it never feels like it is enough, and that is okay. It is an emotional job, and accepting that sometimes we can't cure or help everyone is a healthy skill to realize and a hard lesson to learn.
2. Mental illnesses are very complex. Many clients have been coping with mental illness and disabilities for years and lifetimes prior to receiving services. Look at the strengths and skills that they have adopted to cope and use those to help in provide services to them. Services are supposed to make a client's life better, not cause them more stress.
3. Client determination and consumer choice is a strength. Sometimes I see clients making choices that I do not agree with; living in unliveable conditions, not taking medicine, doing drugs, refusing services. But in the end, it is their choice, their lifestyle and their decision. I am there to help support them, and give them the tools, whether they choose to take them or not and to let them know that the services, and myself, are there when they need it.
4. When you become a case manager for a client, you are an integral part of that client's life and support system. You are so much more important than you realize.
5. It is okay to turn off your phone for an hour, or even a day. The world won't end, people won't die and services won't completely fall apart. Obviously if you are in the middle of a crisis or discharge planning you shouldn't just turn off the phone, but when things have calmed to a dull roar, it is okay to take a break and catch up on the other things that have fallen to the wayside.
6. There are not enough services out there for children, or to help cope with autism. The toughest thing for me has been working with families with children with autism and disabilities and telling them that I wish there was more that we could do to help but that there just aren't the resources available to change their lives the way we wish.
7. Taking a day off or a half day and not thinking about work is needed and should be required. Laughing frequently and chatting often with coworkers is a necessity and a good job environment will make the worst day, worst client or worst crisis, manageable.
8. Documentation is so important. Social work involves a lot of paperwork. More than they ever tell you in school. But learn to manage the paperwork pile that is constantly growing and you can learn to manage the world! You never know when your notes will be needed and how they will be needed. Casenoting is tedious and necessary evil, but they are also one of the most important things we do in ensuring our client's rights are protected, their services are montiored, and their health and safety needs are met.
9. Creativity and problem solving are two of the most important and effective tools of case managment. The services clients can receive are cookie-cutter and don't always fit each individual. Finding ways to be creative, try new things and set unique outcomes and goals can be the difference between a service that doesn't fit their needs to one that can transform their life.
10. Dealing with services providers (PCAs, nurses, homemakers, transporation, etc...) is really hard sometimes! You are always the inbetween person and the link between clients and services. It is okay to get mad at a service provider. It is also very important to maintain relationships with service providers at the same time. It is a delicate balance that can either make your job easy or make your job really, really hard.

At the end of the day, when all is said or done, know that you have made a difference. Whether you have heard a "thank you" from a client or not, you have done good in the world. Sometimes when in the position of a case manager you get to be the punching bag for clients when services fall apart or when life isn't going the way clients hoped. Know that you have done your best and you have, and are, making a difference.