✅ Reviewed for accuracy and relevance by Deanna Cooper Gillingham, RN, CCM, FCM on July 24, 2025.
Case managers routinely interact with multiple stakeholders, including patients, their families, physicians, employers, insurance companies, and vendors. These stakeholders may each have their own agendas and potentially competing priorities. Often, case managers are asked to do more with less, which can add to the stress and overwhelm of their jobs. Add to this the feeling of powerlessness when the case manager knows the right thing to do, but constraints related to hierarchical power structures, ineffective or obstructive policies, dysfunctional communication, a lack of resources, and other issues beyond their control make it nearly impossible, and moral distress arises (Jameton, 1984).
Taking charge of moral distress is critical to a case manager’s wellness and long-term sustainability in the workforce. Obtaining support and validation from colleagues and mentors will empower self-care efforts (Fink-Samnick, 2023). This is one of the many roles played by professional organizations. They offer a network of colleagues and mentors outside the employing organization who bring a fresh perspective and sense of camaraderie.
Burnout, closely related to moral distress, is a prolonged response to chronic emotional and interpersonal stressors on the job, evidenced by exhaustion, cynicism, and inefficacy (Maslach et al., 2001). One way case managers can avoid burnout is to set boundaries with clients and stakeholders. This involves defining clear expectations of the case manager’s roles and responsibilities, along with those of each stakeholder. It can also include methods and times of communication, appropriate response times, and other boundaries.
It is common that, while caring for everyone else, a case manager neglects to care for themselves. Case managers should actively look after their own well-being so they can effectively support their clients. Although self-care is a personal matter that everyone approaches differently, some fundamental components exist, such as lowering stress, engaging in healthy practices, and participating in activities that give energy. Ways to engage in self-care include:
- Exercising regularly
- Eating a well-balanced diet
- Developing a regular sleep routine and getting adequate sleep
- Engaging in hobbies or interests
- Fostering positive relationships
- Taking breaks throughout the day, including a lunch break
- Learning to say no
- Taking time to relax
- Practicing self-awareness/mindfulness
Self-care is a daily, long-term activity that takes practice. When case management work gets overwhelming, it is important to keep things in perspective, ask for help, and embrace change.
Content adapted from CCM Certification Made Easy, 4th Edition by Deanna Cooper Gillingham, RN, CCM, FCM (2025) and used with permission from the Case Management Institute. Purchase your copy at CCMCertificationMadeEasy.com
References
Fink-Samnick, E. (2023). The Ethical Case Manager (p. 19). Blue Bayou Press.
Jameton, A. (1984). Nursing Practice: The Ethical Issues. Prentice-Hall.
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52(1), 397-422. https://doi.org/10.1146/annurev.psych.52.1.397
