Thursday, July 19, 2018

call stress

What happens to me when I am forced to be available* for 168 hours?

✔︎ I feel like I am literally counting down the minutes**

✔︎ I treat my body like crap (stay up too late, eat total junk food/comfort food) and then feel annoyed about it

✔︎ I tend to grab my phone and zone out on Instagram or the like, with the intent of making the minutes go by more quickly.  It does not feel relaxing; it feels like a numbing agent or some kind of illicit drug with potentially neurotoxic effects

✔︎  I fixate on the future

OH, CALL.

My call weeks aren't even that bad, practically speaking.  It's the unpredictability and total loss of control (at any time if my phone rings, I have to address it; there's a loss of freedom and choice there).  During the work day, there is potential for constant interruption and sometimes it really does occur to the point of disorientation (I'll be writing one complicated note while a nurse is calling me from the floor and someone is also standing outside my door with new patient records to review - and everyone seems to want me URGENTLY***).  One might argue that these same pressures are present a) in a normal work day as many physicians and b) as a parent (!).  However, it wouldn't bother me much in 24 hour chunks.

It's the 168 hours IN A ROW that kills me, and the possibility of getting awoken from a deep sleep every night**** (sometimes multiple times!) for 7 in a row.

The thing is . . . I am never going to find the kind of job I want without call*****, so I am going to have to learn to deal with it.  Next year, it will be approximately 1/7, which means a mere 7-8 weeks out of the entire year.******

THINGS I HAVE IMPLEMENTED:

1) That extra hour of childcare!  From 6p - 7p.  Actually, this has helped a lot.  3 kids (including one baby) and the phone = anxiety provoking situation.  I love being able to put G to bed before our nanny goes home on call nights.

2) Also strong weekend child-care coverage.  So that Josh can get some work done and I can round in a non-rushed fashion and maybe even catch up on other work.  Once I am done breastfeeding I could also see going to a workout class (of course, I'd have to step out if I got called, but that's ok) on my way home from work to add a little positive ingredient to those days.  There is an Orange Theory right next to our hospital and I'd like to give it a try someday -- again, after weaning b/c right now I just rush home because I detest pumping and like to avoid it whenever possible.

3) Giving myself a break, particularly about getting some extra sleep or intermittent crappy eating (I'm looking at you, yesterday's dulce de leche cheesecake).  I slept in yesterday + today until 6:15.  Needed it.

4) I TRY at times to find some presence in the moment and appreciate what I am doing (caring for patients, nursing G, hanging out with A&C, etc) and not fixate on when I will be interrupted.  But it's hard.

5) I watch TV instead of surfing the phone.  Josh helps drag me into this and it feels like a much healthier distraction.  Also, GLOW season 2 is genius.

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* also pleasant, compassionate, and knowledgeable but also unfailingly evidence-based

** I admit I also sometimes feel like I am counting the days of pumping.  That's a lot of wishing life would hurry up . . .

*** The funny thing is that rarely are there ACTUAL urgent situations in my field!  But the way health care is constructed, things are engineered to feel urgent (get that note done!  call that family!  figure out this "MAR HOLD"!  review these transfer orders!) even when they are not.

**** in addition to G's nightly snack, typically anywhere from 1 am - 3:30 am these days - and I am not complaining about that because once/night really isn't so bad unless one is adding multiple phone calls to the mix.

***** okay that said - there are places with LESS FREQUENT call, or where there are fellows to take some of the calls away from attending.  But most of those jobs come with other trade-offs, and I am really happy otherwise at my current institution.

****** I'm 80% pay but currently doing 100% call.  I haven't wanted to ruffle the feathers of my colleagues, especially right after taking a maternity leave.  But someday I may ask to have this adjusted, which could save me another week!