Wednesday, September 19, 2018

regroup / response

14 years of blogging, and just one deleted post.

I just could not leave it there if it was somehow giving people the impression that I am not a good clinician, or that I do not care about my patients.  I absolutely care.  I also always provide what I feel is appropriate advice overnight.  Is it always delivered in a warm/fuzzy/empathetic tone?  No*, though I do my best to provide the right instructions to keep the patient safe.  It can get emotionally and physically exhausting at the end of a long week, and (per my prior post), my coping mechanisms are not particularly effective.  Maybe this is a flaw of mine, but I would also venture to guess I am not alone.

In analysis of last week, Josh and I concluded that perhaps 168 hours on in a row is not the best setup for call, and for me the challenges have been compounded this year by a baseline of sleep deprivation that has lasted the longest of my 3.  A practical solution that we came up with is that I am going to see if there are other clinicians that would like to share the overnight calls over two weeks, so that there are breaks to get reasonable nights of sleep.  I also love the idea of creating more easily available literature (love this chart that a reader linked to) for our specific types of patients about what necessitates an overnight call, so perhaps in the coming years access to the right kind of care will improve.

To the few people who felt my post was a personal attack on their choice to call their after-hours pediatrician:  I absolutely NEVER meant it that way.  I know how scary things like croup or baby fevers can be, and have rushed to the ER with a severely wheezing child more than once (C, always C).  Just because it's tough to receive these calls doesn't mean people should not make them.  I believe I am allowed to find some calls more appropriate than others, but I absolutely accept that it is my duty to deal with all of them.  I was hoping to come up with solutions for how I, as the receiver, could better deal with the challenges that come with multiple nights of consecutive wakeups.   I do not believe that just because I have an MD after my name that the expectation is that I am invincible.



* and I do believe that as a woman I may be judged more harshly for this, but that is another story