Saturday, April 15, 2017

More burnout

Maybe it's my schedule over the past two months or just today, but I feel more depressed than usual.  It's the second time this month I looked up medical resident suicide rates and read information on the American Foundation for Suicide Prevention regarding physicians.  It says about 28% of medical residents have a major depressive episode and that male physicians are about 40%  more likely to commit suicide. 

There's just something really wrong about medical training and the culture in medical training.  I usually only have 4 days off a month and am discouraged to take sick time unless I'm intubated.  My schedule and the things I experience really wear on me.

I love my family and my dogs, and sometimes wish I could just run away with them to a different kind of life.  I love them and everything they do for me.  We live our lives just missing one another. 

I'm probably due for an inspirational talk or a day off.  I just want to be happy again. 

Saturday, April 8, 2017

Overnight Hospital Shifts: What To Take On Call

So you're really excited about becoming an intern..for some reason unfathomable to me.  Or you're a nurse, paramedic, upper level resident, etc.

As Napoleon once said, an army marches on it's stomach, but there are additional things you need to consider when going on call.  Go on enough calls and the psychological component starts wearing on you.  You might be q2 call or q3 for years..

The unprepared person takes nothing on call but maybe they're wallet and a stethoscope.  You'll have to do your best to be comfortable for an uncomfortable 24h+ stay in the hospital away from people and friends you love.

1. Backup pair of scrubs in addition to the ones you have on.  Expect blood and fluids to get on you every call.
2. A light jacket with pockets.  Soft shell jackets are best because they're somewhat water resistant and you they don't fray like sweaters.
3.  Extra pair of socks, especially if your shoes aren't so well ventilated.
4. A breathable pair of running/walking shoes.  Some people swear by those clunky clogs, but I prefer running shoes with or without insoles for comfort.  Contrary to television and movies, you don't really run in the hospital, so the clogs aren't so limiting.
5.  Extra t-shirt along with some regular clothes (more optional than anything).  It's nice changing out of your scrubs to go pick up some breakfast or something and look like a normal person.

1. Real food cooked from home, 2 meals for when you're on 24h+ call.  Who ever truly feels fed after eating a granola bar?  Those don't really do anything for my mood.  Take granola/protein bars for emergencies (as in you're headed to a trauma or going to be scrubbed in for hours and you haven't had time to eat anything).
2. A water bottle, since some hospitals are terrible about having a water supply nearby.  If you get to lay down on call, it'll be nice having water in reach.
3. Potentially a thermos container for warm food/soup.  Soup and stew can do a lot for your morale.

Morale Items:
1. Tablet for looking things up and listening to music when you have time.  They generally have more battery reserve than phones, too.
2. Bluetooth speaker.  Nice to have in your call room, especially if you're an audiophile.  I like this one , but the DKnight Magicbox II is good if you're on a budget.
3. Foot powder.  Might sound weird, but it's great having nice, dry feet on such a long shift, especially around hour 18
4. Toothpaste and toothbrush
5. Breath mints or listerine strips to help you feel fresh  
I'm so tired and still have a long way to go today.  cheers.  I hope your call shifts become more comfortable and bearable

Friday, March 24, 2017

Wearing thin

I'm a few hours into another call and I'm exhausted.  I've started feeling sad again and am even more physically exhausted than before.  I thought about switching residencies for a while. I thought about leaving medicine as part of my future a couple of weeks ago.   I'm just so tired and feel pretty blue.  I'm on call all the time and never feel rested.  I've been getting better at my job but I think I just need time off or a different schedule, even though that's impossible.  

I'm so exhausted in every sense of the word that it erodes my hope of feeling happy and feeling better again.  

Sunday, March 19, 2017

Staying resilient

I haven't posted in a while since I've been so exhausted.  Things are generally better these days but I'm so tired all the time.  I've had the blues for a while, just a sadness that lingers and seems to follow me everywhere at work.  I still laugh and joke with colleagues and have bonded with them some more but a lot of my work feels lonely and tiring.  I hope you're all doing well, many of my readers have matched, too!   

Let me know if you have any questions about intern year or residency, it has sure been a journey so far.   

Friday, February 24, 2017

PGY 3 on the horizon

It's been a while since I've written. I've been on call so frequently and so exhausted. I think I've been better at managing my anxiety and burnout but I still feel like those are present in my life every day.  I miss my loved ones a lot and constantly feel like I'm away on a mission. 

The good thing I that I've been come clinically better.  I'm a better physician than I was starting out.  I'm just so tired physically and spiritually.  This blog is still my avenue to obtain fresh air so to speak, by writing and expression.  Everyone says residency gets better and it gives me some hope, but I still don't feel like things are getting better yet.  I'm still waiting to see that.  

Hoping I can rest spirit some and just clear my mind sometime. 

Monday, February 6, 2017

Express Yourself

I'm working post call.  Just another day.   I got to talk to a senior resident about what I'm going through and he said he went through the same thing as me!  It made me feel so much better that I'm not alone.  I've known the resident for a long time and they told me they've noticed I have changed.

Residency is hard.  People drop out. People switch specialties even 2 years into residency.  If you don't have a support structure, build one!  It's so important. If you're not comfortable talking to people in your residency, make friends in other fields at your hospital and talk, even ancillary staff.  

People in the medical world work very hard, down to the techs and people who clean the operating rooms.  I just live in a constant state of exhaustion, hunger, and thirst.  I am careful about how much water and caffeine I take in because I don't want to be stuck with having to go to the bathroom when there's so much to do or I'm in a case.  

Another aspect of residency is working with people in other fields and building my reputation as someone knowledgeable and trustworthy.  So far it's been good. I can't emphasize how important it is to introduce yourself to the people you work with, even if it's just one call shift for a few minutes. 

Going to make it through this week for some hard earned rest. 

Thursday, February 2, 2017

Resident Check In

Just checking in with everyone, wanted to let you all know I'm doing okay.   I'm just so exhausted.

A lot of my colleagues in my year are feeling symptoms of "burnout," or just feeling exhausted emotionally, physically, and psychologically.  I think it's acting synergistically with my own negative feelings.  At least some people appreciate my sense of humor in this exhausting, stressful, anxiety-inducing time.  Sort of makes me feel a little better.

Residency is so much more tiring than college and medical school.  Sometimes you'll be lucky if you don't work two weeks straight.  Taking a sick day because you actually are ill requires calling and e-mailing a lot of people at once and your absence is pretty disruptive to a service, especially if you work somewhere with a high patient census all the time.  And people might even be mad or upset with you or be disappointed in you.  It's a very strange system.

This blog has really been helping me maintain my mental health.  You can't really understand what residency is like until you do it, and it affects a lot of people differently.  

We don't work 40 hours a week.  There's no overtime.  There's no 5 day work weeks.  You might work 80+ hours a week for a year and there's no bonus, no special compensation except for maybe a $5 meal voucher when you're on 30+ hour call.  Even when it's shift change and there's an emergency, you do your duty and you stay the extra 1-2 hours to keep someone stable and save their life.

We stay late after starting our days at 430AM and spend inordinate amounts of time on the phone to make sure that patient gets seen by neurology in time, or beg to get our patient seen urgently because they have a new diagnosis of a serious problem and there's no room in the clinic for 3 months.

Everything about medicine is so tiring.  The administrative things, the legal aspects, how physically demanding it is to not eat, drink, or use the bathroom for hours at a time when you're already sleep deprived and being pulled in 27 directions at once.

I guess I'm in the process of getting stronger.  I just need some rest.