“We need to do a better job at putting ourselves higher on our ‘to do’ list”

–Michelle Obama

 

Work life balance—it is a phrase we are hearing everywhere. It seems our entire society is overworked, tired and trying to find a way out. In reality the concept has always felt nebulous to me.  What does it mean to be balanced? Can one really have true balance?

I have been thinking about this for a long time.

My field, medicine, is very different than most, and has unique challenges when trying to apply this idea of balance. We spend countless years training–sacrificing time, relationships, and more poignantly ourselves in order to become physicians. After this time, we want and expect to become normal humans again, to go to holiday dinners, to relate to our non-medical friends and family members, to have lives and more importantly, balance. Unfortunately, sometimes we struggle with knowing what ‘normal’ is anymore.

When I finished my training, I moved across the country and started a new job. The transition was jarring due relocating my life, but also because I didn’t know what to do with myself. I suddenly had more time than ever. It was lonely and unexpectedly boring. I had let relationships languish and I no longer had the safety net of a training program to provide me with ‘instant friends.’ I had also lost sight of who I was, what I thought was important, and what I was passionate about, because the job had always taken precedent. When it became possible to know myself again, I had forgotten what my interests or passions once were, and those I did remember didn’t matter anymore.

The idea of balance didn’t really make sense. I totally thought I had it! I wasn’t working every weekend, and I wasn’t spending the majority of my waking hours at the hospital. That is being balanced, right?

In my personal life, I got married and had a baby. I was fortunate to be able to take 3 months off for my maternity leave. Life was busier, but manageable.

Things were going well. I was working a few days a week and was luxuriating in my time with my baby outside of those days.

Did I have balance now? I guess.

I actually liked being back at work after maternity leave. The Emergency Department is a complex, stimulating, thrilling, and challenging environment. I love it. I am continually humbled by it, and I find myself enjoying the detective work that each shift brings.

Then winter came. Just like every year, our volumes skyrocketed, and I found myself feeling really challenged. I suspect that having my baby during the prior winter left me forgetting how awful it can get. Also having a toddler at this point and thus more needs at home made it much more difficult to suffer through. It felt like the busiest season of my life.

Once February hit, I could no longer keep up. For the first time I felt that my life was out of balance. By this time, we had been in ‘winter mode’ for a few months. Our hospital was frequently at capacity and the ED was breaking volume records daily. I was running around each shift, constantly apologizing for the wait, playing catch-up on patients that took a while for me to get to, and feeling extremely anxious.

I was anxious about falling behind, scared that I was going to miss something and possibly send home a child who was sicker than I realized. In addition, I was almost always staying late and coming into each shift with dread about how hard it was going to be.

I was exhausted. Couple that with the crazy hours, overnights, super early mornings, and it created a frustration and dissatisfaction in my life that I had never seen before. I didn’t know how to change the situation, and I was afraid I was on the road to burnout.

Most concerning to me was that I found myself becoming pervasively negative, having little to no patience, and getting angry easily. These emotions were bleeding into my personal life and I was ashamed that I was bringing my worst self home to the people I cared about the most. I was broken, tired and tapped out.

I was desperate. I knew there was nothing I could do to change the emergency department environment, but I also knew that I was struggling to survive. At home, making dinner was often out of the question and usually I didn’t even have the energy to have a connecting conversation with my husband. The patience I normally would have for my toddler was gone and I didn’t like the frazzled angry parent I was becoming.

My life was officially out of balance, and I needed to figure how to get it back. STAT. So I took some time and took a few steps back to take a closer look at what was happening. This is what I did…

1. Recognize things are out of balance.
Honestly, I think the recognition was the most important thing for me to understand in order to figure out how to change my situation. Balance is different for everyone and every circumstance. For me, the job had become more draining than usual. My compassion ‘reserves’ were running low on a daily basis and my family was suffering because of it. Rather than ignore the pattern that was developing, I realized I needed to find a way to tackle it.

2. Take a vacation.
Or do something such as a retreat or a long weekend away so you can ‘re-set’ things. Sometimes we all need to take a step back and take an inventory on what is really going on. When we are too close to our anxious and frustrating feelings, the real problem often gets obscured. For me, I was able to honestly say that I can’t change the state of the ER, but maybe I can change things around my work to improve the other aspects of my life.

3. Make a list.
Write a list of all of the things that are contributing to the feelings of imbalance and highlight the ones you have control of altering or improving. Personally, I was struggling with the timing of some of my shifts. I would work an evening shift on a Tuesday, and then turn around and work a very early morning shift on a Thursday. It was dizzying, and it was contributing to poor sleep. Poor sleep added to my daily irritation. I also wasn’t getting enough alone time. I have childcare 3 days a week, and I was working every one of those days as well as some evenings on the weekends. There were many more topics on my list, but these are good examples to think about. Fortunately, I was able to talk to my scheduler about my shift timing. In addition, my husband and I made a plan to carve out some “mommy alone time.” This would allow me to have some time to focus on me and fill the space with activities that were rejuvenating.

4. Call in reinforcements.
You need all the help you can get. I found that I was getting way behind on my ‘at-home’ tasks, and then feeling really guilty about it. This added to my anxiety. We needed to interrupt that cycle as much as possible to save my sanity. We ordered take-out because I was too tired to cook. I realized I desperately needed some support at home during my busy weekends and asked my mother-in-law to come into town to help on one or two of the weekends I was working. She not only took care of our kid, but she is awesome at organizing and did all of my laundry! I was lucky to have someone I could call. This could be anything from hiring cleaners to getting a babysitter to watch the kids while you take a nap.

5. Create and enforce boundaries.
This is a particularly hard one for those of us in medicine. We want to be ‘all-available, all the time.’ We feel this strange need to continue to prove ourselves and our loyalty to our profession by doing things others would think is crazy. Give a lecture after an overnight? Sure! Go to a meeting when you have only had 4 hours of sleep? Of course! This is where you learn to say no and not feel guilty about it. Overextending ourselves in this way only enhances our feeling of being spread too thin, which in turn worsens our ‘balance.’

6. Change your attitude.
I totally understand how annoying this sounds. I was so negative during this period, I probably would have punched you in the face if you would have suggested that all I needed to do was to change my attitude. However, I have learned since this time that the lens from which we look at life matters a lot. I was playing the victim in my narrative. No one understood how hard it was to be me, I was getting all the terrible shifts, all of MY overnights were crazy, etc, etc. As soon as I took my vacation and did my inventory, I was able to actively work on changing my circumstances, and life was less dark. As my mood improved, so did my shifts. Noted.

7. Find things to make you happy.
Then DO them. I told you that I forgot what I enjoyed and what I was passionate while I was in training. It took me a long time to figure out what brings me joy. Now I know that taking trips with my family, cooking, going to a nice restaurant every once and awhile, and now, writing, all bring me a lot of satisfaction and pleasure. If I don’t have time or energy to do any of them, I get sad, irritated and angry.

In the end, I did all of the things above, and then some. I made sure I was scheduling myself to have massages once a month and we found a babysitter to allow my husband and I a few nights alone. I felt better, and I continue to feel better (of course, the volumes also decreased as is typical with the summer).

So, for now, things are good. I am constantly assessing my ‘balance,’ and adjusting as necessary. Adding a new baby to our mix is totally going to throw everything off, but I am hoping I have enough awareness to course-correct. In order for me to continue to be happy I have to make sure I don’t feel this way very often. If it becomes my norm I will need to find another job. I don’t have all the answers, I just know that my family actually deserves my best. I’m going to try really hard give them that.

Have you had similar experiences? Would you like to share below? I’d love to hear how you handle this!

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