As a PA in the emergency department, I spend a lot of my time thinking about and talking about health – mainly the health of my patients. And a majority of the time, that means I put my own health on the back burner. My shifts are absolutely insane – I’m at an ED that sees more than 150,000 visits a year – and that insanity means that I’m more focused on my patients and making sure I don’t miss something than my own self. Some days I get done and realize I’ve never used the restroom, or never took a sip of water, or ate 9 hours ago and am starving. You don’t need me to tell you how unhealthy that is.
In addition to being unhealthy, it also makes me a hypocrite. How am I supposed to education my patients on how to be healthy when I don’t follow the rules I preach? How can I recommend avoiding excess sugars when I have a coke sitting back in my office? Or how can I recommend getting 8 hours of sleep when I’m running on 2.5?
That’s I’m super excited to have teamed up with a group of amazing PA bloggers to share with you the campaign #HealthyInMedicine!
Each of us will be sharing some of the ways we stay healthy in medicine or what being healthy in medicine means to us, and I encourage you to join in! Healthy might mean mental health and what you do to avoid burnout/stress, or it might mean physical health. For me, my mental and my physical health are closely intertwined.
So how am I working to stay #HealthyInMedicine?
I have an obsession with cups. Currently I use a Corkcicle, but I also own 4 S’well bottles (#noshame). I make a point to bring one of these to work with me because I know I’ll drink a lot more water if it stays cold. I have a goal to drink 60 oz of water during my 9-hour shifts. And yes, it means I end up having to go to the bathroom a lot more frequently, but I’ve also noticed it makes me feel a lot more awake and mentally on point – especially on night shifts. I’ve actually decided that drinking more water does a lot more for me than drinking caffeine, and so I actually try to avoid caffeine during my shift.
Getting enough sleep
On the days before I work, I *try* to go to bed at a time that will give me 8-9 hours of sleep. The key word is try because sometimes it’s just not possible. Typically what I do is cut myself off from all electronics roughly an hour before I try to go to bed. I’ll either read a book or write down my plans for the next day. Then, I actually go lay in bed 30 minutes before I’m hoping to go to bed to unwind. I have some pretty significant insomnia, so having an actual bed-time routine has really been helpful for me. On days that I work multiple shifts in a row, I tend to try and go to bed pretty immediately after I get home.
I don’t have a designated lunch break – hell I actually don’t have any designated breaks during my shifts. And when I first started work, I found it really difficult to get up and actually eat during my shift. I was too focused on seeing patients or finishing charts. And I ended up spending the later portion of my shift ignoring how starving I was and a lot more on edge. When I finally made a conceited effort to eat during my shifts, I was amazed at how much better I felt. And I totally understand how crazy/basic this sounds, but you would be surprised at the number of people who do something similar working in medicine.
Now I make a point to bring two meals and several small snacks with me during my shifts. I try to keep my food as clean and basic as possible for two reasons – it’s easier to eat and I feel good afterwards. On the days I bring quick meals or grab something from the cafeteria, I end up feeling bloated and uncomfortable after eating.
On the days I have off, I make an effort to work out for anywhere between 30 minutes to 2 hours. If I have multiple days in a row, I try to work out for longer because I have more time to get my errands/laundry/meal prep done. But even if I only have a day between shifts, I try to work out. I currently am doing the FitBody App by Anna Victoria, and I do really like those workouts (especially the length and the fact I can do them at home). I also am training (for real this time) for the Wine and Dine Half Marathon in November. And I swim or do yoga from youtube. Really, I just want to get my heartrate up and start sweating, and it doesn’t matter what I do to achieve this.
Asking for help
I’m still a new grad less than a year out from starting work, and that means I need help. Honestly though, I don’t think that will ever change. Medicine is a field where you’re never going to know everything. Its constantly changing and evolving. Some days I feel great and super confident with all of my patients, and other days I walk out of every patient room wondering what the hell I’m even going to do with them. So I make every effort to ask for help. Sometimes its reaching out to nursing staff to ask their opinions/how to correctly order something. And other times its telling my attending “hey I don’t know what’s wrong with this patient but I know it’s something serious”. If you’re ever faulted for reaching out for help in a position you don’t feel comfortable with, you need to consider looking for a new job. There is nothing wrong with asking for help. **With that being said, if you’re consistently asking for help with the same things and never learning from previous experiences, you need to do some reevaluation of yourself.
Leaving my patients at work
This is honestly the number one thing I do for my mental health. I do my best to leave my patients at work when I leave. I try not to take notes home. I try not to obsess over treatment plans and patient scenarios and what I could have done better. Yes, it’s not always possible, and yes, I definitely will bring home worry for some of my patients. But I can’t do that for every patient, or I would go insane. The first few months I worked I worried about every. single. patient. I dreamed about my patients at night. I woke up in the middle of the night going “oh f*** did I order that test”. And let me tell you, I wore myself out. I made it so that I dreaded to go to work because I dreaded leaving work.
And it wasn’t until I actually sat down and told myself to cut it out that I realized once I got home there was nothing more I could do for those patients. I couldn’t put in more orders and I couldn’t go back in time to change the things I did do. So I needed to leave work at work.
I also reminded myself that medicine is a team-based approach. Nurses can and will pick up on things that you miss. They can and will question you (and you should encourage it). Attendings can and will pimp you and ask you about those “can’t miss diagnoses”. You’re not the only person laying eyes and hands on your patient and part of what we need to do is trust that this team-based approach helps to eliminate misses.
Taking time for me
The second biggest thing I do for my mental health is taking me time. There are days I lay around the house with my cat and binge watch TV or read 3 books. There are days I don’t talk to a single person. There are days I cancel plans and stay home instead. Just like there are days I reach out to friends and grab food and drinks. I listen to what my body and what it is telling me and actually do it. It took me a long time to be able to reach this point and be willing to take time for me, but once I did it, it drastically improved my mental health.
These are just a few of the things I do to stay #HealthyInMedicine. I encourage you to check out some of the other posts
I also encourage you to follow the hashtag #HealthyInMedicine on Instagram and share the ways you stay healthy in medicine!
And as always, feel free to subscribe to get emails with new posts sent directly to your inbox! I promise not to spam you (I actually probably send less emails than I should). And follow along on social media (FACEBOOK, INSTAGRAM, TWITTER) as I try to survive life as a PA-C with a stethoscope and some sparkle