How Much Do I Actually Work (on call)?

February 4, 2020


Since I’m not very good at tracking time, I actually don’t know the answer to that question! But I think I will try to find out. I would also love some objective data on how often I am woken up — I suspect it feels like much more than it actually is (though there is something about going to sleep KNOWING you could be woken up that is inherently less restful).

YESSS, I am entering a call week. I haven’t been on for a ‘real’ call week that includes nights/weekends since October, so I am as fresh / up for the challenge as I’m ever going to be!

On the downside, call has been harder for me since starting in the program director role. Because as much as I’d like it to, that part of my job doesn’t just ‘stop’ for 7 days! I try to get a lot done beforehand and don’t schedule unessential meetings. But this week, for example, we have a second look meeting Thursday night, I have a (hopefully quick) 3 pm meeting today, and I have a 9:30 AM conf call on Friday.

On the upside, since I take less call now (about half of what I used to, in proportion with the clinical part of my job) and we have changed our nanny’s hours, I no longer feel pressure to be home at a specific point. (I spent so many years stressing over this!). And I certainly am not fitting in multiple pump sessions + racing home to feed a baby — now THAT was stressful. So really, I should be able to complete my work without a lot of external stressors making it harder/more time-constrained than it actually is.

SOOO, tomorrow I will post daily for at least 1 week, and will include:

  • hours worked
  • calls overnight (ie, wakeups)
  • a daily “grade” on my stress management. From A+ to F-. Because why not.

Today promises to be a busy / long one. I am inheriting an inpatient list that is . . . not short. And I have a hospital group business meeting (mandatory for all employed physicians) from 5:30 – 7:00p, though if I have to go late due to patient care issues that is okay. BUT I only have 3 outpatients. Okay! HERE GOES.

PS: I had an Inbox Zero QUADRAFECTA yesterday — both of my digital and physical inboxes were empty yesterday afternoon! I guess I was gearing up. Obviously they are no longer empty but that’s okay. Weekly (to biweekly) dumps are my style — the batching approach. But it feels so amazing in the moments when everything is (transiently) clear!!

PPS: As you can possibly see above, I went to sleep at 8:40 last night. IT WAS AMAZING. Also, I started The Snow Child. Gorgeous wintry scenes; a lovely call week read.


  • Reply Elaine February 4, 2020 at 6:52 am

    I’ll be so intrigued to compare your on-call overnight wake ups to ours. I work in a public hospital and we are the only subspecialty to offer an emergency phone service for patients so there isn’t much to compare our service to (we are the exception not the norm in Australia). Hope the on-call well goes well and there’s lots of As and Bs on your daily reporting.

  • Reply omdg February 4, 2020 at 8:44 am

    I loved The Snow Child! (Curious to hear what you think of the ending….)

    I totally feel you on the “always” being at work. It’s also hard to figure out what “counts.” For instance, yesterday I got up at 5:15 (woke up without alarm at 5!!) and ran another stats model, backed up my computer, and printed some documents to review in the OR that day — which didn’t actually happen. Then I walked to work and thought about my projects. On one hand, does this “count”? On the other, OBVIOUSLY IT COUNTS. Then I was in the OR doing clinical work until 3PM, had some pretty intense cases, walked home. When I got home I printed out my contract, signed it, and sent it back to my new place (!). Then I sat. For a while. Ate dinner. At about 6 I finally went downstairs and prepared for a meeting I’m having today. Sent email at around 7:30, then went upstairs and sat. Went to bed at 8:30. So. It was a remarkably productive day in retrospect, and I am quite proud of all I accomplished! But still I am a little annoyed with myself because I could have exercised during my “sitting” time. On the other hand, I probably just needed to decompress a bit.

    Looking forward to reading your call logs! Maybe you’ll find that logging your actual wakeups makes you see that it’s not as bad as it feels? On pain service we had home call 12/14 days in a row and while we rarely got called, it was still totally horrible. At some point I realized I probably wouldn’t get called and slept better… but then if I did get called I’d be totally disoriented because I’d been in deep sleep rather than crap call sleep. IDK there’s probably no perfect solution.

    Call sleep sucks. No two ways about it.

  • Reply Elisabeth Frost February 4, 2020 at 10:37 am

    I’d love to know how you manage your early wake-ups with your husband’s sleep + not disturbing your kids. I am neither a morning lark or night owl, but at this point get up at the same time as my kids which is just tough. But, when I set an alarm my light-sleeping husband gets disturbed and my kids are usually stirring that early and I have to walk by their doors to get anywhere. So, unless I wake up before 5 (which is TOUGH for me), I feel like it’s hit-or-miss whether I’ll get the quiet time I want?

    Suggestions from anyone?

    I feel like I need a hard reset on life/schedule, and early morning seem like the only way to fit that in…but I’m having a hard time committing.

    • Reply Lily February 4, 2020 at 1:52 pm

      Could be worth trying a Fitbit (or similar) – one of the features I use most is the alarm, which vibrates gently on my wrist. There’s a bit of a buzzing noise (similar to a phone on vibrate but quieter) but I’ve found it a great way to have an alarm that wakes me up but doesn’t disturb my husband. I also set it to go off a few times a day to remind me to take a breath, drink water, look at where my day is going and reset if needed. There’s also a feature that buzzes at 10 to the hour if you haven’t done at least 250 steps – which is a great way to have a subtle reminder to start wrapping up a meeting. It does very little for my fitness levels but I love having it!

      • Reply Elisabeth February 4, 2020 at 6:44 pm

        Lily: I have an Apple watch which has this feature; I just find it annoying to wear a watch to bed? I think I could get used to it pretty quickly, so I should try that. I’ve added it to my to-do list!

    • Reply Kaye February 4, 2020 at 3:47 pm

      I use the iPhone Bedtime feature for my weekday alarm which has an alarm that starts very softly and gently and slowly builds. I usually hear it right away and jump up and turn it off…no one in my family ever seems to hear it. But I also have to walk by kids’ rooms and I also have found that if I am not up in the “5:00 hour” at some point, at least one will wake up. As long as I’m up in the pre-6:00 hour I am usually in the clear to sneak by. I also try to remember to pull their doors at least partly closed after they fall asleep at night. I don’t make any noise or do anything on the level where their bedrooms are and head straight downstairs when I get up. I’d play around with trying to find the sweet spot for how late you can wake up while still being earlier than they start stirring! Finally, depending on how old your kids are- mine now know that before 7 a.m. (the time we all need to start getting ready) is Mommy’s quiet, personal time, so if they DO wake up before then, they are expected to lie in bed or on the couch and quietly read a book and basically leave me alone. Haha! I sympathize!

      • Reply Elisabeth February 4, 2020 at 6:47 pm

        Hi Kaye: thankfully my kids are good at staying in their rooms. They have alarm clocks and aren’t allowed out until it says 7:00. That said, if I stay on the main level, they invariably find some excuse to come out; or even just hearing them puts me on a sort of alert. I should just make sure I have everything I need in the basement. It’s just much cosier upstairs!
        Also, I guess I need to figure out what I should do. Sometimes if I have trouble sleeping, I’ll catch up on back-logged paperwork, or even fit in an early-morning run, but I can’t think of any one thing I’d want to do early every morning? Maybe fitting in reading for pleasure? I never seem to have the energy at the end of the day to fit this in…

    • Reply Sarah Hart-Unger February 5, 2020 at 5:09 am

      I also use the iPhone Bedtime. But Josh often wakes up early too so it’s not an issue (or he has no problem continuing to sleep OR he’s accidentally fallen asleep downstairs so it’s a moot point– 🙂 ). In our old house, kid wakeups were an issue but luckily the layout in this house is such that they are upstairs AND you don’t need to walk past their rooms to get downstairs. These little things can make a difference!!

    • Reply Abigail February 7, 2020 at 1:00 pm

      I use the vibrate and ring function on my Samsung alarm. It vibrates for 15-30 seconds before the sounds start. I also use a song with a lot of low notes so it isn’t startling to baby or husband. They rarely wake up.

  • Reply Erika February 5, 2020 at 10:38 am

    Hi! Would love to hear more about how you’ve shifted the nanny’s hours to cover more of the evening. Getting home on time causes me so much stress. I am contemplating adding in a second babysitter/housekeeper for the morning so I can extend our nanny’s hours into the evening, so curious how it has worked with you being home with her before/during your kids bedtime. Thanks!

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