Call starts Tuesday morning, so halfway through the 168 hours of consecutive availability is Friday at 8 pm. That is downright depressing from this vantage point, but unfortunately that is the math.
I will say that weekends are usually not as stressful, because on those days, I do not have outpatients to fit in and the hospital is generally slightly quieter. I can use Sat/Sun to catch up and I will need it because this week has been demanding and I am behind on everything: patient notes, GME emails & issues, and the rest of life. Yesterday I arrived home at 7 pm and saw several mistakes on a kid’s math homework and just . . could not bring myself to address said mistakes with the kid. So I didn’t.
Josh was at work until late in part because he spent time dealing with some new house issues which are borderline catastrophic (we received a casual email from our insurance agent that they ‘didn’t notice’ things on our roof inspection — oops! — and that due to this oversight, our insurance will be cancelled if these things are not fixed in 3 weeks, and by the way no insurance = not meeting mortgage criteria so it’s not really optional. I cannot tell you how many curse words were uttered when this happened. I knew there was a reason I dislike homeownership).
Being on call highlights the relative balance and life satisfaction I DO have the rest of the time, which is good. And my current schedule only has me doing this ~6 weeks/year which really is not bad at all. But I am still dismayed at the thought that I am not even halfway through.
Here is how yesterday went:
Start the day tired (2 overnight calls and a patient I was worried about = terrible sleep. Patient ended up doing fine). Drag self out of bed at ~6:30 so no time for morning routine or energy for workout.
Leave home without eating breakfast, because I am late and not terribly hungry.
Interview 2 people (our division is hiring – which is good, but bad timing for the interview!) while feeling flustered + overwhelmed about the day ahead
Arrive at work; run around seeing patients. (Bright spot: I have a sweet + helpful resident!)
Run back and forth to hospital attempting to fit inpatient consults between outpatients. Receive EpicChat notifications (some urgent, some not) while seeing outpatients
Eat the following things from the hospital cafeteria throughout the day for lack of better options: pepperoni + cheese, graham crackers + peanut butter, completely stale and borderline disgusting bag of PopChips
Have a healthy venting session with 2 colleagues (I love my colleagues! Another bright spot)
Arrive home dehydrated, hungry, and many outpatient notes undone from the past 2 days
Ignore math homework mistakes, eat a dinner standing up, and put the kids to bed (8 pm)
Anxiously scroll, literally exhaust the internet of things to read online, answer one page, get 7.5 hours uninterrupted sleep (yay!).
(I did not scroll Instagram and haven’t since I quit in November. I actually almost feel like I have an aversion to that app now. So that’s . . . good, I guess.)
So yeah. I am truly unhappy while on call. Every time, I go in with good intentions and then it’s like literally . . . feeling like being beaten up and waiting for the torture to subside. If my job was like this all the time, I would figure out something else to do. But it’s not, so I need to . . . I don’t know, somehow figure out how to do this better. If that’s possible. I think it’s the friction/stress of feeling like I absolutely cannot do the kind of job I want to do, and knowing that the stakes are high. And add complete lack of control over the workload + unpredictability + sleep deprivation + the need to remain nice+patient through it all. It’s a recipe for misery. I also, notably, have zero bandwidth and zero patience for the kids while on call.
Today I will try to eat something that is unprocessed and avoid dehydration; I will also not ruminate on how behind I am because it is very likely I will be able to catch up over the weekend.
I am supposed to participate in a ‘work life balance’ panel at 12:15 today which . . . well. Maybe I’ll just stay quiet.
One more thing!
Here’s how, if I were in charge of the world, I would make call better:
1- Split it up. Tues 8 am to Friday at 5 pm would be one person, and then Friday at 5pm to Tuesday 8 am would be another. Yes, call would be more frequent. 168 hours of pure availability is too many in a row in my opinion.
2- Write out some clinical problem solving algorithms especially for diabetes and put them on our website. Have the paging switchboard people direct people to the algorithm first, and if questions remain unanswered then they can be connected with the on call physician.
3- Alternatively, have some kind of advanced practice practitioner or nursing/diabetes educator coverage to help with overnight calls. (This nurse perhaps be someone very part time who only works some nights and no days. It would not be a bad job – there would be a lot of sleep!). I would gladly pay for this out of my salary! Again, if there were questions we were needed for, we would help out. (In many academic institutions, fellows play this role, as I did when I was a fellow! But we don’t have fellows . . .).
This could also be a national service! Probably one shared nurse/CDE could cover multiple programs/locations. Business idea . . .
4- Clear call day schedules of outpatients to the extent possible.
There! I fixed it. Ha. Even just #1 would help. Maybe I need to lobby my colleagues . . .
One more bright spot! I ordered these and they came yesterday and they are SOOO comfortable. Totally wearing them to work today.