“Just get through residency”, they said. “Things are so much better as an attending”, they implied. I was finally at the light at the end of the tunnel and had reached the goal every medical physician in training dreams of. All throughout medical school and residency I was waiting for the moment when I would finally be done. When all the years of training would come to an end and I could finally start living my dream job and dream life
Burnout. Fatigue. Job Dissatisfaction
Those were the feelings that resonated within me once I began my journey in the job market.
I remember my first day as an attending. With a fresh patient census in hand, and a shiny new badge with the word “Attending” in red ( which I still didn’t believe belonged to me), I acknowledged the change of status in my life. No longer was I a student (though medicine is a lifelong course) or was I under the stewardship of a senior physician. I was now on my own, expected to admit, diagnose, manage, and treat acute and chronic illnesses within the adult population. And discharge patients- in a timely fashion of course. It was overwhelming and exciting at the same time. My first day as an attending I was in the hospital for 15 hours. I chalked it up to being in a new role in a new environment. The second day I stayed for 16 hours. Again, I thought nothing of it. By the end of the week not only was I exhausted but my head was a whirlwind due to the steep learning curve that had occurred within one week.
As the days and months went by and I became more familiar and comfortable with my newly acquired position, I realized the hours and job requirements were not changing. Due to the physician shortage (plaguing many hospitals nationwide) I was picking up extra shifts, extra calls, and also working nights. Going over 12 hours was becoming the new norm and my days off were spent sleeping in an attempt to recover from the week. The people closest to me were taking notice of the impact this was having on me. The social life I couldn’t wait to have after training was nonexistent. My mother claimed I was unrecognizable. Friends asked if I was still in residency.
The light at the end of the tunnel had now become smoke.
The last straw was when I landed in the Emergency Room. Waking up that morning for work I didn’t feel like myself. With a boggy head and fatigued body I trudged to work (going to work ill is another post for the future). I felt “off” the entire day but alas still completed my shift. As I headed to my car that evening something kept telling me to turn back, to get myself checked out. Now as many people know, physicians make the worst kind of patient. “All I need is rest” I kept saying to myself. But I forced myself to head to the ED.
As I sat in the waiting room waiting to be triaged I chuckled to myself, thinking at how paradoxical this all was; having just spent 13 hours taking care of others only to now take care of myself. Once I was placed on the cardiac monitor to my surprise my heart rate was in the 130s. Asked if I had been feeling palpitations, I said no but recalled waves of dizziness throughout the day I tried not to notice. Two liters of normal saline, an EKG, and a full set of labs later I was discharged with a diagnosis; dehydration and fatigue.
I stayed home for two days after my visit to the ED, much of which is a blur as it consisted of sleeping and eating.
After my two hour experience in the Emergency Room I knew I couldn’t do it anymore. The lengthy hours, long stretches of days, and high patient census were enough for me. I needed an exit plan. I honestly did not know what to do or what they next step was; but I did know I could no longer continue in this capacity- for the safety of myself and my patients. As physicians we go through medical school and residency with the goal of spending 30+ plus years in our field. Anticipating working in our “dream jobs”, we envision a lifetime dedicated to patient care. What we are not taught is what to do when patient care does not equal care for ourselves. No one explains the risk of hurting others when you are not well. The idea of job dissatisfaction and what to do if it occurs is rarely brought up during training.
Speaking with a colleague one day and letting her know what I was going through she asked me to consider locum tenems work. I had heard of the idea; traveling doctors filling needs in primary care and inpatient facilities nationwide. I had never considered it a possibility for myself. I was always under the impression that I would always work a full time job in whichever city I was living in.
But as I began to research locum physicians jobs I was pleasantly surprised.
Mulling over blogs from locum physicians, I began to read stories similar to mine and realized that I was not alone. There were several doctors who had once done full time jobs but for one reason or another decided to go into Locums. I was most attracted to the stories of individuals who wanted to reclaim their time; to decide when they wanted to work and how often. Never had I imagined I could create my own schedule; working around family functions, personal events, and holidays rather than the other way around.
Others spoke of the lucrative aspect of Locums, and how with the physician shortage the need for Locums physicians was only going to expand. The idea of traveling to various locations (all the while collecting hotel points, airline miles, etc) was also something that seemed exciting and worthwhile. I was sold.
Initially I was nervous to let physician colleagues know I was going into locums. I wondered if they would question my clinical competency as I was stepping out of full time work. But rather it was quite the opposite. Many applauded me for taking the leap of faith, in taking my career into my own hands, especially at such a young age and at the start of my career.
So how has it been?
Life changing. Locums has been the breath of fresh air in the time where I was unsure about my career path. As Congresswoman Maxine Waters states (whom I affectionately call Auntie Maxine), I am reclaiming my time.
I have been able to learn several hospital and medical systems in a short period of time and become savvy in an array of electronic medical record programs. I have learned there are several different ways to do things; from treating physical ailments to dealing with psychosocial issues. I have meant a plethora of patients from varying backgrounds all with varying degrees of complexities and have learned quite a bit from them. Sure things are not perfect; there are times where I go over my shift at work, or the I have a high patient load. However I am reassured in the fact that it is for a set amount of time and that ultimately my schedule is how I wanted it to be.
Most importantly, transitioning to locums has allowed me to pursue other endeavors outside of medicine. With the extra time in my calendar I have been able to create my NGO, Healing Words Foundation. The joy I get in being a physician philanthropist, something that was previously only a dream makes all the years of studying and training on the road to MD worth it.
Locums tenems work is not the saving grace for physician fatigue, burnout, and job dissatisfaction. It is however what I needed to take charge of my own life. The realization that we as physicians should be able to control our lives and careers is now on the forefront of many hospital administrations and discussions. Overall when we consider patient health, we must consider our own and the fact that an unhealthy individual cannot take care of another. Will I be a Locums physician forever? I don’t know. Will I ever return to full time work? The future can only tell. For now I do know I have finally achieved the work, life balance I longed for and have finally made it to the end of that tunnel.
Originally published at medium.com