deborah212 Posted January 9, 2011 Share Posted January 9, 2011 Hi all, Just finishing my second year as a hospitalist and find that I'm still struggling with the stress of medicine. I think it comes down to a combination of things: 1) being high-strung at baseline 2) juggling rounds, admissions, and discharges and still making time to grab something to eat/have a breather 3) the occasional really sick patient 4) working 4-12s and really dragging by the 3rd and 4th day After being off for several days in a row, I do miss medicine. Looking back at my posts from when I first started, I am much more confidant than when I first began. I think my current problems stem from worrying about my patients even after I sign out and being too hard on myself when less than ideal outcomes occur, if I "miss" something, and second guessing myself. Without feedback from attendings, I tend to wrongly assume they're not happy. I do believe most of this is personality driven, but with 2 years of experience, I had hoped I'd be beyond this by now. I'm a "trees" person and need to mix in a bit of the "forest" too. At least I know my strengths and weaknesses... that's half the battle. I know that hospitalist medicine isn't a forever job for me. It is good, though, for right now. Anyone else have similar experiences or recommendations? Link to comment Share on other sites More sharing options...
jmj11 Posted January 9, 2011 Share Posted January 9, 2011 Hi all, Just finishing my second year as a hospitalist and find that I'm still struggling with the stress of medicine. I think it comes down to a combination of things: 1) being high-strung at baseline 2) juggling rounds, admissions, and discharges and still making time to grab something to eat/have a breather 3) the occasional really sick patient 4) working 4-12s and really dragging by the 3rd and 4th day After being off for several days in a row, I do miss medicine. Looking back at my posts from when I first started, I am much more confidant than when I first began. I think my current problems stem from worrying about my patients even after I sign out and being too hard on myself when less than ideal outcomes occur, if I "miss" something, and second guessing myself. Without feedback from attendings, I tend to wrongly assume they're not happy. I do believe most of this is personality driven, but with 2 years of experience, I had hoped I'd be beyond this by now. I'm a "trees" person and need to mix in a bit of the "forest" too. At least I know my strengths and weaknesses... that's half the battle. I know that hospitalist medicine isn't a forever job for me. It is good, though, for right now. Anyone else have similar experiences or recommendations? I just know that if I were to start hospital medicine right now I would be in your same boat. I'm very comfortable in the filed I'm in because I've been in it so long. However I can remember doing rheumatology for a year. It was a steep learning curve and stressful. However I think being a hospitalist would be one of the most stressful work situations. My wife is an ICU nurse. Her hospital has several MD hospitalists. She comes home talking about how some of those docs are completely stressed out when they have sick patients, especially those perplexing patients who don't respond the way you would expect or who have undiagnosed illnesses. Just don't bee too hard on yourself. When you sign off on a patient, make a point to put them out of your mind. I still have to do that as I must have confrontations with patients about once a week (usually over drug abuse issues). They can be nasty people. But I had to leave that at work or I wouldn't sleep at night. That's my only thoughts. Link to comment Share on other sites More sharing options...
DAVIDHAMEL Posted January 9, 2011 Share Posted January 9, 2011 If you are as busy as the hospitalists where I work, then I feel your pain. I got off a 12 hour ER shift last night with many of the same thoughts and feelings you have expressed. When I am tired, I tend to second guess myself and become more obsessive than usual in looking for the little details that get overlooked in the milieu. Most medical practitioners tend to be perfectionists, and we beat up on ourselves mercilessly when we aren't perfect. The fact that your mistakes bother you is simply an indicator of your caring and professionalism. Link to comment Share on other sites More sharing options...
marilynpac Posted January 9, 2011 Share Posted January 9, 2011 Yep, sounds like your overwhelmed. We've all been there and it usually happens when you're taking care of everyone else and not taking care/time for yourself. You think that docs don't feel the same way...they do. I'm glad you did have some time off b/c you actually had the time to realize how much medicine is a part of your life. You know deborah when you put up those "case of the day" threads, they are invaluable to the people on this forum. You don't have to do that but you do, thank you, thank you, thank you. I have to agree with David, we are our own worst critics. Keep up the excellent work!!! Link to comment Share on other sites More sharing options...
deborah212 Posted January 9, 2011 Author Share Posted January 9, 2011 jmj11, David and marilyn, thank you for the thoughtful responses. They definitely help. It's easy to forget all the good things I/we do during the midst of the day when being bombarded by requests for more Dilaudid, admission pages, and chest pain. I can't say I love what I do currently, but I love medicine. I'll get there eventually. Link to comment Share on other sites More sharing options...
jschmitz47 Posted January 9, 2011 Share Posted January 9, 2011 There is also the "standard" stress management advice. 1. Do you take care of your diet when you have control over it - esp. alcohol moderation? 2. Do you get sleep / exercise during your time off? 3. Do you use one of the standard stress reduction techniques of meditation (relaxation-response or TM), yoga, ...? Even a few minutes of meditation each day helps me. Hey, maybe I should take my own advice. Link to comment Share on other sites More sharing options...
deborah212 Posted January 9, 2011 Author Share Posted January 9, 2011 You know deborah when you put up those "case of the day" threads, they are invaluable to the people on this forum. I've actually been seeing a lot of interesting stuff lately. Still waiting for one that's good to work through and alterable enough for HIPPA. Do you use one of the standard stress reduction techniques of meditation (relaxation-response or TM), yoga I have been thinking about starting up yoga again. A gym just opened up around the corner. Link to comment Share on other sites More sharing options...
sbellin Posted January 11, 2011 Share Posted January 11, 2011 I'm 13 years into it and I still have days like you describe. But I also have more a ha days (when I know what to do and when to do it) then when I started. Link to comment Share on other sites More sharing options...
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