Reflecting on Transitions

My current thoughts are a jumble between stress, exhaustion, and challenge.

Roughly a year ago I wrote on the transition into practice, finished my midwifery program, and took off on my bike with my now-husband on a two week long bike adventure from Seattle to San Francisco. The world seemed full of possibility: we could go anywhere in the country with my job, maybe I could even bike commute, I’d transition into being a confidant, sure, wise midwife, and it would all be amazing.

There have been some hiccups in this ideal, and after four months of a painful job search I began a job in GYN. Exciting and challenging, yes, but fast-paced and slightly isolating? Also yes.

There is no perfect job, especially when you work under capitalism, as even my midwife friends working their dream jobs have frustrations of long hours, difficulty maintaining work-life balance , and the sometimes unbearable heaviness of the work we do.

After nearly nine months of work, I feel sobered. I feel tired. I feel like I’m a cog in a machine some days. I am a float, so I work in clinics that need me on a day to day basis, so that means I am never working in the same clinic two days in a row, never have a consistent schedule, and, for the most part, never see the same patient twice. Appointments fill, fire up the Nurse Practitioner machine to see them all.

Part of what brought me to midwifery is the relationship- building. It brought me joy to see someone week after week, hear about new school projects, and meet mothers, husbands, partners, children of my patients.

Yesterday, I saw a woman in clinic that I had seen roughly a month ago for birth control. She had some issues and questions, and by luck of the draw I saw her again in the same clinic. I knew by her previous chart that I had seen her, counseled her, asked her if her relationship was a safe one, and as I walked through the door, I realized I did not recognize her. Not even a bit. Not even with the familiarity that you may have for someone you sat next to on the bus once. This woman was a complete stranger to me.

This seemed somewhat of a breaking point, emotionally for me. I started to do the math. I see, on average, roughly 20 patients a day (if I’m lucky,yesterday I saw 27) five days a week. If you’re following along here, that’s 100 patients a week. 400 patients a month. And in my nine months of work, that’s 3,600 patients.

Burn out is a topic that is given little more than lip service in the medical world, as both doctors, nurses, and nurse practitioners report increasingly higher levels of stress on the job, being asked to care for more and more patients in less time and for no more pay.

I remember going to a panel at the American College of Nurse Midwives meeting last year on combating burn-out in the profession, and for the life of me I can’t remember what was talked about. I was an excited, energetic student who had not faced the pressures of independent practice, but I imagine the panel talked about many of the same things that my husband told me this morning.

I hope to make self-care goals, and use this blog, and writing about the things I am doing to combat burn out to keep me accountable to those goals
I also hope this new framing of this blog will as serve as a resource for other new providers who are beginning to feel the creep of burn-out affecting them

So, in no particular order, self-care goals round one:

1) Use the mornings that I have late clinic days to engage in self-care, weather that be treating myself to breakfast (currently writing from my beloved Geraldine’s Counter), writing, or riding my bike.

2) After we move, work on making our new apartment a home. Unpack fully, hang up all of our art, print out pictures to hang, host friends for dinners and brunches, and get to know the neighborhood

3) Return to hobbies that I love, sign up for that art class I’ve been wanting to take forever, teach my husband to brew beer, make time for riding my bike.

4) Connect with other nurse practitioners and midwives. One of the things that is so difficult about my job is that I am usually the only NOin the clinic. I love my MAs and other staff, but I miss connecting with other midwives and feeling like part of a community.

5) Make time for real connection with friends and family. If you are friends with me in Facebook, you have probably noticed I’m not really using it anymore. In all my reflecting, I realized that in my very limited time that is not spent in the clinic or commuting, I really only want to be doing things that add value to my life. Many people take joy in social media, but for me, it has always only ever increased my social anxiety and left me with a “everyone is hanging out without me” mentality. So I stopped using it. Instead, I want to focus on talking with friends on the phone who live far away, and making plans with friends in the city to catch up on what’s going on in their lives. So while you may be seeing less of me in your online life, that doesn’t mean I don’t want to hear from you, in fact quite the opposite, and I’ll be making more of an effort to reach out to you in real life 🙂

I’m going to leave my goals there for now, and I hope to check in with them often. Burn-out is a very real and devastating force, and I’d love to hear from all of you about your own efforts to combat it and lead a full, healthy, balanced life, weather your work in the medical field or not.

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3 Responses to Reflecting on Transitions

  1. Rachel says:

    Getting massage is an awesome way to take care of yourself!! I recommend monthly sessions to clients… I know that can get pricey depending on where you go but it’s pretty amazing what it can do for you. Miss you! Love!

  2. As usual, your beautiful writing resonates with me. I can’t wait to hang out with you when I move back!

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