On parental practice and burnout measures (or the beginning of Women’s Health/Pediatrics)

Outpatient OB/GYN has progressed surprisingly well. Fellow male medical students tell me they spent more time outside of the patient rooms than inside of them. With my preceptors, I’ve only been asked to step outside once or twice a day. Far less than I had been expecting. I’m honored each time a patient allows me to participate in their care.

So far, I’ve seen a handful of obstetric visits, ranging from “just found out I’m pregnant” to “very pregnant and waiting for this baby to get out”. I’ve witnessed the power of ultrasound images and how that can bond a future mother to her unborn child. I’ve measured a fundal height, felt a ripening cervix, and received a fetal kick.

I admire the relationship between the provider and patient in the OB/GYN world. There seems to be a lovely kinship between a multiparious Nurse Practitioner and a primigravid twenty-something. A reassuring, “you’ll be fine, kid.”

The GYN visits have brought me from nervous sweat to feigning confidence in my speculum usage. Half a dozen pap smears, a couple wet mounts to check for BV, and a startling amount of cervical bleeding. And again, I’m surprised every time that a patient allows me to perform a bimanual exam, to examine their breasts, or to participate in their most personal health care.

Additionally, I’ve begun a new rotation at a Pediatric outpatient clinic. Lots of well visits, lots of shots, and lots of coughs. The preceptor moves fast and examines smoothly. Much of his work is reassurance to the young parents, but I can tell that he loves his practice. He speaks to the children with such affection, there is no way that he doesn’t have a grandchild or two himself.

Overall, I’m treating the next twelve weeks as preparation and practice. Mackenzi and I have no current plans for children, except that we want them and relatively soon. Through the OB/GYN clinics and the pediatric well-visits, I can stitch together a pre-parent curriculum. I won’t be ready to have a child until we have one, but at least I can anticipate the ride.

I’ve been feeling burnt out the last few weeks.

On Monday, a friend asked me, quite directly, if I am burnt out. At the time, I tried to muster a response along the lines of, “No, just tired”. I couldn’t say it convincingly enough to myself or to her. Burn out is an incredible problem within health care, resulting in mistakes, lost hours, and emotional damage.

So, how will I manage these first feelings of burn out?

I’ll measure myself on a few metrics every week. On a simple scale of 1-5, I’ll take a quick check of how I feel emotionally, spiritually, physically, and relationally.

Am I happy? Am I connected? Am I moving and embodied? Am I loved and loving?

To avoid overreaction regarding a particularly draining week, I’ll add three consecutive weeks together and use that sum to make decisions. With a potential maximum score per week of 20 (four dimensions with a score of 5), and a maximum over three weeks of 60, I’ll set the bar at 30 over three weeks.

If I dip below that number, I’ll make time to seriously reevaluate my decisions, my time, and my energies. Maybe I’ll take some time off. Maybe I’ll prioritize certain areas to bring up the average scores.

Whatever gets measured, get managed. So, I hope to manage my wellness more effectively over the next weeks. I’m just beginning my medical education, and I need to develop strong tools to keep me going.

Haven’t felt great waking up the past week. Part of that is missing my partner who wakes up at 4a like a ninja. I miss morning kisses from her. Haven’t felt a spiritual connection in weeks. Very disconnected and very in my own head. Physically, I’ve felt stiff and weak, but I have been moving and sweating more regularly than weeks prior. I haven’t been reaching out to those that I love recently, and that needs to change.

Emotional – 2/5
Spiritual – 1/5
Physical – 3/5
Relational – 3/5

Total – 9/20
3wk running total – 9/20

Long Form Sundays

On Death Podcast

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