Speaking up for yourself ...

I find this really hard, as a junior amongst my colleagues with tons more experience than I do - but I didn't say anything about my work schedule. I just worked about 125 hours in the last 7 days (1:2 call x4, for us overnight folks) and I am completely exhausted.

I can hardly figure out how to do anything that I usually do that requires memory - like open a combination lock, or park my car into the garage.

I don't feel safe taking care of patients when I am this tired. I have never had to call in sick for being "too tired" - but I am having a lot of trouble sleeping, because my sleep schedule is totally out of whack.

I feel guilty for calling in "sick" - I am very nauseated even sitting up in bed. I don't know how people do this for a living.

I apologize for the lack of posts in the last little bit, but even my interest in looking up cool things to add to my closet has seriously slacked - luckily I planned to get little treats throughout this period for myself.

I have attached a pic of myself getting a post-call coffee with a friend though! Like my big winter jacket? It was kind of chilly (-14 to 20) these last few days!

Miss you all!

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24 Comments

  • ramya replied 5 years ago

    Oh darling Lyn!!!!

    Thats bad!!!!
    I agree with you taking sick leave... Even as a doctor only if you feel your best would you be comfortable looking after others...

    Take care sweet gal!!!
    And yes.. I think you should talk to your seniors you are not being selfish but responsible

  • Raisin replied 5 years ago

    Oh Lyn, that it tough. Both working that much and not feeling like you can speak up about it. Well as you know it's not safe for you or your patients to be that worn out, so I hope you can speak up and get your hours reduced.

    I know how you feel though. I'm young in general, and fairly new in my career (8 years) and my specific field I'm not just 4.5 years in. We can spend 3-5 days straight at a scene sometimes, and with little sleep and it's utterly exhausting. We also run short on manpower constantly. We were missing 2 people out of 4 on our unit 2 summers ago and I spent 3000 hours on call that year! Yes in addition to working 80 hours per week, I was called out constantly, and had 1 kid then and a husband that worked shifts. I knew it was for a limited time so I just did it, but honestly, never again. There is a HUGE rate of burnout in our work and I suspect you guys must be the same. They are finally realizing that people need to take care of themselves physically and mentally, but it s a slow process.

    Anyway, sorry I guess it's a bit of a rant for me too. I hope you can get some sleep immediately. And I encourage you to speak up because I would hate for you to get burnt out too and lose interest in a career you seem to be good at and love.

  • Mochi replied 5 years ago

    Ugh, lyn. I am assuming this is a residency? I am very disappointed--I had thought better of the Canadian system for some reason; don't know why but I did. This is so nonsensical to me and I too am concerned for patients who have to be seen by doctors running around without sleep for days...what a mess. I hope you can find a way out of it.

  • cheryle (Dianthus) replied 5 years ago

    I feel for you. I've had a few bouts of insomnia that last for weeks and it is exhausting and you wonder if you will ever be able to retain a thought again.

    On the plus side, you look adorable. :)

    Hope you get some rest. I have heard that guilt is a waste of time so let it go and move on. Your patients will thank you for getting some sleep.

  • replied 5 years ago

    Lyn, first off, do not feel guilty. There is a kind of superman culture in the western biomedical field, isn't there? And kind of a rite of passage by torture -- I am sure your supervisors are all "Oh, I did it, so you can do it too". (Happens in academia also!). Screw it, your health is more important.

    I think you need to get some sleep, and sort out how you can maximise your rest/sleeping while you are going through this kind of workload. Have you had luck with melatonin and a set routine for winding down when it is time to sleep? A sleep aid to ensure you are getting restorative sleep when you need it?

    Please do get some rest -- I was an operator for a while and ended up with bad shifts and would be up for 36 or 72 hours and it is crazy what your brain will do in order to try and process and shed your experiences when you can't get proper sleep.

  • Isabel replied 5 years ago

    Oh boy, that is not good. I hate how new docs get run into the ground. Your first obligation as a physician is to your patients. If you feel that your judgement is impaired, then you need to step back. Don't think of it as speaking up for yourself, but rather speaking up for your patients. Hang in there sweetie and take care of yourself.

  • Janet replied 5 years ago

    Oh Lyn, I hear you. My BFF is a general surgeon, and I remember well the days when she was in residency (we were housemates at the time). Living on sleep deprivation is so hard, and it does compromise your ability to do your job. It's hard to believe the medical community still does things this way, but there is such an attitude of, "Well, we had to do it this way, so these young newbies coming up need to suffer through the same thing we did."

    I believe we can only be our most helpful to others when we are well taken care of ourselves. Meaning enough rest, food, etc. Please do what you can to take care of yourself. Big hugs.

  • Angie replied 5 years ago

    (((HUGS))).

    It's so hard :(. Hang in there. Feel better soon and get some sleep. xoxo

  • replied 5 years ago

    You really should speak you know. You don't want to end up really sick yourself. Get some rest as soon as you can and hang in there.

  • rachylou replied 5 years ago

    Well, you look very fetching!

    I'm not sure why they have people pull those shifts like that. Everyone knows it's a danger. Countless studies...

  • Deborah replied 5 years ago

    You call in sick if you need to. You cannot look after others if you are not in a good place. Also Lyn you need to care for yourself and if you are too tired to drive etc, you are placing your self and others at risk.

  • lyn* replied 5 years ago

    Thanks everyone; I currently am taking three different types of medication to help me get to sleep (because I have such an odd sleep schedule) - and I know that I am working these extra shifts because others have gone to see their doctors about being tired/exhausted and have gotten notes to limit their own working hours. As a result, the excess are currently being dumped on the "healthy" ones - as if we won't be burning out either.

    It looks like it may be a temporary situation - they are going to hire "extenders" for us next month to cover extra shifts (phew!) - so my sleep schedule will be somewhat more reasonable!

    Most of our staff are very supportive, and one of them has sent me home because I was so bagged - some of them (surprisingly younger ones) - are actually still quite harsh about it, and try to load guilt onto us if we call in sick or don't stay past 28 hours.

    Our union is actually quite good - if the people who schedule the shifts stick to the rules - we can't technically work more than 1:2 x2, with an average of 1:4.

    I feel bad for the surgeon/medical type who have to put up with this for more than two months. I guess I'm through the rough stretch. I just got the rest of my schedule and for the rest of my career, I will never work 1:2x4 again. Yay!!!! I just feel bad for the poor residents who come after me who have to do it :|

    On the plus side, it's an extra $800 to buy something special? :)

  • deb replied 5 years ago

    Get some rest then you can find something wonderful to treat yourself!

  • cciele replied 5 years ago

    That sounds really rough and unreasonable! But glad it is over.... Hope you can get back to a good sleep schedule soon.

  • goldenpig replied 5 years ago

    Oh man, lyn, I totally sympathize! I am totally having flashbacks to those days from my surgery internship/residency. Those were the days before residency work hours reform were instituted in the US. I remember routine 100+ hour workweeks, working from 5:30-10/11 pm on non-call days, a month of straight q2 call (25 hr on, 23 hr off). My first month of internship was the hardest, I would just come home and collapse on the floor crying from sheer exhaustion and fall asleep on the floor. Once I foolishly decided to take a bath after work and DH (then-BF) found me submerged up to my nose asleep in the warm water--I almost drowned, LOL! And I almost nodded off once driving home from work, which is super dangerous. Fortunately things have changed since then (I did a second internship/residency after switching to internal med and during that period they started to institute some changes), because I agree, it's not safe for patients or for the doctors to make them work so hard and while they're so tired. But there's still this tough/macho culture in medicine to overcome ("I did it and so can you") and in some ways it gets ingrained in you...like yesterday when I did 11 cases in a row with no lunch break at 38 weeks pregnant...not as hard as taking overnight call, but still kinda crazy!

    I really hope you can get the rest that you so desperately need to function. Yes,you should call in sick if you are so tired it's unsafe for you and your patients. We doctors have to remember not to push ourselves to the brink of exhaustion, otherwise we'll burn out and/or make mistakes. I hope your schedule gets better and that you can get more rest! Lots of hugs, lyn! And you are looking just fabulous despite working so hard!

  • Mander replied 5 years ago

    I have never understood why people in so many safety-critical fields, like police and doctors, have such crazy and punishing schedules. You'd think that you would want your doctors to feel well-rested and sharp when they see patients, not crazy exhausted and unable to perform routine actions!

  • rae replied 5 years ago

    Yikes... I have no med experience whatsoever, but I'd appreciate it if my doctors weren't super tired... on the doc/hospital end, it would make sense to me that calling in sick is better than not functioning and getting some kind of malpractice suit? Ironically, I also think more kids might want to grow up and study medicine if these crazy hours weren't part of it, and then there might be enough personnel to fill the long hours. :T

    Of course none of the what ifs help you much... hang in there? I wish my skin and hair looked that good when I was horribly sleep deprived.

  • T-Rex replied 5 years ago

    I have a circadian rhythm disorder, so I can understand some (but not all) of what you are going through. I have to take meds to go to sleep, and meds to wake up, just to hold down a daytime job.

    I think you should take the sick leave to catch up on your sleep. If you were responsible for taking care of me, I would want you to be well rested!!!

  • lyn* replied 5 years ago

    I ended up taking a day to sleep ... and no one said anything about it! Sweet.

    @ Rae - they just don't tell us what call is like until we have too much debt/commitment to change our minds!

  • Day Vies replied 5 years ago

    Oh NO!!!! No wonder you've been missing in action. You must call in sick, because these hours are making you sick. There is nothing worth your health. If you don't have your health you don't have anything. you need a mental health day. There are only 168 hours in a week and 64 of them are needed for sleep!

    Call it a mental health day and call in -- sleep/decompress for two days.

  • lyn* replied 5 years ago

    LOL; we can't call in sick for two days, because you'd have to find call coverage (basically impossible). Oh well ... truckin' along!

  • Nicole D replied 5 years ago

    Hi Lyn. Sorry to hear about your gruelling schedlue. Your program director should be made aware if there are any union violations. AS a PD, I can tell you that is something that is taken very seriously. Like accreditation seriously. Duty hours in general is a hot topic. Our IM program is trying out a float system which puts all the overnight call into a two week shift. The problem is, when you become staff, you are right back on the call treadmill! Unless you practice in an academic centre and have residents. There just needs to be more of us, all on salary, working normal hours and having smaller fashion budgets! It does get better, sweetie!

  • Suz replied 5 years ago

    HUGS, Lyn - and hoping you can get some rest.

  • lyn* replied 5 years ago

    Thanks ladies; I've had two nights of sleep and now I'm back on call again tomorrow - haha; oh dear ... some of the nurses are swapping around shifts so they can work with me; so I guess I'm not too angry and hard to deal with at 3 am!!

    @ Nicole - there's a lot of shenanigans going on - the internal medicine residents are weasling the system and sticking the off service residents on the worst services with the worst staff and seriously messing with our call schedules. I guess most of us just keep quiet and not do anything about it because we serve our month and get out of there. One of the staff is no longer "allowed" to have residents due to some abuse issues, and as a result, no internal medicine residents have to work with them, but they're sticking off-service juniors to staff their service instead. I don't think I am going to do anything about it though - I only have one more month and then I won't be there anymore. Just gonna try to keep my nose clear and sanity intact.

    I sort of wish that staff docs would stop yelling at us when we're on overnight. We're here and they don't have to be - and that's okay - but really, yelling at us in the morning because a nurse paged them is kind of crazy. :| I can't really control what the nurses do, and some of them just don't like talking to residents, even though I try to be very nice and answer all of my pages very promptly. Drives me bonkers when I get yelled at (or given the evil death glare) for stuff not in my control.

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