Work-Life Balance as a Resident Physician

Post-Call Glow

I promised my next topic would be on work-life balance in residency, so this post will be about how I am currently trying to maintain this balance during intern year with a few tips for those of you who will be in my shoes in upcoming years. Even though I'm only a month into residency, I currently live for my post-call days and the rare times I actually get a day or weekend off. It's during these times that I can actually feel (and look) like a normal human being again while getting caught up. Also, since my daughter usually spends her summers away and hasn't started to miss me yet, I've been able to have some extra fun without worrying about making the flight to see her on my days off.

I had the blessing of not only having a day off during my second week for the 4th of July, but a post-call day that Friday and a full "golden weekend" off. I was definitely excited for the chance to explore the city during the holiday, and what made it even better was having a friend from my GA-PCOM family in town to experience all the fun with. We went to a block party on the parkway, listened to some great music, and ate lots of yummy food from some of the food trucks that lined the street.

As for my Golden Weekend, I was super excited that Atlanta United was coming to town to play, and with tickets only being $29, I was definitely in attendance. Plus, my friend had never been to an ATLUTD game, so it was a good first experience. We had great seats, the stadium was outdoors with a gorgeous view of the Delaware river, we won the game, and although the Philly fans were a bit intense, they were actually pretty nice for the most part. There were even fireworks after the game (pictured above) which we were happy to see since we both had early work schedules and were too tired to stay up for the fireworks that occurred on the 4th of July. Afterwards, we got a chance to walk around the city to check out the nightlife, talk, and have a few drinks. It was much needed, and I felt so alive! The next day, I slept in (so wonderful!) and took a walk to the Spruce Street Harbor Park where I people-watched, ate more food, and enjoyed a day out in the sun.

Hanging out with my mentor

Since that weekend, my only time off has been during my post call days, so I've made sure to take full advantage of making the most of my free time. My favorite post-call day so far was when I got the chance to spend time with my mentor Dr. Velma Scantlebury while helping out with a dinner she was hosting for the Mandela Washington Fellows. This was a group of young African leaders who are only in the US for six weeks, so it was nice getting to meet them and hear their stories. Plus, I'm always up for free food and it was nice having some time out by the pool.

#ATLUTD #UniteandConquer

Right now, I am currently on day 14/19 without any time off unless I am post-call, so it has been extremely important that I maximize my free time to the fullest extent. As a resident, a lot of time is spent in the hospital taking care of everyone except yourself. It's easy to fall into the typical work-eat-sleep cycle, and not making any time for yourself can eventually lead to burn out. Keeping this in mind, I've made a list of things that have helped me stay sane so far. I'm sure this list will change as I get into heavier months, but so far, here are my general tips for post-call and free days:

#1: Try not to waste the day sleeping
This is probably the hardest thing to do on my list. After working 24-28 hours with very little or no sleep at all, the first thing anyone wants to do when they get home is hit the bed! It can be easy to sleep the day away, and before you know it, it's time to go back to work. I refuse to spend my entire time as a resident just working and sleeping, so I make an effort to sleep when I can while on call (even if just a 15-30 minute nap) and set my alarm to wake up when I'm post call. No matter what time I get off work on my post-call morning, my alarm is set to 230pm. So far I've been managing 4-5 hours of post call sleep, but I do have upcoming days where this will be less (such as when I attend morning general surgery grand rounds).

#2: Work tomorrow? Go to bed early
I love sleep, but if I slept all day on my days off, I wouldn't be able to sleep at night. Not a good thing when I'm typically waking up at 330/4am. So, as mentioned above, I make sure to wake up by 230pm on my days off, and I aim to go back to bed by 9pm. On days where I am truly sleep-deprived, I'll go to bed even earlier to ensure I get at least a full 7 hours of sleep (my optimal amount). This allows me to wake up feeling refreshed and ready for a new day.

#3: Have a To-Do list
It helps to have a plan for your days off. I try to keep a list of things I need to take care of, and I knock them out during my free time so I don't start to feel overwhelmed. Even if the list is something as simple as "watch Hulu, read a chapter, call daughter", it helps to have a plan.

#3: Indulge in some self-care
I am all for self-care and sometimes it's the little things that can make a big difference. On my very first post-call day, I went to the movies. Mostly to keep myself awake, but also because watching movies is something I enjoy doing. I even include blogging as part of my self-care, because I find it therapeutic. There's nothing wrong with treating yourself to a massage, pedicure, or even fancy take-out during your time off. I've done all of these when post-call, and it's a great morale boost.

#4: Get the "Adulting" out of the way
Bills and other responsibilities don't stop just because you're busy or tired. The best way to conquer them is to knock everything out when you have time off. I've utilized post-call days for grocery shopping, paying bills, and doing laundry. Things are usually less busy during the week and grocery store lines are a lot shorter. I even meal prepped the other day for my current string of back-to-back call days since I somehow managed to spend my cafeteria meal credit for the month. In the coming months, I'll utilize the time for doctor appointments and such, so that I can use my personal days for other things like making trips to see my little one and (hopefully) interviews.

#5: It's okay to not be productive
There will be some post-call/off days where you just don't feel like doing anything at all, and that is okay. Yesterday was one of those days for me. I was post-call with probably only a total of one hour of sleep in 27 hours, and I just wanted to be in bed all day. I still set my alarm for 230pm, but instead of being out and about, I stayed in bed, ate snacks, and watched Hulu all day. I think the only productive thing I did was wash clothes, and I was asleep by 8pm. Doing nothing was much needed, and I woke up feeling refreshed, and ready for another day on call.

That's all I have for a list right now. I will be post-call again tomorrow morning and Wednesday, and I already have some "adulting" items to take care of. The good news is I'll be off both days this weekend, and I will definitely be taking advantage of it. My motto is "work hard, play harder", so I am very much looking forward to another golden weekend that will only involve fun, self-care, and being around people that make me happy. If you're a resident or attending, I'd love to hear some additional tips, and to everyone else, I hope you have a wonderful week!

Month One of Intern Year: An Update

Official "long white coat" pic

Happy Tuesday! Today marks exactly one month since I made the move to Philadelphia to begin my journey as a resident physician. It's definitely been a month full of ups and downs, but for the most part, I can say that the transition into my new role has been a pretty smooth one. When I wrote my last post, I had just completed my first week of intern year. Now I am in the middle week four (yep, my program started a week earlier than the July 1st start date that most people usually expect), and I'm finally starting to adjust to the new life.

My second week of intern year was a pretty good one. I switched to a much lighter surgery service on July 1st, and after being on acute care surgery my first week, it was a welcome relief. Instead of constant ER consults and emergency cases, this month has pretty much consisted of elective cases and taking care of post-op patients. Plus, during my second week, I not only had the 4th of July off, but a Golden Weekend! For those who aren't familiar with the term, that means I had both Saturday and Sunday off. Plus, I was post call on July 6th, so it was more like having a three day weekend. I've even had time to do my surgery readings. Sooo glorious! I'll be back on acute care at the end of the month, so I'm making sure to take advantage of being able to breathe right now.

Surgery essentials

During week two, I finally had the chance to get back in the operating room. Intern year mostly involves a lot of floor work such as rounding, writing notes, taking calls from nurses, responding to pages, etc., so being in the operating room is a nice treat. My first case was a neck mass excision. Not a long case, but made me so happy! And last week, I had even more happiness, as I got to go to the OR three times! My first case (and my favorite so far this year) was an extended laparoscopic right hemicolectomy. In layman's terms, we took out a person's right colon using a scope. This was my favorite case because the senior residents were away at orientation and I got to be first assist on the case. As a medical student, I never did much outside of working the camera and closing the patient, so it was super exciting being given the opportunity to make incisions, work tools such as the bovie, laparoscopic grasper, and linear cutter, and then do a large portion of the skin closing. My other cases last week were a back mass excision, and then while on call Saturday, an emergency laparoscopic cholecystectomy (ie we removed a gallbladder). Outside of the OR, I've done a few bedside procedures such as abscess incision and drainage, so I'm constantly having little happy moments that remind me why I love surgery.

Outside of the small happy moments, intern year so far has been all about adapting and adjusting to the unknown. It seems that most people tend to struggle with this, but it hasn't been too bad of an adjustment for me (but then again, I also haven't started trauma service yet, LOL). I have this weird theory that being a parent has somewhat prepared me for the year which is why I haven't struggled with the transition as much as I've been hearing other interns in various specialties say they do. Before you brush me off as crazy, just think about it. New parents are constantly sleep-deprived, working to keep their new little person alive, always worrying if they're doing the right things, afraid of failure, on a steep learning curve, and desperately trying to ensure they have a life outside of just being a parent. Starting residency is basically the same thing. The exception being you are now responsible for multiple lives, and the struggle is having a life outside of being a doctor. See what I mean?

On the grind!

With that being said, having went through the struggle of being a single parent and juggling a million different tasks on a daily basis, I've learned a lot about time management over the years and making time for important things. Work-life balance has always been super important to me, so since starting intern year, I've made sure to take full advantage of my post call days and the rare times when I get a full day off. My next post will be all about that balance and life outside the hospital, but for now, I just wanted to let everyone know that I'm still alive, grinding, and trying to learn as much as I can. My next post will have all the fun stuff, so stay tuned!

I Survived My First Week of Intern Year!

Remind me: why was I excited about getting these?!?!

What a week, what a week! On Sunday, I officially started my first day as a resident physician, and yesterday, I completed my first week of intern year! To say this week has been busy would be an understatement. From the moment I entered the hospital on Sunday, and up until the moment I left Monday morning, things were in full swing. The day started at 430am with getting oriented and rounding on patients, and then the official rounds and work began around 6am. Shortly after that, I was handed two pagers and the consult phone because my senior resident and I were the only ones on surgery for the day, and he was headed into surgery.

Officially a working resident physician!

It was super scary being given so much responsibility right away, but I had no time to freak out. Nurses immediately started paging me, I had new consults to see, labs to check, and there were so many notes to write (progress, consult, H&P, take your pick). Since I was on call my first day, it meant I was working a 24-hour shift, but honestly, I was so busy that the time just flew by. It wasn’t until after midnight that things finally started to slow down and I was caught up enough to take a moment for myself. I took advantage of this by taking a short 2-hour nap in my call room which ended up being interrupted with another ER consult. Around 3am, I started updating my lists and going over everything since the other interns would be joining me at 4am. After rounds and updating my notes, I was officially post-call which meant I got to go home for the day.

Post-Call Smiles

Sleep after being on call for 28 hours is the most amazing thing ever! I didn’t want to sleep all day though since I was back on call Tuesday, so I woke up around 3pm and took a trip to the movies to see Jurassic World. I went to bed around 830, and woke back up around 315am. Then the schedule basically repeated. Thursday was my first normal work day, and it was kind of weird leaving at night. I’m probably an odd person, but I actually prefer being on call since I know I definitely get to leave in the morning, get a decent amount of sleep, and do some normal daytime things. Normal days are weird because there is no guarantee of getting off at a decent time since things can get hectic at any time (as I quickly discovered LOL).

Today was my first full day off since starting, and it was glorious! I slept in until 11am (I went to bed around 11 last night), went shopping for things I needed, put my bed frame and shelves together, and I just ordered food delivery. I am one happy lady!

Tomorrow, I’m back on call, but since it’s the beginning of the month, I’ll be switching to a different surgery service at the same hospital. This past week I was on acute care surgery, and our daily list always had at least 20 patients. The surgery service that I’ll be beginning tomorrow has a much lighter load, so I’m excited for the chance to finally have some time to study during the day, and maybe get more uninterrupted sleep during the night. Plus, the intern on call tonight just texted me and told me to come in a little later than usual in the morning. Woo-hoo!

Even though I’ve been super busy, I can’t help but feel super happy at the same time. This week, I inserted my first NG tube, performed a bedside I&D on an abscess, signed prescriptions with my name for the first time, and even placed my first orders as a physician! I even got paged over the overhead as “Doctor Danielle Ward” and even though it freaked me out, I couldn’t help but smile at hearing my new name being called. I literally break out into a smile when I think of all the awesome things I accomplished this week! After having not really studied much of anything since March, and not doing anything surgery related since November, I was terrified I had forgot all my knowledge. I actually know more than I thought I would, but there's still so much more to learn. Fortunately, everyone has been super helpful during the times I’ve gotten lost, or not known how to do something on the computer, and I ordered some new surgery textbooks to build my knowledge base. 

I must say this lifestyle is definitely not for the weak, but I feel completely in my element and blessed to be in the position I am. I still get kind of sad when I think about the fact that I’m not a true categorical general surgery resident (and I’ll have to reapply to next year's general surgery programs in the coming weeks), but I am so happy for the chance to really learn and improve as a physician this year. On top of that, I am living my dreams! Plus, knowing my daughter is rooting for me and not mad that I’m away makes me that much happier. She sent the above text the other day, and it completely made my week!

Anyway, my food just arrived and I’m about to start winding down for the night. Just wanted to give a quick update to let everyone know that I’m still alive :-)

Gearing Up for Residency!

I've got a long white coat now!

Things are starting to get real! I’ve spent the past few weeks completing on-boarding residency paperwork and courses, finding a place to live, moving, going through ATLS training and residency orientation which ended yesterday, and trying to mentally prepare myself for the fact that TOMORROW I officially begin my first day as a resident physician. I can’t believe I’ve made it to this point!

My daughter really knows how to make me emotional

If I’m going to keep it real though, everything has been a bit overwhelming, and I’m still in the adjustment phase. The largest adjustment so far is not having my daughter around for intern year. My parents (and my sister who I will continue to pay) have agreed to keep her for the year in Mississippi so that I can really focus on killing it as an intern, but not knowing my schedule also means not knowing when I’ll be able to see my daughter and the strong possibility of having to miss her birthday and the holidays with her. It is a blessing knowing that she’ll be taken care of, but the mommy-guilt is super strong! My daughter, on the other hand, is all happy go lucky, especially since my parents spoil the mess out of her. She even had the nerve to ask me why she couldn’t just stay with them for a few years until I finished residency :-/ I know being away from me is best right now, especially since I’ll be super busy this year, but she could at least pretend to miss me, LOL. She knows how to cheer me right up though, and the text she sent me the other day (above) really made me smile.

I’m also adjusting to my new surroundings. Believe it or not, at the beginning of this month, I had no idea where I was going to live! Philly prices are beyond expensive and since I won’t have my daughter this year, I decided to do a roommate search online. This resulted in a one-day flight to Philly a couple of weeks ago where I literally landed around 730am and flew back to Atlanta at 8pm. The day was a success though because I found a great roommate and now have a home for the next year. While here that day, I also took care of the FBI fingerprinting that I had to do in person, ate some great food, and since I found my place pretty early during the day, I even had time to go to the movies and have dinner and drinks at Morgan’s Pier before going back to the airport. The following week, my mother and sister drove to Atlanta to get the bulk of my belongings, so I literally made the drive to Philadelphia six days ago with what could fit in my car. This meant minimal belongings along with the pleasure of sleeping on an airbed all week, but luckily my last year of medical school was spent constantly on the move, so I’m used to traveling and getting used to new surroundings. Hopefully, I’ll get used to parallel parking and living in the city soon, but the bright side is Amazon delivered my bed today, so I’m looking forward to some real sleep tonight. 

My first pager!

The day after moving to Philadelphia, I began part one of the Advanced Trauma Life Support (ATLS) course, signed my training license, and received my long white coat! The day started off rough when my GPS turned off and I accidentally drove to New Jersey, but I made it in on time, and everything went smoothly. I was officially ATLS certified on Tuesday, and orientation began on Wednesday. We were given pagers, and I also was lucky enough to get one of the spots as chief intern resident. This pretty much just means that the other residents will come to me with any issues they may have, and I’ll be responsible for keeping the Graduate Medical Education (GME) staff up-to-date on everything. I see it as a great way to get to know my fellow interns, in addition to getting to know some of the faculty and staff in the program. The rest of orientation went well, and yesterday after my ACLS/BLS re-certification, I attended orientation at the hospital I will be at for the next two months. It was so surreal being given a badge that has “DO” after my name and the word “physician” under it!

It's starting to feel real now!

Tomorrow, I officially start my first day as a resident physician, and I’m on the general surgery service for the next four months. I’ll be starting off with a bang, since my first day will be on call, but I’m looking forward to finally working again. If you’re not familiar with being on call, it means my shift will last around 28 hours. The good news is when I finish on Monday morning, I’ll be post-call and will have the rest of the day off to sleep and relax. I figure it will be a great way to adjust to my new position, and being busy helps get my mind off things. Plus, I finally had a day off today, and I took full advantage of it by getting a massage, going to the nail salon, and just overall relaxing and doing what makes me happy (such as typing up this post). I’ve been dealing with a little bit of sadness over what I’ve had to recently leave behind, but I truly am excited for the upcoming new journey. I worked hard to get to this point, and I understand that sacrifices are sometimes needed to achieve goals. Hopefully it won’t be too long before my next post, but right now, I’m going to go get ready for bed because the hospital will be waiting for me bright and early tomorrow morning!

Graduation Week 2018: Say Hello to Dr. Ward!

On May 24, 2018, I finally achieved my lifelong dream of becoming a physician! God is sooo good!!!! There have been so many emotions flooding through me these past few weeks, but now that I’ve finally calmed down from the high of graduation, I can reflect a little bit. I’m still at a loss of words to describe the joy I feel for this new accomplishment, so I’ll just let all the pictures speak for me. ***WARNING: Photo overload ahead!***

Hooded!

Hearing my name with "doctor" said in front of it as I walked across the stage was so surreal! It was even more amazing hearing the cheers of my friends and family.

My daughter has been my biggest supporter on this crazy journey. For years, she has told her teachers and friends that her mommy is a doctor. Now when she says it, it will be true! I'm so extremely thankful for her always being so understanding of my crazy schedule and the sacrifices made to get to this point. I hope I have inspired her to pursue any and all of her dreams.

So thankful for my amazing parents! My mom, who was the first African-American female from the state of Mississippi to graduate from the United States Military Academy (West Point), gave birth to the first doctor in my family. Excellence is in my DNA! And my dad is just downright awesome and not afraid put me back into reality when I get too big-headed, LOL.

My sisters are everything! I literally couldn't have made it through medical school without the support, babysitting, advice, and constant laughs they bring me. 

Thankful to this amazing guy for putting up with all my med school craziness for the past three years! Whether it was being my voice of reason when I had crazy ideas (and still supporting me when I did the crazy things anyway), listening to my rants, cheering me up during the rough times, or helping me stay current with the outside world when I got too far under my med school rock, I am so very appreciative of you! 

My circle may be small, but the love is strong! This journey would not have been anywhere near possible without the people you see above! I am truly blessed!

Thankful for everyone in my med school family. You all made this journey that much easier, and I am blessed to not only call you all my friends, but my colleagues. The GA-PCOM class of 2018 was the best to ever do it!

 

Check out all these beautiful black doctors! So proud of my classmates!

And of course, I couldn't end without giving a shout-out to the Student National Medical Association (SNMA). It has been such an amazing part of both my pre-medical and medical school experience, and I am proud to say that I graduated with SNMA!