Nicole Berwald, MD Editors’ note: This is one of our articles that was written from a female’s perspective but will likely resonate with readers of both genders. We welcome dialogue from all of you on this topic.
Emergency medicine physicians are team players. Throughout the residency selection and training process, ability to “function as a member of a team” is one our most important and frequently evaluated professional characteristics. Our patients do better when our teams function seamlessly and often our clinical work environment is more enjoyable when the team gets along. We are strong work team players.
But we are also FemInEms. We are mothers, daughters, partners and friends. In these roles, we function as members, and often captains, of various home teams. And unfortunately, sometimes, the work team and the home team don’t play nice together. We frequently get pushed and pulled in opposite directions, perfecting the sport of dodging curve balls. And, every now and then, that curve ball lands smack in your face, testing your emotions and putting your coping skills to the test.
Consider this real-life scenario. The night before her first shift back from vacation, a FemInEM opens her work email to catch up. She hadn’t checked her email for the past 48 hours, working hard to shepherd her 3 children and husband back from their week away. As soon as she opened her email, her heart dropped. There it was, an email from her boss (time stamped 2 days ago) informing her that her next 3 eight- hour shifts would be extended to twelve hours due to a staffing shortage. That was the whole email. No request from her boss for help covering the department, just information that she was going work longer shifts.
And that’s what she should do, right? Work the shifts, make it happen. After all, she is a team player and the work team needs her. But what about the home team. She has to play for them too. How does she respond?
Several scenarios that run through her mind quickly. Consequences of this singular action (shift extension) that affect her balance as multiple team player. Who will pick up the kids? How will dinner get made? Can the daycare keep them longer? How much will that cost? Soccer practice is on Tuesday and Junior’s birthday is Thursday. How will it all get done?
As EM docs we adapt to adversity very quickly. A skill that likely developed as a coping mechanism, we can move through all 5 stages of grief in under five minutes. In brief flashes we experience anger, denial, bargaining, depression and finally acceptance. We do this so we can move forward and find a solution that works, often free of the emotional turmoil that plagues our more touch-y feel-y colleagues. Our solutions are often effective but frequently result in transferring some our obligations onto others.
It is a tough spot to be in. Work needs you to cover the shift so who is going to pick up your kids from daycare? Your husband can do it, but he has a standing meeting with his boss that he would have to cancel. Or your shift was supposed to be over at 3pm and you promised to meet your mom at her chemotherapy session by 5. You could ask your non-doctor sister to go, but you know how important it is for “my daughter the doctor” to check in for each session. We know this type of conflict is not unique to women or to doctors, however as women emergency physicians, we often move from obligation to obligation in such quick succession that any small ripple can throw the balance very far out of whack.
So, what’s the point of highlighting all of this. It isn’t to complain about everything on our plate. Our goal is to empower FemInEMs (and others) to understand that their struggle is not unique. We all deal with this. And we all want to show up for all of our teams. We do not want to let down our co-workers, patients, families or friends. We are physicians and professionals. But we can approach these circumstances from vantage point of control instead of frustration. In situations like this, we must find a way to make our value known and reach a solution that works for all of our teams.
In situations like this, you can make it known to your boss that that you are there for the team, BUT communicate to him what that means for you. For some it might mean financial compensation for the extra hours in excess of the usual rate. Or perhaps being flexible for these shifts translates into fewer night shifts or an extra holiday off over the block. The home team will really appreciate that.
The thing about the work place and negotiation is that someone else is often asking, it just might not be you. Empower yourself. As EM physicians we have to be flexible, it’s part of the job. There are many ways to be compensated for inconvenience in EM and you just need to ask for what you need. Standing up for yourself, while still respecting the needs of all of your teams, is the surest way to feel good when that next email comes your way.
I totally agree!!!! As an Er physician you easily multitask and this is just another way it happens . We quickly look for solutions when our double team status throws us a curve ball but have to remember not to always sacrifice ourselves . I also feel that we take that Hippocratic oath very seriously and let it carry over to our non doctor lives. We really want “1st to do no harm”, so both our teams can win the championship. Sometimes I feel we should have taking a circus juggling course … Might have made some days easier!!! But… Read more »
Great article, but one big thing is seriously missing….. Taking care of ourselves! We often sacrifice ourselves, our own personal needs for the sake of our work team or our home team. As difficult as this is to navigate, the easiest and most frequently lost time is the time we had put aside for our individual needs. I believe this is the single most contributing cause of burnout. So, do forgot to advocate for the third team… Me, myself, and I.
Thank you for your comments. Great additions to the conversation.