Mental and Physical Exhaustion

[BlackScrubs]

I’m dealing with extreme mental and physical exhaustion for a few weeks now and don’t really know how to get help. I’ve been feeling like this a few weeks - it just hit me like a ton of bricks.
I have already notified my group that I can no longer work all nights or pick up extra shifts. I’m considering going down to part time but don’t want to make a rushed decision.
I’m trying to get in to see a sleep medicine doctor since my sleep is so disrupted.
I don’t know what else to do. My mind can’t rest and my body is extremely fatigued.
I think this is a culmination of the pandemic, agreeing to help cover holes in the schedule to the point of being overworked, a recent pay cut, unpaid compliance training, unpaid meetings, unrealistic expectations from admin.
I’ve worked several job sites my career the expectations and workload aren’t better elsewhere.

[White.Beard.Doc]

Something has to give. Meet with your director immediately to work out a plan to cut back your hours and get some rest. In your situation it seems like you should start with a week off ASAP. Consider seeing both a sleep doc and a mental health counselor.

[jfoxcpacfp]

I’m so sorry - this has been such a rough couple of years for so many people and it sounds like you are at the extreme end of busy.
At what stage of your career are you? In addition to what WBD suggested, there are a number of trained physician coaches (all doc’s) out there who have been there and done that and will meet 1-1 to help you with getting some perspective. I would suggest financial planning to give you some clarity on what you can and can’t afford to do over the short- and long-term, but I’m afraid additional meetings would only add to the stress. If you’d like a list of coaches I recommend, you can email me at [email protected]. I have no financial relationship with anyone (other than than one is a long-time planning client).

[Bdoc]

It really depends what type of Doc you are. If you are a surgeon, maybe you are correct. And im not burned out yet, but my goal is to work part time. If your salary is 300 and part time is 150 but your mind/body is good, take the pay cut. $$ isnt everything.

[VagabondMD]

There is a lot of this going around. Your body and minding are responding appropriately to abnormal circumstances. This pandemic, with the horrible political environment and anti-health crusaders, has broken a lot of health care workers.Do whatever you need to do to take care of yourself. This might include a break, counseling, fewer shifts, shorter shifts, or whatever you think you need. Do not let anyone convince you otherwise. We need you (and others like you) in the game long term.

[StateOfMyHead]

It sounds like the past year + has been stressful for you but if the extreme fatigue is acute onset over the past few weeks without a clear external contributing factor I would see your pcp to rule out a medical concern.

[Zaphod]

You are working extra and a pay cut? thats bs.

Agree with at least a week off asap. Maybe look for more reasonable work at same time, but at least just rest, and try to rebalance.

[legobikes]

You are working extra and a pay cut? thats bs.

Agree with at least a week off asap. Maybe look for more reasonable work at same time, but at least just rest, and try to rebalance.

Yep. Are you Emergency?

[BlackScrubs]

Yep. Are you Emergency?

Yes

[White.Beard.Doc]

Yes

I am sure you feel responsible for covering your group and your patients and doing a million other things. But there comes a point where you simply have to take care of yourself. I strongly suggest you take some sick time to regain your balance. I know how hard that can be, you may not want to ask for help. But you really do need to ask for help. I have worked in the ED for many years, I have grey hair and a grey beard, I have been a medical director and done everything that entails. If you feel like talking at any point, please feel free to message me.

[Max Power]

You are a physician. Have some self respect. Pay cut (as inflation goes crazy!) plus more hours/shifts? No way.

Sometimes you need to step back or even check out to think it through. You won't ever enjoy the work if you don't see the "why" and have fun plans, dates, trips, etc for days off. As was said, money's not everything... and the more you make, the worse your health and your financial decisions tend to get anyways.

And if you aren't already, start working out with weights. Power pose yoga (astanga, etc) is also good if you you don't like iron. Seriously. I don't care if you're busy. Both take less than an hour, will tire you out (esp lifting), and it lets your mind wander while you do it, and you will sleep like a baby.

You need to control your career asap. The sleep part will get very bad very fast... cut some shifts and get to the gym/studio. It is worth draining some accounts to prevent serious health problems. If you go manic or anxiety or something, you will lose MUCH more money than you would have by cutting down or checking out for a month or two. Again, you're a doc. Have some respect... there is always work for us.

[CordMcNally]

You need to control your career asap. The sleep part will get very bad very fast... cut some shifts and get to the gym/studio. It is worth draining some accounts to prevent serious health problems. If you go manic or anxiety or something, you will lose MUCH more money than you would have by cutting down or checking out for a month or two. Again, you're a doc. Have some respect... there is always work for us.

The way EM is set up now makes it very difficult to control your career. If you’re not a partner in a SDG it can be tough. You may be able to work part time but it’ll likely be at the expense of working in less desirable places with even increased stress during your shifts. I have a job 99% of other EM docs would love to have and it’s still tough and has only gotten tougher these last 18 months.

[Max Power]

The way EM is set up now makes it very difficult to control your career. If you’re not a partner in a SDG it can be tough. You may be able to work part time but it’ll likely be at the expense of working in less desirable places with even increased stress during your shifts. I have a job 99% of other EM docs would love to have and it’s still tough and has only gotten tougher these last 18 months.

I realize this, but you get what you allow.

The low stress easy life makes us fat and bored and FOMO.
Intermediate stress is good... it sharpens us, keeps us challenged.
Overload stress is toxic... breaks the body, breaks the mind, the spirit. It should be avoided even if it means doing locums in bumble or regrouping for the rest of the year.

You get what you allow.

[avenger]

I developed a chronic illness which probably was borne in some part out of stress.

I had to completely rethink how I look at life and work.

Please listen to others and take this as a warning sign. You need to work on yourself so that you can have a long meaningful career.

[wideopenspaces]

Step one, you gotta get some sleep ASAP. No one is well when they are sleep deprived. If you can't get ahold of your pcp for something, prescribe yourself some trazodone, hydroxyzine, gabapentin, mirtazapine, or heck even seroquel. I know it's not ideal but you gotta get some rest. Then you can figure out the next steps. I'm sorry this sucks. Hang in there and please take care of yourself.