¶ Clear Communication for Self-Care
I'm going to start with my number one thing that I do to make sure that self-care is very important while working , and that , for me , is working out . For the past two and a half years , y'all I'm telling you , I've been getting my Billy Blanks on Richard Simmons Royce . It's sweating time , and sizzle , and sizzle , and sizzle .
Let's keep it moving , because you're going to get me started . Anyway , tip number four and sizzle , let's keep it moving because you're going to get me started Anyway tip number four . This happens everywhere . Let me check my fourth note , which is communicate about expectations , concerns to staff and colleagues .
Be very clear to consulting physicians what you can , can't do or what the concerns are and that's it . And I think sometimes when you are very opaque about things , it leads to more calls , more questions , you know , just more . It's just not a really good . It's not a good situation because people don't know where you stand .
Right .
So for me , when I start my my evenings , or whenever I start my mornings , when I'm rounding in the ICU , the first question I always ask , like I'll ask , I'll say , like what happened overnight Right to have is what are your specific nursing concerns that you have ?
Specifically that you have , because I want to hear from you like two hours later about something that you should have brought up like an hour ago , two hours ago , and I'm in the or now . So I just say what concerns do you have ? And then , by the time I'm walking out of the patient's room , I asked the nurse .
I'm like okay , so we covered a , b , c , d , e , f and g . Does that address ? That address the issues that you may have ? Good , all right , don't call me , I'm out .
Don't call me , love you , but don't call me .
I'm out . You know what I'm saying .
Yes .
Or with colleagues or with coworkers . I'm very clear like , hey , listen , I just want to make sure you're consulting me for A , b , c and D , right , okay , cool , I'm going to write down specifically about this , this , this and this .
And , just to be clear , you will be following up on this right , because I'm going to document this right , like that's how I talk with them and stuff . Because for me it's just like there's I always have this thing and this is why I'm in therapy . Probably I always have are not crossed , the i's are not dotted . Do you see what I'm saying ?
And I can't move on . So that's why I'm just like listen , I know it's uncomfortable , but listen , when I finish seeing this trauma patient , you , the ed doc , you're going discharge , right , all right , cool .
This patient is still in the ed .
He's just wondering when I cleared the c-spine and all the trauma labs and all the trauma stuff is negative . I talked to you already about it . Don't call me two hours later saying , hey , are we discharged ?
I told you yeah , so clear , clear communication is definitely self-care that you are right about , so I learned . I learned about that . You sure you can cover me for this date . You sure , sure . So I learned about that . You sure you can cover me for this date , you sure , sure .
So I learned about that specifically with you Triple sure , especially in in clinical decision making .
My wife the habitual line stepper , If I don't show up on this thing .
What's she going to do ?
She's going to line step .
OK , she going line step Okay . So , anyway , I learned about , like specifically , being very clear and creating conditionals , which I'll tell you in a second .
Was that off ramps ?
No , not necessarily off ramps , but creating conditionals in clinical like , in your clinical decision making in medicine , so that you get the calls that are pertinent . And I learned that from Dr Vadia , who was my guy and aunt attending .
You be naming all these people . Oh , she was good .
She was good . She was a younger attending , so she definitely like she knew what her boundaries were . She had young children , she liked to be home with her kids by a certain time and she was very clear , and so you knew exactly what Dr Vedia wanted you to call her for and didn't want you to call her for . She was extremely clear .
She was like if this , then that , if that then this , if this , do not do that , if not this , then do this .
Sounds like trauma .
I mean , yeah , she was very algorithmic in terms of her communication with us to say what she wants to be called for and what she doesn't want to be called for , and I learned that very early enough so that when I became an attending , you know , I could replicate that and let the nurses know call me if this happens .
You know , call me if this doesn't happen , you know . And I think that that makes for self-care , because then you don't have people calling you because they don't know what you want them to call you for . So , yeah , she put out 200 of urine in the last hour . Great , why are you calling me ? Yeah ?
I think one of the things that drives me nuts .
Why ? Why did I get that call One of ?
the facilities that I'm at is like I'll get like a page at 2 in the morning of yeah , someone's like home medications are like reconciled and it's just like okay , this is blinking , like you know . It says NPO for like a case . Right , you know the nurse is going to be mad at us , but y'all be doing that shit .
We call ourselves out , but sometimes we got to call you out too , so stop running .
Well , I think you call ourselves out , but sometimes we got to call you out too , so stop running . Well , I think you know again , but that part of that is clear communication .
Don't call me for no damn home . Don't call me for no home . Bed reconciliation at two in the morning .
Some of that is clear communication right .
But it clear communication gets rid of the ambiguity .
You guys move on right .
Ask questions . You guys move on , right , ask questions . It takes the emotion out of things when you ask questions to me , in my opinion , right and then give options if there are .
So that's what dr media was doing .
Yep , if this , then that I think one thing that the residents um can definitely talk about or can definitely experience and I think internal medicine doctors experience this a lot , hospitalists experience this a lot is getting dumped on right because , I could not be , I am yeah , because hospitalists I feel bad .
I even go front y'all like they are I feel bad for y'all they get dumped on a lot y'all are the city dump and I think one way I saw this on reddit and it made a lot of sense like you got to be really careful because it's very easy to start snapping at people , right it's very easy to start snapping at people , right , it's very easy to start snapping
at people of course , but a lot of times when they call like either way , like if they call like you can't just hang up , right , you got you could , you could , but you got to handle it .
So I think one way to look at it is this like , look like , you know , I think sometimes it's there is this like me , versus the world type of mentality , right , which is the opposite of the beratement type thing , right , which is you got beratement on one side which is like yo man , I can't believe I messed this up , I ain't shit , you know stuff like that
, right , like in my head , right not physically right , right I'm in therapy , right . But then there's the other side , which is like yo , like we . We ain't met nobody on the service . Don't call me yo , it's me against the wheel , we just trying to get through .
¶ Navigating Interprofessional Relationships in Healthcare
And that's just as stressful , right , because anytime someone calls you , it's like yo . Why are you calling me about a potassium of 2.7 ? Because it's low . So , why are you calling me about that ?
And it's like but , dude , like you get let me see if I could like tap the bone and release some potassium and calcium or something like that .
Anyway , but , ortho , we love you , but I think that having that other approach can be just so stressful also , right ? oh , yeah , absolutely I think if you just look at it as look man , this is just , this is the game . This is the game of being in the hospital . This is how it is . We're in a litigious excuse me United States .
Everybody wants to cover themselves , or some people may not just be as educated quote unquote as how you think you may be . So having this being upset about certain things in the whole scheme of things is really not that big of a deal . It's really screaming at that nurse or screaming at that case .
Worker or screaming at your colleague really going to get you through the day any faster than what you really have to and , if anything , if you are so very miffed- and just so y'all know , nurses be screaming at each other too , y'all so of course they do y'all be nurse ? On nurse crime ?
yeah , but if you are so very miffed about , you know , an interaction that you had , you know , based on some clinical decision that either was or was not made . Um , then at that point you have to either make the decision to walk away if you are that mad Damn , got like costochondritis or something .
That's because you're not working out .
Anyway , I worked out today what are you talking about . Or you have an academic discussion so that they understand what your thought process was , because when you encounter them again , that academic discussion can at least be in their heads .
Yeah .
You know like they need to understand that right , Like I've had plenty of academic discussions , particularly about preeclampsia .
You know with nurses , you know about certain , you know situations that we've had with patients , situations that we've had with patients , and so that understanding , you know , allows them to kind of see things a little bit differently , so that now they approach the patient , they approach me differently , they approach what they're doing very differently .
I see that a lot . I'll tell you where I see that a lot .
I see that a lot in the icu like particularly icus , where it's a mixed unit where you have medical and you know medical critical care patients , and then you have surgical critical care patients and we treat everybody differently right medicine tends to do things like hydrate , hydrate , hydrate no surgery is hydrate yeah , you guys , you know , whereas medicine tends to
you know , use las , use Lasix , a lot and things , and we're just like yo chill , you know , or you know like we're just or we're just more , not cavalier , but like , for example , like you know , if someone needs , if someone's creatinine is elevated , but we know that a decision will be , a decision will change based off of someone .
Has you know contrast or not ? Like to hell with . If they need dialysis , like I can put a dialysis catheter in , but if I miss some , like some internal bleeding or what have you , whereas medicine tends to be a little bit more like well , I'm going to lean on the consultant to let me know that .
Or let's make a decision based off of an ambiguous CT scan , and I get it right , because they're worried about the other things that come along with it . Right ? Dialysis in and of itself doesn't occur in a vacuum , like there could be some people who just don't come off of dialysis because of that . I get it , so you know it's just different .
So sometimes , excuse me , a lot of times the nurses are just like listen , like I'm asking a question because , to be honest with you , like the majority of the patients that I've been taking care of up until this point have been medical patients and we do it this way , and now you're telling me to do X , y and Z .
And they may not understand why . Yeah , so that academic discussion . Like you know , don't sleep on that .
Let's get into the last couple of tips , because this show is getting a little bit longer than I thought it was going to be . Y'all .
We had a lot to discuss .
We did have a lot to discuss . What are you , my therapist ? Let ? We had a lot to discuss . We did have a lot to discuss . What are you , my therapist ? Let's move on
¶ Setting Boundaries for Work-Life Balance
. Hey , tip number five is boundaries . Yo Straight up . This is my favorite part and I keep it short and sweet in this one Boundaries . Here's one thing that I do . Scrubs never come home with me . Oh , I have a lot of coworkers who take scrubs home with them . Scrubs never come in with scrubs and I just there's a doctor on instagram what's his name ?
the anesthesiologist . He always posts he's home and he has like his yeah , he's got like his surgical cap .
Sometimes he's got his scrubs and his white coat and he's home and he's like making dinner or he's fixing his bed or he's vacuuming all in the white coat and the scrubs I got you and people are always like why you got your scrubs on doing all these chores .
Well , you got to let people know that he's a doctor you could put it in a caption yeah , it doesn't go for the same effect .
It's like remember when we were in med school and then people would go to like the plaza and they would go study in the Guys they're in their first two years of medical school Not one clinical and they would go to Starbucks , or what have you ? Only simulation Reading a USMLE book in scrubs ? I'm like . But why USMLE 1. ?
Why , like you didn't go to class in scrubs ? Remember that you didn't go to school in scrubs . Most people went to class in scrubs , but I know people for a fact will go to school in regular clothes and change and change and go to Starbucks in scrubs .
But they're studying . Maybe they just want to be comfortable .
Oh , hold on a second . This is before figs , this is before all those other things . These are those stiff-ass , those things that my mom used to wear and shit like that . I had to iron back in the day and put like starch in all that shit , like those type of scrubs . You know what I'm saying ? Dna scrubs Hell yeah , why are you rocking these at Starbucks ?
You just want everybody to know you're a doctor . Just call it what it is , or you're studying to become a doctor . I mean , they can figure it out by the first aid book that you have holding up like this . Really , who reads like this and highlights ? You know the book is hanging Like everybody ain't got to know that you're reading from the first aid book .
Nee , they put the book on the table . Stop playing . So , so scrubs never come home with me , right , for me I feel like it's like a day cleanse , right , like a day like I've known that I didn't do that in in residency oh , I did in residency just because I was just so tired . But as an attending .
I've never brought scrubs home plus my swag was whack back then too and stuff okay , but now what that means . But now , like the , clothes I wear the sneakers . You know , I'm saying the nikes , I wear yo them fake jordans .
I got the man with the transformer t-shirt .
Yeah , I know this shirt is a little too stiff for me anyway , or it's a little too small . There's a medium , but what y'all think , what y'all think , but yeah , that's for me . The other thing that's really in , that's really um big , is I'm not reachable when I go home .
Right , so the only person Tiger text off .
The only person that can reach me is the on-call surgeon Right when I'm home the on-call surgeon , just in case they need me to come in as backup , and the physician assistant who's on call with that surgeon . Nobody else can reach me , right , you know , because it's just like I don't want to answer anything at 7.01 , 7.10 .
There's somebody there who's there who can answer that question for you . And for me , I just feel like it's a slippery slope .
Boundaries , boundaries boundaries ? Because once I answer that question You're going to be liable to answer all the others .
Well , it's not even just that . But once I answer that question , then I got to call my colleague and tell him or her what happened . And then they may be like I don't even agree with that , why'd you do this ? And now you're like stuck in this thing , like now I gotta go back and call this person and say yes or no . It's just so .
I just like no , the person's on you handle it . Yeah , that is really huge because that , like I said , like those 12 hours that you got me , you got me after 1201 bye-bye , I'm out , you know , and that's where , like the release , like that I could turn off the brain . I'm not expecting a phone call because you can't get through .
I've seen some people on reddit right , like like they just whitelist you know whoever you know they want to be able to get through to them , like some somebody was saying in residency that would be their program director and , um , I think , like they're they , they're able to change it on a monthly basis .
So that the co-resident who's on the service with them can get through , but nobody else and the attending in the attending right , and that's it . So for me , like that's really big , and you mentioned tiger tiger text off .
First of all , let's talk about Tiger Text for a second .
Go ahead and cook , cook .
Listen , I'm not about that Tiger Text . Life . I can't stand it . I cannot stand Tiger Text . And , as a matter of fact , when I'm on , the nurses know if I leave that hospital , I tell them , especially at night , do not Tiger Text me . You can call me , but don't tiger text me because I will sleep through that sucker .
And if you trying to text me , some people don't know you're not supposed to use tiger text for Uber emergency Like that is inappropriate . Uber emergency Like that is inappropriate . Like you cannot use Tiger text for you know she's bleeding something crazy . I need you to come in . That's a phone call . That's a phone call Number one .
It's a phone call because you need to make sure that it was communicated to me ASAP . Number two , it's a phone call because if I need you to do something before I get there , you can do that right away on the phone , like Tiger Text is for me . It's like the lazy man's way of communicating .
You think it's line stepping ?
No , anyway , that doesn't make no sense . It's the lazy man's way of communicating . I'm sorry , I think it's . I think texting in medicine is a slippery slope because a lot of people don't know how to use it . And you're and we are assuming that people's judgment you know that people's judgment will lend them to use that text in an appropriate way .
Now , if you want to text me and just be like hey , just you know , wanted you to know , like you know , the blood pressure was up , and then I rechecked it and was fine , I'm like all right , cool , I don't have a problem with that . But I have literally had people text me .
Speak about notification fatigue Right .
Oh my God , Text me Speak about notification fatigue , right , oh my God .
Text me . It's similar to like nurses and alarm fatigue .
It's crazy . Honestly , I'm like , for all of that , I'd rather just have a pager again . Yeah , I'd rather just have a pager , cause then I know I can't sleep through it . I think .
Tiger text makes it very easy for people to reach you .
It takes the barrier away from communicating with you , and I can see the rationale of like yeah , we always want to make it easier for people to get in contact with you , right , and we're living in a society now that texts more than calls right and then wouldn't it be better to know what the message is than have to get a page and then find out what it is
?
right , I'm just , I'm just listening what the pros are right .
I'm listening what the pros are right . So , rather than get the you , you get what I'm saying right right , but with decreasing the barrier of trying to get in touch with the person who's the decision maker .
Now , what you've done is you flooded that person with all of these different notifications and decisions and people just contacting that person with stuff that's really like right I'm gonna use my sat words with like superfluous right , yeah , yeah yeah so no , I think yeah and and again for me I'm like , I don't like there's the assumption of good judgment , and not
everybody has good judgment as to when you should text someone and when you shouldn't .
You know Like , yeah , I think some of the texts that I have gotten in the past , I can't say that where I work now that they really use Tiger text , at least with me as much , so I don't get very many Tiger texts right now that they really use tiger text at least with me as much , so I don't get very many tiger texts right now . You a liar ?
No , I don't . I really don't . I don't get that many tiger texts at all . I really don't , because I'm mostly on the floor .
First of all , so we potting , or yeah , I don't .
I really don't get that many tiger sex and the nurses call me .
All right , so let's move on to number six . She over here potting and shit , are you not potting ?
What are you talking about ? The nurses call me all the time . They know because I tell them .
Well , now , you trained them . Now , right , but that's what I'm
¶ Self-Care Strategies for Healthcare Professionals
saying . But in the beginning , though , that wasn't what you were saying no , uh-uh , that's not true .
Nene , not for this facility , Not for this facility , maybe the one before that , but not for this facility . I tell these nurses from the beginning . I told them from the beginning if you need me , call me .
I'm on a three hour , you know , bender , okay , so if I go to my hotel room I'm falling asleep , so don't tiger text me because I'm not going to hear it . You can ask any nurse on LND at that facility . You can ask them , and they all know the night nurses . I've told them from the beginning . They don't tiger text me number six .
Listen , guys , this is something . What's your problem ? I'm just saying number six , listen , guys , I bring my own meals when I can . No soda , so no Pepsi , no ginger ale , just water , water .
And when nobody's looking , a Red Bull when nobody's looking a Red Bull if anybody's ever looking at you , they've they're always A Red Bull . If anybody's ever looking at you , they're always seeing a Red Bull in your mouth .
That's not true . Whatever , please don't put that information out there . I can't even . Please don't put that information out there . I can't , nope , I really can't . One Red Bull per shift . How do you know ? You're not even there .
You're home . What shift are you on at home ? What shift are you on at home ?
So , your nutrition , the way how you eat . The same way you eat off shift is the same way you eat when you're on shift .
I want to know what shift you're on at home that justifies you drinking even one Red Bull Like for what . What are you doing at home that you even need one .
Listen , man , I'm like I'm working out like , as you can see , my body , my body is like on , like cock D , you know what I'm saying . Like I am like come on , girl , you see this .
I burn the sugar and stuff . What does that have to do with the question ?
I'm asking you . You're talking about two separate situations , anyway , you drink a lot of Red Bull .
Let's move on . What's your point ? I'm not . I'm , yeah , just the same . You same way you were with the tiger tags . Yep , tit for tat guys .
You see she doesn't do therapy , so that's how she is . So I'm just gonna leave that on , leave that behind me and just kind of move on because what ?
I've learned about myself is that I'm an empath you know , and I see that she's struggling with certain things as someone who likes to move to a higher level , you know I just offer you that is , maybe consider therapy , baby . So for me bringing my own meals , me bringing my own , like water and all that stuff .
You know I tend so when I go to the cafeteria and when I'm very stressed , I'll tell you right now , if you were to put a can of soda in front of me and water in front of me when I'm very stressed , I'm going to grab the can of soda Right . If you put a slice of pizza in front of me , or a salad . I'm the same or a salad in front of me .
Yeah .
I'm going to eat the pizza , yeah , right . So what I've done is I've just made it just very easy for a new nutritional for me to be more , to be better with my diet . So I bring in , like you know , pre-packaged meals and stuff , right . So I'd use like factor , I love that stuff , right , they're not sponsoring the show but they should , right .
But I bring factor in . I have my water , I have my seltzer water because I really like carbonated stuff . So I bring that in and those are my options and that's it . You know and that's another game changer of just saying you know what , no matter how stressed you are , you're going to stay at least as you're going to be .
Really , you're going to be OK with your diet .
Right .
You're like , as long as you're not taking in Pepsi and ginger ale and all these different things on things .
that Right . You really shouldn't .
That you really should , and you don't have to have two slices . You know because you go to , you know because that's what's available there . And that's great . Now , you're right , I got to get that half a Red Bull out of the shift and stuff .
Really Wow . So we just lying on the podcast ? Okay , you was lying on number five . No , I wasn't Nii .
What are you talking about ? Why Number seven ? So , guys , listen , there is no number seven . But listen , guys , these are the six tips .
I'm potting , she's not potting , so , whatever , these are the six things that I do to , or you know , to reflect and to make sure that I'm keeping myself in the center , obviously , like we all do this , because we really want to make sure that the patient is taken care of . That's the most important thing . Right , that's a very important thing .
But just as important as that is how you show up , how you take care of yourself . And you got to remember yo , this is a long haul , yo , this is a marathon , this ain't no sprint . You know what I'm saying . We talking about this 25 , 30 year career . You got to be good to to yourself .
You know I'm saying absolutely like this , this takes time to look like this , this takes time . You know I'm saying , oh , alfred , sending me in on here . You know I'm saying this tay digs , look this , denzel washington , idris elba look , you know I'm saying it takes time anyway .
So um also knowing that self self-care is going to look different for everybody and so you guys not even gonna , you're not even to talk about the people who I say I look like .
You do look like you could pass for T-Diggs . People are constantly asking me what's it like to be a sexist ? Thank you , that's about it . So it's not going to look the same for everyone , and you know , even if you're getting tips from people and you're like man , it's great that you know he exercises every day . Why can't I just exercise .
I don't exercise every day .
You exercise six days a week . Me I mean come on , but that took time , though I understand that Guys all this , but that's the OK , go ahead , go ahead . But that's the point that I'm making , right .
She line stepping Go ahead .
Anyway , that's the point that I'm making , right , that you're catching people who might be giving you tips at different points you know , at different points in their life , in different points of realization , and so you're trying to get to a certain you know , if a person is trying to get to a certain point , if they're listening to this podcast and they're like ,
oh man , like you know , I wish I could , you know I could exercise every single day , it's like , well , you didn't start out exercising every single day . Nope , I didn't . You know , and that was like a journey that you had to take and you literally were so deliberate about it at first that it wasn't even your habit . T25 .
You never wore a sports bra before insanity , did you ? That's right .
T25 , y'all , it had to become your habit , and so that's what I mean .
Hairy chest out and everything , looking like Richard Simmons Sizzle and sizzle and sizzle and sizzle . Remember those days and you was laughing at me the whole time . Look at this guy . Look at this guy . Look at this guy . Look at this guy , look at him . Look at these Billy Blanks and shit . Any who , yeah .
Any who , but it takes time y'all . Rome is not built . It takes time , yeah .
Yeah , and it takes time , Listen , and you got to practice this stuff , right , Like you know . Being clear with your colleagues , being clear with nurses or being clear with whoever it may be , that could be a .
That's a lot right , yeah , it could be a game changer for you . That's a game changer , even being clear of your attendings .
that could be a lot . That takes a lot of practice , and that's something that you have to practice for several years before you get to a point where you feel like you're at a steady state with that . So , guys , this is me . Me giving you these seven tips are not like I practice , there wasn't a number seven .
Number six tips joints , like every day , but I try to like get at least most . I try to prioritize even this right and for me , like I like working out , that's number one . I ain't giving up with that , I like working out . And in everything else , you know , I may or may not have to come around to it , depending on how it is , except the scrubs .
I ain't rocking those scrubs and stuff , but yeah so , yeah , I'm glad you clarify the equivalent of taking homework with you yes , I'm glad you clarified that , because I think that is one thing I don't want people coming out of .
this is like yo , I got to do all these like nine things that he said Six .
There wasn't even a number seven . Where'd you get to ? Nine , six things , woosa . So , yeah , no , I think that's important and I think you know , if you could start one thing today , what would that be right ?
so the first thing you should do is , if you want to start one thing is , text us yo 833-230-2860 . Text us what you think about these . There's a list of 15 , yeah , what you think . You know , like you think , six .
Do you think that you know what's the number one thing that you would like from this six , this list of six that you know you would prioritize , or do you have your own ?
list . Let us know Do you have your own thing Because ?
maybe there's something . I look at your list . I'm like yo man list . I'm like yo man . I'm getting rid of my number two , I'm getting rid of my number three , I'm getting rid of Renee . I want to get your list . You know , I'm saying I go out the window . Yeah , dude guys , we need your , we need your support , not your laughter on this podcast .
You know I'm saying but listen y'all . This was great . We kind of talked about a whole bunch of different things . Text us , let us know what you think if you think Kendrick won .
If you things Text us , let us know what you think , if you think Kendrick won , if you think Nas or Drake won , what you think about the night shift , what you think about these six tips , and we'd love to hear what you guys got to say .
Yeah .
We'll catch you guys on the next episode . Y'all , peace , peace you stuck . That was a good episode , guys .