Feeling like I'm juggling too many things ...

[Doctor Bagel]

Is this a second year phenomenon? I'm not working a ton, but I've felt a little irritable lately because I'm torn between different work obligations. My primary rotation is at the state hospital, which is the state hospital full of long-term chronically ill patients and lots of administrative meetings. I'm also doing a half day of outpt, and I'm in the call pool for the university hospital/VA.

I'm not on call a ton -- like an average of every other weekend with a few weekday short calls. The outpt component is pretty small, and the work at the state hospital isn't super rigorous. However, I just feel like I can't focus on any one thing because I always have to run off to get somewhere else (there's a 30 minute commute between the state hospital and everything else (didactics, supervision, outpt, call) which doesn't help). Is it the commute that's driving all this irritation?

Anyway, logically this should be fine, but I feel like I can't focus on my learning objectives. Maybe the contrast between the state hospital and outpt is always problematic? Especially when you're new to outpt, meaning that it takes up a lot more of my time than 3 hours/day? Adding in the call pool (a new addition) and the commute (now worse because of construction) might be just throwing the whole thing over the edge. Or is this just 2nd year?

Maybe programs with the outpt year as the 2nd year really do make sense?

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[Sneezing]

It makes sense. You are not alone. Its all of it. At least they are short calls, that's a positive. Commute time is you time to listen to music!

 

[Doctor Bagel]

Hmm, music for commute time. I just realized I was also feeling a bit more agitated because my family is in town, so I'm juggling that, too.

I think maybe I need to build in more structured time in my schedule to devote to learning/reading/thinking about each task.

 

[OldPsychDoc]

It makes sense. You are not alone. Its all of it. At least they are short calls, that's a positive. Commute time is you time to listen to music!

Playlist suggestions for Doctor Bagel's commute!
C'mon, everybody--let's help our colleague survive, nay thrive, in PGY2!

Pink Floyd--"Comfortably Numb". Aw heck--just play the whole "The Wall" album.

 

[OldPsychDoc]

Hmm, music for commute time. I just realized I was also feeling a bit more agitated because my family is in town, so I'm juggling that, too.

I think maybe I need to build in more structured time in my schedule to devote to learning/reading/thinking about each task.

DB--I was just in a meeting with my chair, and I realized that there's a word he uses in darn near every meeting I've been in with him, and it's why he's really a great manager: The word is "sustainability".

Take care of yourself. Workout. Eat a good breakfast. Crank the tunes. Put down the books and go out on your nights off. Cultivate positive friendships. Trust me--you'll learn the "stuff" just fine.

 

[billypilgrim37]

Playlist suggestions for Doctor Bagel's commute!
C'mon, everybody--let's help our colleague survive, nay thrive, in PGY2!

Pink Floyd--"Comfortably Numb". Aw heck--just play the whole "The Wall" album.

Radiohead--"Let Down" seems like the perfect tune to cry to as you drive home from the state hospital at 930pm.

 

[heyjack70]

my experience during second year was very similar, felt I was constantly running from one place to the next. I think it gets easier as the year goes on. It's better to feel stressed now than when you are working a similar split job as an attending.

 

[digitlnoize]

Playlist suggestions for Doctor Bagel's commute!
C'mon, everybody--let's help our colleague survive, nay thrive, in PGY2!

Pink Floyd--"Comfortably Numb". Aw heck--just play the whole "The Wall" album.

Zak Brown Band - Let It Go.

 

[Doctor Bagel]

my experience during second year was very similar, felt I was constantly running from one place to the next. I think it gets easier as the year goes on. It's better to feel stressed now than when you are working a similar split job as an attending.

It has made me think about what our attendings do. It might be something to consider when picking a job after residency.

This day at the state hospital has left me feeling a little like crying, but at least I get to go home before 9:30. So much sadness here.

To add to the juggling, I just remembered I'm taking Step III next month and haven't started studying. That might explain a little more of this free floating anxiety stuff.

So:
1. music
2. good self care
3. develop studying schedule

 

[Manicsleep]

Beatles. A Hard Day's Night

 

[masterofmonkeys]

Zak Brown Band - Let It Go.

Great album. It's like hick hippie zen.

 

[Sophie]

Hey DB. I can definitely understand where you're coming from. I'm on the consult service right now (which kind of feels like being on call every single day, since I can never predict what's coming my way), plus I have two outpatient therapy cases this year (yeah, it's only 2, but at this point that means 50 minutes of therapy followed by an hour of writing up process notes, plus a progress note, and all that time spent agonizing over having no idea what I'm doing and feeling guilty that these people are paying money for these sessions), an hour of outpatient supervision, an hour of consult supervision, and classes scattered throughout the week (hour on Tuesday, hour on Wednesday, 2 hours on Thursday, 2 hours on Friday). Plus I'm on 24 hour call (from home) roughly once per week covering the ER, inpatient unit, and main hospital. Luckily all of these activities take place within a few blocks of each other, but I still feel pulled in many directions at once.

Another rotation we do this year is supposed to be even more disjointed - with multiple different sites (including one that's about an hour away), no single day spent all at one site, and still with all the classes, supervision, outpatients, and call.

I think it's just a 2nd year thing.

 

[atsai3]

Sorry to hear about your experience.

If it helps at all, I think the difficult second year is fairly common in pysch. At least it was common in my circle of co-residents, and among my friends at other programs on the east and west coasts. Many regarded their second year as even tougher than intern year. You're right, the reasons are probably multifactorial. For many in my cohort, there was a mismatch of expectations i.e., finishing intern year and looking forward to an easier second year but finding out that it actually isn't much easier -- as well as the morale-corroding experience of engaging in the often sisyphean task of treating chronically ill and treatment-resistant patients.

 

[Sneezing]

It has made me think about what our attendings do. It might be something to consider when picking a job after residency.

This day at the state hospital has left me feeling a little like crying, but at least I get to go home before 9:30. So much sadness here.

To add to the juggling, I just remembered I'm taking Step III next month and haven't started studying. That might explain a little more of this free floating anxiety stuff.

So:
1. music
2. good self care
3. develop studying schedule

4. discover and exceed boundaries of libido

 

[Rhayven44]

"Doctor My Eyes" by Jackson Brown.

 

[Doctor Bagel]

To add to the fun -- I got paged 4 times during one clinic appointment this morning for VA consults when I'm not even on call until 4:30 pm. And we just got told we can't take weekends before and after a 5 day vacation off (something we did all the time in the past) because we have too few people in our call pool. 2nd year is a bummer. 👎

 

[Ibid]

Pink Floyd--"Comfortably Numb". .

Simply impossible to follow. RIP Syd.

 

[WhoisJohnGalt]

I definitely feel this way. I'm doing an off-site inpatient rotation, still doing call on-campus, and (this one's my own fault) moonlighting at yet another site. So I definitely feel like I spend a lot of time driving and being pulled in several different academic directions (outpatient substance abuse last month, geri-psych inpatient this month, VA call, and emergency triage moonlighting)! Kinda nice to get a feel for what the options are though. For example, geri-psych definitely gets crossed off the list!!

 

[DD214_DOC]

Wow, that's terrible. I take weekday call about twice a month, sometimes three depending on things. Weekend call is like every 15 weekends or something. Was on Saturday call about 4 weeks ago and not on again until November.

 

[Doctor Bagel]

Wow, that's terrible. I take weekday call about twice a month, sometimes three depending on things. Weekend call is like every 15 weekends or something. Was on Saturday call about 4 weeks ago and not on again until November.

Wow, I'm jealous. All our overnight calls are weekend calls because of night float, but weekend call is like 2 to 3 calls.

 

[Sneezing]

There are definitely programs out there with light call schedules. Mine definitely isn't. I tell myself its not medicine Q4 so I'm happy. Weekend calls just suck.

 

[peppy]

plus I have two outpatient therapy cases this year (yeah, it's only 2, but at this point that means 50 minutes of therapy followed by an hour of writing up process notes, plus a progress note, and all that time spent agonizing over having no idea what I'm doing and feeling guilty that these people are paying money for these sessions),

I know exactly how you feel. 😳
I think that one thing that makes 2nd year difficult is that I think many of us develop an idealized image of what it is going to be like during internship (thinking that all the hard times will be over after internship).

 

[WhoisJohnGalt]

I know exactly how you feel. 😳
I think that one thing that makes 2nd year difficult is that I think many of us develop an idealized image of what it is going to be like during internship (thinking that all the hard times will be over after internship).

Agreed. This year (so far anyway) hasn't been any easier, just different. Hoping that will change once our interns get "certified" to be on call by themselves!

 

[Chimed]

Playlist suggestions for Doctor Bagel's commute!
C'mon, everybody--let's help our colleague survive, nay thrive, in PGY2!

Pink Floyd--"Comfortably Numb". Aw heck--just play the whole "The Wall" album.

Good stuff. But if you want a more "modern" version of human angst put to music, go with Radiohead's Ok Computer. 😀

 

[Chimed]

plus I have two outpatient therapy cases this year (yeah, it's only 2, but at this point that means 50 minutes of therapy followed by an hour of writing up process notes, plus a progress note, and all that time spent agonizing over having no idea what I'm doing and feeling guilty that these people are paying money for these sessions)....

The only thing you need to do now is take away the guilty feeling and you'll be pretty ready to do psychodynamic therapy!

Just kidding....😛 (kinda...)

Don't worry, most everyone feels like this during 2nd year. I felt the same way. It does it better. Just keep at it! 🙂

 

[psychgeek1]

That does sound pretty hectic. I think what might help you is using an organizer or a time scheduler. It might seem petty but it really helps