How to Be a Present Parent

[gaspusher]

Any tips from the more senior members. I have a newborn at home and plan to have another child. Half my partners seem to be absent parents and the other half are part timers. I'm just worried that with my typical three overnight OB shifts and three in house OR calls a month that I will miss out on my children. My hours can also be unpredictable as we sit our own cases.

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[Onefellswoop87]

Set boundaries as much as possible. Not that you need need to plan every one of the 168 hours per week but figure out what is personal, work, family, spouse, etc time. And as much as possible, once the work schedule is set, stick to it. If you used to be the person who picked up an extra shift cause you had nothing else planned, try to reduce that urge. All your kids will take away from that is that mom/dad told me we’d do something this weekend and now they are at work.
Sometimes and often those spouse/family/etc times overlap but you can’t mentally be present if you are physically somewhere else. You’ve gotta do both, be mentally and physically present; people, especially young kids, notice when you are split.
Also, I know this wasn’t directly your question, but communicate with your partner. My spouse eventually told me to stop telling her when I finished in the OR cause inevitably something else would come up, someone would stop and talk in the hallway, or one more email or one more trying, etc. So I changed to tell her when I was walking to the car because that was a reasonably set and known quantity of time til I’d be home.
And recognize when you each have difficult days cause your work stress is important but it’s different than her/his equally important home/work stress (unknown if your partner is a stay at home partner). I recall one time come home to directly complain about a work issue and my wife shot back “At least you got to talk to adults today” (we had 3 kids then, oldest in preK). Wish that was a bit more if a wake up call to me, but we are much better now since not at that job and I grew up some too, but I digress. Learn from my mistakes haha
Kids don’t remember all the memories you think you’re making (I know that sounds defeatist) but they remember you being present. You don’t need a great first date everyone to woo and impress your kids, you need to be present and engaged. So also have them be part of your adult life. Don’t just live vicariously through them and only do their activities. Take them on your errands, have then sit in the cart at Home Depot, if your a runner then buy a running stroller (my kids remember me taking them or really remember me taking each of their younger siblings on runs).
Kids also recall actions over words. If you say your kids and partner are your priority, then you have to follow through with actions and do actions with them.
The days are long but the weeks are fast. Enjoy the ride

 

[Beeftenderloin]

I have 2 kids under 2 and just recently put in a request to drop my FTE to 0.8 for the reasons you describe. No one wishes they spent more time at work on their death bed.

 

[emergentmd]

I can't tell you how to do it because every situation is different. I can tell you a present parent = a better relationships with their kids = more rounded adults.

I am very present and the bond you build when they are young can not be built when they are old. My 15 yr old girl still comes up to me and gives me hugs even when her friends are around. This almost never happens with most teenage girls who thinks its not cool or actually dislike their parents.

 

[Gern Blansten]

I did not do a great job and was busy a lot. But remember that the times that you are there, put your phone down and be engaged. I think that will be a huge difference maker. Allowing flexibility on the kids bedtimes when appropriate allows you to have quality time, even if you are working late. Your partner bringing the kids up to bring you lunch when you are in house call on a weekend. If you are working Christmas, try to find time for the family to come to the hospital. I recall many Christmases and other holidays spent eating a lunch my wife brought me in the conference room overlooking the helipad. We could watch the helicopter take off or land when it timed out right. If you have little kids, big events don't have to be celebrated on the calendar day of the event. If you are on call Christmas day, celebrate the next day. The kids really won't know or care until they are older. Same with birthdays. Set the date for the party when you can be fully there and engaged with no risk of missing it. No one will care and the kids, if young, will have no idea.
These are minor suggestions that can make a little difference, but every little bit helps.
As mentioned above, recognize that your partner, if they are a stay at home parent, likely has a more frustrating and thankless job than you do. So, when possible, as you arrive home, tag in with the kids and let them decompress for some mindless "me time." I have done the stay at home parent thing for a few week intervals at different points due to health, school, or work issues. If you ever do it, it will really make you appreciate getting to go to work. As much as you love your kids, the daily grind of non-stop work with the complete lack of gratitude and nothing tangible to show for it at the end of the day is a grind and can be maddening.

 

[Anestheezee]

There's some excellent advice here. Here's a mental model I use:
I often imagine myself as a video game character with "XP" in various "skills" of your life represented as bar diagrams. The different "skills" are things like "work" "family" "financial" "education" "friendships" "husband/wife/partner relationships". As a full-time anesthesiologist for 5 years after residency, I found my "XP" got really high in the work/financial buckets but was depleted in the others. That XP dwindles slowly over time but will sustain if you are like a master at level 28 vs a level 3 peon. Some people like to be super specialized characters like a "crossbow archer" while others want to be a more well-rounded character like a "knight." There are plusses and minuses to the different strategies and your kids will usually adopt whatever strategy you choose. I don't like the idea of being deficient in certain skills (I prefer the "well-rounded character approach" So I dropped down to part time to reduce focus on those financial/work buckets and start building the others.

More details of my situation (the "too long didn't read" part):

I have a 5 and 7 year old girl and boy. Wife is half-time MD. We nanny during her schedule because it's more predictable. My wife always wanted to be a teacher so she homeschools our kids on her own accord. I have been full time until this year when I dropped down to halftime which is 2 weeks on with usual call / 2 weeks off.

Our kids and my wife have a ritual with my call shifts: when I'm taking in-house overnight call they call it "slumber party" and the kids take over our bed and watch TV with mom and sleep with her. I'm not much of a TV watcher so they don't get it when I'm around.

One thing I've noticed about dropping down to halftime is I have so many hobbies I want to do that don't involve kids. Now, my kids often see me at home not being mentally present. Being physically AND NOT mentally present I think might be more detrimental. I'm noticing that when I was working full time, I'm gone and they don't see me. But now that I'm part time, I'm "gone" and they "see me." I don't think that situation works very well because it models being mentally absent with people that are in your presence. So going back to work almost makes it easier because when I'm home it prioritizes quality time, not quantity of time. I'm not sure what is the right course of action yet but I'm also still learning!

 

[AKMD_1984]

Part time or retire early
Or pain clinic
Tons of colleagues bring their kids to their office etc

 

[circleK]

On the flip side sometimes this career allows more time with my kids than other parents. The non-physicians in my town don’t get random weekdays off (post-call days) to swim all day long with their kids like I am today.
And if your group is at all decent it will have a robust way to put in specific requests so you don’t miss any off the important stuff.

 

[agammaglobulin]

Kids don’t remember all the memories you think you’re making (I know that sounds defeatist) but they remember you being present.

As a young parent I can say this is gold. I've had several bedtime talks after a day full of the zoo/ice cream/friends house and ask them what was their favorite part of the day. Their response is almost always something very simple and involves time with mom and/or dad. It's hard to be present as a parent, but is clearly the most important thing.

 

[bellevueperson]

Cut down if you can afford to. I did and noticed my kids started asking for me and not just mom (also a physician but more predictable hours). You'll probably also have more energy to enjoy the time you spend with them. Tomorrow isn't a guarantee.

 

[T-burglar]

Work less. Don’t see the current market as an opportunity to make another million that you don’t need , but as an opportunity to make the same salary for less work.

 

[aneftp]

The key to a successful marriage with young kids is to keep working harder if you are the breadwinner. And work even more and make more at your stage in life. I know that sounds completely opposite of what you want to hear.

Hire some help for the stay at home wife for the first couple of years.

The stay at home wife needs some time for herself. That’s actually more important right now than you being home to “help” with the kids. Happy wife. Happy life.

Once kids are school age and can actually remember stuff. Than you can cut back. In this day and age. Don’t leave any money on the table you can make.

 

[cchoukal]

This is a great thread and I really appreciate the kinds of advice and experiences people are sharing here, particularly in light of the tension created over the past few months in the political threads. It's clear to me that people I really disagree with, politically, share a lot of my experiences and struggles, personally.

When my two girls were born, in the pre-vaccine pandemic period, August, 2020, I developed a lot of anxiety, panic attacks, and depression. The idea of being a present parent at that time gave me hives. As I've gotten better, and the girls have gotten older, I think about this stuff a LOT more. Since 2010, I had been a professor at a large academic medical center, doing anesthesia, ICU, and all the academic things that go with that, from teaching residents, having employees, traveling for talks, and publishing papers. I loved it and thought it was who I was, what made me ME. Once the girls were born, it certainly wasn't the kind of thing where I was like, "I love them so much, I just want to be with them every second, get me out of academics, fatherhood is my new love and identity" but all the "homework" required to have a successful academic career became extraordinarily more stressful, because I just couldn't get anything done at home. Long story, short, about two years ago, I left that position, with its more or less predictable (and certainly fewer) clinical hours for a busy private practice, doing my own cases in the OR, no ICU, and not in charge of anything.

What I've noticed is that, although I'm technically away from home more hours, because my work is simpler and so much more circumscribed, when I AM home, I have literally nothing else to do but pay attention to my girls. I am immeasurably happier, and I think it is in part because I have shed the obligatory tension between academic productivity and time with family. There's more to it, of course, but I wanted to share my experience with this. I hope that it is helpful to hear that, at least for me, it has been less about the NUMBER of hours that I'm working versus at home, and more about how I am when I'm at home.

As far as other "tips and tricks:"

I do manage to FaceTime my girls almost every AM as cases are starting. It's a good touchstone for them as they start their day, and people in the OR get a huge kick out of it.

My wife brings one girl at a time to visit the hospital sometimes when I'm on a quiet OB shift. They can't stop talking about surgery, hoping to see a broken leg, wearing the bonnets, and the whole experience.

The poster who mentioned paying for help was SPOT ON. It is, for us, the single-biggest improvement in our QOL to pay for a full time nanny, even though my wife doesn't work (notwithstanding she's managing a huge construction project on our new house...). Having help with young kids achieves SO many of your goals. It gives the primary caretaker a lot more "me time," de-stresses everything, and allows you better odds of being the kind of parent you imagined, because you both have breaks from it. In our case, it's also making our kids bilingual.

So, anyway, thanks to the OP for bringing this up, thanks to the other posters for sharing your vulnerabilities, and I look forward to more and more posts on this topic!

 

[cchoukal]

Our kids and my wife have a ritual with my call shifts: when I'm taking in-house overnight call they call it "slumber party" and the kids take over our bed and watch TV with mom and sleep with her.

We totally do this too! We'll have to start calling it "slumber party" to make it even more special.

 

[abolt18]

Any tips from the more senior members. I have a newborn at home and plan to have another child. Half my partners seem to be absent parents and the other half are part timers. I'm just worried that with my typical three overnight OB shifts and three in house OR calls a month that I will miss out on my children. My hours can also be unpredictable as we sit our own cases.

A few thoughts.

1. They won't miss you if you're away a lot at this stage of life so don't stress it until they're a little older (i.e. picking up extra shifts to pay off student loans if you have them). But when you ARE home, if you're consistent about things like, eating meals together, reading to them and singing with them at bedtime, inviting them to help you with making food or doing chores, etc, they'll remember that.

2. My kids are 7, 10, and 11 and they make it VERY clear that they don't like me working a bunch of overnight shifts. I just finished training so I'm working hard to deal with student loans and they understand that. The reality is I'm not working any more nights than I did as a resident, but I worked very few nights during my year as faculty in academics and my year of fellowship so it's been a bit of whiplash for them.

3. I got rid of all social media (except SDN) in 2017 because I realized it was taking too much of my attention away from my kids. Same with things like YouTube. Can't have it on my phone because it'll suck me in. It has been a huge help. I have recently asked them to make me a box or basket for my phone for when I get home so I don't carry it around staring at a screen pointlessly and I'll put it away for a few hours every evening.

4. I rarely play video games, and when I do I play them with my kids or they like to watch me play. Too much of a time-suck and too easy to get mad at them for interrupting. I've kind of morphed a lot of my hobbies to things I can do with my kids. Mountain biking, running, chess, whatever.

It's a lifetime pursuit. Always trying to be better and bond in a more meaningful way with each of them (I've got a lot of improving to do). I also often tell them the best way I can love them is to love their mother, because if our relationship is strong, we'll be able to do a better job raising them. The fact that you're asking these questions is likely a major positive. Just keep asking them as the kids grow because their needs constantly change and parenthood is a game of adaptation.

Money matters a LOT less than being a present parent.

 

[dumbmedstudent]

Some great replies in this thread 👍

 

[Anestheezee]

I was just going to say, there's some damn good advice here! Thanks for sharing your thoughts, everyone!

 

[San Marzano]

I went to 0.8 FTE when my oldest was 1 and now have two more munchkins at home and zero regrets. The difference between full time and 0.8 looks small on paper but that extra time at home adds up big time.

 

[PpfSuxTube]

Any tips from the more senior members. I have a newborn at home and plan to have another child. Half my partners seem to be absent parents and the other half are part timers. I'm just worried that with my typical three overnight OB shifts and three in house OR calls a month that I will miss out on my children. My hours can also be unpredictable as we sit our own cases.

I take about 4-5 in house calls per month but we make it work. Wife and kids seem OK with it anyway

2 kids under 3 yo. No family support.
We have a sitter who helps about 10 hours per week.


I sat down one morning and analyzed every single minute I was spending doing house work and figured out how to shave minutes off it. Everything that could be was automated or delegated was.

I take every day off offered, and any shorter days available.

Cut all hobbies except 1, that can be done 5am to 6am. Evening time is kid and family time.
Find new hobbies that can be done with your kids. A jogging chariot was great when the kid can sit up. It's now on my bike and kids love the bike ride too.

No alcohol.
Basement gym.
Grocery's online, delivered to door.
Meal prep food for 4 days ahead and freeze it. Robot vacuum daily and house cleaner every 2 wks. Robot lawnmower, although my 3 yo loves the gas mower and begs me to cut the grass daily to follow me with his bubble mower.
Dog walker

Good luck.

A divorce is the most expensive thing you'll ever buy...

Expect your wife to hate you for a while, mine did apparently it's common enough. We almost went to a counselor but got thru it... be nice to each other. Try be patient

 

[emergentmd]

We totally do this too! We'll have to start calling it "slumber party" to make it even more special.

I facetime my kids when they are on the way to school and facetime them before they go to bed when I am not at home. Its 5-10 mins, sometimes it boring, sometimes they have no interest in talking, sometimes it feels like a waste of time But it isn't.

You decided to have kids so you took on the commitment to be the best parent you can be. Being ER, I always scheduled my shifts around their schedule. I can't think of any moderate events that I missed since birth. I have had someone cover me for 2-3 hrs so I can be at an event, eventhough it costs me $750, it was well worth it. I never missed the $750 but would an event.

I did a locums overnight shift 2 hrs from home. Finished at 7am, drove 2 hrs back home to be present for an hour at a school kiddie fundraiser when my son was 7. Parents thought I was crazy b/c to them it was not a big deal. To this day, he still mentions me being present. It doesn't really matter if I or other people think it is important; it only matters what he thought.

You build these bridges that seem insignificant when they are young; these same bridges will be what will save you alot of $$$/time/headaches later.

 

[Pharmado]

Lots of great advice here. I wanted to focus on OPs colleagues. If none of your colleagues appear to be engaged parents you need to ask yourself why that is. If the answer is “because the job prevents me,” then you can either focus on making every single minute efficient (something likely to burn you out quickly) or better yet, you can find a job that allows you to be the parent you want to be. The time when they are little they will never remember but you hope to never forget.

 

[GravelRider]

This is something that is constantly a struggle. With limited time you need to work a busy full time job, be that present parent, but also do things for your marriage and yourself. I think about when I was a kid and my dad was the coach of all my sports teams. He worked alot (non-physician) and traveled for business, but he still came to every practice and every game. In fact, my town didn’t even have a baseball program when I was a kid, but he helped to establish a league. Then later on he helped to establish a travel basketball team that became popular and successful. My father went to most school board and PTA meetings. He was well known to most people in the community. My relationship with my father was very rocky in my teenage and early 20s, but as I outgrew my stubborn self and became an adult, I look back at all the time my dad spent coaching and improving the community with appreciation and fondness. I don’t think I will ever be able to be as involved as my father because of my schedule, but it’s something I will try to do.

Some points I’ve settled on:
1.) Put the damn phone away. Lock it up if you have to. That thing is a cancer, so cut it out of your life. If your phone is nearby, it is constantly calling your attention away from your kids. They will notice that. Kids notice a lot. I’ve recently been toying with the idea of keeping a smartphone for work that lives in my car or even at work and a “dumbphone” for home. I’m still trying to work out the logistics of that because I do use FaceTime and other apps on weekends and off time. Quit social media. It’s useless.

2.) Incorporate your kids into your downtime activities. Exercise with them. Find some kid and adult friendly movies that you can watch together when you want to veg out after call. Plan it with them so they look forward to it. Tell them when you get home from call, you’ll make some popcorn and watch a movie. I’m not much of a video-gamer, but I bought a Nintendo Switch a few years ago as a way to veg after a call. My kindergartener has had a blast watching me play Legend of Zelda recently. We talk about the game and strategy while I play. Kids love plans and having things to look forward to. If playing Nintendo for an hour with dad is something they can look forward after a night of call, they’ll be just as happy when your call is over as you are.

3.) Make time with your spouse. Find a babysitter and go out to dinner. Try to remember why you and your spouse got together in the first place. Raising kids and working full time is hard and there will be a lot of disagreements coming. Try to see past it. Having any resentment toward your spouse will bleed into the time you spend with your kids. They will notice.

4.) Kids are smart and observant. They remember more than we give them credit for.

5.) Call. I am the worst version of myself in the days leading up to a 24hr call and the days after. I’m irritable, tired, and my daily habits with diet and exercise are notably worse. My ability to recover after a busy call gets worse as I get older. My spouse has been urging me to give up call or find a way to work less. It’s probably a bit earlier on in my career than I initially planned, but the market is such that I can work less and still make a pretty darn good living.

I think the investments of time you make in your kids will pay off more than milking a few percentage points out of the stock market or making a few thousand more taking the extra call.

 

[patriot6]

Some points I’ve settled on:
1.) Put the damn phone away. Lock it up if you have to. That thing is a cancer, so cut it out of your life. If your phone is nearby, it is constantly calling your attention away from your kids. They will notice that. Kids notice a lot. I’ve recently been toying with the idea of keeping a smartphone for work that lives in my car or even at work and a “dumbphone” for home. I’m still trying to work out the logistics of that because I do use FaceTime and other apps on weekends and off time. Quit social media. It’s useless.

great thread, all. the quoted point above is my #1 point as well. a year or so ago, my 8yo said "dad, you spend too much time on the phone." i always felt like my phone was constantly removing me from being present. i tried all sorts of things... switching sim cards to a "dumb phone" when home, the light phone, leaving my iphone on do not disturb. somehow, i'd always end up back on it... browsing reddit while bathing the kids or checking email while my wife read books to the littles. i always had a justification. i finally worked up the courage to pitch it altogether. i now use The F1 Feature Phone - Sunbeam Wireless - The tools your family needs. feature phone, no internet, just the basics; been using it for about 6 months. yes, it makes many parts of my life less convenient. but, the reward greatly outweighs the cost. GL to all!

 

[abolt18]

great thread, all. the quoted point above is my #1 point as well. a year or so ago, my 8yo said "dad, you spend too much time on the phone." i always felt like my phone was constantly removing me from being present. i tried all sorts of things... switching sim cards to a "dumb phone" when home, the light phone, leaving my iphone on do not disturb. somehow, i'd always end up back on it... browsing reddit while bathing the kids or checking email while my wife read books to the littles. i always had a justification. i finally worked up the courage to pitch it altogether. i now use The F1 Feature Phone - Sunbeam Wireless - The tools your family needs. feature phone, no internet, just the basics; been using it for about 6 months. yes, it makes many parts of my life less convenient. but, the reward greatly outweighs the cost. GL to all!

Intrigued!