Best. Week. Ever.
I’ve been thinking about how I want my days to go. Not in the “I hope all of the critically ill children in Nashville get better this week” sort of way but in the “If I could spend my time exactly as I wanted to, what would that look like” sort of way. Days on service in the PICU just seem to run themselves. Sign out at 7a, rounds until about 11a, do the things we figured out we had to do on rounds for a few hours, and then sign out to the night team at 430p. Rinse, repeat. I’ve spent the last couple of weeks either being run by this schedule or recovering from being run by it, so this is the first time in a bit that I’ve been able to put the things in my day where I want them. And I’m being very deliberate in saying that I’ve been “being run by this schedule.” Those rinse-and-repeat days don’t feel like they have a lot of agency in them. I get to decide where I want to start rounds, but typically there are other factors that make the chosen starting place just make sense. I get to decide how I want to care for my patients, but the pathophysiology the patients have, or acuity of it, often dictates what needs to be done. Sometimes, that rhythm is nice. But after a while, it feels like a mindless slog I just must put my head down and get through.
The planner I use has a great exercise where, at the beginning of each quarter, it has me fill out what my ideal week would look like. It comes from the recognition that no matter how crazy our schedules are, there are many things we can anticipate about how the day will go. There will be an ideal time to get up and go to bed. Work will start at some point. For those of you raising little humans, they will need to be picked up and dropped off at places with a generally predictable pattern. The caveat is that it’s an ideal week set in the current reality. While my truly ideal week involves sleeping until 10a, being served a leisurely brunch by my home cook, and then reading a book until 3p at which point I might take a walk and then be served an early dinner so I’m nice and tucked into my bed at 9p, that’s not my current reality. My current reality does not involve a home cook (maybe someday!). It does involve working as a pediatric intensivist because I really do like the work and because doing so allows me to have my current lifestyle, which I very much love. So, in a roundabout sense, working shifts in the unit is part of my ideal week.
Completing this exercise every quarter isn’t meant to lay out in black and white (or, in my case, black, purple, and white) how uncontrollable and far-from-ideal my schedule is, but to show me what I want to be working towards while taking agency over my schedule as I can. For this quarter, my ideal week looked like this:
That’s the schedule I made with my autonomous, fully capacitated brain. I learned two lessons here.
First, I must say that my recent weeks haven’t been all that different from the “ideal” week above. I started work at 7a and ended at 5p instead of the above 8a to 4p, but it’s not all that far off. My bedtime has been my, well, bedrock. If I’m not on call in the unit, I am in bed at 9p, +/- 15 minutes. So, these past few weeks that have felt like a slog I just must get through are…my ideal week?
Second, and this is where the “aha” moment comes in, I really didn’t expect a whole lot of myself when I created my ideal week this quarter. I probably looked ahead at these three months and thought they would be rough, so set my expectations low. Shockingly, it’s become a self-fulfilling prophecy. It’s not so shocking if I put it into a Thought Model:
C: April, May, and June on my calendar
T: “Ugh, those months are going to be rough because of X, Y, and Z”
F: Disempowered
A: Set really low expectations of myself for the quarter, hamstring my ability to be creative about how I might make the quarter better for myself, slide into a victim mentality, and create days that I just mindlessly get my way through
R: I make the months rough on myself because I’m wallowing in a victim mentality and am not using my “ideal week” exercise to figure out where I can control my time instead of time controlling me
The good news is that the black and white of my planner and the purple pen I use to fill it out are not mallet, chisel, and stone. I’ve got another month to see if I can improve this experience. What if I adjust my “ideal week” to get a workout on all five weekdays instead of the two? The two times I’ve done it weekly for the past few weeks show that I can work out before my workday starts if I really want to. What if I build an hour of break into that 8a - 3p slot (or 7a - 5p service day slot)? The hour may shift around a bit from day to day or get cut down to 45 minutes if a true emergency arises, but committing to a daily brain rest feels revolutionary. I’ll have to practice not using the hour to catch up on emails or some other faux productivity. Maybe I’ll grab a half-full bottle of bubbles from the unit and blow them in my office to kick it off. What if I habit stack and add 10 minutes of stretching to my already-solid bedtime routine? Something popped up on my Instagram feed a couple of months ago: “You’re not old; you just need to stretch.” I think about it constantly, if I’m honest.
Every once in a while, we must just put our heads down and get through something unpleasant. But when the unpleasant is something of our own making (sheepishly raising my hand), there are different ways out than through. What is your ideal week? Scribble it out here. Don’t get too precious about it; just fill out the absolutes (kids need to be picked up from daycare, or the Department of Child Services will be called, from what I understand) and then see where you have the agency to create the rest of the week to your liking. Try it for a few weeks and see where it needs zhuzhed. The ideal week for your spring and summer may differ greatly from the ideal week for your fall and winter, but that’s okay. We’re not aiming for perfection here; this is not a new tool to beat yourself up with for how much you’re failing. This allows us to see where we have agency, where we are not helpless victims but strong and powerful victors.
And with that and my victorious and powerful agency, I’m off to blow some bubbles.