Redefining Productivity: The Case for Taking Days Completely Off

Because I work in a specialty that practices via shift work, weekends stopped meaning something to me long ago. My husband travels for work, and we don’t have children, so I became used to working whenever and never needed to shift into any sort of Monday - Friday schedule for my family.  I started my faculty career taking advantage of Saturday and Sunday shifts to get ahead with administrative work and writing.  The same is true with being scheduled to work on holidays, the “little ones” like Columbus Day, and the “big ones” like Christmas.  The PICU was naturally quieter on weekends (and holidays), and I could get in clinical time while also chipping away at all my other responsibilities at an academic medical center.  

A few years ago, I noticed this meant I could sometimes work for two or three weeks straight without a day off.  Once I figured that out, I started “taking it easier” when I was scheduled to work on weekends.  I’d care for patients and do “easy things” like read journal articles and clean out my email inbox, but wouldn’t do anything more difficult like work on a manuscript or write a lecture.  That could still mean I’d work daily for weeks, but I just started giving myself grace if I wanted to work fewer hours on non-clinical weekdays.  Even then, I’d still work about 60 hours a week on average over the month.  That’s felt necessary given the amount of work I do, but it also felt completely fine.  I’m not burned out, and I’m content with my productivity.  I recognize the necessity of taking vacations: we just took one a few weeks ago and are already planning another.  Balance.  Check.  Got it. 

A friend from out of town visited and stayed with us this past weekend.  We had a great weekend, did a reasonable amount of touristy things, and he flew home Monday morning.  Since I had nothing pressing, I decided to take the rest of the day off and just hang out at home with my husband.  I had an absolute ball, even though we didn’t do anything special.  Because I’d convinced myself that I deserved to take it easy after having a houseguest, I didn’t feel any guilt about being completely unproductive.  It turns out that I was productive in an entirely unanticipated way.  I woke up on Tuesday, looking forward to the day. I went to the gym, worked a shift in the unit, and then taught a class on the undergraduate campus. It felt awesome. I laughed easily.  I was happy to troubleshoot when curveballs were thrown my way.  I came home excited to tell my husband about my day.  I went to bed that night feeling fulfilled and like I’d made a difference in the world.  Those feelings have persisted this entire week.  Before my long weekend, I felt good.  But now, I feel great.

How often do we say things that seem “no, duh” on the surface but feel completely revolutionary and profoundly true in our bones? We need days off. Not a day here and there, but a couple of days off every week if possible. Knowledge workers have been wedged into systems that were put in place during the Industrial Revolution.  In the Industrial Age, productivity could be measured by an actual product: a widget, a cement block, or a car.  The value workers produced during their clock-in and clock-out Monday - Friday workweeks could be easily quantified by however many widgets, cement blocks, or cars they made.  Physicians are knowledge workers, and the value of knowledge work cannot be measured so easily.  The RVUs we generate and the manuscripts we publish are ways to squish knowledge work into the Industrial Age system that was never designed to track our productivity.

Because knowledge work cannot be measured so easily (our “widgets” like RVUs and manuscripts don’t lend themselves to being easily accounted for at the end of a week), we get into the habit of being productive whenever and wherever we can.  Like when we’re working a shift on a Saturday.  Or when we answer emails while watching our kids’ soccer games (for all you parents out there).  Our productivity becomes a way of life until something novel shakes us out of it.  Like a friend visiting from out of town and then recognizing I just wanted to hang out with my husband for a day.

Here’s the cool part: I felt great this week and am still on track to get everything done that genuinely needed to be done this week.  I’m not behind.  Sure, some “nice to have been done” things will be put off until next week, but there has been more than enough time to get the things that matter done.  In reality, the list of “nice to have been done” things will never end.  So if those things are true, there’s more than enough time to get the things that matter done, and the “nice to have been done” list will never be complete - why am I working for weeks straight without a weekend off?          

So, how can we create weekends if we’re scheduled to work daily for weeks on end?  First, we have to take the time off that we already have.  Stop using days without shifts or meetings to finish charts and answer emails.  Take the days you have off entirely off.  Second, decide ahead of time how you’ll use the blocks of time you have between meetings during the week.  Using a few minutes on Monday, look at your schedule and decide you’ll use the two hours you have free on Tuesday to work on a manuscript, the hour and a half you have free on Thursday to write the lecture you’re giving the following week.  It’s incredible how much I can get done during a 90-minute free block when I don’t waste the first twenty minutes deciding how to use it.  Third, get honest about what must be done each week.  This doesn’t mean you have to push things off until the day before; it just means that you decide what will get done that week and commit to doing it during the time you planned to (as opposed to putting it off when the time comes because you don’t feel like doing the task you planned), and hold yourself to a standard of B+ work (instead of the “perfect” result that can be paralyzing to the point of hampering any productivity at all).  Lastly, and most importantly, find two days you could take off in a row, a Saturday and Sunday, a Wednesday and Thursday, whatever, and commit to taking them entirely off, even if it feels too overwhelming, or even risky, to do so,  And then see how you feel coming back to work afterward.  How’s your mood?  How’s your brain space?  How’s your motivation?  How much do you get done the following week?  Experiment with it.  Collect data about where your workday/day off balance needs to be.  Then, nudge your brain to figure out how to make that schedule a reality for more weeks than not. 

I’ve got two shifts this weekend.  Later today, I’ll look forward to next week to see if I can fit my weekend in.