Things I wish I’d learnt before Emergency Medicine and Parenthood

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Author: Louisa Mitchell / Code: CC15, CC23, CC24, CC8 / Published: 16/03/2016

An emergency medicine consultant, a senior surgical trainee, and a salaried GP sat in a bar. Old friends on a rare night out, they were collectively parents to six young children. Conversation turned to the challenges of combining parenthood and a medical career.As the EM consultant, I found it striking that the challenges were similar for all three of us despite our very different career pathways. The stereotypically ‘family friendly’ career choice one of us had made, general practice, wasn’t easier, practically or emotionally, than the surgical career traditionally reserved for the career-absorbed

Following this discussion, I decided to survey selected regional colleagues for the key tips they wish theyd known when they had embarked on combined parenthood and emergency medicine. I hope the distillation of the emergent themes from these responses below, prove valuable to those planning, or in the throes of, the combined careers of emergency medicine and being a parent.

Emergency Medicine and families

  • EM is a surprisingly family friendly speciality- the shift and on call patterns give time off during the day to see your children, and theres more flexibility around shift work than more regular working days.
  • EM also works well as the nature of our workload, and the lack of ongoing responsibility for named patients means you can fairly rigidly compartmentalise life and work – many surveyed agreed “when youre at work, be 100% about work, when home, be 100% there for your family”.
  • EM also works well as a part time career choice, for the same reasons.

Planning parenthood and early days

  • There is never a good time to have a baby- there will always be money, work, or time issues, and another exam or hurdle to pass. There is always a way to make it work.
  • Don’t leave it so long that it’s too late.
  • It’s perfectly possible to go through EM training and exams with children, and even as a single parent. That’s not to say its easy, but nothing worth having is given away easily. Keep your goals in mind when it gets difficult.
  • While youre a trainee, base your family in one location and accept the commute to your training hospitals. Dont keep moving house – the commutes are worth it in the long run. If the hospital is an hours drive away or more, finding somewhere local to stay after late finishes and between night shifts is imperative.
  • The BMA website offers really useful information for all doctors considering starting a family.
  • Most agree that, for Dads, 2 weeks paternity leave isnt enough. Try and take at least a week of annual leave on top of it. This is particularly important if you are adding to your family i.e. already have at least one child to look after.
  • The parent not on parental leave (usually Dad) will be TIRED at work in the early days. It is expected that you will go back to work and function as normal. Lack of sleep as well as the huge change to your life is exhausting. Be kind to yourself and do what you can to make work temporarily easier.

Logistics and nativities

  • A set rota is makes childcare planning much easier if both parents are working. They are becoming rarer – as out of hours consultant shop floor presence becomes the norm, rotas get more complex. A predictable, if not set, rota is achievable, however, and it really helps those with young families (also all those with other outside interests!)
  • Think about how youd like to get to and from work in your permanent post. This affects where you should live. Being able to commute by bike or even on foot is great for some. Others dont mind quite a long commute, and use this as their decompression time so they arrive home leaving work behind in every sense. If youve got some flexibility around your hours, avoid 9am starts and 5pm finishes – were the specialty that never sleeps, why would you want to commute with everyone else?
  • Consider where you and your partners wider family live, too. There are pros and cons of living near grandparents, but they can potentially help cover unexpected late finishes or times when both parents must be at work.
  • Have bomb-proof childcare set up when youre clinically committed or on call. This must include being called by nursery or school if theres a problem.
  • One consultant advised “Move heaven and high water to attend nativity plays, school concerts etc. They are precious, unrepeatable memories – you will need to be super organised and willing to swap / time shift but it is so worth it.”
  • But another stated “Missing the occasional nativity etc when they are young because of shift patterns isn’t the end of the world. As they grow up there are so many opportunities to attend sports/music/arts things with them.”

Colleagues and children

  • Your colleagues will be surprisingly understanding and flexible so long as you show willingness to be flexible too. This is one of the joys of emergency medicine – youre part of a mutually supportive team. If things are difficult, talk to your trainers and your colleagues – we have all had hard times, and all will try to help. Remember you are not alone. And take the help that is offered!
  • Be flexible within your inflexibility. Yes, you may only work 3 days a week (if part time or fixed rota) but within this, try and help your colleagues out wherever possible. If you can make the odd extra shift work within your child-care arrangements if the department is under pressure then do so. What goes around comes around.

Time management and priorities

  • Everyone surveyed stated that family must come first. Careers are great but you cant plan everything else in your life around them.
  • Learning to say no – to some of both work’s and your childrens demands – is empowering.
  • Kids grow up quickly and those early years never come again. Our careers go on almost for ever. Remember there is no rush to ‘be successful in your career.
  • Learn effective email and time management. Think hard about putting work email on your phone, for example. Develop strategies or rules that keep work from encroaching into your home life. For some, rigid compartmentalising is key. For others, a bit of flexibility helps keep on top of things.
  • There are always going to be more worthy causes at work than people to champion them. Learn to say “I think this is really important but I cannot meet that need at the moment.” Someone else may step in, or they may not, but the needs consistently outweigh the resource to meet them. You cant do everything

Looking after yourself

  • Any feelings of guilt to family or work are probably only in your head – you cant be everything for everyone all the time (see above). Be realistic.
  • Imposter syndrome appears to be particularly prevalent amongst women returning to emergency medicine after maternity leave – it will pass, and you arent alone.
  • All EM senior doctors work hard. Sometimes it helps to remind yourself that this means you are being a great role model to your children. For the same reason, you shouldn’t moan about work too much when at home!
  • Stay active, healthy, and dont drop your own hobbies. When your kids leave home they (and your partner) are all that stands between you and burnout.
The other parent and career in the equation
  • Dont fool yourself for one minute that your career is more important than your partners career, job or parenting role. Similarly, never let anyone tell you your work priorities are of greater import than your partners – thats a (constantly evolving) discussion between the two of you.
  • Look after your relationship.
Final thoughts
  • A consultant I once worked for said he missed his kids’ childhoods and when he stopped working, they didn’t know him. He died a year after retirement. Now is the time to live life as a parent, not later.
  • No-one will ever put They gave their life and soul to the NHS on your gravestone. But if youre lucky, they might just put They were a really good Mum [or Dad].

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