Boundaries, or lack thereof

Confession: I surf, scroll and check. It’s a compulsion and applies to my social media, work and personal email, and even the EMR because I have an Epic app on my phone. I get secure chat alerts on days off asking me to do things for my patients. I oblige more than I should. It doesn’t seem like much in the moment, but I can’t deny that the thousand micro-crossings of my personal boundaries and well-being must take a toll over time. People talk about not checking email on nights and weekends and while in theory I support it and secretly aspire for it, I simply haven’t been able to imagine an existence where that’s possible. 

But I think it’s time. 

I logged onto the EMR from my phone just to see if there were any new results that popped in (in retrospect, why?? Am I really going to act on them on a Sunday?), and remembered one of my medically complex patients was hospitalized. I figured I’d hop on her chart to see how she’s doing as I know it had been a bit of a tenuous course for her but I thought she was on the mend. As I was opening the chart, I got an alert that said,

You are about to open the chart of a deceased patient.

My heart dropped. I closed the EMR. My day was suddenly shrouded with grief over this longtime patient of mine, as well as sadness for her surviving family members who are also under my care. I regretted the thoughtless choice to open Epic on a day off when I was home with my family. And suddenly I realized how desperately I’m in need of some clear boundary settings to protect my heart and stay present rather than worry about my patients when I’m with family. 

This is one of many #EmpathProblems that I expect I’ll write more about in the future. To feel so deeply about the folks I care for can be incredibly fulfilling and make the job even that much more of a calling, but it can also be incredibly draining. It’s important to compartmentalize deep emotions I have about my patients when necessary to go on living non-doctor parts of my life. But I also recognize the need to feel and process hard things my patients go through. To set some clear boundaries like avoiding compulsive EMR and email checking, silencing push notifications on my phone, and setting away messages when I’m “off” can be important steps in creating a bit more healthy separation. 

I can’t undo the heaviness of the loss of my patient today, as much as I wish I had learned of this when I was in clinic and able to process it more effectively in my workplace. For now, I will accept that this grieving day I’m spending with my family was a hard lesson that I finally allowed myself to learn. I will never shed my doctor self fully no matter where I am, but I’m hopeful that small steps in setting boundaries can help me nurture the other parts of my identity that help me live the full life I dream of.