December 26, 2018

For many physicians, working during the holiday season is simply part of the job.

Holidays can be a stressful time for anyone, and may be even more stressful for a busy physician who must tend to patients. However, for many physicians, working during the holiday season is simply part of the job, and most have experienced being on call or on duty at the hospital during a time when it seems like everyone else is having fun.

Whether it is the changing weather, the back-to-back socializing, the added financial pressure of gift giving or shopping, or the increased amount of unhealthy food at parties leading to poor nutrition, there are plenty of factors that may contribute to the holiday blues.

For Daniel L W Hanley, MD, an urgent care physician at Vybe Urgent Care in Trenton, New Jersey, the biggest challenge of working during the holiday season is time management. As the volume of patients increases, physicians must be sure that care quality is not being sacrificed. For Andrew Bernales, MD, a pediatric resident in Springfield, Illinois, the biggest challenge of being on call during the holidays is “knowing that it’s a holiday, and [that] everyone is out with family and friends enjoying themselves.” Uli K Chettipally, MD, MPH, an emergency physician at The Permanente Medical Group in Oakland, California, adds that “missing out on social activities and missing family” are some of the most difficult aspects of working during the holidays. 

Coping With the Holiday Rush

Although it may be disappointing to miss the merry making or to be content with hospital food instead of taking part in your family’s feast, there are ways to make working during a holiday a more positive experience.

Take care of your physical health. Self-care is essential during times of stress. It may be tempting to keep eating cake, but it’s important to eat as healthily as possible. Having too much wine the day before a scheduled work shift may not be the best idea, as this could have a negative effect on energy, efficiency, and productivity.  It is also beneficial to exercise regularly: a brisk 15-minute walk around the hospital or some jumping jacks during breaks can improve both physical and emotional well-being. The Department of Health and Human Services recommends moving regularly throughout the day; any amount of physical activity is better than none.¹

Guard your mental health. To be alert and able to address patient needs effectively, physicians need to focus on maintaining their mental health. Dr Hanley suggests diffusing potentially stressful situations by acknowledging that patients may be waiting longer than usual — and apologizing.

“It may not be my fault, but this helps validate that the patient’s time is just as important as mine. I don’t speed things up any more than I’m comfortable with, however,” said Dr Hanley. “If patients have to wait, then they need to wait. Always be mindful of burning out. It’s ok to take a mental break from time to time.” He also noted that taking unexpected days off may help: “Missing work for health reasons is a valid excuse, and it is your boss’s job to find coverage, not yours.”

Limit social media use. Try not to scroll through Instagram or Facebook during the work day. A recent study suggests that limiting social media use may help improve well-being.² Seeing a constant stream of updates about friends’ celebrations on the newsfeed may just make you feel worse about missing out on the festivities. During breaks, consider reading a book, taking a power nap, or even meditating for a few minutes.

If possible, celebrate earlier or later. The most important part of the holidays is spending time with family and loved ones. If you are scheduled to work during the “official” holiday, try to arrange for any get togethers to be held before or after that day so that everyone can be together.

Remember the positives. Try to focus on the brighter side of the situation. Dr Bernales pointed out that despite being away from your family, “At least you’re with coworkers and not completely alone.”

Shift perspective. Physicians have the privilege of being able to help people in times of need. “Being away from family is, unquestionably, stressful,” said Dr Hanley. “I keep in mind that patients are in the same situation, and also have to deal with the added stressors of being sick and in a scary place. Hospitals are not hotels. That said, working every year on the holidays is unsustainable — unless it’s a personal choice. Taking more control of your schedule or asking for other considerations to be made, such as financial assistance, may help.”

Plan in advance. This might take the form of discussing the holiday season schedule with your boss weeks — or months — before the season begins. Team members can start by negotiating how the hours will be distributed. Knowing work schedules well ahead of time may help manage expectations of both you and your family, and can help mitigate disappointment over having to miss family events. Dr Chettipally tries to minimize disruption by scheduling work hours for early in the day. It is worth considering a similar approach if some freedom is allowed in planning your own hours. Prioritizing your workload early during the day and keeping on top of your tasks can alleviate some of the added stress and ensure that work is finished on time.

Part of a Physician’s Vocation

Working during the holidays is often unavoidable, but it’s good to explore whether it might be possible to minimize the number of hours on duty or to share the workload with other staff members. It is also worth remembering that the decision to be at the hospital during the holidays is often not up to the patients. Many patients may be feeling lonely or sad, and the presence of a caring, engaged physician during the holidays can be reassuring.  Don’t minimize the challenges: acknowledge any stressors, but also acknowledge the importance of the physician’s job and the critical role they play in making patients’ holidays a little bit easier.

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References

1. Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans. JAMA. 2018;320(19):2020-2028.
2. Hunt MG, Marx R, Lipson C, Young J. No more FOMO: limiting social media decreases loneliness and depression. J Soc Clin Psychol. 2018;37(10):751-768