Practice what you preach: Promoting clinician self-health

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I spend a large amount of time during each office session reminding patients to eat a healthy diet, exercise and get a good night's sleep. I encourage smoking cessation and condom use. Although this is generally to reinforce what most people already know, it is also an important part of health promotion and disease prevention. 

I often find myself wondering why so many certified nurse midwives, nurse practitioners and physicians alike, do not practice the same healthy habits they recommend to patients in their own lives. How many practitioners do you know who are obese or who smoke? How many providers do you know that work even when they are ill? 

Last week, I overheard two physicians in my office bragging that they never take sick days – not because they are never sick, but because they come to work no matter how bad they feel. Is this something of which we as health care providers should be proud? 

There is definitely pressure in my practice to work no matter how one feels. The running joke is not to call out sick unless you are calling out dead. I've even seen a fellow midwife continue to see patients as she passed a kidney stone.

If you call out sick that means that your patients must be rescheduled or seen by another provider. If it's an on-call shift, someone else must cover your call. Illness is always inconvenient for the patients, co-workers and the office staff alike.

As health care providers we spend so much of our lives caring for others that we often forget to care for ourselves. There are weeks that I am scheduled for as many as 112 hours in office and on-call shifts, and it is not uncommon for me to be up all night with laboring moms. I also have a husband and two young children who need my attention and care, and most weeks I have very little time left over for myself.

Given these conditions, it is not surprising that professional burnout is high among midwives. Although nursing is a  rewarding profession, it can be very stressful as well as emotionally and spiritually draining.

Whenever I encourage women to take time to care for themselves, I feel like a hypocrite knowing that I only take a sick day if I am at death's door. Shouldn't we practice what we preach? We need to start encouraging better health promotion within our own profession.

Staying at home when you are ill is the most basic form of self-care. I believe that most patients would rather have an appointment cancelled or rescheduled than be exposed to a sick provider.

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