Last spring, I started having right wrist pain. I don’t remember injuring my wrist in any traumatic way, but one day I noticed the pain and it never really went away. In fact, it got progressively worse until I saw a specialist in June. He immediately gave me a diagnosis based on my symptoms and advised rest and immobilization for the next four to six weeks.
I laughed when he advised rest. I’m a midwife in a busy practice and work 48 to 96 hours a week. My job is very wrist-intensive and resting it really wasn’t an option. I never even considered taking time off of work to rest and recover.
I tried to wear the immobilization splint as much as possible, but honestly it was nearly impossible to keep it on while working. There was no change after six weeks, and I continued to try to ignore the worsening pain and swelling.
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A month later I saw a new surgeon, who gave me the same diagnosis, confirmed it with an MRI and advised surgery. It was late summer, a very bad time to take a medical leave of absence, so I put off the surgery until late September — a full six months after the pain started.
The injury was worse than the surgeon anticipated, the surgery was more complex and the recovery time was double what he had originally predicted. Apparently working with the injury for so long took its toll.
After ten weeks of rest and hand therapy, not to mention ten weeks of guilt and worry over being away from my practice so long, I finally went back to work this week.
Everyone was happy to see me, and I know the workload will be lightened a little with my return. But life and my practice continued to move forward without me. Babies were born, EHR was implemented and women had annual exams. My colleagues coped with my absence, just as we all cope when someone is out on maternity leave or becomes ill.
Medical professionals seem to view working while sick or injured as a badge of honor. Practices and hospitals perpetuate this attitude by making providers feel irreplaceable, and creating a culture of blame and even shame, for providers who call out sick.
In reality, this is a terrible example to set for patients even as we are lecturing them on self-care. Most patients do not want to be cared for by a sick practitioner, despite the potential inconvenience caused if the provider calls out sick or cancels office hours.
In order to provide the best care for our patients, we must first take good care of ourselves. This includes respecting our physical limitations and remembering that we can often do more harm than good by working while sick or injured.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.
