Monday, April 11, 2016

The Return From Maternity Leave: Rusty or Rested?

This article on KevinMD was published a week or so before the end of my maternity leave. As I read it, steam emanated from my ears. How dare the author insinuate that physicians lose their technical skills from taking time off equivalent to more than a mere weekend? What about those who must take prolonged time off for sick leave? And what about maternity leave? Are all physician moms, by the sheer reasoning that they had babies, now deemed incompetent?

It goes without saying that we physicians are humans who need adequate time to heal physically in order to perform well mentally. We all need vacations (longer than a weekend) to help stave off burnout, and we all become sick from time to time. During my training and career as an anesthesiologist, I have taken significant periods of time off for vacation, maternity, and sick leave, and yet I've never had a problem integrating back into the basic flow of my job. In fact, on my first day back to work after three months of maternity leave, I had a patient go into anaphylactic shock in the OR - a very rare and deadly event. End tidal CO2 dropped from 37 to 10 and blood pressure was 50/30, but once I identified it I knew exactly what to do. I counteracted the reaction and saved his life with the fortunate and timely assistance of a couple of colleagues who I immediately called into the room (having extra hands is obviously essential in these kinds of situations).

I recently posed this question of competence to physician moms in an online discussion group. Most respondents agreed with me but cited other issues they had returning to work. Some had to regain their prowess with the EMR, others stated that they had a little trouble multitasking, but all felt confident in their abilities to do their required work tasks. I would say that the hardest part for me has been transitioning each day from Mom to MD and back to Mom again. Preparations the night before a workday seem endless, and morning routines take longer than they used to. Picking up my daughter from childcare after work increases the commute time and anxiety depending on how late my OR day has become. I have yet to be the last parent to pick up their child at night, but I'm sure there will be a day like that sometime. Evenings go by so quickly, and I feel I have barely seen my daughter before bedtime comes. Add in being a part-time physician, and suddenly I feel what some moms warned me about: not enough at work, not enough at home.

So Mothers In Medicine, I ask you: how did you feel returning to work after maternity leave? Rusty or rested? Share your experiences here.

10 comments:

  1. Today is my first day back at work after a three month maternity leave. I feel overwhelmed. I definitely don't feel rested. I feel left out and behind. I don't have any clinical work until Wednesday but I am slightly anxious to see if I have retained all my skills. I think it is inevitable that some things have been forgotten and will need to be relearned. The thing I hate the most is that I spent a large part of the last month of my maternity leave missing work and now that I am at work, I wish I had cherished the time with my baby more.

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  2. I couldn't wait to get back to work after maternity leave - I was bored to death at home all day. But I did feel pretty rusty when I got back to work after 10 weeks off. Definitely took me a few weeks to get back up to speed.

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  3. When I was sued, the plaintiff's lawyer used my maternity leave to suggest that I was rusty and out of practice, despite seeing over 1200 patients between coming back and when the case occurred. Years later, I still have a bad taste in my mouth, but I don't accept his claim.

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  4. I did not feel rusty at the end of my maternity leave (6 weeks, during which I wrote a case report, took curbsides by e-mail and kept up with the literature.) But I certainly didn't feel rested -- I felt edgy, bored out of my mind and unappreciated as a human being rather than just a provider of milk. I actually wanted to return to work earlier, but my residency program wouldn't let me.
    I've made it very clear to the chief of my division that if I ever have another kid, I'm only going to take 2-4 weeks off, then come back 50% time for the rest of my maternity leave. I think sitting at home with a baby for weeks is cognitively bad for me.

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  5. Like you, I'm an anesthesiologist. I had my first baby in residency and was out 5 weeks. I came back as soon as I got the ok after a c-section because I missed work so much--stay at home mom just isn't for me. I thought I was competent in the OR but did have one attending tell me I was rusty, so I'm sure that the sleep deprivation took a toll. I'm 38 weeks pregnant now (as an attending) and despite knowing I'll have a difficult time not working, I plan to take 12 weeks off. Part of it is to spend some quality time with the new baby and my 4 year old son, but also to hopefully get more adjusted to a family routine so I'm not as sleep deprived when I return and can stay alert in the OR. At the end of my leave, I'm also going to a meeting in order to get ready to return.

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  6. I took 6 months off and this duration was appropriate as I was leaving one job to start the next. Interestingly enough, 6 months was way too long for me, and like many have commented above, I began to feel bored, depressed, and was itching to get back to work. My 'rustiness' was more due to having to learn a new system at work than the actual work itself. Though it's been tiring, I did feel that I was more appreciative of my time w/ my daughter post work than I was during leave. I do recall being fearful that somehow I'd forget everything... and that was pure nonsense. I ended up squeezing in a few moonlighting shifts during leave to quell those fears. I guess everyone has their own style of course, just like we did when it came to studying for tests, etc.... In the end you have to do what feels right for you.

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  7. I'm nearing the end of MS4 year and had my first baby at the beginning of MS4 year. I took 4 months before going back to clinical rotations, though during some of that time I worked on a research project. I did feel rusty coming back, but of course my knowledge base is not very big to begin with, and luckily it didn't matter much, since there are low expectations for med students in general! I thought 4 months was ok, but I would have taken 6 if I could. Since coming back, I really have only felt balance during my lighter, 30-40h/wk rotations. I have found myself crying multiple times during my heavier rotations when I leave before my baby gets up and get home after she goes to bed. I would definitely try to do part-time residency, which is offered by my program, if it was 50% time, not 1 month on, 1 month off.

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  8. I was off for eight months (not entirely maternity leave - also leaving a job and starting a practice.) That first day in the new office was exhilarating and fun. I didn't feel rusty; I felt like I was back where I belonged. I HATED being home full-time.

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  9. 1st one midfellowship 8weeks off - zero rust as I was still learning my speciality I never stopped studying/reading. 2nd one 12weeks off - was insane and inventing reasons to go to my office, as an ED doc, I literally had no pt care, not even emails about pts. Nerves, but not rust, the first day back and tons of exhaustion. But like many whom have already spoken, I clearly am not meant to be a SAHM.

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