Acknowledging and Attending - the first few months

I'm about 3 months in into my first after-residency attending job. I really underestimated how hard this was going to be.

Logically, this shouldn't be surprising. I uprooted my family from a large metro area, plopped them down into a rural community where our nearest ties were about 2 hours away by car, and started a new job. I had a wonderful few months playing stay-at-home mom, then started my new clinic job refreshed and enthusiastic.

What took me by surprise was how unconfident I felt about everything. Once I was done seeing my first patient, I immediately went to find the nurse practitioner down the hall to run my plan by her. I knew it would feel weird not to precept as a resident, so I gave myself a break the first few days. I got some reassuring texts from other recent graduates, telling me they had done the same thing when they first started. For a while, it felt like every new patient was the first time I had ever treated that condition (insert: asthma, allergies, COPD, coronary artery disease, etc.) even if I had seen it and treated it confidently many times in residency. It's getting better, but it still feels that way more than I think it should

I had done my residency training in an urban setting treating young diverse families, and within my first couple weeks in my new job, I felt like I had met more people over the age of 90 than I had ever met before. Additionally, I was in a new system with different specialty and subspecialty resource availability and it felt like the referral patterns were completely different. I have felt like I was both under-referring and over-referring depending on the issue. I also still feel like I am over working up some problems and probably not working other problems up enough. Additionally, my husband's work has been more demanding than usual and Toddler is on his 3rd ear infection in the past two months so there has been a little more scrambling than anticipated.

Luckily, I know I'm not alone. My best friend from medical school started her new primary care job the same week I did - and we've talked at least weekly since, running our cases and insecurities by each other. I just came back from a mini-reunion dinner with my residency classmates, and I know they're all experiencing similar things.

One of my good friends moved across the country to do a primary care nurse practitioner residency and is blogging about her adventures. She recently had one tough week of both life and career difficulties and wrote about acknowledging that it has been hard. Not complaining. Just acknowledging. I don't think we give ourselves permission to simply acknowledge the difficulties of our situations. I am looking back over the past few months, and I know I have made at least some good medical decisions thus far, and people are coming back to see me which is probably a good sign.

I have decided that I am going to acknowledge that these past few months have been difficult, but I'm also going to embrace that this is a time of immense growth and I will never have a chance again to experience anything like this year. I am going to accept that I have already made mistakes, and I will make more. I'm going to also acknowledge that I am a good mom  and a good doctor, and will continue to wake up and try again the next day.

Kicks