Latest / The Hidden Load: For the educators and leaders in medicine who hold everyone up. / The Re-Entry Whiplash: Protecting Your Vacation Peace
Transcript
- Santina Wheat: Welcome to the hidden load for the educators and leaders in medicine who hold everyone up. We will tackle the hard topics and help you conquer your chaos and get to calm all by starting to acknowledge and remove that hidden load. This podcast is a space for us to name the things that are common, but not normal. Each week, we'll look at the invisible weight you're carrying and explore practical coaching-based tools to help you find more calm, better boundaries, and a sense of purpose that doesn't require you to run on empty. I'm so glad that you've carved time out for yourself today. Let's get into the episode. Welcome back to The Hidden Load. I am your host, Dr. Santina or Tina Wheat. When we speak about vacation and healthcare, the conversation is often focused on a single moment, the handoff. We talk about how to effectively prepare to leave the clinic or the hospital floor. We talk about how to secure safe coverage for our patients, clear the immediate inbox, delegate critical tasks. and secure that elusive structural permission to finally disconnect and rest. Those are the things that our organizations ask of us to make sure that everything will be covered while we're gone. And let me be clear, that emphasis is vital. Without a robust system backed handoff, uninterrupted rest is completely impossible. Recently I wrote in my blog about how crucial it is to build trust and be able to transfer that trust to your team, to build real coverage systems, and to sever your digital ties entirely while away. Those are foundational leadership skills that protect us from career burnout. And I will add that to the show notes so you can read it if you haven't had the opportunity. As I sit at my desk today, officially back from my own recent time away, I am confronted by a distinct heavy phase of a vacation life cycle that none of us feel prepared for in medicine, the reentry. In fact, this is the time that I often find people say it's not worth disconnecting during vacation because of the reentry. So let's talk a little bit about what the vacation life cycle is. First, there is that pre-leave sprint, getting ready to go, trying to close as much as you can, closing your inbox, finishing up projects so that you don't have to hand them off. And then there's also the asking other people that they can cover you, and then the actual handoff. And then hopefully you meet that pristine bliss. of the rest, of actually enjoying your vacation. But then we get to what we're talking about today, the unprepared gap. There's that re-entry whiplash, followed by the immediate relapse, where if we haven't taken care of how we re-enter, we fall right back into burnout. This re-entry is frequently the most difficult and overwhelming and fragile phase of any significant time off. I'm not just talking about a long weekend. I'm talking about a good one or two-week vacation that most of us truly need. I want you to think about the contrast. There is a pristine, almost luminous bliss to the final couple of days of a good vacation. You feel your shoulders drop. You feel reconnected to your friends or family, to your passions, and to your core identity outside of the hospital. You have slept deeply and you look at your spouse, your kids, or your friends, whoever it was that you traveled with, and you think, I feel like myself again. I am going to carry this calm back with me on my return. I am never going to let the demands of my job consume me like it did before. But then you cross your front door threshold and the reality whiplash hits you like a brick wall. This isn't a theory I'm observing for a distance. It is exactly what I experienced this week. You walk through the front door and the physical environment immediately demands your attention. There is a mountain of loaded luggage sitting in the hallway. And so you have to think about unpacking it, doing all of the laundry, putting all of the laundry away, and everything else in your suitcases. There is the task of sorting through the stack of physical mail that arrived and opening the boxes that arrived while you were gone. And in my case, this was all of the back to school supplies. So sorting and getting ready for school was part of this. You look out the window if you happen to have a yard and see the overgrown grass that kept growing while you were off enjoying yourself if you didn't have someone to care for it. We tend to dismiss these household tasks as minor chores, and each of them individually isn't so bad. But they do all add up. And psychologically, physical clutter is a massive threat trigger. It sends an immediate subconscious signal to your prefrontal cortex. The period of safety and rest is over. High alert demand has returned. And if you happen to not leave a clean house, then this feels a little bit worse. And let's be honest, those domestic tasks are just the opening act. There is all of the things that are going to cause your shoulders to rise at work. Before I even opened my clinical schedule or logged into my institutional portal to check my email, I could feel the familiar tightening sensation of work anxiety surfacing in my chest. The mental gear started turning, whether I wanted them to or not. If you're like me, you picture the staggering mountain of unread emails sitting in your inbox. You mentally prepare for the cascade of meetings that were pushed off to wait until you get back, that were scheduled right on your return. You brace yourself for the hidden operational emergencies, the personnel frictions, or the clinical complications that potentially occurred in your absence. And you realize that from the second your foot steps onto the clinic floor, you will be expected to make high-stakes, rapid decisions on complex items that were held for your return. The hardest gear to shift isn't the logistical one, it's the cognitive and emotional one. So let's talk about this cognitive shift and the disparity that you have. First, there is vacation mode. This is an unstructured flow. Time is more likely to flow organically, there are minimal external obligations, and your nervous system is in this blissful parasympathetic recovery. But then there's the immediate work mode, which is a high alert demand. There is time structured and 15-minute blocks. There are relentless external inputs of your EMR, your staff, and your patients. There's all of the decisions and demands at home that we're not even talking about. And this all puts your nervous system into a forced sympathetic overdrive. You are expected by yourself and your team to jump instantly from vacation mode where time flows organically and obligations are minimal straight back into home logistics and high volume work mode. You have to immediately resume meal planning, ensure that school routines are running, set alarms, and show up to administrative briefing meetings fully composed, highly energetic, and completely up to speed. Which means you need to catch up on what you missed. This instant jump from blissful calm to high alert demand is a direct pathway straight back to professional exhaustion. And none of us want to do that. Why do we do this to ourselves? Well, in healthcare, we carry an internalized toxic expectation that we must be. Immediately available, immediately productive, and immediately flawless the moment our vacation dates end. We allow our re-entry to be chaotic, cluttered, and unmanaged, and then we wonder why the benefits of a two-week vacation evaporate within 48 hours of being back at work. And so I think that we need to find a way that this doesn't happen in 48 hours. I think that we need to find a way to hold on to that bliss from vacation that allows us to continue to sustain and continue to thrive in our careers. And so sustaining a long-term career and thriving in that career in healthcare leadership. Requires that we actively reject this expectation of instant pre-vacation level functionality. We must accept that rest is not an extra concept that lives in a vacuum. It is a physical biological process that requires an intentional runway for return. To protect the energy and perspective I built during my time off, I deployed a structured tactical reset protocol for my forced. First 48 hours back. This protocol requires establishing boundaries and protecting your time with the exact same discipline you use to protect your vacation in the first place. So let's talk about the three non-negotiable pillars of this protocol. Pillar number one is the operational catch-up buffer. This means that you lock out your first clinical or administrative block for inbox and system triage. In my case, it still actually looked like I was on vacation. But I ensured I had no meeting scheduled for the first four hours so that I could get through my several email inboxes and my EMR to make sure that I could address anything urgent, that I could see what had happened, and I could walk into my first clinical day with a clean slate. The second pillar is the home environment reset. This means clearing physical home clutter within 24 hours to stabilize psychological focus. And this doesn't have to just be you. I make my family participate in this. I tell them that they have 24 hours to have everything put away. Everybody helps with the mail. Everybody helps with the laundry. We don't worry as much about the outside because that's not immediately in my clutter zone, but we do clearly identify what needs to be done to allow for a stable focus. And then pillar number three is the post-vacation boundaries audit. And this is not just about returning from vacation. This is about knowing what you can manage. what you can have to continue to maintain your peace. So this is using the perspective of rest to permanently prune things that don't need to be yours. Maybe you notice as you go through your emails that somebody else could be handling something, or you notice that you are okay without a certain alert being set. So let's go into each of these pillars just a little bit more. So pillar number one, that operationalize a catch-up buffer on the calendar. This is literally, if you can, a block on your schedule. I make sure now that I'm not seeing patients during that first block and I do not schedule back to back staff meetings. I actually fought this one a little bit myself because I felt like I needed to be available. And my coordinator told me no. My coordinator told me that I needed time to catch up, that I needed time to reset. She said it was okay if people didn't see me for another four hours. This is not laziness. This is essential high value workload management. Having an explicit buffer means that you're actually giving yourself that cognitive space to triage those unread emails, to review major clinical issues that were handled by coverage, and consolidate all those wait until she get back's requests into a prioritized master list so that you know what you have to manage first. When you give yourself permission to ease back into the workflow rather than jumping straight onto the treadmill, you eliminate that high cortisol spike that fuels re-entry panel. So then pillar number two, resetting the home environment first. Giving yourself that time and permission you need to reset your physical home environment before you attempt to tackle the clinic or the hospital. If your home environment feels cluttered, chaotic, and disorganized, your brain will remain in a state of baseline friction and you will not be able to feel settled at work. You will think about all of the things that need to keep happening. Tackle your laundry, sort the physical meal, clear the suitcases out of the living space, and manage core household needs within the first 24 hours of landing. Creating an orderly, peaceful home environment establishes a psychological anchor that stabilizes your focus when you step into the hospital the next morning. Even though we all really love to spend as much of our vacation away as we can. For some, these two first pillars might mean returning from vacation a day early so that you have time at home before you actually have to walk into your workday. And then pillar number three, perform a boundaries audit. This re-entry window is the single most powerful opportunity you will have all year to perform a boundaries audit. When you sit down and look at that massive pile of unread emails, pushed meetings, and accumulated requests. Look at them with the fresh eyes of someone who just stepped out of the system and ask yourself. Does this task actually require my time? Or was I carrying out of pure habit? Especially those tasks that were well managed by others while you were gone. Use that clarity you gained on vacation to prune your commitments. You do not need to accept the clutter of the past season as a mandatory for the next chapter. You don't have to let every meeting back onto your calendar just because it was there before you left. Only let back in the responsibilities that directly align with your core purpose, your leadership goals, and your long term sustainability and more importantly, ability to thrive. Taking a vacation is not a luxury or a sign of weakness. It is a vital act of leadership stamina. But to enjoy the full sustained harvest of that rest, we have to become masters of the reset. Don't let a chaotic, unmanaged re-entry rob you of the purpose, clarity, and peace that you reclaimed during your time off. I want you to design your return with explicit intention, calendar blocks, and a home environment reset. By operationalizing your right to a smooth return, you build a foundation that supports your long-term professional longevity. So here's my challenge for you this week. If you have a vacation or time off coming up on your calendar over the next few months, I want you to open your scheduling software right now. Before you book the flight, before you finalize the coverage, I want you to block out the first four hours of your return date on your master calendar. Label it operational re-entry buffer. Protect that time with the exact same fierce boundaries you use to protect your time away. Give yourself the runway you deserve to land safely. Clear the clutter, and protect the piece that you worked so hard to build. Thank you for joining me for this episode of the Hidden Load. If this re-entry protocol spoke to you today, please share it with a colleague who is currently preparing for or returning from their own time off. Let's lighten this load together. And remember, if you are listening to this during the month of August, I am running a birthday month special. Check the show notes and contact me for details if you are interested. I am Dr. Santina Wheat. And I will see you next week. Thank you for listening to The Hidden Load. If today's conversation spoke to you, I would love for you to share it with a colleague who might need to hear it too. It's one of the simplest ways we can start shifting the culture of medicine together. And remember, your time spent reflecting here matters. You can earn free CME or CE credits for listening to today's episode through the Pinnacle app. You'll find that link in the show notes. If you are looking for one-on-one coaching support or want to dive deeper into the resources we discussed today, let's connect. You can find information on how to reach me in the show notes. don't forget to hit subscribe so that you never miss an episode ⁓ and leave me a rating so that others can find me too. and take care of yourself because you deserve to be held up too. And I'll see you next time.