Self-care: Have You Filled Your Bucket Today?

I started pondering this topic after I witnessed a healthcare professional post on Facebook about her hospital system expecting her to return to work (five days in) when still actively symptomatic and ill from COVID.  She needed more recuperative time but was struggling to give herself permission to take it.  Unfortunately, this scenario is all too common in the healthcare community.

How did we get here?

Demoting the importance of my own health started right from the get-go in my medical career.  I had so many extraordinary experiences in residency, but I also learned some very bad habits.

• How to eat a salad in 5 minutes. Chew less.
• How to hold my pee for 16+ hours. Yes really! I would go to the bathroom before I left for work and often not again until after I returned home. @thekegelchronicles, I know I know!
• How to prioritize residency/work above self and all others.
  1. Dad falls and breaks a hip: I will see you after my shift.
  2. Best friend having seizures all night due to brain cancer recurrence: I’ll try to coordinate your care as best I can while at work and I’ll see you after my shift.
• How to learn to not feel my emotions until I was home if even then. I didn’t have time to grieve a patient I lost; still more patients needed my care.

As an attending, I continued to live by this culture. 

I ambulated on an improperly healed ankle fracture for two years through the COVID pandemic telling myself I could not seek care right now. I could tolerate the pain, therefore I did.  After a very long fertility struggle, I miscarried while working.  One would argue that leaving the hospital wouldn’t have changed the miscarriage, and I wholeheartedly agree. However, it would have been nice to go home to the comfort of my husband and have an epic sob. Instead, I shoved it away and kept on working as my dream literally flushed away.

On this journey of MD, I learned and cultivated thoughts that fortified the belief that my well-being was secondary to my career and my patients.

This toxic culture is reinforced with every illness.  Calling in sick with the flu, one of two things will transpire:  either a colleague will come in and work an extra day or the remaining healthcare workers will be overwhelmed due to the patient load with safety of care potentially compromised.  A colleague working an extra day might not seem like a huge burden, but it is a colossal request when someone is already exhausted and deficient in self-care.  Inter-colleague resentment is born. The cycle perpetuates.

Institutional Healthcare has no reserve and has been built on the foundation of healthcare workers devaluing their own health and well-being in service of the medical system and patients they serve. 

“I can’t call in sick; there will be no one to care for my patients.” 

As we save lives and heal others, we harm ourselves propagating the burnout, anxiety, depression, and substance abuse issues that plague many healthcare workers. Healthcare personnel who are ill, deserve to become patients who are served by the healthcare system.  Typically, neither the individual nor the medical system is able to recognize healthcare workers being more than essential personnel. 

The World Health Organization defines self-care as “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare professional.”

Do you really understand how to perform self-care?

Are you filling your self-care bucket?

This question is inspired by a children’s book I love called Have You Filled a Bucket Today by Carol McCloud.

“A bucket filler is a loving, caring person who says and does nice things to make others feel special. When you treat others with kindness and respect, you fill their bucket. But you can also dip into a bucket and take out some good feelings. You dip into a bucket when you make fun of someone, when you say or do mean things, or even when you ignore someone.”

When you dip into someone’s bucket you also dip into your own = double bucket dipping.

I translate that concept into self-care as follows:

• Bucket filling for ourselves--regular and proactive promotion of your health and well-being.
• Bucket filling for others--regular and proactive promotion of another’s health and well-being without compromising our own.
• Bucket dipping for ourselves--regularly compromising/demoting our own health and well-being to promote the health and well-being of other people, institutions, etc. TOXIC!!

If we are regularly downgrading our own health and well-being to elevate the health and well-being of others, a medical system, or anything else in our life, I would argue we are still on the hunt for true self-care. We all choose to dip into our own buckets in service of caring for others; it’s part of the territory. Balance can only be achieved if we fill our bucket more than we are dipping from it. 

We must be proactive!  

We need that massage, hot bath, good book, nature walk, or family/friend time to be in service of keeping our bucket full rather than replacing a never-ending deficit.

How do we change our core beliefs about self-care?

We must change our thoughts. 

Our thoughts, repeated and instilled with the idea that they are true, become beliefs. We can harness our avid curiosity to examine the thought before we retain it and then the magic happens.

We can think with intention and create new thoughts more serving to our well-being. 

With time, these newly cultivated thoughts become the beliefs we choose on purpose. 

We become empowered to care for ourselves because we believe that self-care means “me too” instead of “me last.”

***Have You Filled Your Bucket Today is a favorite book in my household and very helpful for teaching emotional skills to children. If you are interested in knowing more about the book click here!***