This podcast episode is a continuation of Episode 1: Tips & Pointers for New Mental Health Professionals. These tips are specifically geared towards mental health trainees or people who are early in their mental health careers. This may be graduate students in psychology, post doc students, psychiatric residents, medical students interested in psychiatry, or psychiatrists who are early in their career, what we call early-career psychiatrists.
The transcript of the podcast has been posted below this summary list.
Summary of Episode 2: Awareness and Self-Care for Early-Career Psychiatrists
Keep some goodies in your office. You spend so many hours there in your office at the clinic or at a hospital and you’ll need to have some things on hand.
Be aware that colleagues and family members will ask you for advice. If you want to learn more about how to handle this, I’m happy to talk with you about it or if you’ve run into the situation I’d love to hear your thoughts about it.
Be aware that some of your colleagues will have mental health concerns. Think about how you can be supportive when interacting with them.
Be careful with what you print, fax, email, or copy at work. It may end up in the wrong hands. The best advice I can give you is don’t do it at all.
Remember that your work computer is likely monitored. Even though your supervisor may not find out how much time you’ve been spending on social media while at work, it really doesn’t set a good example.
Choose your attire wisely. If you have a question about whether something is appropriate or not to wear to work, you probably shouldn’t wear it to work.
Maintain a professional appearance even when away from the office. Sometimes we are observed by patients and patient’s family members and we don’t even know.
Be careful when connecting with colleagues or patients on social networks. Adjust your privacy settings so that your personal life remains private.
Eat breakfast. You never know what events or emergencies may come up that could prevent you from eating later.
For women: buy dresses and pants that have pockets. Often times you cannot bring your purse on a psychiatric unit.
Have your cell on only if you need it for urgent matters. If your hospital still uses pagers, carry you pager instead.
It’s your hard-earned license and you need to be able to confidently defend all of the decisions you make regarding patient or client care. Remember that when you feel pressured to handle a patient’s care in a certain way.
Work for and with people you respect. When looking at potential job sites, think about the workplace environment, not just the benefits, the location or the salary.
Treat everyone at work with respect. The janitors, the maintenance staff, the cooks in the kitchen all play a vital role in keeping things going.
Get your own therapy and get some supervision. You will have clients who will do things or say things that you never, ever, ever dealt with in training.
Have a group of colleagues you can connect with regularly for fun outside of the facility. It’s really, really nice to have that to look forward to and to talk with people who know what it’s like to be a mental health professional.
Transcript of Episode 2: Awareness and Self-Care for Early-Career Psychiatrists
This podcast episode is a continuation of mental health tips for professionals. These are mental health tips that I wish I would have learned early on in my training. These tips are specifically geared towards mental health trainees or people who are early in their mental health careers. This may be graduate students in psychology, post doc students, psychiatric residents, medical students interested in psychiatry, or psychiatrist who are early in their career what we call early career psychiatrist.
I’ve been in practice since 2008 and I’ve had variety of experiences both inside the hospital what we call inpatient care and outside of the hospital. In outpatient clinics, residential programs, et cetera. These are some tips, some pointers that I’ve learned over the years. I think it can be really, really helpful for you.
One of the tips that I have is keep some goodies in your office. Protein bars, bottle of water, a mini fan. Special supplies, ladies. A light sweater in case it becomes too cold or some of your lunch accidentally ends up on your shirt.
Having your goodies in your drawer can really make a difference and can make you feel comfortable when you’re in your office. You spend so many hours there in your office at the clinic or at a hospital so you want some goodies there. Also too, some condiments, salt and pepper, ketchup, things like that. Some extra utensils can be handy. Let’s say you go out for lunch and come back and you’re wanting to eat some more of your leftovers and you don’t have any utensils that can be really frustrating. Keep some of those things in your office. Also, I recommend some stickers.
Something that I really enjoyed when I worked primarily on an inpatient psychiatric unit was that sometimes some of my colleagues or coworkers would bring their children by just for a few minutes so we have the acute psychiatric unit which was then one part of the hospital and then we also had our offices in another part. Sometimes in our professional offices, some of the staff might bring their daughter or son by for a few minutes. Usually a spouse would come by and want to have lunch with one of the psychologists or one of the discharge planners or social workers.
I loved having something for the kids and so they knew when they come by Dr. Watkins’s office I always have some stickers for them. You might consider going to the 99 cents store, the Dollar Store and just having some goodies available for some of the kiddos who might end up stopping by.
Know that as you continue on in your career, some of the staff at your clinic or at the hospital will ask you for advice and they’ll want to dive to personal information to you. I never learned about this in training.
It’s very interesting what happens because you’re seen as the leader, you’re the psychiatrist or the psychologist. Obviously you help people with challenging situations all of the time. You’ll find that sometimes a nurse or a social worker or one of the other staff might just knock on your door and come on in and want to start talking. If you want to learn more about how to handle this, I’m happy to talk with you about it or if you’ve run into the situation I’d love to hear your thoughts about it.
I do have a perspective on it that I’d be happy to share with you. You can leave a comment on my website, yourmentalhealthfirst.com or message me on Facebook, Facebook.com/mwatkinsmd or you can tweet @MWatkinsMD. Perhaps I’ll do a Periscope, a scope about this topic because this is something that many of us aren’t prepared for because there might be some people who want to talk with you about your suggestions or recommendations. I had a nurse asked me, “Dr. Watkins, what do you think I should take for hot flashes?” You have to be very careful with some of these situations.
We can talk more about how to handle these situations. Feel free to reach out to me and we can discuss it.
Also know that some of your colleagues will have mental health concerns. We are not immune. I’ve had colleagues who’ve had concerns with substance use, bipolar disorder, anxiety, personality disorders, depression. Think about how you would handle interacting with a colleague who has any of these concerns. How would you or could you be supportive? We can talk some more about this because this does come up from time to time and again it’s not something that’s talked about very much when we’re in training.
We talk about patients or clients having these concerns but we don’t really talk about what we would do if one of our colleagues had a mental health issue that needed to be addressed. Let’s generate some discussion about this. Please go to yourmentalhealthfirst.com.
Also, know that you have to be careful with what you print, fax, email, or copy at work. It may end up in the wrong hands so do your best to keep this to a minimum or the best advice I can give you is don’t do it at all. It’s very tempting sometimes just to send a quick fax or make some copies at work.
You might forget and leave something on the copy machine and someone else might get access to it. You’re reported to your supervisor or it could be something that’s embarrassing that you don’t really want people to have access to. Who knows, maybe you’re copying your divorce decree or something at work and you don’t want people to know about all your personal business. You’re trying to look at your profile on match.com and someone else sees what you’re doing. Just be careful with some of the personal stuff at work. It’s best that you take care of these things at home.
Also know that your work computer is likely monitored. People don’t think about this stuff. You have a log in and a password. An administrator can access that information and think about the sites that you search at work. Think about what is on your screen when a coworker walks by. Do you really want them seeing you updating your Twitter account and posting on Facebook and such? Even if your supervisor may not find out how much time you’ve been spending on social media while at work, it really doesn’t set a good example.
It’s not a good image or representation of yourself for people to see that you’re constantly on websites and social media that aren’t related to work. Think about that. Also too, remember that not everyone is your friend but you can always be friendly with good boundaries. When you’re first starting out sometimes it’s hard to know who you can trust at work and who you want to share information with and who do you want to socialize with outside of work. You can always be friendly but just know that not everyone is going to be your friend of course.
You don’t want to share personal information with people who aren’t at that appropriate level of connection with you. Just be conscientious and cautious about these things but you can always be friendly and have good boundaries. Remember that you always represent you regardless of where you work. Think about the message that you’re conveying. We’re going to talk a little bit more about how you dress, how you communicate, showing up on time, et cetera. You always represent you and so you want to represent yourself in the best way possible.
This is really important, especially when you’re starting out because you’re setting the stage for how you will conduct yourself in the workplace. Yes, you will be judged by how you dress. It is what it is. Choose your attire wisely. This is one of my favorite topics and if you want to learn more about this I’m happy to blog about it especially for women. The length of your skirt, how you wear your hair, how much make up you’re wearing, how much perfume if any.
I suggest that you don’t wear any perfume at all but you want to be very aware of these things and also have some colleagues that you can check in with at work too who have your back. Maybe your partner too can talk with you if there’s any question. My thought is if you have a question about whether something is appropriate or not to wear to work, you probably shouldn’t wear it to work. I tend to be pretty conservative and I don’t want anything that’s going to distract the patient or the client from their experience of me and with me.
I definitely don’t want to give any material for anyone else to be talking about me so seeing something about how I was dressed unless it’s something positive of course I would love to get a compliment on how together I look, the nice colors and arrangement of my jewelry and so forth. It shouldn’t be anything that’s too flashy or too distracting. It really should be overall very conservative and professional and appropriate. Again, if you have any question about whether it’s appropriate or not to wear to work, you probably should save it for after dinner cocktails or something like that but not for the workplace.
Again, you represent yourself wherever you go. Where I practice I don’t live in a small town but it is a city that you can bump into people from time to time. At Target, at Whole Foods, at Safeway and I have bumped into patients and I have bumped into family members of patients. After this happened a few times I just became more aware of how I dress when I was going out to the grocery store. When I was a medical student and I went to the grocery store, I’d wear scrubs. I actually wore scrubs all the time. I wear scrubs, I sleep in scrubs, I wore scrubs to study, I go to the grocery store in scrubs. It was like being able to wear pajamas 24/7.
Then as I got older and I started to have these random interactions with patients and family members outside of the hospital or my private practice I realized how important it is that I maintain a certain appearance even in public. It’s not to say that I need to wear my office attire when I’m doing some shopping on the weekends but I don’t want to go out in public with sweatpants on, no make up at all and my hair not combed. I want to make sure that the basics are taken care of. I’m happy to talk about this more but again this is something that we don’t talk about in training but these things become real issues as you start off in your career.
Again, this is something that we don’t learn about during training but very important for when you’re out there in the real world. Sometimes we are observed by patients and patient’s family members and we don’t even know. I remember when I was in psychiatry residency, one of my patient said, “Oh, I saw you and I think it was your son at Target.” I was thinking, “Oh my gosh, what was I doing at Target? Was I disciplining Jonathan? Was I buying underwear?” I couldn’t remember what I was doing at Target but it made me think I will probably be observed in a community and not even know that a patient saw me.
I just want to be very aware of that. I want you to know about that too as you progress in your mental health training. Sometimes you’ll have to process what that experience was like for the patient because if they see you in a community they might be learning more about you than they would ever know about you in the office. They might have some thoughts and feelings about seeing you running errands in the community and some ideas about where you shop and who you are with and so forth. That might need to be processed in the coming appointment.
We can talk a little bit more about this if you go to yourmentalhealth.com and just post a comment and let me know if you want to talk about this further I’d be happy to do so.
Also, in this age of social media you’re going to find that your coworkers and colleagues might want to connect with you. They want to be Facebook friends or maybe some of your patients might find you online and they want to connect and be Facebook friends. If you’re not comfortable it’s okay. If you’re not comfortable and you can always direct them to your LinkedIn page.
That’s my personal strategy. I’ll say something like, “I don’t usually connect with my patients on Facebook but I’m happy to connect with you on LinkedIn.” With a colleague, if you do decide that you want to be Facebook friends but you work closely together, you can adjust your privacy settings and you can decide how much interaction you want to have with them and how much access they have to your Facebook account. How much access they have to your photos and post and so forth. Always remember that you can adjust privacy settings as well.
Be careful when you’re leaving your office or the hospital at night especially when it’s dark.
You can ask security to escort you. You can ask a colleague to join you or walk with pepper spray or a flashlight. Don’t be distracted. This is not the time to be on your cellphone, walking in the dark going to your car at the far end of the parking lot. I would much rather that you have someone with you, a colleague or security escort. If you have to walk by yourself being very focused and walking quickly and looking straight ahead and just being very aware of your surroundings as you’re heading towards your car. This is something again that we don’t really talk about as professionals but you want to be careful when walking to your car at night time.
Also to eat breakfast. Even if it’s a banana or yogurt or smoothie. I love smoothies. I love my Vitamix smoothies are awesome. I make them for my husband and for me in the morning. They are great. You may not get to eat lunch so at least start off with something in your stomach. You never know what events or emergencies may come up later. When I was in training sometimes this would happen, I would skip breakfast and then something would happen with a patient or there would be something urgent that needed to be taken care of and I wouldn’t eat. Then I would just be so hungry and then by the time lunch time rolled around I wouldn’t make the healthiest choices.
I would choose cheeseburger, french fries, whatever they had in the hospital cafeteria because I just be so exhausted and so hungry that I just wanted to eat up anything that they have available that was quick to eat. Try to eat breakfast. Something quick. Something that you can eat on the go even if it’s a protein bar or banana and you won’t regret that later on, trust me.
Getting back to clothing, for women, buy dresses and pants that have pockets. I love having pockets and I wish that I could have pockets sewn into all of my dresses that I have that I wear at work.
As a psychiatrist, we don’t wear white coats. That’s pretty much the standard for both pediatricians and psychiatrists. There are several reasons for this and we can talk about that later but usually you’ll be wearing a nice dress or slacks or a skirt and a sweater or a blouse. Sometimes you may not have pockets. Now, when I purchase dresses or pants or skirts I’m looking at the types of pockets or if there are pockets because it’s very nice to have packets to put keys in. If you’re a psychiatrist or psychologist working in a hospital it’s nice to have your keys handy.
Also just to keep a few items with you. I like to keep mints with me. Breath mints. That’s really nice to have that. We can just reach down and get what you need also pens too. I like to keep a pen handy because I never know when I might have to sign something. Think about that when you’re purchasing dresses or pants. Think about pockets. Remember, often times you cannot bring your purse on a psychiatric unit so we as women are used to having a little purse or clutch that we have our items then. When you’re on a psychiatric unit and you usually can have a purse or a bag or a tote. Having those pockets really can make a difference.
Back to cellphones, there’s a reason why we generally do not allow patients to keep their cellphones with them on the inpatient unit. They are distracting. Try to have your cell on only if you need it for urgent matters. If you do need to have your cellphone on, have it on vibration mode or consider using a do not disturb or airplane mode. I like the respond with text feature a lot. I have three main respond with text responses. I have one that’s says, “Seeing patients now. Call you back.” I have another one that says, “Eating now, call you back.” A third one that says, “I can’t talk now. Call you back.”
If your hospital still uses pagers, which one of the hospitals I work at still does, carry your pager instead. That way staff can reach you if there is something acute or urgent that comes up. If they use cellphones to reach you, then just be very aware when you need to have your cellphone on and be available versus not. Of course, when you’re seeing patients in private practice you really don’t want to have your cellphone on. It’s not fair to the patient. It’s not fair to yourself. I’m very protective of my time with patients in private practice.
I make sure to have my cellphone off because I don’t want anything that’s distracting and I want to be truly present and focused on what my patient is saying.
Earlier we talked about how when you’re working at the hospital or at a clinic, there will be people who will ask you for advice. Also too, know that friends, strangers, coworkers, family, they will also ask you for medical psychiatric or psychological advice just accept this will happen I have lots of tips and pointers for you in how to handle this coming soon on yourmentalhealthfirst.com.
I’m happy to talk about this because again it’s something that we don’t talk about much during training. How do you handle it when you feel like you are the family’s psychiatrist or the family’s doctor or the family’s psychologist and you feel almost swamped and overwhelmed by the mental health concerns of others. Also too sometimes you find that when you’re in general public and people ask what you do, sometimes you might find that you’re reluctant to say that you’re a psychologist or a therapist or a psychiatrist because it’s almost like the flood gates open.
All of a sudden people want to share and they want to talk about friends they have who are going through certain situations and stressors and so forth. They wanted to just pick your brain about things so I do have some thoughts about this and we can talk more about this and if you have experiences that you want to share about this or general questions please go to yourmentalhealthfirst.com. Also remember that it’s your license. It is you who will have to defend the decisions that you make. The staff working with you will likely not be meeting with you or with your lawyer if you’re sued.
Always remember this so you might feel pressured to manage the patient’s care, the client’s care in a certain way. It’s your hard-earned license and you need to be able to confidently defend all of the decisions you make regarding patient or client care. Never forget that.
It’s also important to work for and with people you respect. This may not be entirely in your control but when looking at potential job sites, think about the workplace environment, not just the benefits, the location or the salary.
You want to think about the people that you’ll be working with day in and day out. Are these good people? Do you feel like you can respect them? Do you feel like they’ll respect you? Do they like what they do? Are they team players? Are they really cohesive, genuine and sincere? People don’t really talk about that when you’re thinking about your first job we don’t talk about looking at the people that you will be working with. I think this is a very, very important point. Be very kind to the folks who are doing more of the ground work than you are.
Hospitals, clinics, offices do not function solely because the doctor has showed up. The janitors, the maintenance staff, the cooks in the kitchen all play a vital role in keeping things going. A surgeon could not operate if the lights in the operating room are malfunctioning. A client will not receive the confidential care they deserve if they are in office with the door that can’t close properly. A patient may not feel comfortable in an office that has scuffed walls or trash cans that are full. Everyone who works at a hospital or clinic is playing a vital role in patient care.
My husband is a stationary engineer at a hospital in San Francisco. He does a lot of the skilled maintenance in the hospital and so this is something that I knew years before I met him, how vital and important his role is in the hospital. Everyone deserves to be treated with respect. The same way that I greet the janitors, the same way that I greet a patient is the same way I create a colleague. It’s always, “Hi, how are you doing? How’s your day going?” I treat everyone consistently the same way and so I encourage you to not have a different way in which you interact with people based on their level of experience or seniority or how many degrees are after their name.
Everyone plays such a vital important role in how the hospital functions and if we don’t have patients we don’t have a hospital. Right? If we don’t have patients we don’t have a clinic or a private practice. You really need to think about the roles that each person plays and treat them with the respect that they deserve.
My next two tips are get your own therapy and get some supervision or someone to help you with making decisions regarding the care of your patients. Sometimes there are groups that you can join where you can talk about the cases and general terms without any potentially identifying information.
You can work through your own issues and concerns, the counter transference that comes up during patient care or client care so it’s very important to get your own therapy. Know that you will have clients who will do things or say things that you never, ever, ever dealt with in training. You will have scenarios that will test your ethics and boundaries. You have to expect the unexpected but know that you can handle whatever comes your way. I can talk with you about this more. Let me know some of the challenges that you’ve had. Go to yourmentalhealthfirst.com.
Lastly, have a group of colleagues you can connect with regularly for fun outside of the facility that you work and train at together. One of the things that I really enjoy that I started was this group called Drinks in the city. This is a group of my female psychiatric colleagues and we get together quarterly and we have fun in San Francisco or sometimes what we call the East Bay / Oakland / Berkeley area and we just talk and hang out and have fun and have good food and drink good wine. Just socialize and enjoy each other’s company and it’s really, really nice to have that to look forward to and to talk with people who know what it’s like to be a mental health professional.
If you want to learn more about how you can start a group in your area I’d be happy to talk with you about that too.
Again, thanks so much for listening. I’m so happy that you’ve taken this opportunity to put your mental health first by learning ways in which you can become the best mental health professional that you can be or just in general learning more about mental health careers. I’m happy to answer any questions that you have. I do reply to comments that you post or that you tweet. Thanks for listening and I’ll talk with you in the next episode of Your Mental Health First.