Maintaining physical and mental health while working locums

Illustration of how to take care of yourself as a physician

Ripal H. Patel, MD, MPH, shares how he takes care of his physical and mental health while working locums assignments.

When do you feel you are the most healthy? For me, the time I feel at the top of my game, pinnacle of fitness, and the most energetic, believe it or not, is during my locums work weeks. How, you might ask? Aren’t you working long hours, on the road, staying in hotels, and consuming fast food? 

On the contrary. As physicians, I feel our job can uplift us, or utterly destroy us — both in the physical and mental realm. Knowing both areas, I wanted to further engage my practice through a locums model but knew I had to find a way to continue to promote both physical and mental wellness. 

Think about food before you leave

During my work weeks, things function like a well-oiled machine. I have a packing check-list, a driver to coordinate airport transportation, and I utilize the same companies for my flights and rental cars. I also generally stay at the same Airbnbs and hotels. This alone takes significant anxiety and variability out of travel. 

The week before, I’ll review my calendar, and make plans for meal preparation. What can I cook for lunch or dinner that is healthy, fast, requires minimal ingredients, and, in my case, is vegetarian? Couple this with the fact that — to optimize the grocery budget — I need to eat the same meal everyday for four days (meal prep). And so I check the internet, check YouTube, look at cooking magazines and blogs. And guess what? Outside of healthcare, you’re NOT the only one asking these questions, because — guess what again? — a TON of people travel for their jobs. And further, people come back exhausted and want a fast, filling meal. So the resources are unlimited, and as you save up recipes and hone your cooking skills (I save them on my Google Drive), prepping will be fun, and so much healthier and cheaper than eating out (and often, if you finish a shift late, you won’t have any options on where to eat out).

I’ll couple this with the other locums tricks-of-the-trade: purchase a few small, good quality cooking items (such as a non-stick pan, sharp knife, counter-grip cutting boards, spices, etc.), and leave them at the hotel or Airbnb. You’ll be shocked how LITTLE you need to cook delicious, healthy, and fast meals. Finally, pack snacks for those long 12-hour shifts — like nuts (rich in Omega-3s) and fruits. If you buy junk food and let it sit in front of you during shifts, trust me, you’ll eat it.

Exercise is crucial

So what about exercise? Yes, stop rolling your eyes, I dread it too. But we as physicians must embody health to our patients. And Lord knows we need the stamina to power through the days. I’ll share my secret on gyms, and it really involves two words: Planet Fitness. In case you weren’t business savvy, Planet Fitness makes its money on you NOT using your membership (Lifetime Fitness is the opposite model, they want to keep you there all day), and they tend to have locations in abandoned strip malls and such (to keep rates ultra low). I have a monthly membership, and every hospital I cover (yes, even those ultra remote hospitals like in southern New Mexico) still have a Planet Fitness. Now, it only works for 10-hour shifts, which gives me enough time to leave the hospital (usually 30 minutes late), work-out, come home, make dinner, prep for tomorrow, get about 15 minutes of Netflix in, and still grab my 7.5 hours of sleep).

Please revisit the sleep again. You HAVE to sleep, and really I prioritize my entire day around it.

When you can’t hit the gym

Now, how about those grueling 12-hour marathons of pain? You may be stronger than me, but after 12 hours my knees are weak, my head is spinning, and I can barely muster enough energy to get to the car, walk to my hotel, change, and pass out. Every single task I need to do after my shift ends that will get me to bed requires so much effort. Solution? Keep it local. I go back to YouTube on this one. There are hundreds of full-body, no equipment required, exercises for people JUST LIKE US, that you can do in your  hotel room while you prep for the next day. The goal isn’t to get cut on these days or to make gains, it’s just to keep your body tuned up, stretched, and in motion. I have severely limited my 12-hour shift days as I pass 40, so a few a month with light routines like this works perfectly.

And what if no hotel gym or Planet Fitness is available, and you have a dodgy Wi-Fi-connection? Then it comes to buying work-out bands, which pack easily and provide an insanely impressive workout that can be done simply at your hotel. 

Set aside time for mental health

Okay, okay, so you’ve got the meals prepped. You’ve got the 20-minute Yoga for 12-hour days, and either a hotel gym or a Planet Fitness (or yes, even HOSPITALS will have quality gyms to use in their PT sections) for days you can actually exercise. What about the weekends? That’s off time, man! That’s no cooking, that’s craft brews, and that’s eight to 10 hours of sleep. Granted, I love playing tennis, swimming, going to fitness classes, and cycling. But that to me is fun: getting outdoors into fresh air and doing activities I truly love. And those are the times I prioritize most, spending time with friends and family.

Mental health is multifaceted, but as physicians I feel our relationships can be so fragmented, both by our commitments to our jobs and the fact that we have all traveled and moved so much. Joining friend-circles as we finish our training and settle into into our 30s isn’t easy, only because most of those circles are preformed. So make an effort, build a solid friend base, and give time to them, because if COVID has taught us anything, it’s how social we are.

And so, with rekindled bonds and a healthy plan of attack for eating and exercise, we can continue to stay well and optimize our lives and patient care. Most people think travel can be destructive to the mind and body; I’d wager the opposite: I feel it forces us to be creative and hypervigilant to truly focus on our well-being.

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