As I come to the end of a busy run of shifts in the intensive care unit, I manage to get home in time to bath my children. My special skill is to make up silly games often resulting in a lot of bath water on the floor and a late bedtime. On this occasion, we play the “Would you rather?” game.

“Would you rather be a toothbrush for a smelly giant or a sponge for a dirty ogre?” I ask my two daughters. After the debate results in a tie, they redirect the question at me. I then realise that I am a sponge to a dirty ogre most days.

The role of senior healthcare providers is often less medical than they anticipate during training. Instead, we often act as a sink for stress, uncertainty, and conflict between the patient and the system in which we work. Those who absorb this stress most effectively can make brilliant intensive care doctors. Bringing a sense of calm in the fog of medicine when a patient suddenly deteriorates is a valuable skill. We must absorb the stress from the family, the pressure from limited beds, and the uncertainty of survival. We must be an absorbent sponge, eager to clean up the water on the floor of the hospital, and hold it tight.

However, a sponge cannot absorb forever. When saturated we face two choices. We can let the sponge slowly drip as others hold out their hands underneath to catch the excess. After that busy week, you may drink one extra glass of wine, be short with your family, or shout at your dog. Your sponge is dripping and they are catching the drops.

I prefer to squeeze the sponge. I selfishly go for breakfast alone on my way home from that last night shift. I let my parents care for my children on their regular day even when I have a compensatory day off. I go the gym when I should clean the car. I have a night out and stay in bed the next morning. I squeeze the sponge.

There are dangers to both approaches. Just as when you wash that dirty car, the water that comes out when you squeeze the sponge looks very different from when it went in. It runs cloudy and pulls with it the dirt and grime that it absorbed. So too you risk damaging the sponge if you squeeze it too tightly. Still, I much prefer to squeeze than to drip. How about you?

#SqueezeTheSponge

The BMJ is calling for doctors to be able to take the breaks that they need for their wellbeing and for patient safety. You can follow our work at https://www.bmj.com/wellbeing and take part in the campaign by sharing your examples of where things are changing for the better or where more work needs to be done through social media using #giveusabreak.

 

Matt Morgan is honorary senior research fellow at Cardiff University, consultant in intensive care medicine, Research and Development lead for Critical Care at University Hospital of Wales, and an editor of OnExamination. He is on twitter: @dr_mattmorgan

Competing interests: None declared 

Read more in Matt’s first book, Critical – science and stories from the brink of life

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