Is this too much?

[LMV]

We currently have three daughters (16, 12, and 2) at home with a fourth who should be arriving any day [unless she’s like our oldest daughter who arrived only after induction at 42 weeks]. I’m a physician but I’m off work at the moment in preparation for her birth and the plan is for me to return to picking up at least a few ED shifts each month after she is two weeks old. We’re honestly not sure how that will work but we’re in a bit of a physician crunch at work at the moment and my husband and I feel like we do need to at least try this. He has been working as an attorney but arranging his work around when I’m home or the kids are sleeping etc so we won’t have child care issues. I’ll actually be home more over the next six months than I was over the previous six months.

 

We have done medical respite and emergency foster care for medically fragile kids over the past few years. Over the past year we have mostly had one child who seems to get along well with our kids and really isn’t a very intense medical placement. We just got a call from her caseworker that she has been readmitted to the hospital and they are hoping to arrange some respite for after discharge. We have done this many times before so I almost said yes with the provision that it would be ok if we ended up dropping her off at DH’s Aunt’s house with the rest of our kids if I went into labor. I refrained from committing to get a chance to talk to DH a little and left things open so the caseworker will check in with us on Thursday after my next OB appointment and see where things are and where things are regarding discharge for this child. The caseworker also mentioned that it may not be possible for her to return to her current long term foster placement and wondered if we would consider taking her at least as an emergency foster placement and ideally as a long term foster placement.

 

DH and I have discussed this. In our hearts, we feel pulled to do this. We have developed a connection with this child over the past year and feel like if she needs this then we're probably meant to come through for her. We’re going to do some praying and we want the opportunity to talk to our two older daughters at home. Our oldest daughter has a rehearsal for a state wide ensemble she plays in tonight so we’ll sit down with them both separately some time tomorrow and at least discuss the situation.

 

I know that ultimately we will have to make the decision that is right for our family. However, I also know that sometimes people with a certain degree of detachment from the situation can identify pitfalls much more readily. I also know that many of you have some BTDT insight on one or more of the issues of the situation. Any suggestions, advice, or illuminating questions are welcome.

 

Thanks!

[Impish]

First of all, as a physican and mother already, I'm genuinely surprised that you're considering working in the ER 2 wks post partum. Having worked in health care, I know how physically demanding it can be, and would think that 6 wks recovery would be the least you might want to wait before committing to anything as far as shifts go.

 

I get the Dr crunch. But you need to take care of YOU first. If you end up hemorraging from doing too much too soon, you, your kids, your dh will suffer for it.

 

Also, since not every pregnancy, childbirth is the same, there is also the potential for complications, for post partum, etc.

 

I would really not make any commitments until you are fully recovered from giving birth, and then take one thing at a time. You don't know what the demands of your newest addition may be...I've had 3 very laid back babies, and 2 high needs ones. (Thankfully, the 2 high needs weren't back to back!)

 

I'd honestly wait and see. You can always add more. Backing out of commitments, though, is harder, esp if there's a foster child involved.

 

Give yourself, your new baby, and your existing family time to adjust to the changes already coming, before taking on more.

 

Best of luck to you and yours, an easy labour and delivery, and a healthy, happy baby girl! :grouphug:

[Alice]

I’m a physician also. Our situations sound similar in that my husband and I also trade off being home. I can understand the going back to work. I’ve often helped out at work over the years because I feel responsible but also because I know that it’s a good job and that when needed I can call in favors. I also think going back to work with a dh who is home with the kids is very different than going back to work and having to worry about the complications of childcare.

 

Ultimately you and your dh have to make the decision. I’d say that the pitfall I see is that I often think I can do it all and end up taking on too much. I think it’s a flaw true of a lot of doctors, we think can handle a lot more than we can. It’s probably reflective of the whole medical education system.

 

What I would do is to make sure there are ways to get out of the situation if it’s bad. Can you cut back on shifts if you find it’s too hard? Can you agree to do the respite care and then see if you think foster care is possible? And more importantly will you be willing to admit that it isn’t working if it isn’t working? Will this leave you stretched to the max so if your newborn is high needs or doesn’t sleep or you have complications that things will be really bad?

 

Good luck with the decision and the new baby! I always like finding other homeschooling physicians moms on the boards. :)

[LMV]

First of all, as a physican and mother already, I'm genuinely surprised that you're considering working in the ER 2 wks post partum. Having worked in health care, I know how physically demanding it can be, and would think that 6 wks recovery would be the least you might want to wait before committing to anything as far as shifts go.

 

I get the Dr crunch. But you need to take care of YOU first. If you end up hemorraging from doing too much too soon, you, your kids, your dh will suffer for it.

 

Also, since not every pregnancy, childbirth is the same, there is also the potential for complications, for post partum, etc.

 

I probably didn't explain this very well. Returning to working after two weeks (probably one shift a week) presumes that my OB feels that is appropriate. If I don't deliver vaginally [which is the plan but, well babies have their own plans too so....;)] then I (and my colleagues) realize that will probably require some adaptation of the plan. Obviously any antepartum/postpartum or neonatal complications will have to be addressed as well.

I would really not make any commitments until you are fully recovered from giving birth, and then take one thing at a time. You don't know what the demands of your newest addition may be...I've had 3 very laid back babies, and 2 high needs ones. (Thankfully, the 2 high needs weren't back to back!)

 

I'd honestly wait and see. You can always add more. Backing out of commitments, though, is harder, esp if there's a foster child involved.

 

Give yourself, your new baby, and your existing family time to adjust to the changes already coming, before taking on more.

 

Best of luck to you and yours, an easy labour and delivery, and a healthy, happy baby girl! :grouphug:

 

Logically you're probably right and if the caseworker finds another viable option for this child then we will certainly consider that a blessing. I'm just not sure where we are if there doesn't seem to be another option.

 

Thanks for the well wishes!

[Trilliums]

I don't have any great advice or illuminating questions:001_smile:, but i do relate to your pull to care for this child. We have also cared off and on for a young girl (now 13) and the possibility of her coming to us for long term placement has recently come up. She has some emotional issues that do cause me so some concerns. But, I know in my heart that we would willingly bring her to our home and we are actively asking for this placement (although this is not a foster care situation).

 

Yes, you do have a lot on your plate now, and yes, this does seem like a strain, but it sounds manageable with the support you have and taking on only a few shifts (probably key not to overdo it on workload).

 

Best wishes with however it turns out.:grouphug:

[Catwoman]

I think your intentions are incredibly good and honorable, but I think you are trying to do too much. When will you have time to relax and enjoy your new baby? When will you have time to REST? :confused:

 

Only you and your dh know what you're capable of doing, but IMO, I think your plans are too much, too soon.

[LMV]

I’m a physician also. Our situations sound similar in that my husband and I also trade off being home. I can understand the going back to work. I’ve often helped out at work over the years because I feel responsible but also because I know that it’s a good job and that when needed I can call in favors. I also think going back to work with a dh who is home with the kids is very different than going back to work and having to worry about the complications of childcare.

 

I wouldn't be able to do this without my husband being so supportive of me and our kids. He is great with our kids so I know when I go out the door they're in good hands and that gives me peace I know I wouldn't have in a non relative child care scenario.

 

Much of our physician crunch is due to the reality that bad things sometimes happen to good people and sometimes good people happen to be physicians or the children of physicians. I also do feel a certain amount of responsibility to do what I can both because it is my job and because my colleagues have certainly pitched in when I needed a little extra flexibility due to our kids' health issues. We do the best we can and help each other out when we can and if we all do that it works most of the time.

 

Ultimately you and your dh have to make the decision. I’d say that the pitfall I see is that I often think I can do it all and end up taking on too much. I think it’s a flaw true of a lot of doctors, we think can handle a lot more than we can. It’s probably reflective of the whole medical education system.

 

What I would do is to make sure there are ways to get out of the situation if it’s bad. Can you cut back on shifts if you find it’s too hard? Can you agree to do the respite care and then see if you think foster care is possible? And more importantly will you be willing to admit that it isn’t working if it isn’t working? Will this leave you stretched to the max so if your newborn is high needs or doesn’t sleep or you have complications that things will be really bad?

 

I think the shifts can be a little negotiable and I've committed to trying this more than definitely committing to doing it if that makes sense.

 

The situation with this child is a little more complicated because children have a way of growing into your heart and then you find that the option of letting them go just really isn't an option you can live with. This is what leaves us pausing. We want to help this child but we also want to ensure that we are able to care for the children we have. We're definitely going to do some praying on this and we need to see where are kids are with this [and where some of our extended family is with this in the context of everything they have in their own lives and with their own kids].

 

 

Good luck with the decision and the new baby! I always like finding other homeschooling physicians moms on the boards. :)

Thanks! We're actually doing a hybrid approach with a charter school within a school and did a little stumbling into this but it's working and we're cherishing the moments. Our oldest daughter will be off to college next fall it's amazing where the time went.

[LMV]

I don't have any great advice or illuminating questions:001_smile:, but i do relate to your pull to care for this child. We have also cared off and on for a young girl (now 13) and the possibility of her coming to us for long term placement has recently come up. She has some emotional issues that do cause me so some concerns. But, I know in my heart that we would willingly bring her to our home and we are actively asking for this placement (although this is not a foster care situation).

 

Yes, you do have a lot on your plate now, and yes, this does seem like a strain, but it sounds manageable with the support you have and taking on only a few shifts (probably key not to overdo it on workload).

 

Best wishes with however it turns out.:grouphug:

 

:grouphug: Hugs to you also. I hope everything works out with this for all involved.

[LMV]

I think your intentions are incredibly good and honorable, but I think you are trying to do too much. When will you have time to relax and enjoy your new baby? When will you have time to REST? :confused:

 

Only you and your dh know what you're capable of doing, but IMO, I think your plans are too much, too soon.

 

Thanks for being willing to express your reservations. I'm keeping them in mind and I guess I'll just try to keep my eyes open and be as realistic as possible. My husband is amazing and very involved dad so that does help. Whether it is enough I'm not really sure.

[StephanieZ]

This is a deeply personal decision.

 

But, since you ask . . .

 

Yes, it is too much.

 

You owe it to yourself and your family to devote your energies to THEM and YOURSELF.

 

So, unless you feel so drawn to this foster child that you feel there is already a commitment to parent permanently, I would urge you to NOT DO IT.

 

Every hour is precious. Give those precious hours to your kids, your husband, your self, and your NEW BABY!

[linj2fly]

Specifically addressing return to work--I think it's too early :)

 

It's really great that you have such a supportive, reliable husband. He can help with the kids, but you have to take care of your body. This is not your first delivery. You're a multip now, and each delivery takes a little longer to recover from. (But then again, you know how well/soon you have recovered). Factor in your age as well. I agree with impish about the risks of increased clotting and possible hemorrhage if you push yourself too far. Plus, assuming you're doing 12 hour shifts, I wonder how much pain you will be in. I still remember perineal and vulvar pain up to 3 weeks out just from going grocery shopping. If you have to work, maybe you can try doing half/partial shifts to see how you can handle it.

 

What has your group/employer done about covering your absence? (given that it's not a surprise). Are there not any EPs at any of your area's hospitals that want/need extra shifts? Locum tenems?

 

I'm so sorry you're in this situation. I wish you the best and congratulations!! :grouphug:

[LMV]

To update:

 

-We have a beautiful new daughter. She is very loved and we are all very blessed.

-We did end up doing a little respite before our daughter was born. The caseworker thought that would give her time to make the already established foster situation work. From what we understand it really didn't so we're doing some more praying on where we go from here. We will probably be taking her again this weekend for respite and I think that may help us have a better understanding of how this could all work (or perhaps that it really won't work).

-I should be trying to start back to work next week so we'll see how that goes. Halloween is always a crazy time in the ED :glare: :huh:

[Starr]

Congratulations! and :grouphug: with all your decisions.

[elfgivas]

Very Big Smile!

 

i hope it all went well, and you are on your way to feeling wonderful, if somewhat sleep deprived. i loved those early days.

 

i totally understand the going back to work thing. i hope that works well for you.

 

respite care is different than long term placement. i think respite care is a gift you give both the child and her foster family, whoever they are... and it is a precious, irreplaceable gift. when i did social work, it was much easier to find foster families than good respite care placements. i'd lean towards staying on as respite care, and hoping a good foster placement option appears.

 

enjoy your baby :001_smile:

ann

[Parrothead]

I think your intentions are incredibly good and honorable, but I think you are trying to do too much. When will you have time to relax and enjoy your new baby? When will you have time to REST? :confused:

 

Only you and your dh know what you're capable of doing, but IMO, I think your plans are too much, too soon.

:iagree:You need time to bond with the baby.

[LMV]

Thanks everyone for all of the positive baby thoughts (whether you agree with the decisions we're making I believe you want the best for our family)! So far things are going pretty well. Our baby daughter is settling in and starting to develop the earliest glimmers of a personality. On the work front, I survived a pretty hectic day shift in the ED on Halloween and was glad I did it at the end (even if just as glad to be going home at the end).

 

respite care is different than long term placement. i think respite care is a gift you give both the child and her foster family, whoever they are... and it is a precious, irreplaceable gift. when i did social work, it was much easier to find foster families than good respite care placements. i'd lean towards staying on as respite care, and hoping a good foster placement option appears.

 

enjoy your baby :001_smile:

ann

 

I like this perspective. I think the caseworker is still hoping if she can just give the current foster family enough respite that it will all come together. For this child's sake, I hope she is right. She should be joining us again the weekend after this because our oldest daughter invited her to attend her youth orchestra concert which is happening next weekend. We'll probably do a four day weekend because I don't think she has school (as they will be observing Veteran's Day).

Edited November 2, 2012 by LMV

[TranquilMind]

This is a deeply personal decision.

 

But, since you ask . . .

 

Yes, it is too much.

 

 

 

I couldn't even imagine trying to do more than exist in the post partum weeks. But then I was old when I had my first. Maybe you aren't. It took all I had to just get through those weeks with just the baby and no working and that's with husband's full time help for 2 weeks and then every night and all weekend.