For me today was the first day of the new work year. This is the year that I am going to learn how to corral all of my work activities into a normal length day, rather than having a long period of inactivity after seeing patients before I wade into writing coherent notes on the visits. It isn't a resolution, more an idea whose time has come. Almost everyday I find myself alone in the department long after everyone has left, finally powering through the notes without difficulty.

It means I don't get home until much later than I should, my dogs are languishing without me and I am truncating my evenings so that I scramble into bed every night with a feeling of panic that I will not have enough time to sleep. All too soon the alarm wakes me and I repeat the previous day.

The challenge is to find a way to move directly to writing notes without the down time. Or, working my hours and leaving, with some notes unwritten, at the appropriate time. This means that charts can stack up, and I used to be OK with that, but since my health has been so limiting, I think I have a fear that I may not return to write the note. So why do I have to spend so much time in the down mode when it so obviously negatively impacts my life.

It functions, I think, as a way to decompress from the demands of seeing patients before I have to organize my thoughts, but the more I think about it, the problem is the level of mental fatigue created by the patient visit. This, I think, it a function of the intensity of the encounter, and that lies within my control if I choose to exert it.

So I can go home at a better hour if I take better control of myself during patient visits. I wonder if other people are getting in the way of their own time management. It can't be solely a work phenomenon either. How many other people "reward" themselves with downtime after mental or physical exertion, with an end result that really impacts the rest of their lives?