As do most pediatric hospitalists, I work certain hours for specific shifts. This schedule implies work during these stated hours and life outside of those hours. However, I do not know a single physician that has not brought work home or has not done work during their “off time.” Some even check emails on vacation. Others will sneak in a work meeting in between their children’s soccer practices or dance recitals. And even more feel the crunch of time at work, having to power through every moment to get work done. The last couple of years have blurred that boundary even more, especially online and hybrid meetings becoming the new norm. The separation between work and life no longer exists for many, which has brought flexibility but also challenges.

The last few years have also taught us to keep in perspective our own well-being.1  As a community, “work-life balance” has shifted its language to being “work-life integration.”2  Specifically, having these work-related activities outside of work hours tends to lead to negative effects, especially for those with families.2  However, different people have different needs for this integration to help with balance and well-being. To frame this discussion, I want to acknowledge that there are different ways people manage boundaries, most succinctly described by Ellen Kossek as Separators, Integrators, and Cyclers.3 

I am an Integrator. My personal time and professional time tend to blend: sometimes work is done at home and sometimes personal tasks are done at work. The only way I can make it through my clinical workday is to go against the fast-paced culture of medicine to enjoy the sunshine during lunch, to have my afternoon meditation moments, or to even take a nap. After, I am so much more productive and refreshed. When I am home, I tend to check emails before bed and finish last-minute tasks while watching TV. I find relief in getting to finish other work-related items in the comfort of my home and to conduct meetings where I can be relaxed.

My partner is a Separator. He gravitates toward a greater divide between work life and personal life. His activities and tasks completed at work are almost exclusively work related. His idea of a lunch break is working through lunch so that when the minute his shift is over, there is no work to be taken home. He finishes his administrative paperwork only during work hours. He does not respond to emails when on vacation. When he takes meetings from home, he always takes them in the office space, as a physical separation between his professional time and his personal time.

There are also colleagues that are Cyclers, who switch back and forth between Separator and Integrator, depending on the day, workload, personal life situations, or tasks. These are the individuals that are the “in office” Separators and the “work from home” Integrators. When different situations arise, trialing to be a Separator or an Integrator during that period and settling in on 1 type can help to better move through workdays and personal time. This requires intentionality and frequent reflection.

Understanding our own identity as a Separator, Integrator, or Cycler can help with work-life integration and managing our time in and out of work. Especially in this postpandemic era, work-life boundaries can no longer solely rely on physical location, and intentionality becomes more critical to maintaining our well-being. For all of us, this looks like prioritizing our needs to ensure that whether we are Separators, Integrators, or Cyclers, we are using our time to provide great patient care, but also using our time to remember what we need to fill our cups. Some nursing pages can wait a few minutes. Some notes can be done at a different time. Some emails can receive an “out of office” message while on service. Some leadership tasks can be delegated. But mostly, it is okay to take a break either from work or at work: to have more life bleed into work, to leave all work at work (for the Separators), and to take those moments in the workday to rest (for the Integrators). Because at the end of the day, understanding our time management and allowing for breaks lend into being well, which as pediatric hospitalists, means that our patients receive better care.4 

I would like to acknowledge Josette Bianchi-Hayes, MD, from Stony Brook Children’s, for her guidance in the well-being space. I would also like to acknowledge Matthew Smith, MD, from Children’s Hospital Los Angeles, for his continued discussion on work-life integration.

Dr Mou researched the background and relevant frameworks for this discussion, drafted the initial manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted.

FUNDING: No external funding.

CONFLICT OF INTEREST DISCLOSURES: The author has indicated she has no conflicts of interest to disclose.

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