At the start of her session, “Motherhood & Medicine: You Can’t Have it All (All the Time)”, Bethany Grubb, MPH, MPAS, PA-C, listed the expectations placed on mothers who are physician assistants (PA) including:

• Demonstrating interpersonal and communication skills (stability, flexibility, emotional resilience, etc)
• Patient care (compassion and respectable behaviors with patients and their families)
• Professionalism (healthy behavior and life balance, demonstrating self-reflection, etc)

“I think as moms and practitioners in medicine, we do have some unique challenges and a lot of that has become very clear in the midst of this pandemic,” Ms Grubb added.

For mental health, Ms Grubb highlighted that it is a discussion that is important and needs to be at the forefront. Presenting a graph she created, Ms Grubb focused on two important features that are connected with mental health for PAs: life events and life-giving practices.

Emphasizing the difficulties of being a new mom, she added that to do those things that bring mothers life, it is important to create that time, make the time, and make it a priority in order for them to happen.

Continuing on, Ms Grubb called attention to a few reminders mothers and caregivers may need to hear. She shared a few points with participants including:

• I am not required to deny my needs in order to meet someone else's.
• I do not need to take responsibility for what isn't my responsibility.
• There will never be a time where I am not enough.
• Meeting other people's expectations of me was never my job.

For most of the lecture, Ms Grubb introduced the different phases mothers and caregivers may go through or already have gone through in addition to discussing the practical and life-giving sides of each phase.

“You're going to kind of be in this place where you're going to have moments like ‘I’m just surviving’, and others where you feel like you're thriving. That is actually going to fluctuate where we may feel all those things in a minute,” she stated.

Starting with the “Pregnancy/Baby Phase,” Ms Grubb shares that the practical side included support (“the village”) or paying for help for things like house cleaning, grocery delivery, and more.

“You know, we couldn't do this without a village, and so I think what’s sometimes hard is not everybody feels like they have it. You may actually have to pay for people to come in to help and, obviously, that is a great thing,” she added.

She continued by sharing the life-giving practices that are needed in the baby phase as well including sleep, exercise, counseling, and more.

The following phase listed was the “Early Years,” which consists of kids that are starting in preschool or elementary school. Aside from elementary school aspects, Ms Grubb adds that preschool and kid’s activities could make up the practical side while exercise, taking time away amongst other activities make up life-giving practices.

The next phase, “Middle to Later Years,” focuses on when the kids are older. On the practical side, Ms Grubb emphasized on the importance of empowering kids to help. This includes folding laundry, doing dishes, and more. This can also include working with the older kids to take on babysitter responsibilities as well. For life-giving practices, Ms Grubb listed reading, alone time, exercise, and many more that could be utilized during this phase.

Moving on, Ms Grubb presented the idea of mindfulness and how her own journey shows how she tried to incorporate it into daily practice. She listed the main factors of mindfulness as:

• Intention
• Behavior
• Practice
• Second nature
• Becoming who you are

The next topic Ms Grubb touched on was “Professionally.”

“Sometimes we don't always take that time to step back and just check in with yourself to really think about, 'What is my why? Why am I at this job right now?',” Ms Grubb stated. She juxtaposed this with the importance of knowing oneself.

“It’s really important, and again I think this is the piece that we sometimes move away from, that we need to know ourselves and obviously there's so many different ways to.”

On these different ways to know oneself, Ms Grubb listed some helpful tools including:

• Enneagrams
• Coaching
• Strength Finders 2.0

She presented the importance of difficult conversations many mothers or caregivers may have with their partner. Finally, she shared that a sense of community in addition to many of the mindfulness practices already discussed could optimize patient care through shared decision making. This also getting involved overall whether it’s donating to PA-PAC, participating in Society of Dermatology Physician Assistants 19th Annual Fall Dermatology Conference, and more.

Ms Grubb concluded, “As moms, and as working moms, we can sort of step back and go, ‘Okay, how can I make a difference? How can I give back in a way that brings me life?’ We discussed ways that we can actually allow that to happen, and some of that is knowing ourselves, some of it is finding that community or deepening that community. It's learning how to advocate for ourselves and for others with encouragement in staying curious.”

Reference
Grubb B. Motherhood & medicine: you can’t have it all (all the time). Presented at: Society of Dermatology Physician Assistants 19th Annual Fall Dermatology Conference; November 4-7, 2021; Los Angeles, CA.