I hope this finds you well. Today, I took some time shopping for a new outfit to wear to the upcoming festivities marking the end of your emergency medicine residency. We have celebrated many educational milestones over the years, haven’t we?

It seems like only yesterday that you started the third year of medical school. I remember the anticipation and pressure associated with moving out of the sim[ulation] lab and beginning to care for real human beings. Hospital systems and processes were foreign territories. Personalities and hierarchies required endless finesse to achieve what seemed like otherwise straightforward academic goals.

You accomplished all of this with grace and humor, winning the ultimate prize of matching with a highly desired residency in a very busy trauma center. You said “so long” to the place you called home and waved goodbye to the fellow medical students who became your family during the last four years.

You and your peers stepped into medical practice during a time like no other. Honestly, you were all pushed, without warning, into the deep end of the turbulent pool of health care. You didn’t even have the benefit of wearing any water wings!

The unknowns of residency became exponentially larger and more terrifying with the arrival of the COVID-19 pandemic. Continuous waves of extremely sick patients suddenly slammed into you and this new and unfamiliar medical system.

This last year has provided you with an entire education in a wholly different arena. Just when you thought you had reached a point of resiliency and confidence when caring for patients, you were forced to join the “business” of health care and market yourself.

That put you in the position of working in an industry laser-focused on profits and productivity. All of that time and effort spent honing the skills needed to be a good doctor seems to be subjugated to revenue, productivity goals, and billable services. You are now a cash cow.

I have had the privilege of working with hundreds, if not thousands, of residents in my nearly 40 years of nursing practice. Cakes have been baked, pizzas ordered, and money collected to celebrate and honor the critical milestone of the end of residencies.

And then, suddenly, those days we spent working together were over. A large yawning vacuum replaced the now seasoned residents, along with their hard-won skills and experience. On the first of July, a whole new group of fresh faces arrived; as if by clockwork, the cycle would begin once again.

Experiencing my own child’s residency completion has an entirely different feel. As a mother and nurse, I have watched you on this wild ride known as on-the-job training.

My heart has often ached after hearing your voice on the phone, and I have felt that blinding, gut-wrenching terror of wondering if I would ever see you again. It is both a blessing and a burden to understand the reality of how dangerous health care is. We both know that there is no guarantee of a long, healthy life.

While we can talk about health care’s challenges and analyze situations together, I am still your mom. I have noticed the subtle shifts that the last few years have caused in you; those tortuous shift rotations and the endless sleep deprivation have left their marks. Amazingly, though, you are still you – all of your kindness and compassion continues.

As you start to make the transition into a full-fledged attending physician in yet another new place, I ask for your patience as I offer a few suggestions:

When times are challenging, remember to think about why you went into medicine. Don’t ever let go of being a healer or allow the “business” of the health care industry to take that away from you.

Just as you do primary and secondary surveys of your patients, do the same for yourself and your coworkers. It is important to not only take care of those we serve but also each other, and emotional health is just as important as physical health.

Remember those who have taught you well along the way. What was it about them that made them great teachers and healers? Hold onto these traits as you move forward and teach others.

I say it a lot and will say it again: Participate in politics. Write letters, support causes that positively impact those you serve, and most importantly, pay attention.

Nourish your soul. Get outside, try new things, and allow yourself time for restorative rest and relaxation.

Use your resources; stay connected. Solitude is great, but isolation can be treacherous.

Look up from your computer and allow yourself to sit in the sacred moments that your patients share with you. You will see many people on the worst day of their lives; being able to lessen their pain is an honor and privilege.

Thanks for listening to me ramble. Now, it’s time to move on to other projects like booking my flight to your graduation!

As always, please remember that I am endlessly proud of you.

June Garen is a nurse and author of Hey! I Could Use a Little Help Here! My Story of Healthcare Workplace Violence.

Image credit: Shutterstock.com