The Art of Not Taking Everything Home With You

November 24, 2025

If you keep replaying cases at 2 AM or checking charts after dinner, you're not alone. Here’s how to stop ruminating over your shift, set real boundaries, and actually enjoy your life outside the clinic.

TL;DR — What you actually need to know

Purpose: Learn how to leave work at work so you can stay sane and actually enjoy your life.

Red flags: Replaying cases all night, checking email constantly, waking up panicked about decisions you already made.

Initial checks: Did I do the best I could with the info I had? Did I escalate appropriately? Did I document well?

First-line strategy: Set boundaries and give your brain a clear off switch through end-of-day rituals.

Follow-up: Reflect once, call out one thing you’ll do better on your next shift, then move on.

They Definitely Did Not Teach This

There is a skill in medicine that nobody teaches you, but it is just as important as learning how to work up abdominal pain or read an X-ray.

You have to learn how to leave work at work.

Most new providers think this magically happens once you feel more confident, but it doesn’t. You have to intentionally separate yourself from your job. It might feel counterintuitive, but protecting your peace will make you a better provider and a more present human being outside of work.

A Real Example (ugh, I still cringe thinking about this)

I once managed a tough DKA case on a day where everything was a ****show. We had multiple sick patients, the attending was pulled into a long code, and we were holding admissions in the ED.

DKA is a balancing act. You can’t bring the glucose down too quickly, or you run the risk of complications. But if you bring it down too slowly, guess what? More complications. Fun, right?

I ended up transferring the patient to a higher level of care. On the way, they had a STEMI. They survived and were eventually discharged. Clinically, I did what I should have done. But my brain didn’t care. This case tortured me for weeks.

I couldn’t quit thinking… Did I move fast enough? Did I manage it perfectly? Should I have caught something sooner?

Eventually I got over it. And I actually learned a really valuable lesson. So much of what happens in medicine is out of your hands. And your brain hates uncertainty, so it looks for something familiar to control. That usually ends with rumination and blaming yourself.

This is why being mindful that this is how your brain functions and learning to set healthy boundaries is so important.

Why Your Brain Will Not Leave You Alone

All of this is normal! Your brain genuinely thinks it’s being helpful. It doesn’t like loose ends or uncertainty, so when you leave a shift where things were chaotic or left open-ended, it keeps working even though you’re already home.

It does this because:

you’re a new grad and everything feels high stakes
you want to do well
you feel responsible for everything
your nervous system cannot power down without a transition

Annoying? Very. But normal.

What To Do When Your Brain Will Not Shut Off

1. Do a quick mental check

Ask yourself these five questions when you feel like you’re starting to spiral:

Did I do my best with the information I had?
Did I escalate when I needed to?
Did I document clearly?
Was any of this actually in my control?
Is this thought helping me or just stressing me out?

2. Before you leave work

A few small habits make your evening a lot easier:

Document clearly (and close as many charts as you can!)
Finish what you reasonably can before you leave so there are fewer loose ends.
Jot down any patients you know your brain will stress about.
Do a quick reset in the car or parking lot before you drive home (breath work, meditation, podcast, etc.).

Nothing fancy. But I promise, it will make a huge difference.

3. When you get home

This is where boundaries matter most:

Make sure you can get true critical results if needed.
Otherwise, no checking your EMR, or inbox!!
If you start spiraling about a patient, go back to your five questions we talked about above.
Remind yourself to “Be where your feet are”.
Anything non-urgent goes to tomorrow brain because tonight brain is done.

FAQ

1. How do I tell the difference between healthy reflection and unhealthy spiraling?

Healthy reflection feels productive and has an endpoint. You can usually objectively identify the key points of the case and what you’ll change moving forward.

Spiraling feels panicky and keeps you thinking about the same thing over and over and over. I often think about the quote, “Worry is like a rocking chair. It gives you something to do but gets you nowhere.”

2. When should I actually follow up on a case after I leave?

Only if you get new info that would change your management urgently OR you receive a critical result.

3. What if I can’t stop thinking about a patient?

Physically write down your answers to the five questions above. Seeing it on paper gives you a clear, wide angle view of the situation and usually helps calm down your nervous system.

4. What about cases where something truly did not go well?

Debrief, identify objective changes you’ll make, and talk with your attending or mentor. Mistakes will happen. The goal is to mitigate the negative consequences and take the lessons learned with you into future shifts.

5. How do I know if I need more support?

If your sleep, relationships, or ability to focus are consistently affected, ask for help. You do not have to carry everything alone.

You deserve to go home and actually be at home, not half at work in your head. Use the grounding questions we mention above, set firm boundaries, and give yourself a break.

And by the way… if you’re on our email list, check your inbox on Tuesday. We’re finally sharing something we have been working on behind the scenes.

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