Decisions, decisions

Who has time to suss out the answers to these daily dilemmas when patients are calling, doctors are bellowing and you haven’t had enough shut-eye in weeks?

We did in the Winter 2011 issue of Scrubs, so settle in and read on.

1. Your feet ache at the end of a long shift. Do you massage and soak them? Or elevate them?

Either one. Each gets the blood circulating, thereby easing the tension, swelling and fatigue that comes from being on your feet for extended periods of time, says Christopher Ferguson, a podiatrist at St. Luke’s-Roosevelt Hospital in New York City. “The more circulation, the better your feet will feel,” says Ferguson.

You can’t go wrong, so the best fix is whichever one works with your routine. (If time permits, indulge in both!) If you can only spare a minute, give your soles a quick massage right after you kick off your shoes, using your thumbs to firmly stroke from your heels toward your toes. If you can spare 10 minutes, soak your feet in warm water with a drop or two of your favorite essential oil. To soothe your nerves as well as your aching feet, simply sit on the floor with one hip next to the wall. Then gently swing your legs up the wall as you slowly let your back and head recline on the floor. Now just rest as you reverse the effects of gravity.

2. You’re starving after your shift. Should you muster the energy to fix a salad? Or can you simply break out the cheese and crackers and pour a glass of wine?

Go ahead and have the cheese and crackers (as long as it’s onlyan occasional indulgence) says Wendy Bazilian, DrPH, RD, head of nutrition at the Golden Door Spa in Escondido, Calif. After all, cheese is a decent source of protein and calcium. But if cheese and crackers are the only thing you’re eating, cautions Bazilian, chances are you’re going to eat too much. She suggests you slice a modest portion of cheese and put the rest away, right away. Then add some grapes, an apple or a pear, a few walnuts, some hummus or sliced vegetables to make your plate more interesting as well as more satisfying. “Think of your meal as a Mediterranean-style appetizer,” she says. Studies have shown that a glass of wine may have some protective benefits for the heart, provided you stick with a single glass.

As for that salad, it may make you feel virtuous, although its actual virtues can vary dramatically. If you’re in a hurry and just pour bottled dressing on a plate full of lettuce, you’re sitting down to a nutritional nightmare. “A commercial dressing with poor-quality ingredients can add a burger’s worth of calories to a salad,” says Bazilian. Salad is only the better choice if you take the time to wash and chop lots of fresh vegetables and make a vinaigrette (try three parts olive oil to one part vinegar).

3. A doctor snaps at you in front of a patient. Should you silently seethe? Or speak up?

Speak up…but not right away, says Mark Goulston, MD, a psychiatrist in Los Angeles and the author of Just Listen: Discover the Secret to Getting Through to Absolutely Anyone. “Give the doctor a look that telegraphs your displeasure, but don’t let it interrupt your work,” he suggests. Later, after you’ve taken care of your patient, pull the doctor aside and ask, “When could I have a few minutes to talk about how we can work together better in the future?” When the time comes to have that conversation, focus on your and the doctor’s shared purpose—acting professionally while taking care of people who are sick—rather than your emotional response to what the doctor said. Be firm but tactful. For example, you may wish to gently ask, “Is there a different way you could communicate your frustration?”

It may not be easy to say something, but it’s important to stand up for yourself. Keeping quiet all but ensures that your frustrations over the doctor’s rude behavior will percolate, and you might end up taking it out on yourself. “Many of my patients tell me they go off their diets or exercise regimes after they’ve had a bad encounter at work,” says Dr. Goulston. “They say to themselves, ‘Oh, the hell with it, I’m just going to _________.’” (Fill in the blank with some temporarily comforting but ultimately self-sabotaging behavior, such as drinking or eating too much.) Pent-up anger can have serious long-term health consequences, as well as some not-so-nice short term repercussions if you end up taking it out on those around you, whether your patients, colleagues, partner or kids.

Read the full article and get 6 more tips from dry skin fixes to fading midday makeup by picking up the Winter 2011 issue of Scrubs Magazine.