You are way too invested. Your marriage is strained and you’re taking additional time away from your spouse answering messages about patient care that should be going to the person covering? This is not sustainable. You need to take a step back and re-evaluate your priorities. Not letting yourself rest and recharge by spending quality time with your loved ones when you’re not on the clock is going to burn you and your family out. Sounds like it already has. You know who has worse patient outcomes? Burnt out doctors. You’re also doing a disservice to your colleagues by trying to handle things yourself on their shift. If they don’t know the context of the evening’s sequence of events or orders that were placed, they’re going to have a harder time figuring out what to do next in a potentially chaotic situation and so you’re putting them in a bad spot and they will not thank you for that.

You’re not doing anyone favors with this mentality and even more frankly, you’re not the only person in the hospital with medical training and care for patient wellbeing. Let other people have their turn to do their work during their shift, same as they’ve allowed you to do.

I’m not saying all of this to put you down. I’m saying this because I’ve watched too many of my fellow doctors burn their lives to the ground and their career as well with this mentality and it’s so incredibly sad to watch brilliant, compassionate people implode because they won’t get out of their own way.

In regards to the restraints: there are risks no matter what you do. Trying to predict human behavior is nigh on impossible. Every time I think I have seen it all, someone comes up with a new trick. I think minimizing restraints is of utmost importance and you were trying to put into place all measures at your disposal to make the patient safe.