Time for Some Real Talk: I have the best job in the world & even I don’t know how much more I can take

Let me start with the positive and please bear this is mind as you read this post. I adore my job, I can’t imagine doing anything else. In a way that is probably a little unhealthy, it is a lot of what defines me. I found my place and my calling and I’m not going anywhere. That said the last 2 years have been filled with extremely long days and unpaid weekends leading me to be more exhausted and broken than either a PhD or FRCPath exams achieved, partly because for both of those you knew when it would end. So I want to shine a light on how I feel in order for others to feel less alone if they are feeling the same way, and to remind us all that, despite how it feels right now, it has not always been like this and that this too shall pass.

Last night in a press conference our Prime Minster uttered the words ‘extraordinary effort’. It wasn’t in praise, it was a request for all of us in healthcare to make one more effort, to step up to the plate yet again and give it our all for the sake of the country. The thing is, phrasing a request like this doesn’t feel like a call to action to me anymore, it feels more like an insult. Although I acknowledge people’s experiences of the pandemic have been vastly variable, for most healthcare workers we’ve been making an ‘extraordinary effort’ for almost 2 years. Two years of changing guidance, 2 years of practically no down time and in recent times, experiencing both abuse and bad temper, alongside belittling of the things we are doing to find a way out of this i.e. requests to wear masks and to get vaccinated.

Given it is undoubtedly hard right now what can we do to get each other through this (other than make press conference statements – yes I may be a little bitter). This post isn’t based on evidence, I’m just going to talk here from personal experience. I know this is what I tell others off for as anecdotes aren’t facts. However as this is about feelings I can only truly tell it from my perspective.

Acknowledge all burdens are not equal and any single solution won’t fix everything

As a lot of people have pointed out, we may be in the same storm but we are all in very different boats, our experience and well as stressors throughout this aren’t the same. As leaders, colleagues and friends it therefore crucial that we take time to understand the things that are adding to stress levels and impacting our colleagues. For instance, because of my health it is easier for me if I can work from home a couple of days a week. It saves me a 3 hour return commute and gives me space to mentally focus on tasks without interruption. For someone else however, they might find working from home in itself a stressor, they may wish to have distinct work and home separation, they may have a lack of space or family reasons why this makes it harder for them not easier. We need to work on how to check in with our colleagues about what it is that they find difficult and then, where possible, customise our approaches to support them. It takes longer and requires more resource, but if we’re serious about helping each other through this than that is what it is going to take. I believe we should be finding equity rather than equality in our solutions, although fairness is important:

  • Equality is providing the same level of opportunity and assistance to all
  • Equity is providing various levels of support and assistance depending on specific needs

A little respect goes a long way

At times of stress and challenge it is really easy to close down in terms of empathy and compassion. I hold up my hands to raising my voice in a meeting last week. I did immediately apologise, but it is really difficult with the cognitive and emotional load everyone is experiencing, coupled with me being so tired to always remember to think of others. Every little moment like that if not addressed chips away at the others in the room and adds an unnecessary additional burden. At the moment, in those moments where we may not feel like it, it is even more important enough to be kind to each other.

Whether you are in a formal or informal leadership position, it is also really important right now to acknowledge the work of those around you. It’s easy to have tunnel vision and revert to task thinking when we are all so overwhelmed but people are doing A LOT based on good will. If we want people to go above and beyond then we need to acknowledge it and respect the fact that it is not a given that it will always happen. Saying thank you is still a powerful tool.

The system isn’t set up to support us so lets change it

Two years into the pandemic the system is still not set up to support the work demands that are being placed on the workforce. I have colleagues who have not had a full day off in two years. I do weekends on-call without any acknowledgement in terms of pay or returned time. From conversations I’ve had most IPC teams do not have systems in place to support on-call working, despite the fact that we have just about all had to do it over the last 2 years. We’ve all been doing this because we focus on the needs of the patient and the service, but at some point the service and the system that it sits within needs to be fixed. Services shouldn’t constantly rely on good will and changes need to me made so the system is empowered to support those who work within it. When emergencies and major incidents first happen it takes a while for the infrastructure and the system as a whole to respond, at this point however we need to be looking to the future and working to fix the system we work within. This won’t be the last time we have to face these kind of challenges, although hopefully not over such a protracted period, lets learn the lessons and get measures in place to make it better for everyone moving forward.

The workforce issues are going to get worse before they get better

As I said, I’m not going anywhere, but it would be naïve to say that this is the wider attitude amongst healthcare workers. A number of my colleagues who could retire have done so, more have moved either into non operational roles or out of healthcare all together. I don’t feel we have reached the peak of this yet. I think a lot of people will stay until they feel this aspect is over and then make decisions about what is best for them moving forward, burn out is a real thing right now. This will place even more pressure on those of us who remain. Its takes ~11 years to train a me, there aren’t a lot of people waiting in the wings to swoop in and support. My guess is also that a fair amount of trainees will be included in the numbers who are considering alternative choices. Those of us who remain need to know what the plan is? How are the exhausted workforce who remain going to be supported so they don’t have to then do the work of the 2 people who have left as well as their own? Are we, as we all predict, going to be hit my massive catch up targets when the pandemic is finally over which means there will be no respite to support recovery. The focus of the system seems to (understandably) be on right now but to give people hope for the future we need to know that there is a plan on how we will make it through not just today, but tomorrow and next year.

This isn’t a war, no matter how much our politicians language make it sound like it is

A lot of the language people have utilised linked to the pandemic has very deliberately utilised language reflective of going to war. In some ways this creates a nice psychological short cut in terms of significance and in peoples minds. The problem with it is that most healthcare professionals didn’t enlist to be part of a war, they are not obligated to stay and fight it out. The support systems are not part of the existing infrastructure to enable them to deal with the stress and emotional load we have put upon them. Most of them have given extra hours and supported extra job roles as part of good will, a gift if you like from them to wider society. However, like all gifts these can and should not be taken for granted, they are under no obligation to just keep on giving. We have moved from an emergency situation to a state of life, as much as we don’t want to acknowledge it. It’s a state of life that will not last forever but we cannot expect people to continuously act like they are in emergency response anymore. Plans and language aimed at healthcare workers need to acknowledge this otherwise we are not recognising the reality of most of their lives.

Wellness programmes are not going to fix this

I’ve already come out as not being the biggest fan of wellness programmes, although I know what they are trying to achieve. I’ve talked before about the fact that I think the NHS system has to address the issues and not continuously put the responsibility on individuals to fix. That said I don’t think the system is going to ‘White Knight’ for me anytime soon. I have come up with a strategy for me that means when I reach the point that all I want to do is walk out or walk away I have a bathroom disco. For those of you who don’t know I have a converted bathroom cubicle as my office, hence bathroom disco. I frequently fail to make time for food or even a couple of tea, back in the day I used to have a walk around the block or settle down for a cup of tea, I drink my tea black it takes 20 minutes to cool, when things became too much. There’s no time for any of that right now. When it becomes overwhelming I’ve decided I will allow myself a ~3minute bathroom disco break. I lock the door, put on an energising track and dance like a loon. It not only brings me joy but stops me spiralling and wakes me up enough to re-set myself for the challenge ahead. If we have going to survive this we all need to find a bathroom disco equivalent to get us through the next 5 minutes some days, let alone the next 5 months.

So there it is. I’m going to put on my big girl pants and prepare again for my ‘extraordinary effort’. Those making these requests however should remember that I am so fortunate to know that I will eventually get back to a job I love. Others were not so fortunate prior to this and so they are right now making different choices in response to your plea. Lets follow our words with actions that also enable them to stay!

All opinions on this blog are my own

Saturday Morning Zombies: how infection is portrayed in the genre

As it’s Halloween and National Pathology Week 2021 is coming up I thought I’d re-share my love of zombie movies plus a little activity if anyone is looking for a fun outbreak to run with colleagues or as part of outreach.

It’s Saturday morning and I’m spending my day watching zombie movies. There is a reason that I watch in the morning… I’m a complete scaredy-cat and so I don’t want to watch these before I go to sleep. Also, I don’t really like horror movies. Correction: I only like horror movies with plot, i.e. Get Out.

So, why am I spending Saturday exploring the world of zombie horror?

Three reasons:

  • Despite not liking horror movies as such, I’m intellectually obsessed with how infection is portrayed in them and debating whether the infectious cause would result in different types of zombies.
  • Nicola Baldwin and I, because of our shared obsession with the genre (albeit for different reasons), are going to create a new piece of work on zombies and infection for the Rise of the Resistance Festival (online 7th and 8th May 2021). I therefore need to do some homework.
  • My husband really really likes zombie movies: he is super-stoked that this is my weekend homework, rather than writing papers or analysing data

My friends and I talk about this so much as part of our ‘pub conversations’ that we honestly do have a zombie survival plan. So much so that one of my best friends included saving her husband ‘during the zombie apocalypse’ as part of her wedding vows. This may sound silly and, believe me, it is; But there is some interesting and philosophical stuff in here:

  • Where is the best place to run to (cities vs country)?
  • What would you do in the 1st 24 hours, 1st week, 1st month?
  • Who would you get to join your party? Why? What skills do you need?
  • Do you take people along for the ride because you like them, or does everyone have to have purpose?
  • What rules of society might you abandon for the sake of saving the human race, i.e. monogamy, patriarchy?
  • How much aid would you offer to strangers ‘Good of the Many’?
  • Would you opt to die as you or turn if infected? ‘Survival at any cost and in any form?’
  • What would your ‘rules’ be?

These questions are all about how we, as humans, would react to a zombie outbreak. However, the thing that really fascinates me is how the zombie might change based on the cause of the zombie infection.

There are real life instances where infection can result in behaviour change. As part of my interest in this, I created the activity at the bottom of the page called ‘Zombie Island’. It was one of the first public engagement activities I designed and ended up being turned into a live action takeover event in the city centre of Toronto, where visitors had to solve different clues and challenges in order to cure themselves before they became zombies. The activity in Toronto was called Zombie Rendezvous and the link to the booklet is below:

Zombie Island – How Will You Save your Tropical Island Home?

The first thing you need to do is design your zombie. Will it be due to:

  • A virus?
  • A bacteria
  • A fungus?

This decision will affect not only how your zombie transmits infection, but also how fast and easy/hard to kill it is.

How do infectious causes affect zombie characteristics?

Slide taken from Design You Zombie Activity (see downloads below)

Once you have your zombies designed you can then play the scenario. Each different type of zombie requires different infection control and public health decisions/prioritisation. Make the wrong choices and the zombies will reach the port or airport and get off your island to infect the outside world. They can also infect your food supply, take down your military, or cause mass point-source outbreaks if you fail to shut down public events. All decisions aren’t equal, so make your choice…+

More on all of this later when I’ve watched some movies. Remember – aim for the head!

All opinions on this blog are my own.

Some Days All We Control Is Ourselves: How to respond when things don’t go to plan

Earlier this week I made a post about wellness programmes and the problems I have engaging with them. I did say however, that I don’t discount the fact that sometimes we need to take some personal action to manage the situation we are in, even if that is to just to survive to the next encounter.

What kind of situation am I talking about? Well this post was prompted by something that happened a couple of weeks ago. I gave a talk, it was supposed to be inspiring, but I felt it didn’t land. I followed a really amazing speaker who everyone really engaged with and so it felt really clear to me that I didn’t get a similar response. It was my second talk of the day, in the middle of a week where I was running conferences on the Monday and the Friday. Needless to say I was feeling more than a little tired.

Why is the fact that I was tired important? What kind of impact does that have on my perceptions? Was the outcome, in terms of talk impact, a real failure or just a perceived one? Also it was just a talk so does it really matter?

The truth is that maybe the circumstances in this case didn’t have significant outcomes. However I think this is just an example of how fatigue and tiredness can alter our perceptions of performance. In some cases this altered perception can lead to more consequences for us as individuals, in terms of stress etc, and also change the way we do our jobs, therefore impacting on others.

So, I was curious whether it is just me that feels this way. Are others more likely to feel like a failure, or that they have failed, when they are tired. So I ran a poll on twitter and I was pretty surprised by the results:

I’ve always felt really alone in this and that my response to tiredness, increasing levels of self criticism and feelings of failure, was a ‘me thing’ and probably a weakness/fault. I don’t know therefore whether I was pleased or saddened by the results. It seems like most of us feel this way at least some of the time, so why don’t we talk about it more? In a world where the focus is being placed on us to to find ways forward and when, I suspect, many of us are feeling broken, stressed and tired, what can we do to support ourselves and others through these periods where we are feeling like our own harshest critics?

So having said that wellness sessions don’t really work for me what can we do? Some of the lovely people who responded on twitter gave some great advice, which I’ve combined with some my random thoughts to try and help us all in finding a way through when everything feels too much. All things won’t work for all people but hopefully there is something that could work for everyone as a piece of support or way forward.

Try to be self aware and remind yourself of the cause

By identify the route cause you can start to distance yourself from it, you’ll also hopefully be able to find an intervention that might help. Tired, try and find a window to sleep. Stressed, try and be kind to yourself and find some time to do something you enjoy. Know that you can re-evaluate once you’ve given yourself some time/space/sleep. It’s worth considering what your interventions in different scenarios might be when you are in a good place so you have a plan for when you need it in order to alleviate how you feel.

Try to not make decisions and react when aware you are in a hyper reactive mind set

Leading on from being aware of how you are feeling, a key suggestion was knowing what not to do when you’re not feeling quite yourself. Don’t send emails, make decisions or react during a time when you’re judgement may not be truly reflective of your normal thought processes. In these periods I tend towards being overly apologetic, submissive etc, others I know will tend to be the opposite and come across as less collaborative. Wait until you can find your way back to the middle ground.

Try to change your inner dialogue

If you find yourself spiralling (see my previous shame spiral post) do something to put yourself in a different mindset, read a book, go for a run, make a to do list with some things that are easy to tick off. I find shame spiralling slightly different as it’s linked to a specific event rather than a general feeling (which my mind can sometimes hook onto things). Often when I shame spiral it’s because I’ve actually failed, rather than just perceiving I have, but the response is similar. For most things in life, tomorrow offers a re-do. If what has happened is non critical, or even if it is critical but is fixable then tomorrow will arrive and with it some level of distance to support reflection plus hopefully with the benefit of sleep and relaxation.

Reach out to trusted advisors and get a reality check

Try to be kind with yourself by thinking how you would respond to someone else in your situation and use that as a benchmark. I often find this impossible to do by myself and so that’s where checking in with my friends really helps. I’m lucky enough to have wonderful colleagues who I also count as friends, who are always willing to have tea, catch up via WhatsApp or provide support via twitter. Know who your trusted people are and be open and honest with where you are at. As the poll showed me you will be surprised at how many people have experience of what you’re going through and how they can support you through it.

Know tomorrow is another day

This doesn’t help everyone, but one thing helps me quite a lot. When the going gets tough, the tough get planning. To tide me over to the point where I can make actual decisions or feel more like me, I find daydreaming about plans for that future helpful. I start to plan holidays or pleasant experiences, anything that draws my mind from the present. I try to consciously be aware of the fact that the way I feel now won’t last and think about what could happen when I’m refreshed.

Remember the good times

Quite a few people have said that it is useful to keep a success/achievement list somewhere. It is all too easy when feeling this way to only focus on our failures, be they real or perceived, but keeping a list in a drawer/computer folder can be a useful prompt. This doesn’t have to be a work related list, it should cover the whole of your life and remind you that you are more than just a job/situation and of everything you have to offer. As Laura said ‘more roses, less thorns’

Do something you love

Sometimes it’s not about addressing the problem, sometimes it’s about treating yourself, or as my wellness colleagues would say ‘self care’. In my case I go back to movies/TV series as that bring me comfort or cook. I watched a Christmas movie a couple of weeks ago as they are a place of comfort and joy to me. Other people suggesting singing, going to the spa, reading a favourite book. My friends and I often talk about making our pit of despair comfortable if we’re going to be there for a while. This is what this is to me. I acknowledge that I may not just snap out of it, so how do I make myself feel better whilst I get through it.

Put your feelings into context

As stated at the start I tend to focus my feelings of failure, linked to tiredness, onto different scenarios. These are often for me perceived issues rather than actually knowing that something has happened i.e. thinking I gave a bad talk rather than receiving the evaluation that says I gave a bad talk. Similar I know, but I think the way out of it for me is different. If like me you start to obsess I sometimes try to make myself take a step back. If it didn’t go well, does it really matter. In my case this week the worst case scenario here is that I am not invited back to speak, and some people might feel slightly less of my skill set. Now this hurts as part of my sense of identity is that I’m not a bad public speaker and I quite enjoy it. That said, does it matter? I don’t believe I am the best public speaker in the world, so as part of that I have to acknowledge that there will be people who do a better job at it than I, it’s not going to cost me my career. If it is something that matters, then know that once you feel more yourself, that is the time to make plans about recovery. Definitely not whilst you are in the midst of it.

Stop fighting it

This may be the 90s goth in me but sometimes you just need to sit back, ride the wave and enjoy the rain:

One thing you have all taught me is that feeling this way is not a failure in itself, it’s not a weakness, it is life and so lets not beat ourselves up about it, lets watch a movie, bake a cake and know that it will end.

All opinions on this blog are my own

Lets Talk About Wellness: Is it just me whose struggling to engage with wellness programmes?

I’ve had a LOT of emails and messages this week linked to various Wellness Programmes and links and my emotional response to them has surprised me. I’m not normally a cynic, I’m usually someone who is keen to engage and see the benefit of things. I have, instead of wanting to engage with these items, been really irritated by them and so I wanted to explore why I feel this way and understand if I’m the only one.

Let me start by talking about what my currently day to day looks like, as I think my thoughts linked to this are very context specific. I’m just getting home at 19:30 after leaving the house at 6:30 this morning and working a 10hr day without lunch or tea break.  I have an hour and half to spend with my husband and eat before going to bed and starting the whole thing again tomorrow.  The sad thing is that this has actually been quite a reasonable day, 12+ hour days are frequent.

Last week I ran 2 conferences and so wasn’t tied to my desk, followed by a couple of days off sick post booster vaccine That meant going into last weekend I had over 2200 emails on my inbox and over 1100 unread. I needed to cover IPC over the weekend and so in order to try to get back on top of it I worked to get the email mountain down from 2200+ to 156 to action. As I’m also on clinical this week that action pile in one day is back up to 190.

What’s the point of me telling you this? I think my aim is show that I fight just to stand still. If I take my eye off the ball even for a day I sink into quick sand. No one covers my whole role if I’m off sick, there isn’t another Consultant Clinical Scientist in the department. My point is that I don’t get how wellness works when this is my life?

My Trust and the NHS has invested a lot in wellness programmes and resilience training. This post may sound like its having a go at the really lovely people who provide those programmes and put so much energy into getting them up and running, but it isn’t. This is a post that is expressing my tiredness and exhaustion at working in Infection Prevention and Control in a pandemic within a system that does not deliver the resource for lunchbreaks, let alone provision for me to be training up my successor so there would be cover.

So what is that doesn’t work for me about wellness and resilience programmes?

The programmes we’ve instituted are things like ‘Wellness Wednesdays’ which includes a lunch time seminar on a wellness topic. We’ve been given access to the headspace app to support meditation and promote sleeping and healthy eating. There are also things like yoga sessions run in the Trust and GOSH supported 5k Park runs to encourage an active life style. There’s also access to counselling.

All of this looks amazing when written down and don’t get me wrong I think its great. However it only works if you’ve addressed the system issues that are driving some of the problems.

For example, I have never managed to attend a wellness seminar, despite having them in my diary, because I don’t have time to have lunch and usually spend my life in back to back ‘urgent’ work zooms. The biggest system change for me would be to enable me to have a lunch break and then I could choose whether to spend it on a wellness seminar OR I could step outside my windowless office and see sunlight!

The activity stuff is great. I used to run pre-pandemic. Now I work mostly 12 hours days with a 3 hour round trip commute. On a good day I get 2 hours at home in the evening during which time I might, for instance, have time to wash my hair and eat. On weekends I am either working or too broken to make food and catch up with all of the household tasks, such as food shopping, that are needed to get me through the next week. In terms of wellness, the better fix for me would be to enable me to actually have a homelife so I could choose what to do with it, if I don’t have time to eat I’m not going to be able to join in yoga.

One of the final things that I find really tricky about all the wellness stuff is that it seems to go on and on about being present in the moment. I have a meeting in a Tuesday where the first 5 minutes is a wellness meditation. I will give an honest confession here, if I have time I use that 5 minutes to actually make a cup of tea so I can have a drink. This doesn’t normally happen as I’m always running late from previous zooms, but that is the intervention that works for me. I find being in the present hard. I’m exhausted and physically pretty broken, spending 5 minutes noticing that is not helpful to me. I’m surviving this by planning and focusing on the future, which is how I always manage my stress and survive.

So where is the system letting me down?

Some of the problem with this is the way that Healthcare Science functions. We’re not like some other specialists, who effectively do the same job with different specialisms and therefore cover each other for sickness and holiday. We’re not like some other colleagues who work in a team of multiple similar roles and, although may not always truly cross cover, have someone to pick up their responsive role. We are usually lone individuals, as there’s never considered to be enough work to have more than one of us. That causes issues in terms of career progression and training up someone to eventually take over (as it can take 10+ years) but it also means that no one actually covers your work load. They may pick up the screaming urgent stuff that has to be managed but the rest just builds and builds.

All of this means taking holiday becomes a trial that becomes inherently stressful. You spend so much time trying to pin everything down before you go that you pull double hours and when I return I frequently have up to 3000 – 4000 emails and my diary is back to back as I’ve been unavailable for a week or 2.

It also means that when that workload becomes too much it very hard to get someone to help carry the load. Don’t get me wrong, I have great teams and we work really well together but I don’t have someone I’m training up to be the new me that I can hand bits off to, in the way my medical colleagues do with their registrars. It also means we’re not planning for the future

It’s not just Healthcare Scientists that are struggling however, so it’s not unique to us as a group. It is physically not possible to be on 8 hours of zoom calls, deal with 300 – 600 emails and a day and then actually do productive work that requires thinking on top of this. So how do we change the system to improve the way that we communicate? To determine whether the meetings we have are productive? To change expectations in terms of being available for 8am meetings and 6pm meetings when we only supposedly work 9 – 5? This is something we can start to tackle as individuals but requires changes in culture, which is in my opinion is something that organisations should be investing in as much as free yoga.

Instead the response is usually that we should find things that we can drop to create time and space. The sad thing about this response is that it means all drivers for work become focussed on core work and reduces both time and acceptance for tasks that require creativity and innovation, the kind of tasks that will actually permit changes to the system in which we are existing. For me it is these tasks that energise rather than drain me, these tasks that give me hope that I will make it out the other end and permit planning for a future where we do things better for both ourselves and our patients. I feel especially infuriated when I’m told I should discard the only things that are enabling me to continue, to do even more of all the things that are leaving me hollow and tired, even when these things are done on top of everything else. I know to many it seems like an easy fix but to me it would be the straw that broke my back.

So here’s my plea. Instead of placing the burden to fix burn out on individuals, lets also work with the systems that led us here. The pandemic is a once in a lifetime challenge, but what it’s done is expose problems that were already present in the system, not ones that only exist because of the pandemic. Personal responsibility is important, but making people feel responsible for their burnout as if its another of their failures is not the way forward. Support them, offer individual help, but also acknowledge the system wide issues that led them there.

Apologies for the rant, but I for one feel waaaaaaaaaaaay better for getting that off my chest. Now I’m off to watch a YouTube video on the importance of laughter yoga.

All opinions on this blog are my own.

Happy Birthday Girlymicrobiologist Blog: One year on what I have learnt about writing a blog?

The Girlymicrobiologist blog is one year old today, well in actual fact it’s 6 but we’re not talking about the wilderness years when it lingered unused. It started out as a way to help deal with some of the madness of the pandemic and in order to feel like I had a direct route to talk about science and being a scientist, that was unfiltered through anyone else. I thought it would be read by a handful of people and would be highly niche, but in the last year I’ve published 73 posts, and had over 16,000 views from ~11,000 visitors. Numbers I could never have dreamed of. I know there will be many blogs out there with much higher numbers but for someone who is basically putting her thoughts on electronic paper once a week I am constantly shocked and delighted by the response. So as someone who came into this a complete novice I wanted to share a few things I’ve learnt and thoughts that I’ve had.

It’s OK to break the rules

When I first started writing blogs for other people I was told to obey the following rules:

  • 500 – 800 words
  • 2 – 3 pictures
  • use sub-headings
  • post at the same time regularly

Now that I write one for myself you may have noticed that I have pretty much abandoned the word limit, if not the sub-headings. I try to post on a Friday, as writing my blog is what I do on a Friday night. You can however see that I also frequently don’t succeed at this. Mostly because I’m a real person managing this on top of a fairly stressful job and doing the best I can.

In terms of article length, apparently more the modern thinking is that the longer the length the more reads something will get and people are investing time and so like more for that investment. That’s not the reason my posts are longer however, my posts are longer because I don’t really over edit myself. I want to write as if you and are sitting and chatting over a nice G and T. This is probably not considered an acceptable ‘style’ but its mine and I’m OK with that. So my advice now is to write what you’re passionate about in a way that works for you and, in the nicest possible way, screw the rules.

Numbers only have meaning if you give it to them

I’ve quoted some numbers in terms of posts and viewership to you, but actually one of the main things I’ve learnt is that those don’t really matter. When people started to read the blog I tried to find benchmarks by which I could measure success, I am a scientist after all, What I found was that most of the benchmarks out there are for people who are doing this professionally or want to make money. I am neither of these things and so I found it hard to judge what I should be aiming for. What I’ve landed on, because I personally needed something, is a readership of ~1000 views a month. Mostly because I was looking for consistency, rather than any kind of massive growth.

Reads are obviously closely linked to numbers of posts. I try to post every week, in order to keep things regular and for people to get into a rhythm of knowing when things are going to come out. If you post more you will get more reads. Therefore you need to decide early on how much metrics matter to you. Some people find metrics are a good way of motivating them and giving them structure. I am a somewhat obsessive individual and if I focussed too much on numbers I would end up writing blogs at midnight in order to make sure I hit that weeks count and feeling like a failure if I didn’t hit quota. Because of this I tend to use metrics as a light touch to look at trends rather than using them to judge success.

I don’t really know what will land and generate a lot of reads

We’ve talked about everything from tea to childlessness on Girlymicro and what I’ve learnt is that I don’t ever know which posts will really resonate with people and get a lot of reads and which won’t. For instance my post about being childless in my 40 got over 2500 views, for a post that I thought would be read by and resonate with a small number of people. Other posts that I thought would have wide appeal have been read by a few hundred. Some of this is probably based on the timing of the post and who picks something up and shares it on. I try not to get too worried about this because, as I’ve said, I’ve decided not to be too concerned about numbers. I want to sit on a Friday night and write honestly from me to you, if that post has meaning for one other person that’s good enough for me.

I did think at the start that I would write a lot more about technical science, but as time has gone on that’s really not what I write about. There are a few reasons for this. One, there are many great technical science blogs out there that review the literature and sign post to good papers. I do some of this but mostly if I’m writing about science it also has a narrative element linked to it. I think that’s because what I’ve decided I most like to talk about is de-mystifying science and who scientists are. I want to talk about the highs and lows, the things that I’ve learnt and the things we can do better. These topics are the ones I haven’t found covered so well by other sources and also have the most meaning to me. I’ve come to the conclusion that what resonates most well are the posts that are authentically me, and that the topic is almost secondary. That’s serendipitous as those are also the posts that are easiest to write and so I just go with writing about things I care about.

Once you start it’s hard to stop

On the subject of writing about things that I care about. I had thought when I started, that writing a blog once a week would be a chore and that I would find it difficult to find things to talk about. The opposite has been true, I have a lot more ideas than I thought possible. For instance, I currently have 93 blog posts in some level of draft. I’m inspired to write by seeing what everyone tweets, by time taken with friends and colleagues to have cups of tea, and by corridor conversations. Ideas are sparked by reading news articles, by watching programmes and movies, by people sharing their science and by unexpected events that elicit an emotional response of some kind.

On a Friday night I will often sit down and words just happen, I have planned to write about something but then something will happen or I will have a thought and the words come almost fully formed. I don’t fight it and, for those of you who read this regularly, you’ll notice there are plenty of spelling and other mistakes. I write in a stream of consciousness and don’t worry about editing myself too much. I don’t aim for perfection, I aim for honestly.

We’re on this journey together and I don’t know where we will go

I have a had a number of people comment on how brave my blog is, but I don’t really think it’s brave. What I hope it is, is an honest space where I trust you to read what I write with the intention of that writing in mind, and that you trust me to not glamourize or pull punches with what I share. I hope that you know that I write in order to help us learn and develop together, to raise awareness and to help us rise to our challenges and everyday be a little more courageous together.

So where do we go from here? I’m not someone who can function without a plan, but I’m kind of trying. I’m really enjoying this, the dialogue and the conversations writing has prompted. I feel so much less alone in the challenges I face, and so something that I started in order to help others has ended up helping me so much more than I had believed possible.

Some lovely people have said I could try and get an agent interested in the blog, to be honest I wouldn’t even know where to start, although I will happily take suggestions if anyone has any. For now the most important thing for me, is that you and I keep our regular catch ups, that we spend 10 minutes together over virtual tea and cake, and continue to learn and grow in each others company. To every one of you who has invested some of your precious time in reading the blog over the last year I am grateful beyond having words to express. In what has been the most challenging of times you have been kind, generous and supportive, and I don’t know I would have made it through as intact as I have without you. Thank you!

All opinions on this blog are my own.

Embarking on My 17th Year as a Healthcare Scientist: What have I learnt?

When I applied to become a Clinical Scientist (the term Healthcare Scientist didn’t exist then) in 2004 I have to admit I didn’t even know what one was. This lack of awareness that such a wonderful position existed has been a real driver for me ad became an ongoing passion to raise the profile of this, all too often invisible work force, that impacts across patient pathways and is so key to patient outcomes. If the great future scientists out there don’t know that they can join us, they never will.

Life has changed a lot since I walked in on my first day with very little idea how to pipette, what Staphylococcus aureus was, or how to spell Erythromycin. I (mostly) know what I’m talking about now, I’ve got married, brought a house, got a PhD, passed FRCPath and been awarded a New Years Honour. Importantly for me I found my passion, I know my why and I’m privileged to work with amazing people doing the best job on the planet.

My NHS career turned 17 on the 4th October 2021 and so is old enough to learn to drive. In continuing this metaphor I thought I’d write about the journey so far and what I’ve learnt.

Things to know as you start out on your journey

Have a plan

Your plan will change and evolve over time but if you want to make the most of the opportunities presented to you it’s worth having an idea of what boxes you need to tick in order to get to various fixed points along the way. Do you ultimately want a consultant post? You’ll need FRCPath, what will you need to be able to get there? Do you want to be a lab manager? You’ll need some leadership, recruitment and management experience, what opportunities can you access to help you?

Having a plan doesn’t mean you should feel boxed in and trapped by these ideas, but you can use them to help you prioritise chances that are presented to you. Not only that but can use it to ground yourself when everything feels a little overwhelming. You can also use this awareness to find champions and coaches/mentors that will help support you along the way. Invest a little time early on to make the most of your time later.

It’s OK to re-plan your route

Opportunities will come about and open up that you can’t predict when you start out. The term Healthcare Scientist didn’t exist when I joined the NHS, therefore there certainly weren’t any lead Healthcare Scientists. Getting a PhD wasn’t part of my plan, as when I joined there wasn’t a clear route through to being a Consultant, and so I didn’t know that I needed one. The National Institute of Health Research (NIHR) has been a massive part of my scientific career, enabling me to have a role as a Clinical Academic, but they didn’t even exist until 3 years+ into my career.

So have a plan, but don’t be so tied to it and so linear that you miss out on things that will change your life and career. Having the right people as part of your networks can help you realise when you need to take a leap of faith into one of these alternate routes is key.

Sometimes you may take a wrong turn, the extra journey will not be wasted

There will be times during your career when things don’t go to plan. Road blocks will spring up, paths that seemed clear will be obscured, and to be frank sometimes the car will just break down. The thing to bear in mind at these points is that none of this time is wasted as long as you learn from the experiences being offered to you. Sometimes these experiences are not particularly pleasant whilst you are going through them. I would be lying to you if I said there wouldn’t be challenges along the way. You will however emerge stronger and more knowledgeable from them, as long as you see them for what they are, learning opportunities. So deep breaths, make that cup of tea and know that this is still an important part of your journey.

For those of you mid-trip here are some things I learnt somewhere post registration

Remember you are part of a system at every level and take the time to understand how it works

It was only when I started on my leadership journey as part of the GOSH Gateway to Leadership programme, that I really began to appreciate the importance of systems. As a trainee I was very focussed on my department, with a few links to my professional community at a national level, via the Association of Clinical Biochemists and Laboratory Medicine. It was only when I was on this cross disciplinary programme that I met people who were outside of my silo that I began to understand what the drivers for other peoples behaviour might be.

Now I spend a lot of time in national strategic committees and working with different professional backgrounds and it has enriched not only my practice, but also enabled me to work towards impact on a level I could never achieve as an individual. If you really want to be a driver for change then understanding the landscape within which you are working and making those changes will only make you more successful.

Influence is not about seniority

For a long time when I was starting out I believed that titles and seniority were key to influencing others and therefore supporting change and improvements. It took a while for me to learn about the difference between formal authority and informal authority. Informal authority is actually really key in order to win people over and get engagement with proposals. It’s built up over time, requires work and effort to maintain and is based on your credibility. Formal authority is given to you in the form of job title and role. You can make huge impact where ever you are RIGHT NOW, you don’t need to wait to be given authority. Put in some time and develop the informal authority to enable you to make things happen.

Don’t compete with anyone but yourself, your journey is your own

The world of Healthcare Science is a small one, it can feel like everyone is trying for the same end points and therefore is competing over the same limited opportunities. In my opinion this isn’t actually the truth. It feels like it, but it isn’t. When you speak to people, very rarely do they want the exact same thing as you. This competitive drive can mean that as a community we don’t support each other enough. Once you realise that others are not really competition, it dawns on you that your only competition is actually yourself. You can tick the boxes you need to tick with principles and grace, these don’t require anyone to lose out. Also, if we do these things as a community together we also often achieve more. If we form FRCPath study groups to help us pass then we are not losing out on consultant posts, as more people have FRCPath, we are increasing our chances of succeeding together. There will be enough consultant posts as we are not all looking for the same things in a job, the ideal post for one person will not be the same for another. Don’t spend too much time focussed on what others are doing and achieving, keep an eye on your road map.

We rise by lifting others

Part of succeeding as a community is to really function as a community. Twitter and #IBMSChat are great examples of this, sharing opportunities, knowledge and experiences for the good of everyone. No matter where you are with your journey there will be people behind you who you can sign post and offer support to. This is part of the reason I believe outreach and public engagement is so important, we need to support people at all parts of their pathway.

The other thing is, that it is crucial that as your formal authority increases you consciously make the decision to send the elevator back down, or ride share where you can. As leaders we are obliged (in my opinion) to amplify the voices of those who may not otherwise be heard. If you are lucky enough to have a voice then you need to use it, not just for yourself, but for everyone that either doesn’t have one or holds one that is unheard or ignored.

You will never be liked by everyone, and that’s ok

Amplifying the voice of others or being a driver for change, frequently does not increase your popularity. I’ve always been a people pleaser, I want people to like me, I want positive feedback, I want positive reinforcement. Sadly I have discovered that not everyone is going to like me. I am not going to be everyones favourite person. Being someone who likes change and disrupts the status quo will lead to benefits, but will also make people feel uncomfortable and that will sometimes drive challenging behaviour. Sometimes clinically it’s also my job to hold the line, to deliver bad news, to not be the popular one. Not everyone is going to like me, but I’ve discovered that it is rarely personal. It’s mostly about the response to the role or the situation and some key learning for me has been learning to separate these from who I am, in order to not take it personally.

What to do when you hit your original destination

Know your why, why are you doing this? What are you passionate about? Where are you going?

When you reach your planned destination, there’s only one thing to do and that’s plan for the next stop along the way. It’s really important therefore to check in with yourself and know your why? Why did you pick this original target and how are you now going to build upon all of the hard work that has got you to this point? What is your driving purpose and how are you going to stay true to that in the next phase of your career?

It’s worth doing some of this thinking as you approach your destination so that you can be ready once you’ve re-stocked on drinks, snacks and mix tapes/downloaded Spotify playlists to hit the road again.

Sit back, smell the roses and take time to celebrate

Finally, to complete the metaphor. It’s important to look in the back mirror every now and again to assess just how far you’ve come. Celebrating can feel indulgent and like boasting, in fact it’s the opposite. It’s inspiring to those that are following behind you and is important to show to others that they to can achieve. People can’t be what they can’t see and so by talking about the journey you will enable others to make informed choices about their own. On long journeys it can feel like you still have miles to go but by looking back you can see how far you’ve come and put it into some kind of context.

I’ve been listening to Hamilton a lot lately and these words have a particular resonance for me. Whatever your journey, it is yours and no one elses, therefore it will come together at the time that is right for you. So celebrate the moments, large and small, after all the journey is most of the fun.

I am the one thing in life I can control
(Wait for it, wait for it, wait for it, wait for it)
I am inimitable
I am an original

I’m not falling behind or running late
(Wait for it, wait for it, wait for it, wait for it)
I’m not standing still
I am lying in wait (Wait, wait, wait)

Wait For It – Hamilton

All opinions on this blog are my own

A Trip Down Memory Lane: Top tips I’ve learnt over 20 years of event organising

Its 6am and I’m back into the groove work wise post holiday. That means, for me, that I need to get prepared to run 2 one day conferences in a week in the first week of October. In many ways this is a foolish endeavour, but due to SARS CoV2, delays and the impending clinical business of winter it seemed the only way. As these events loom therefore I will be calling upon 20 years of organising events, both big and small, in order to try to make them a success.

I haven’t always worked as a scientist, I know, shocking! For a very small window between my BSc in zoology and starting an MRes in Biophysics I worked for Birmingham City Council in a couple of roles. One of those was as an event planner. I cannot tell you how brilliant that job was, some days I can’t believe I left, but deep down science was always my calling.

When organising an event there are some decisions you need to make early on. The big one being whether you are going to organise it yourself or outsource it to someone else, be that a company, venue or individual.

The decision about whether to outsource or not depends on a number of factors:

Manpower – organising events is time consuming and for very large events I.e. large conferences, you are unlikely to have the capacity to do this by yourself. I usually draw the line at events of over 350 to organise with a small voluntary working group, but it depends on the event and how much cat hearding is required

Infrastructure – do you have access to IT and other support to permit registrations, have a Web presence etc. In some ways this is less of an issue these days with platforms such as Eventbrite but they will take a cut of any charged ticket. You will also need to have things like a bank account that funds can be paid into, which can be problematic depending on who you are organising for with budget codes etc. If you don’t have the ability to register attendees you may have to find a partner organisation.

Finance – Obvious I know but events cost money. Some of the ones I’ve organised (especially the ones I’m running in October) make a considerable loss as they are about giving back, sharing knowledge, and developing networks etc. Some non work events I’ve helped run have been focused on breaking even with profits donated to Charity. There are others that have needed to make money in order to justify their existence. How much money you have to spend or need to make will dictate how much outsourcing is appropriate/possible and is more common for events that need to make money or at least break even, as these tend to link to scale.

Marketing – Do you have preexisting networks or links for you to be able to use to reach potential attendees? Twitter networks? Professional body mailing lists? If not then you may need external support or advice on how to get your event info to reach the people who might be most interested in it. Again, this is usually more important if you are trying to run a for profit where you needs 1000s to attend. It is certainly less of a concern if you’re organising a hen do.

Designing your brief

Start with your why. Who are you organising this event for? What are you trying to achieve? Are there learning or other outcomes, such as the bride having fun, that you need to achieve? Whichever way you decide to go in terms of organisation you will need to have a clear brief in your mind linked to these questions and others in order to decide what you want your event to be. You’ll need this for yourself if you are making your own decisions, but you will need it to even get a quote for an external events company. Spend some time doing your thinking here and you will save yourself a lot of drama later on.

You need to decide:

  • How many people i.e. small family event for 8 or large conference for 5000, plus everything in between
  • Catered or not. Short meetings may not need full catering, if you are organising an event with food what might the dietary requirements look like, how long will you be giving for breaks as this will impact on what type of food you can provide, is it a formal event as food will need to match this etc
  • Is onsite accommodation required? This is more common for multi day events, or scenarios where people will be coming from further afield i.e. weddings, or international meetings
  • What feel are you trying to achieve: formal, informal, networking focused
  • What level of technical support do you need: audio-visual, ticketing etc
  • Always bear in mind accessibility requirements, especially if you are organising a public event. This doesn’t just mean in term of physical access to spaces but to the content that will be provided. I run small loss making events so I can’t address this the way I’d like but you should be aware of the limitations of what you can provide
  • Who are your target audience? Where are they based? What links do you have with them? How will your achieve your objectives with them i.e. lectures, group work, open circulation?
  • How will you evaluate the event and what does success look like?

Your brief will dictate:

Room type and number required I.e. are you going to have breakout sessions or lectures or both

What kind of seating you want i.e. for lectures you might want lecture type seating, if you are having a networking event then cabaret might be more appropriate, or if the focus is on a larger single group working together then board room might work best.

Food choices, the more formal the event the more formal the food. It would seem really odd to have silver service in the middle of a conference day for instance.

Venue is everything

If you find the right venue to fit your brief (either yourself or via a planner) everything else becomes much easier. As we are a small team we tend to go for venues that can offer a package of support i.e. they come with furniture, audio visual options, flip charts and other paraphernalia and most importantly (as catering is super important to participant experience) good and plentiful food options. Your choices will vary dependent on whether you have greater resource either in money or time than we do. Knowing your ask means that you can find the right fit for you.

Find your team

If you are going to go it alone in terms of organisation then you need to find your team. This is true whether you are organising a group outing for friends or a work event. The kind of team will depend on the people who are doing the event planning. Some events benefit from creative disagreement to ensure inclusion. For the most part I like to work drama free as organising these events with limited resource is stressful enough. I therefore try to find people to work with who are interested in collaboration and are focussed on task completion. This works well for the type of events I’m currently involved with, but there are definitely events where innovation of process during the planning is part of the learning (such as nosocomial) and these require more risk taking and creativity.

Some scenarios also mean that there is less choice about who forms part of the the group. It is therefore crucial that whatever group you end up working with it is important that you have an idea of the strengths and weaknesses of everyone so that you can maximise the efficiency of the group and minimise frustration. There are things I’m really good at, I can hold a vision in my mind and have ideas. I need someone in the group therefore who grounds me and keeps me to task and deadline. It also helps if everyone has the same passion for the work as you do, or at least are equally committed. Uneven distribution of workload is one of the things that inevitably leads to stress in these settings.


One final and yet super important thing is to plan as part of the process how you are going to evaluate both the event and it’s impact. Learning is key. Did you participant love/hate the venue? It will impact on whether you will use it again. Did the delivery set up facilitate the learning needs? Did the agenda fulfil the brief? You are bound to do this more than once, even if not for the same event. Learning what went well and what could be improved is important in order to get better at this. Also understand that you will never please everyone, don’t take criticism to heart, you have put yourself out there and done something. Use comments as learning not as judgement.

That said if you want to join me at either of our upcoming events you can judge me against this post and see how well I/we stack up

Environment Network 2021: Designing and building for infection prevention – 8th October, London

Healthcare Science Education 2021: The role of innovation in education – 4th October, London (free)

All opinions on this blog are my own

What I Did On My Holidays: Or the benefits of taking some away from it all

It’s Thursday night and I’ve been working for over 12 hours already in a desperate attempt to see the bottom of my inbox before I go. I have 45 left in my action folder and have reduced the inbox itself from 1250+ to 0. Sounds great, right? It definitely is but the act of getting to this point has left me so wound up about what I might have missed that I’m in a bit of a panic that I’ve forgotten something crucial. I’m thinking from the graph below that I’m not the only one who finds the build up to stepping away super stressful. So in an attempt to persuade myself of the benefits of a break and to lull my brain into some form of relaxation I’m going to focus on why holidays and taking time away from the inbox is so important.

As I write this my out of office is on. It says that I am away and will not be accessing emails whilst I’m away. More than that it states that I will delete any emails that arrive before I return from holiday, with a request that if it is still going to be relevant the sender should re-send after my return date. For many years I took laptops and phones away with me, in recent years I’ve decided that I will no longer do that. I can’t trust myself to not take it out and just ‘take a quick look’ or ‘do one quick thing’. Before I knew it I had always spent every day of my leave working and came back more frazzled then before I went. If the opportunity presents itself I will also become the person who is a walking version of the tweet below.

The ‘I will delete’ section comes from the fact that I will return to over 1000 new emails. My diary for when I get back is already full to bursting, from all the meetings I have to squeeze into less time because I’ve been on leave. This means that I will have A LOT of emails and no actual time to read them. I may or may not delete the intervening ones, but this message means that if anything is important it isn’t up to me to email dive to find it, it’s up to the sender to re-send. This means that when I come back I will panic less about the amount of time it will take me to catch up with having been away.

So given that even the process of going away drives me to a special level of stressed out, why am I doing it?

I think everyone in healthcare is run down and tired. When I’m this tired I lose the capacity to put things into perspective, everything is a disaster, my anxiety levels go up and I find it hard to see the wood for the trees. Going away and spending some quality time with my family enables me to recharge. It helps ground me and reminds me of what’s important. It enables me to become something other than Dr Cloutman-Green and spend time laughing, reading books, indulging in bubble baths and possibly even managing to have a lie in past 6am.

Letting my brain experience other things and stepping away from the day job also allows me to recharge my creative batteries. I come back able to look at problems from a different perspective, increasing my chance of solving issues. It also enables me to get inspired and remember why I have the best in the world, in order to help me plan and engage with change with a re-energised passion. Within 48 hours of being away I always have so many thoughts and plans that bubble up due to having a change of scenery. It’s another reason why I have to leave the laptop behind, as otherwise the urge to act on them immediately is too great. I keep a notebook to write them down so I don’t fear forgetting them but then can move onto the next book. It makes me better at my job when I return.

Not only is it good for me but it’s good for my team

It’s really easy to fall into a trap where you feel like if you aren’t there things fall apart. To be honest for me it’s less about this but my imposter syndrome telling me that if I’m not there to catch and double check myself people will find that I’ve made some huge mistake (let me be clear I’ve never found this to be the case – it’s why it’s irrational). It’s really important for me to go away and find that this doesn’t happen. It’s a little bonkers I know, but the more tired I am the more this fear grows, and the harder it is to step away and become less tired. It is quite the cycle, but knowing that it exists is 50% of the battle of controlling it.

Although I fear stepping away it’s easy to ignore the opportunity that this gives to my team(s) to try things out, to take on tasks or sit on meetings that they don’t always have access to. It gives them experience of a slightly different role to decide whether they enjoy it and supports their career development and networking. We are a team and I am not a one woman army, so it’s important to acknowledge that.

Not only is stepping away a development opportunity for teams, it is also a needed piece of leadership by example. I would hate anyone I work with to feel they can’t take breaks and recharge. I don’t want them working stupid long hours and fearing what happens if they are not ‘always on’. I need to lead by example and therefore give implicit permission that others also fully step away. For example I took the ‘I will delete’ message from my Clinical Lead. She led by example and I therefore feel able to adopt her practice. I want to make sure I also lead by example.

Finally, it makes me a less grouchy human being! When I’m tired, like many people, I get tetchy, read more than is meant into communication and frankly don’t communicate as well. My patience and tolerance become stretched wafer thin. I think that everyone around me has a much better experience of working with/living with/being friends with me when I’m refreshed, recharged and ready to go.

On that note this is my final job of the day, apart from packing and all that jazz, so I’m outta here.

See you all when I get back!

All opinions on this blog are my own

Keeping Things in Perspective: My attempt at seeing the glass as half full with a list of pandemic positives

It’s been a long 18+ months in the world of Healthcare Science and Infection Prevention and Control. I’ve posted quite a lot about the pandemic here and how hard it’s been, especially coming into winter and the challenges that will bring. Challenges now acknowledged, it’s a Friday night, I have music playing and so I also wanted to reflect on what the pandemic has brought us that isn’t all negative.

Raised the profile of my profession

For many years I have had to try to explain what my job involved to the public, explain what polymerase chain reaction (PCR), and I’ve frequently been met with slightly glazed expressions. This is no ones fault, it’s just that those terms haven’t really meant anything for most peoples day to day life until the last couple of years. Suddenly public interest and awareness in not only testing and infection control, but also in the science behind these processes, has really been increased. Now I can hardly ever get a cab without being asked about how things work and what the current clinical situation is. If we engage well with this interest and awareness we will be able to have conversations about science and its impact on individuals and society for years to come, in a way we haven’t been able to before.

We’ve been invited into the room

Despite my love for my subject, microbiology has never been a sexy discipline. It’s never a topic that gets you into many strategic meetings where key decisions are being made, pathology as a whole is often left out in the cold when big decisions happen. Suddenly pathology, and microbiology in particular, have become a focus for decision makers. Healthcare Scientists as a professional group have often struggled to be invited to meetings, or even know that they were occurring. There has been a definite pivot over the last 18 months, with consideration of the importance of diagnostics in patient management. 80% of patient pathways rely on diagnostic impact at some point, it’s logical therefore that pathways can’t truly be optimised without considering diagnostics. So I for one am happy about the fact that by having a seat at the table we can work together to make this better, not just for SARS CoV2 but across all patient pathways.

The scientific and infrastructure legacy

Implementation of research techniques into clinical settings is always challenging, it requires access to space, finances and expert knowledge. We’ve always been very fortunate in the NHS, in that we have a lot of wonderful scientists who are really well placed to respond to scientific and clinical challenges by not just improving what they have, but by bringing in the latest research approaches. The things we have always struggled with are access to financial support to develop services and space in which to locate the new platforms required. One thing that has really struck me over the last 18 months is that the conversations in this regard have changed. Instead of flat out no, the discussion is about which is the best way forward and how can we make it work. This doesn’t mean that the answer is always yes, but it means that many of us have access to the infrastructure we need to really maximise patient care. The big question for us all now is how we maximise the legacy of that infrastructure to improve across challenges when this particular one is less enormous. This is a great problem to have and we need to ensure we actually spend some time thinking about the answer, rather than drifting into a solution.

Developed networks across boundaries and silos

It’s too easy in times of challenge and stress to react by becoming insular and regressing into known comfortable places, reinforcing silos and boundary based working. One of the things I’m proudest of for my profession and clinical colleagues is that instead of regressing into the known during the pandemic, they have instead reached across divides in order to form networks and learn from each other. This can’t have been easy to manage and yet the impact this has made has been really clear to me. At no time before as a scientist have I have been at a table with so many different professions, all with their own expertise, discussing, listening and learning from each other. I really hope that those networks and relationships that have been forged under such pressure will continue when we move back to a more standard healthcare model, as being part of those discussions has given me real pleasure.

I’ve got to know my colleagues much better

I am fortunate enough to be part of some exceptional teams (research, HCS education, IPC and microbiology). I’m not saying that the pandemic hasn’t on occasions challenged us and relationships within those teams, how can it not. The gift of those challenges has been however that we have come to know and understand each other in a way that would never have occured in a more standard situation. I spend more time with my teams than my family, I’ve known many of them for over 10 years, in many ways they are parts of my family. I’m super grateful therefore for the way we have bonded and deepened those relationships over the last 18 months, and it will only make us stronger to face whatever challenge happens next.

I’ve learnt so much about myself and my preferences/drives

Not only have I learnt more about my colleagues, but I feel I’ve learnt an awful lot about myself. The things that really matter to me, the things that drive me, the things that energise me and the things that drain me. For instance I have learnt that for me planning for the future is energising, whilst existing in constant responsive mode is draining. I miss sitting and planning research events, outreach events, teaching and developing the service. All of those things fuel my need for creativity and change. Living every working day in responsive mode where non of those things can happen I find incredibly draining, which is why my battery feels constantly empty. It’s why this blog has been a lifeline, even though it time consuming and yet another thing on my to do list.

The other thing I’ve learnt about myself is that despite appearances I’m more of an introvert than I knew. I’ve loved just spending time at home with my husband and not having the demands of a social life. I always knew that I could turn on ‘extrovert me’ for a given number of hours but then would reach a point where I needed to stop. Now I’ve discovered how happy and comfortable I am without the need to deal with those social demands in my world. I think I may try to keep my limited social circle up for some time to come as I feel happier and less anxious in small groups.

I’ve learnt so much and upskilled in so many areas

I didn’t realise until I came to sit down and write this blog how many new experiences I’ve had as a result of the pandemic that I would never have experienced otherwise. I’ve been involved with a life drawing class posing (fully clothed) as part of their pandemic professionals series. I’ve has my COVID-19 dreams painted as part of the Dream Appreciation process by DreamsID, the product of which I not only have for my office as an amazing piece of art, but has also been exhibited at the Freud Museum in London as well as other places. I’ve even been persuaded to take part in a stand up comedy show after training for National Pathology Week. These experiences have all developed skills and left me with memories that will last far longer than the pandemic. Many of them would never have happened if it wasn’t for the pandemic pushing creativity and causing people to work and develop projects in new ways. Even this blog was started as a way of being able to still channel creativity and sharing in the pandemic. So I guess I’ve learnt a lot, and not just about viruses.

Enjoying the genius of responses from companies and professional bodies

This may be a weird one but I have rather enjoyed seeing companies and other professional groups trying to come to terms with the pandemic. It’s been really interesting and enjoyable for me to see people tackle difficult and sometimes repetitive messaging in a way that brings humour or innovation into the mix. I’ve also found it pleasing when big business or big names have channelled some of their resources into learning and other messaging to support the pandemic approach. It has often renewed my faith in mankind when other sections of the population have been busy destroying it.

Leicester General Hospital Genius Signage

If we can survive this we can deal with anything that’s thrown at us

Finally, I think it’s easy to forget how much we’ve achieved and how far we’ve come. No matter what your job, or the reason you’ve spent a few moments of your valuable time reading this blog – know that you have come far, that you have achieved much and that you are making a difference and having an impact. Sometimes you just need to step far enough back that you can see it. So thank you, all of you.

All opinions on this blog are my own

Fulfilling A Promise: Why we need to talk about whether we are actually delivering on patient centred care

Warning – This is a long one and I’m not even a little bit sorry as I think we need to talk about this

Lets get this bit but out of the way first. I don’t believe that any of us for one second mean to provide anything less than the best care we are empowered to give. I do however believe that there are a couple of key components that may mean that we don’t always provide the care we aspire to. In my head there are three key reasons behind this:

  • Empowered to give is the key phrase here. Are we supported in delivering the best care? Do we have the right staff, equipment, training etc?
  • Does the organisational culture support delivery of patient centred care, in terms of high level decision making, expectation setting and provision to challenge?
  • Are we as individuals aware of the behavioural patterns we fall into during times of stress i.e. if we trained during a hierarchical medical era is this where we shift to in our practice in times of psychological challenge, such as a pandemic?

This post isn’t a criticism of individuals or centres, but it is a challenge to ensure we are thinking and questioning as part of our everyday practice. An encouragement to question whether we are providing the best in patient care, or at least actively identifying areas where the system has fallen down. We can only improve if we question, question ourselves, the situation and the system.

So why am I posting this now?

I’ve had more to do with being on the other side of healthcare than I’d like over the last three weeks. The outcome was pretty dire and I made a promise to the amazing person who was the patient that I would use whatever influence I have to remind people that we get the principles of person centred care wrong it is the patient that suffers. In my case it meant that the patient suffered loss of dignity and the final weeks of their life without the support of family and friends.

I work in paediatrics and I must admit I had fallen into the trap myself of thinking that every world was like my world, not that I’m claiming my world is perfect. Paediatrics is however more family focussed by it’s very nature as we need families to support us in providing care. We also need to listen differently as many of our patients can’t articulate their clinical condition and so the input of non verbals and families into their care is especially important. My sojourn in the world of adult healthcare was therefore a considerable shock to my system and has left me both reeling and questioning my own practice.

Impacts on dignity and right to choose

The NHS Constitution clearly sets out key principles that we should be using in all of out interactions, with each other and with our patients. These include clear statements on respect and dignity. For us really to fulfil this pledge though we need to hear what patients are saying to us.

For example, if as part of a patients’ care they are experiencing loose stools and they are not supported to access the bathroom, and instead left lying in a contaminated bed, they will not only be at increased risk of infection (from the femoral line they have in), but they are also likely to become less compliant with their care in general. Are we under these circumstances really demonstrating through our actions that we care for the patient in front of us?

As healthcare professionals we are often a bit non-plussed about faecal contamination, for those not in our world however we need to remember that to many individuals this is a humiliating event. If we compound scenarios like this with not explaining why medically we are making it worse by adding in medication, such as laxatives, which make the situation more likely to reoccur, then are we really thinking about how we are impacting on patients psychological health, or undertaking holistic healthcare?

Is this really seeing patients as equal participants in their care choices if we aren’t giving them the information to inform those judgements?

Too often we make decisions based on our knowledge and do not engage with the patients and families in front of us in order to support their engagement with their own care. How often do we ask them what matters to them? Only by asking this question can we establish what dignity and the right to choose really means for the patient impacted.

Importance of communication assumptions about levels of understanding

Communication is especially important right now. Due to the pandemic patients are frequently isolated from support mechanisms. This lack of support may mean they don’t challenge their care, it also means if that challenge is unheard that they don’t necessarily have access to escalation procedures, or even worse access to sign posting about what to do next. They are effectively in a very lonely bubble, with the only people to support them a bunch of strangers who may or may not have the time to develop connections or truly support.

When I was finally allowed to visit the healthcare centre (a story for the next section) not a single person, apart from the palliative care team, introduced themselves until the last day when to be honest it all felt too late. Not one ‘hello my name is’, not one explanation to the person before them or us their family as to why they were there and what they were doing. Because of my job I felt like I could explain things and to ask the questions that needed asking, but most people do not have a healthcare professional as part of their family. This was apparently the way the whole episode of care had occurred. I thought we had come so far in terms of not just seeing patients as anatomy and conditions, but this just showed me how wrong I was. On the day of his death everyone was brilliant, supportive and demonstrated amazing communication skills (apart from the medics who didn’t even come in) but the impact of those skills would have been so much greater if used when someone was able to respond and participate.

The Palliative Care and Support team came to visit on the day before he died. They said ‘hello my name is’, they didn’t however explain what palliative care was or even really check my family knew what the reality of that visit meant. When I spoke to my family after they had gone they were shocked when I explained. We have to remember that not everyone lives in a world where those words have meaning, we need to stop hiding between titles as barriers and truly check that what we believe has been heard is actually what was received. The other extreme is the ‘infantilising nature of healthcare’ where we assume that people don’t have the knowledge and capacity to be involved in their care or decision making. It takes time to get a feel for the level of a patients engagement/understanding and pitch your content appropriately. Some patients have a considerable amount of knowledge about their own condition, but whatever their level of knowledge we should be talking to people at the level that is appropriate for them, not what is appropriate for us.

Long and short is that I’m saying how we communicate matters, not just what we communicate, and that we should all spend time (me included) reflecting on how we do this in practice. I’m as guilty as anyone for rushing in, delivering the information in my head and then rushing onto the next task, but is that what is actually needed of me? Take the time to get patients names right, learn who they are not just the reason for admission, and make sure we communicate in a way that works for them.

See the source image

Who are we making COVID-19 decisions for?

The hospital in which all this occurred has banned all visiting because of COVID-19. Not only that, they had removed all entertainment centres, and thus a big means of distraction, for all patients. This may seem really trivial, what does it matter if someone can’t watch TV. It matters because England got to the European final and football, as trivial as it may seem, is super significant in some peoples identities. Dying without being able to engage in one of the few seminal moments you are still able to experience is significant. It matters because if you have unexpectedly found out you have only weeks to live and you have no visitation to provide support then distraction is probably one of the few things that may aid you processing that information.

The same hospital that banned visiting had less than 20% of the staff on the ward wearing masks. If a patient is in a cubicle I can see no barrier to visitation from an IPC perspective, just get them to wear a mask. If we are insisting on banning visitation in order to prevent in-patient acquisition then staff need to be also protecting their patients. If staff are not wearing masks and protecting their patients then I question what is the point in banning visitation? Who are we protecting? What is the purpose of this policy that leaves someone at the worst time of their lives alone without support?

Visitation was allowed during end of life care. Sadly end of life care wasn’t from the moment they said you were going to face a life limiting condition, it was for the hours/days where death could be imminent. Sadly it is during these times when the patient themselves becomes less cognisant of their surroundings. It is beyond the time when you can have conversations about wills, final wishes, funeral arrangements. It is passed the time you can have most impact in terms of psychological support. Visitation also involved battling every day at reception for the password to be permitted to visit. Battling because no one had ever put the name in the book that allowed them to issue it. Delaying by 15 to 30 minutes when you would get to the ward. Extending a period of incredible stress as you wouldn’t know what you might find. All because no one had filled in a form. I of all people understand how busy everyone is and that it seems like a minor thing, but I can tell you as the person who uncharacteristically could have screamed at a stranger in those moments, a minor thing for us can have significant consequences for others.

So after this outpouring which I’m hoping will make us all think, what do I believe that we should be doing differently, myself included:

  • Make every conversation and encounter matter. Think about what you are delivering and how it has been received, has it been understood? Have we really listened to the response rather than just delivered information?
  • Even during a pandemic patients are more than their conditions. Against their will they are living in our world. A world that they don’t necessarily understand the rules or the language of. We are their translators, a key role that we need to understand we fulfil. Simple things like explaining our roles can make all the difference.
  • Challenge where needed systems and processes that don’t feel like they are supporting patient centred care. Sometimes the people making the rule/policy will not understand the true impact of it unless they get the feedback about it’s impact. We all need to be part of the change.
  • Take the time. Understand how you react to stress and how that response impacts on your practice. It’s hard to reflect on our practice right now but it’s rarely been needed more.

All opinion on this blog are my own

Hello Shame Spiral, My Old Friend: The warning signs that I need rest and space to reflect

A couple of weeks ago I came off a virtual meeting. There was a delay and the sound dropped in and out. I should have raised awareness of this or sat back and kept quiet, instead I kept trying to contribute and ended up talking over everyone. This is rude and a trait of mine that I’m super aware of at the best of times. Sometimes I have so many thoughts I just have to articulate them to process and this comes across as super domineering and is especially not good for the introverts around the table. I struggle with it and I try every day to be better, it’s just I fail more frequently than I’d like.

This post isn’t actually about that though. It’s about the fact that I hung up on the call, sat on my sofa and cried. I then engaged in panicked reaching out for reassurance, which just makes everything worse. When I hit this point its usually a warning sign that I’m a) not well or b) so tired I’m not functioning well. It results in me wanting to ostrich and run away from interactions with anyone but my most trusted. Crucially it also stops me being able to self reflect, take the learning and move on in a balanced way.

When I am strung out like this I get stuck on feelings and can’t process enough to really engage with unbiased evaluation. To me that’s what a shame spiral is, the inability to evaluate and therefore move onto the other sections of the reflective cycle. Therefore preventing real learning from the scenario to take place.

Its taken me a long time to see these warning signs in myself. To know when I’m wallowing in self recrimination rather than self reflection.

I sometimes wonder if it’s just me that does this, goes through this, reacts in this way? I don’t wish this on anyone else but in many ways I’m hoping I’m not alone. On the off chance that the Shame Club isn’t a party of one I thought I would talk about it and share some of the things that I’ve learnt to help me deal.

Break the Cycle

The first thing I need to do is to find a way to stop the spiral. Part of the reason for me writing this post is that the writing of it will support the processing. It will help me to move past feeling to evaluation and to put the incident into context. I need to stop relieving the moment and get to the point where I have distance to evaluate and learn.

Now sometimes I need more of a break than others to let this happen. For me as my spirals are often triggered by tiredness, just the process of getting some sleep can enable me to look on things with fresh eyes. If I can concentrate enough a good book can transport me enough, so can a complete change of scene such as a walk/bubble bath/run. Shame spirals were one of the reasons I took up running, I’m so bad at it all I can do is focus on taking one step after another and it breaks the thought process.

Get a Reality Check

Once I’ve broken my descent it’s key for me to really undertake an evaluation step. Was it really as bad as I felt? Was anyone hurt by what I did? What are the ramifications? Is it just my imposter syndrome screaming at me that I should be seen and not heard? This is where checking in with others is more useful. If I do it too early I can only hear the response through the lens of shame. If I get feedback at this point I am able to put it in context and therefore it’s more useful in terms of evaluating what my next steps should be. This process is the start of me regaining some balance.

Own it and Embrace the Learning

No one is perfect! I know we all know this but for me there’s is a gaping chasm between knowing this and feeling/accepting it. I am super aware of my flaws (I mean I bet there are ones I don’t know about, but the ones I’m aware of loom big in my mind). When I mess up, especially linked to a flaw I know I have, I feel the failure of it strongly. There’s no point in ignoring it however, the main thing is for me to acknowledge the failure or ‘not being my best self’ and try to learn from it.

The big thing for me is to try to work with the incident and take learning from that, separating out my emotions. For instance: I talked over someone in a meeting, I should apologise for it, try to be even more aware of that tendency and do it less in the future. The key thing here for me is to commit to reduction rather than setting myself up for future failure. I will do X less, I will do Y better. I acknowledge this is an interative process and that development takes time and continuous improvement.

I also try to work out the triggers for whatever the incident was and therefore consider if there’s anything I can do to support it not reoccurring in future. For instance I’m more likely to fail when I’m tired or unwell. I’m more likely to spiral as a result of that failure if I’m, you’ve guessed it, tired or unwell. The key learning therefore is that I need to take better care of myself, or identify earlier before the failure that I’m not in the best place.

I’m hoping that by hooking my responses and thought process onto the Gibbs reflective cycle that it will support visualisation of the steps I find helpful and might give you a framework if you ever have similar issues to use as a framework to help you through.

Also, let’s all remember:

  • Life is learning
  • Perfection is not all that interesting
  • We are often our own biggest critics

All opinions on this blog are my own

Coming to Terms With Not Being Superwoman: My turbulent journey towards work life balance

I’m writing this blog post on a tube on the way to work. I try not to work on the tube these days, I try to use it as time to get me into and out of the right head space for work. Right now my brain is whirling too much to focus and in circumstances like this I’ve learnt the best thing I can do is get some of those thoughts down into something productive.

I’m an all or nothing kind of girl. I’m not good at doing things in moderation. I’m not good with hierarchy, barriers and boundaries. Sometimes I like to think its why I’ve (to some extent) achieved. It’s my inner voice that moves me on rather than external drivers. The flip side to this is I also don’t know when and how to stop. The same urge that makes me want to cross artificial barriers imposed upon me mean that I struggle to impose them on myself.

This means that I find work life balance a difficult thing to identify sometimes, let alone to achieve.

Learning the hard way

During my PhD I didn’t have a full weekend off for three years. By the time I submitted my PhD and was preparing for FRCPath I had developed a discreet bald patch where I’d lost my hair and was doing a regular battle with angio oedema, where my face would swell when I tried to eat. I submitted my PhD one year early so I could successfully pass FRCPath first time, however the legacy of that time lives on in my deteriorated health.

I grew up thinking that success was about hard work. If you worked hard enough then you would be rewarded. If you got the qualifications then you would get the job. It was a really simplistic view of the world that I think I only woke up to not being true over the last couple of years. The fight doesn’t stop just because you are qualified to step into the role, that is when the fight actually begins. If you use all your energy and will power to cross the line to get the qualifications it will leave you depleted when you have to step into the arena for the true battle.

Succeeding and being good at my job is something that has always been important to me. Lately however I’ve begun to realise that giving it my all, all the time, isn’t in itself enough. I can’t work for the next 25 years until I’m due to retire with the intensity that I have worked for the last 10 + years. I need time away to really be successful. I need time to refresh my mind to enable me to bring the best version of myself to the challenges I face. Creativity needs energy not exhaustion. I don’t really feel yet that I have mastered or even begun to be able to prioritise stepping away in order to achieve this, but at least having the realisation is taking an important step along the way.

Facing the hard truth. We are all replaceable

I used to run, I was awful at it, but never the less I persisted. I haven’t been running since the pandemic started. I arrive home in a ball of flames at the end of the week and my husband spends the weekend putting me back together so that I go out and do it all again. This isn’t sustainable, and as time goes on I feel less and less than me and more and more like an infection prevention automaton. I have given up most of what makes me me to try and deliver for my job because I believe in it. This isn’t a long term strategy however. It is the bits that make me me that also make me good at my job. The other thing is that if something happened to me tomorrow, it is my friends and family that would mourn me. Another infection control doctor would be found. My stuff would be packed up and handed over and at most I would occasionally be brought up in conversation. I know this because I’ve already seen it happen to a colleague.

I worked with an amazing admin guy in my department. He’d been there for 15 years. A few years ago he went home one night, sat in his favourite chair and died. I’d worked with him for 10 years, he pulled my pony tail every time he went past my desk. He left chocolate on that same desk when I was having a bad day to cheer me up. He talked to me about his dogs, his music and his wife. After 15 years working in the department I was one of 3 people who went from work to his funeral. No one from the lab he supported went. My wonderful consultant boss went with me and our clinical lead went to represent the department. 3 people out of 40.

That day was a real revelation to me. The people who I spend more time with than my family may not feel the same way about me as I do about them. If the same thing happened to me would I even get three? Would I be replaced and never discussed in the same way after all those years of service? Sometimes I think my knowledge matters but I’m not convinced that I do. Then I think should it? After all this is a job, its not a family. The problem is as someone who is ‘all in’ sometimes I can find it hard to remember the difference.

Family is everything

Given all the above I’ve spent a lot of time thinking about how I balance the person that I am, the environment I work in and the need to re-energise and be the best version of myself. This has involved coming to the realisation that the thing that matters most to me and what I need above all else is my family. They mean everything to me. They have been my cheer leaders to get me to where I am, but they are also the ones who have suffered from me having my focus elsewhere. I have missed so many birthdays and special events due to being ‘all in’ elsewhere. Life is not a movie. Life isn’t a 3 part story arch about the workaholic who final finds love, moves to the country and raises sheep. It is however about constant learning and re-evaluation. So here is what I have learnt:

I don’t have the capacity sometimes to set boundaries for myself, but if I’m ‘all in’ for them that that is the start for me of being able to find a way to balance the demands of a job I love with the need to be ‘all in’ with those that matter most.

The top things I’ve learnt:

  • Spend time reflecting on who you are and what drives you
  • Know which things refresh you and which thing drain you
  • If like me you find it difficult to set boundaries find something/someone who can support you in doing so

I am far from having cracked this one but having done the thinking I feel I’ve at least taken some steps in the right direction. Like all things I’ll be taking it one day and one step at a time.

All opinions on this blog are my own

Just One More Sleep: Why ‘Freedom Day’ doesn’t feel like Christmas to those in infection prevention

Working in Infection Prevention and Control is basically about assessing risk. It’s pretty much what I do, what I eat and breath. So today I wanted to post (with that in mind) why I’m tired to the core of my being when I hear the joyful proclamations about the 19th July and so called Freedom Day, and it’s not just me others are definitely feeling it too.

This doesn’t mean that I don’t understand the strong urge to ‘get back to normal’. This is a very human trait. We all like to feel in control and this has been a prolonged period of high stress and uncertainty. I suppose my frustration is with the failure to really communicate that normality comes with a cost. It will likely bring economic benefits but it will cost some people their lives and NHS workers just a little bit more of their sanity. If as a society we agreed that the economics were worth it I would grudgingly keep my mouth shut but we’re not even having the conversation. There is no such thing as a free lunch and at the moment society is passing me the bill when I’m not sure I’ve brought my wallet.

It’s All About the Shades of Grey

For cognitive comfort we tend to feel comfortable seeing the world in black and white. The reality is (as with most things) that the world and decisions are made up of shades of grey. It is possible to live in a world where we are neither in complete lock down nor where everything is effectively considered back to normal and presenting increased risk.

When I’m dealing with an outbreak in a hospital setting (I acknowledge the situations aren’t identical) I bring in a series of measures to find the source and stop transmission. Often because of the risk to patients and staff you do all these things at the same time, in order to maximise your risk reduction. Then once you have identified the source and stopped further cases being identified you gradually reduce your measures.

You do your intervention reductions in this way for a number of reasons:

  • You often don’t know what is having the greatest impact so a step wise reduction enables you to learn more about how you might control a similar outbreak better in the future. You will know which interventions are most important.
  • Reducing your measures one at a time enables you to continue to monitor your cases. If they come back you know you need to maintain that intervention for longer and maybe step down others with a lesser impact first.
  • It tells you more about whether you have effectively dealt with your source without putting large amounts of people at risk again.
  • It stops you going all the way back to square one if you aren’t where you thought you were. You’ve worked hard to get things under control, so you don’t want to return to where you have an escalating scenario.

Stopping basically all of your public health measures in one go, masking, social distancing, most contact isolation etc without taking a staggered approach means that not only are you rolling the dice on your main intervention (vaccination) working in isolation, but also you are failing to gather the information you need to support staggered reintroduction of key control measures moving forward if it doesn’t.

Risk Assessment and Personal Choice

One of the things that has really struck me is that we are moving from a place where that risk assessment and risk reduction is guided at national level to personal assessment.

In many ways there is nothing fundamentally wrong with personal risk assessment. We ask healthcare staff to do this in clinical situations on a daily basis. What do I mean when I’m talking about personal risk assessment. In healthcare it could be something like: You are going in to take blood from a 4 year old child. Before you go into the room you might gather the following information in order to assess the risk and take steps to reduce it:

  • Is the child on its own?
  • Do they react badly to needles – are they scared?
  • Do you know the child? Do you have a relationship where they are more likely to trust you?
  • Do you have safety needles available to reduce the risk of a sharps injury?

The difference with the government approach to risk assessment and personal responsibility is that we are asking people to do this who are:

  • not necessarily used to undertaking this kind of assessment in relation to infection
  • not necessarily accessing the information/evidence to enable them to make such an assessment

It is hard enough working your way through the information and evidence that is related to SARS CoV2 even if it is your job. We are asking the entire of England to be able to do this with little or no support. The quality of information out there is highly variable and often not context specific to make it particularly usable. There is plenty of misinformation out there which could lead to individuals with the best of intentions making bad decisions.

Mixed Messages

This then brings me onto the mixed messages. The government is telling people to use the evidence to make their own risk assessments and then supporting events that are contrary to a lot of the information we are saying is important in making those risk assessments.

The evidence still shows that masks will be important in confined spaces or in areas with high people density. We are at the same time encourage events where people in their thousands meet without those measures included. You can say that the research events are there so you could obtain data to improve future measures and risk assessments, although when only 15% of those attending complete the post event testing the outcomes become dubious. Outside of the research events however, large numbers of people are gathering in public settings, such as Trafalgar and Leicester Square, with no testing or monitoring. These events cannot be said to support the same goal.

It is not rocket science that combining alcohol and emotion can lead to the abandonment of key sections of the risk assessment process.

One of the other things we need to talk about is that personal risk assessments are fine, but in this particular circumstance your risk assessment and behaviour directly also impacts my risk. Mask wearing is about protecting others, so if you opt out of wearing a mask and I wear mine, I bear the brunt of your decision.

We are also not talking enough about how the knowledge linked to vaccination may impact on risk assessment. I know a lot of people who feel like SARS CoV2 doesn’t impact on them any more because they are double vaccinated. In healthcare we are seeing a lot of people who are still getting pretty unwell despite their vaccination status. They are not hospital unwell, but they are still pretty unwell, can’t get off the sofa unwell. They are also still able to pass on the virus to others in their household, at work, or elsewhere. Some of the people then exposed will not be able to have the vaccine, such as children or those with certain underlying conditions. They can therefore still get very sick. Again, the transmitter may not experience such extreme personal consequences but they can cause them for others.

The government messaging doesn’t strongly support prevention of harm to others. Personal choice makes it sound all about the person. A pandemic response however is about as much of a group effort as you can imagine mounting. Personal choice undermines all of what we have been trying to message and removes that shared responsibility.

If we are truly serious about supporting individuals to make their own risk assessments then we need to do a much better job of giving them a framework and high quality information in order to make it. We also need them to understand the consequences of making an incorrect risk assessment. I have no answers on this one, just anxiety and fear about where the current approach is leading us.

All opinions in this blog are my own

It’s Time to Talk About the F Word… Not that F word. We need to Talk About Failure

I’ve been a football fan for almost my entire life. I’m an Aston Villa fan so I know quite a lot about loss, quite a lot about hope, followed by broken dreams. So Sunday’s England game is not my first road show. I have also faced a fair number of road blocks on the road to success. Most people look at my career path and see success and progress. I look at it and see all the people who told me I wasn’t good enough, that I couldn’t make it, and that I didn’t have what it takes. I see the fire and determination that built up in me to show them they were wrong. It’s one of the reasons I’m so passionate about lifting others up. I’m no stranger to failure, but my experiences have taught me to believe that failure is actually critical to success. We come back from it stronger. We also (if we take the time) come back wiser, having learnt the lessons it offers us.

My bad relationship with failure started early

When I was at secondary school I took a history exam, I got 96%, my father jokingly asked what happened to the other 4%. I took it to heart and was crushed by my ‘failure’.

No member of my family has ever failed an exam, not a driving test, not an academic test, nothing. It was just not done or considered a possibility.

So imagine my horror when I became sick whilst doing my GCSE’s. I went from planning to sit 11 GCSE’s to only being able to go to school for an hour a day and being allowed to sit only Maths, Duel Science and English. I was well enough in the build up to revise for a single weekend. I had been told that all plans to attend university needed to be revised and that I would be lucky to attend Sixth Form. I was a failure. People were planning for my complete academic crash and burn. This was super hard for the girl who had never considered anything else but an academic future.

So I took a beat, or, in reality, quite a few, and decided screw it. I would not be defined by being ill, I would not be defined by being a failure. I got my 5 GCSE’s and found a Sixth Form that would take me. The first year of Sixth Form I still couldn’t attend normally. I did 2 A-levels, Biology and Drama. I also did General Studies, mostly as I didn’t need to turn up for class. My Drama classes were end of day, so I could crash out. It was only the Biology that was the stretch. In my second year I realised I needed a third subject to go to uni. I found a Psychology teacher who allowed me to attend classes at evening school as well as during the day. I covered the minimum amount of topics to be able to pass the exam. I crossed my fingers and hoped that I would overcome. I got my 4 A-levels, I came second in my year and I got into Uni. I took a year off in between as I still was not well so that I could maximise my chances. Needless to say this journey left me a fair number of hang ups about not only failing, but not being able to keep up and whether I was ever going to be good enough again to be accepted by my peers.

My rocky journey to learning to, if not love, then at least to appreciate failure

Since our rocky start, failure and I have gradually come to an uneasy détente. I try to avoid it at all costs and it reminds me that it is an ever-present part of life. Rather like that relative/friend who always turns up at parties, even if they haven’t actually been invited. In recent years, we’ve spent an increasing amount of time in each other’s company and, although it surprises no one more than I, I actually have some good things to say about about the F word thatcan make you better in the long run.

Sometimes you need to feel the fear

Let’s start with the easier things to like. I often talk to my students and mentees about the benefits of feeling the fear. Fear of failure can be overwhelming, leading to paralysis. However, if you can manage the fear it can be used to motivate and focus the mind. This is especially true with high-stakes assessments, such as exams or dissertations. There are different ways that can be used in order to harness the fear of failure to your advantage: from being prepared far enough ahead that the fear is spread over time, to working with peers to support bench marking and fear control. Different strokes for different folks. The main thing is to not hide from it, but acknowledge it and manage it to your advantage.Failure, however, comes in all shapes and forms, not just as high-stakes encounters. It happens in leadership conversations, data analysis and day to day life. When the inevitable happens, and it is inevitable, you need a plan for how to address it. Below are some of my tips about how I face, process, and learn from failure.

Separating the failure from the person

I often shock people when I say I fail all the time, but it’s true. I fail to have conversations in the way I want, I fail to always be there for my team in the way I want to and I most certainly fail to keep on top of my workload. That’s before I even begin to talk about failing to have any work life balance or to give my husband the attention he deserves.

One of the things that has really helped me to manage some of the guilt and fear linked with these failures is understanding that most of them are linked to roles that I play. That doesn’t make them any less significant, but it does enable me to box them and learn from them without them creeping into everything I do and impacting on how I feel about myself as a person. Dr Cloutman-Green often needs to do better and learn from failure in terms of how that outbreak phone call went. That doesn’t mean that Dream is a failure at all she does. It’s about placing sufficient boundaries on the failure to give me distance to permit reflection and learning.

Allowing time to grieve and emotionally process

Now, you may all be better people than I and leap straight into the ‘learning’ post-failure. I’m afraid I don’t have that much mental strength. I need ‘wallow time’. Time to process the emotions linked to what’s happened, so I can move forward and reach a point where I have the cognitive space to reflect. Reflection for me needs to have the emotional response removed. I don’t believe in bottling up my emotions for a later melt down so I allow myself a grieving period. This is normally 48 hours-(it can be a week if it’s something big) where I allow myself guilt-free to feel. To express (in an appropriate way) my frustration/anger/disappointment targeted at the failure. This helps me understand the level to which the activity linked to the failure mattered to me. Is it worth repeating, do I care enough to end up potentially back in this place? I usually do this in the company of my two coping mechanisms: cake and gin. They’ve been my companions in failure for over 10 years, so they are experts in handling me and getting me back to a balanced viewpoint.

Devoting time to reflection to support learning once the grieving us done

So we’ve acknowledge that the failure sucks. We’ve learnt that we care enough about whatever it was linked to that we are prepared to put on the Big Girl Pants and get back into the foray. Now is the time to sit down and learn the lessons in order to reduce our chance of ending up back with cake and gin.

If the failure is linked to things like paper or grant failure, now is the time to open that dreaded feedback and spend some time with it now your emotions are under control. Which parts of it are the things you secretly knew were true? Which parts, despite feeling harsh, can be used to make what you’ve done better for the second time around? If it’s for an exam, which parts didn’t go well? How will your planning and preparation address these next time? If it’s that you sucked when having that conversation or argument, then now is the time to reflect on why and be prepared to dive back in there and try it again. Hopefully the next time will be better.

It’s rarely as bad as it feels in the moment

Some of the time I take when reflecting and learning lessons is to think: if this had happened to my best friend, what would I say to her? We are often our own worst critics. As well as the learning, and sometimes to help with this, thinking of how you would handle this as a friend means that you can review it from a different viewpoint. This can not only help your learning but also put it in a context that may enable you to be just a little kinder to yourself.

Failure is context specific, so find the right people to support your thinking

If you can’t manage distancing during reflection, this is the time to call on your champions in order to get them to help you. My husband, who is a great fan of telling me that experiencing a little failure would be good for me, fulfils this for me. I will arrive home in floods of tears because I haven’t met X deadline. He will ask “did anyone die?” No. “Did anyone get fired?” No. “Was anyone hurt in anyway?” No. “Then either let it go or put it in late, there will always be another X.”

Sometimes we all get so bogged in the weeds of what we should be doing that we find it difficult to put our failures in the context that they deserve. Can you try again? Almost always. So why are you still here? Learn the lessons and go try again. Good luck with that. If you fail I’ll be here with my good friends gin and cake to help you recover, reflect and learn.

All opinions on this blog are my own

What’s Your Get Psyched Mix? How I use Music to Support my Work

Music has always been an important part of my life, from singing with the Birmingham Royal Ballet for eight years before Uni, to the freedom I find dancing (badly) whether it be in my kitchen or the lab. I’m not knowledgeable, but few things hold memories and modulate my emotions is the same way as listening to music, be that classical, alternative or pop. The key moments and people in my life all have music linked to them: from the Blue Danube for my sister to Dean Martins’ Somewhere Beyond the Sea as the first dance at my wedding.

I have written dissertations, produced my PhD thesis and undertaken specific experiments, all linked to specific pieces. In fact I really struggle to do much in silence. I’m not very good at only doing one thing at once. For me,, despite it being counter-intuitive to some, music helps me focus rather than acting as a distraction. The only time I can work comfortably in silence is when I’m verbalising to support memory, i.e. revising or learning lines.

In an episode of ‘How I met your mother’ Barney (one of the main characters) introduced the idea of a ‘Get Psyched’ mix. I found this idea really useful and have since produced my own ‘Get Psyched’ playlist which I use to address particular challenges I face in work. For today’s post I thought I would share how I use them and give some example tracks for each. Warning – I enjoy cheese and angry girl music so my taste will not suit everyone. I make no apologise for the smell of fromage coming from this post.

Music to Boost my Confidence

We all have days when imposter syndrome hits. As Healthcare Scientists, we also have high stress key assessments, such as FRCPath, that need to be faced. One of the key times I have used a playlist was during my 4 days of FRCPath examinations. I listened to a set of 10 songs to train my brain to get into the right headspace. I would listen to them whilst walking to the examination centre. I would listen to them at lunchtime. I would listen to them in breaks if I felt that I was starting to go into an anxiety loop. All of them took me back to a space where I could focus on why I was doing this high-stakes exam. They helped me focus on the finish line rather than being distracted by the steps along the way. They brought me back to be able to see the big picture. In a space where I felt out of control they gave me routine. It was the same 10 songs. I didn’t need to add to my cognitive load of thinking about what I wanted to play. They freed me and, by the time I reached the end, I had my game face on and I was ready to face anything.

One Off High-Stakes Events

Music for me in this context is when I need to hit my ‘movie moment’. You can picture it: It’s that moment in a movie where it is reaching its denouement. They are about to face that crucial encounter/combat/story moment. The music comes on and (as my husband says) it’s all about the slow walk into the camera.

These are usually one or two songs that I will play in the lead up to a difficult/high-stakes moment: sometimes a meeting that I’m worried about, sometimes a presentation that’s making me nervous. It has to hit my soul fast and hard. It has to make me want to sing out loud. It needs to make me want to strut. If you ever see me walking up and down a corridor mouthing to myself, this is usually during one of these moments. So much of how individual events turn out are based on the mood and the mental space you are in when you walk through a door. I like to make sure I do it in slow-mo with presence!

Music to Reflect and/or to Boost Your Mood

Sometimes music for me is a way of allowing me to express negative as well as positive feelings. No one is up beat all the time. Working within Healthcare Science, and especially as a clinical academic, there’s a lot of failure: grant failure, paper rejection, barriers based on professional background. That’s before we even talk about being a woman in science. When I get grant rejections etc. I always say to my students that I allow myself to mourn for 48 hours. I then get myself together and get back on that horse. Music is key to this. I play my angry girl music and process my disappointment in a focussed way that allows it to be to put in a separate box from the rest of my working and home life.

Once I have spent my allotted 48 hours, I put on music that brings me back to myself. Fighting music to get my head back in the fight. It draws a line under the wallowing and brings me back to a place where I can draw on0 learning from the failure I’ve just experienced without it being tied to negative emotions. I challenge the world to ‘bring it on’. I’m ready!

Music to Focus The Mind

We’ve all been there. It’s late and you’re still in the lab. You’re tired and you have just one more thing that you need to do before you go home: You need something with a beat to energise you, something you can sing to in order to help you keep awake as caffeine requires leaving the lab. For this I generally have my girls: Beyoncé, Lady Gaga and Taylor Swift. I have been caught by my old consultant dancing with tubes across the lab to Single Ladies and I make no apologies for it.

The other times I use this kind of music with a really defined beat is when I’m writing. It helps me keep the tempo up and my production level high. When I have a deadline the music definitely goes on. As time goes on, if needed, I tune out the words and I just type or pipette to the beat and get into a zone that means I can work for hours. Without music getting into this particular head space can take hours. By using the right music I can get there in a couple of tracks.

I’m writing this as I’ve found music such a helpful tool in terms of getting me into the head space I need to occupy in order to succeed. I also thought it might be helpful to explain to those people who don’t use music in this way and think that it’s just a distraction tool from getting things done, that the opposite may be true. We all work and focus differently. I’m at my least productive in silence. If I put my headphones in, understand that it’s not that I’m ignoring you. It’s because I’m getting into the headspace where I do my best work. Also, if you hear Freak on a Leash by Korn or Head Like a Hole by Nine Inch Nails through my office door, approach with chocolate or caffeine in hand as some significant rejection is likely to have occurred.

One final thing. This post is in honour of the fantastic She’miah. She’miah is our team PA. She’s truly amazing and she’s leaving in 2 weeks. I will miss our bathroom office disco pick me ups more than I can say This last one is for you girl!

All opinions on this blog are my own

Talking About the Taboos: My Journey to being an ‘Obstinate Headstrong Girl’ Whilst Working in Science

I’ve had a few encounters recently that have led me to write this blog. I’m not writing it as an expert; This isn’t anywhere near my field. I’m writing to share my experiences and learning in case it helps others. Apologies, as it’s not a short read.

I’m challenged by some people I that I’m too worried about raising the profile of women in science, of talking too much about ‘female’ issues, and of challenging my colleagues too frequently. A really respected mentor once said to me that he didn’t think actions against women in the workplace still happened. I shared some stories and pointed out that they still did, they just didn’t happen to him, where he could see them or when he was paying attention to them. I count myself lucky that nothing really serious has ever happened to me at work, but I shouldn’t have to count myself as lucky: they just shouldn’t happen.

I have another post brewing about everyday sexism in the workplace, but this one is different. This one is about why I set out becoming the ‘obstinate head strong girl’ that I aspire to be!

I finished my undergraduate degree in 2002 and spent a year working before returning to undertake an MRes. This was my first experience of full-time ‘proper’ work. I took a six month temp contract for a council, working in their business development office. It was a mostly male floor, supported by myself, two other part time admin staff (both female students) and a lovely older lady who managed the team. My job was to support the officers in tasks such as typing up letters. Yes, they wrote by hand as some of them still didn’t know how to use a computer; I also ran reception, took minutes, that kind of thing.

The Problem is that You are Too Friendly

I’d been there about a month when I was in the post/stationary room stamping that day’s mail. One of my older male colleagues came up behind me and stuck his erection in my back and grabbed my breasts. I stood there, stock still, in complete shock. I didn’t know what to do. These things didn’t happen to me: I was the nerdy girl not the pretty girl, I had no experience of how to handle this kind of breach (I am not implying that pretty girls should know, or have to put up with this either). After what felt like hours (but was more likely a few minutes) where he spoke to me about what we should do next, I shoved him away and ran out of the room.

I went to my boss, the person responsible for me, and told her what had happened. She said she would speak to her boss, who also happened to be the boss of everyone on the floor. I recovered from my shock and got angry whilst I waited, but I was sure there would be censure and we could all put this behind us. She came back and we talked. She explained to me that I was overtly-smiley and chatty with my colleagues. This could be misconstrued and, in future, I should probably just take steps to not be alone with the man that had done it. That was it. The married man with multiple children could do what he wished as it was my friendly demeanour that was the issue.

I spent the next four months being hyper-aware of when I could go into rooms on my own, to be friendly, but not too friendly. As my contract end-date rolled up, I experienced a similar repeat performance from the same individual. It wasn’t as bad this time as I had learned from the first event, but I just couldn’t let it go. What if he went further with someone else, what if he did it to someone else who wasn’t in the privileged position I was in to ‘let it go’. On my last week with the council I emailed HR directly to express my sadness over the way the situation had been handled. They told me to get a cab down and speak to them. I did. I recounted the event, the way it had been handled, the way I felt. The guy got suspended on full pay whilst an investigation was undertaken. I was called back in to repeatedly account for the event and my actions. It was determined that as it was my word against his nothing could be done. I learnt early that even when people listen, accountability is not always the result. No policy was changed. At least the guy had a note on his record in case he did it again so that it was no longer the ‘future girls’ word against his.

I’m ‘lucky’: that was the worse thing in a workplace that has ever happened to me. We all the know of the labs where you wouldn’t apply to work at because of the way the PI behaves, or the ‘expectations’ placed on the post docs if they want to advance. It didn’t interfere with my progression. It did, however, teach me an important lesson about the importance of bystanders. However annoying the bad behaviour of the individual was, the worse thing for me was that the people I trusted and who held responsibility for my safety at work chose to make it about me being too smiley, rather than address the action of the person who had breached barriers and made me feel unsafe. I swore that I would never be that bystander and I would support others so they would not feel as alone as I did in that workplace.

The Problem is that You Are Not Friendly Enough

Roll on some years and I’m now working as a scientist with a part-time academic contract. I’ve learnt the lesson taught to me about not being too friendly, about boundaries at work, about always keeping it professional so my actions couldn’t be used against me. I’m working as the only microbiologist on a research project. The PI on the grant begins to spend a lot of time with the other female researcher. Late night drinks, wine in the office, that kind of thing. I stick to my guns about being valued for what I can add to a project: that doesn’t require me to be available to have drinks with the boss at 9pm. Suddenly, protocols are written that are not technically appropriate, papers are written without a standard authorship order, and presentations and conference trips are handed on the basis of time spent with the PI. When queries and issues are raised, I’m now told that I’m not committed enough, not friendly enough, I’ve not invested enough in building relationships outside of work structures. Unlike before, my future is impacted because I have not walked the tightrope of being approachable well enough. The difference this time is that, although I cried, I simultaneously empowered myself to leave by looking for funding to support an exit. Again, I was fortunate enough to have a way out, to be a clinical academic rather than academia being my only option. I had also started to learn the power of finding my tribe, and making sure that I always had support from other embedded around me. This enabled constructive challenge of my perceptions, but also assurance when things went awry.

Why are you Reacting to Such Little Things? It’s only people being friendly/joking

I’ve now been working as a scientist for 17 years. Issues crop up less frequently the higher you climb up the ladder. However, when they do they always feel like high stakes. I’m no longer in a position where I could easily find another post, co-applicants on grants are harder to switch around as the world we inhabit is small, and relationship building is a key part of my role. So do things still happen?

Sadly, the answer is yes. The thing that makes the incidents happening now worse, in many ways, is that they get laughed off as being linked to me being overly sensitive. I still try to embody the friendly girl I was at 22 without opening myself up to unwelcome physical acts at work. I have, however, on 3 occasions being kissed full on on the mouth in unsolicited encounters with male members of staff. None of it threatening, like when I was in my first job, but still unwelcome. Blocked doorways that, as you’ve tried to go through, have resulted in a facial assault because ‘its Christmas’ or because it’s someone’s ‘last day and they just want to say thank you’. I’m by no means prudish but the only person who gets to kiss me on the mouth is my husband! Uninvited physical intimacy is just not OK. It always comes as a shock and it always takes me back to being a 20 year old with no coping mechanisms standing in a post room.

What happens most frequently however are the comments. Just before the pandemic I was in Paris at an academic meeting. The organiser forgot to book my second night in the hotel. I’m sitting there in a room full of senior male academics at the dinner when the organiser came through and said I had no room. The most senior man in the room responded by saying ‘don’t worry about booking her in the extra night, we’re in Paris, there are more than enough brothels where she could go and work in’. Every man in that room laughed. No one called him out, no one indicated that the comment was humiliating and inappropriate. I didn’t know what to say and so sat there in silence as they laughed away. This isn’t a one-off event. The ‘little ladies’, ‘sweethearts’ etc. may feel innocuous enough but are too frequently used in conversations to undermine women in the room. That’s not to say I’m anti-endearment. I have plenty of colleagues where we have built up relationships over the time where I welcome this reinforcement of our relationship. It is different to do it when your relationship capital doesn’t justify it, or when you are doing it in order to enforce power or hierarchy.

So why have I written this post? I want to let people know that these behaviours happen. It’s unwelcome and it’s not up to the women involved to modify who they are in order to not tempt others to behave badly.

Here, therefore, are a few of my thoughts about how we can all act differently:

  • Don’t be a bystander! Know that if you are in the room you have a duty to act as the impacted individual may not be in a position to do so.
  • Find your tribe so you have support for when (and hopefully if) these events occur.
  • Talk about your experiences so that we can raise awareness, share learning, lead improvements and, most importantly, so others don’t feel alone.
  • Know that you have more power than you feel like you do. There are people out there who are ready, willing, and able to support you.
  • If someone comes to you with their story remember that you have a duty of care. Don’t brush things under the carpet because it is easier to do nothing than deal with a situation.

Finally, to all my obstinate headstrong women out there who are standing up and challenging, I applaud you. I appreciate all you are doing now, I appreciate the fact that you are leading the way and that you are members of my tribe. To all those who consider me difficult for calling out these situations when I see them, I understand why I make you uncomfortable, but I have no plans to change. In fact I plan to grow into this role more. In my opinion we could all do with a channelling a little Elizabeth Bennett from time to time.

All opinions in this blog are my own

Guest Blog from Francis Yongblah, Kip Heath and Anthony De Souza: Healthcare Scientists Celebrating Pride Month and why Visibility is still so Important!

It’s the end of Pride Month 2021, but that doesn’t mean that the fight for equality has ended. Healthcare scientists that are part of the LGBT+ community talk about why representation is important to them.

Francis Yongblah, Microbiology Laboratory Manager and HSST Trainee.

As a Gay, Asian Healthcare Scientist, representation of the LGBTQ+ community in Healthcare science is crucial to me. I have been a Healthcare Scientist for just over 12 years and in that time I have experienced and been exposed to homophobia and prejudice in the laboratory workplace. Although these incidents were very early in my career, these scenarios have always stayed in my mind and something that I have never forgotten. Early on in my career, I felt that I had to hide who I was as an individual and could not actually be me for fear of being judged or treated unfairly. These scenarios made me worry that, because of my characteristics of being a gay man, my professional development and career would have been hindered. No healthcare scientist should feel like this, and it’s important for everyone to recognise the attributes and contribution that a diverse workforce can bring to a service, team and the positive impact it can have on patient outcomes.

I have worked hard as an LGBTQ+ Scientist in order to ensure that my career has been able to develop and I can go as far as I am able to and not to be held back by my sexuality. I feel it key to have representation for the healthcare scientist workforce in order to be able to recognise how key it is to have a diverse workforce, as well as recognising that there are LGBTQ+ Healthcare Scientists within the workforce. We’ve now come a long way from when my career had just started out and I feel proud to have my organisation and the NHS represent and support LGBTQ+ Healthcare Scientists. There has also recently been a lot of support from the Institute of Biomedical Sciences (IBMS) to promote the LGBTQ+ Healthcare Scientists in our workforce.,

Kip Heath, Deputy Trust Lead Healthcare Scientist and Science Communicator

For me, it’s essential that we foster a workplace environment (and, indeed, a society) in which people are accepted regardless of their gender or sexuality. I’m a queer woman married to a cis heterosexual man. He’s a wonderful and supportive individual and the only person I could imagine taking on the world with. But, to that outside world, we are a standard heterosexual couple. On the one hand, that can be an advantage as I can hide my sexuality fairly easily. However, there have been workplaces that I’ve not felt comfortable or accepted as myself. But I have found that my identity can be easily erased, even by other members of the LGBT+ community.

Now I work in leadership positions where I need to provide support across the healthcare science workforce. My boss talks about the importance of bringing your authentic self to work and leading by example. Our workforce is hugely diverse and it’s important that we demonstrate that. I want to make sure that LGBT+ healthcare scientists in our Trust never feel like they need to hide themselves at work and that there are people that they can open up to if they have any issues. In my role as a science communicator, I raise awareness of healthcare science careers to students and show them that the profession is open to LGBT+ scientists, and that their sexuality is not a barrier to progression.

Anthony De Souza, Practice educator for HCS, HEI lecturer & LGBT+ Forum co-chair

Representation is important to me because, when I grew up, there was no one in my life or on TV that was like me. This added to a feeling of invisibility and isolation, making me feel like I didn’t matter and that there was no place for me in society. I’ve been lucky enough to feel safe enough at work to be myself these days, but everyone’s situation within an organisation will differ.

We know that diversity equates to strength but what are we doing to create an inclusive space for scientists? Science is a diverse and ever changing space where a variety of perspectives yields better conversations, we need an environment that actively supports that. We also need to recognise that much of the discrimination individuals may face happens before they’ve even accepted a job offer, this could be binary choices on demographic questions or uniformity of interview panels.

To be our best at work we have to commit our energy and focus for the good of patients’. We can only do this if we don’t have to constantly edit how we act to fit a pre-defined notion of ‘normal’, react in real time to how we’re perceived or routinely have to deflect micro-aggressions. 

Shining a light on excellence throughout the workforce of scientists from different gender identities, sexual orientation, disability, age or race is important for visibility. We need role models that we can relate to and learn from. This also challenges the wider communities’ pre conceived notions of what a professional usually looks, sounds and acts like.

Today you are you, that is truer than true.

There is no one alive, who is youer than you

– Dr Seuss

All opinions on this blog are my own

Roll Up Roll Up: Join us for a host of events running on the 3/4/5 June as part of the Rise of the Resistance Festival

It all started with a conversation Help us keep that conversation going and enjoy some great events along the way!

Rise Of The Resistance is a digital festival of creative responses to Antimicrobial Resistance (AMR), on 3 – 5 June 2021.. Curated by NOSOCOMIAL, an award-winning collaboration of Healthcare Scientists and theatre makers which hosts performances, panels and events.

We have events designed for:

  • Children and families.
  • Those interested mainly in the science.
  • Those mainly interested in the creative pieces.
  • A grown up audience (due to language content i.e. swearing).

A link to the Eventbrite for all bookings is here

Healthcare Scientists are 5% of the NHS workforce in the UK, responsible for 80% of diagnoses. Rise Of The Resistance celebrates the impact of Healthcare Science. It seeks to reinforce relationships between Healthcare Scientists, patients, families and the public, believing that better communication and understanding are vital for managing future threats to global health such as AMR.

NOSOCOMIAL comprises around 25 scientists and artists. We won the 2019 CSO Partnering Patients and Citizens Award, and 2020 Antibiotic Guardian award for Public Engagement. Rise Of The Resistance is our first festival.

Events For Children and Families

SOCK THE PUPPET – aimed at families and children aged 7 and under

Fri, 4 June 2021 – 10:30 – 11:30

A story for children about Socks, Science, Superbugs and Making Friends, narrated by Stephanie Houtman

Meet Sock the Puppet. Sock is excited to go and sing for the children in Hospital with Ms Clown. Sock loves the Hospital. It is always clean and tidy.

The children love Sock’s singing. All the children hug Sock.

When Sock catches all the bugs that make the children poorly, Sock has an adventure to the cleanest, tidiest place in the whole Hospital: The Laboratory.

Can you help Sock find a way back to Ms Clown and the children?

Join us at Rise Of The Resistance for the story of Sock, narrated by Stephanie Houtman (Peppa Pig Live), directed by Saskia Marland, with a special appearance by Sock.

After you book tickets, you will receive a worksheet to make your own Sock at home, designed by artist and maker Abi Bown.

Created by the team behind Nosocomial and Remember, Remember! – playwright Nicola Baldwin, and Healthcare Scientists Vicki Heath and Dr Elaine Cloutman-Green BEM, of Great Ormond Street Hospital.

Sock The Puppet will also be available as a podcast.

With thanks to Eibhlin Jones, Laura Walsh, Amy Sutton and Tara Kearney.

Book here

REMEMBER, REMEMBER – aimed at families and children up to GCSE age

Sat, 5 June 2021 – 11:00 – 12:00

Join our time-travelling zoom Healthcare Science in a detective drama about the “True” story of the Gunpowder Plot. For ages 5+ to 105+

A Zoom storytelling science drama.

REMEMBER, REMEMBER! is a pre-recorded Zoom drama. You will receive a link to watch the online premiere.

Activity books, and script, will also be sent out so people can take part at home.

London, 2021. Healthcare Scientists Lily, Rosa, and Frank receive a mysterious message for ‘HELPE’ on one of the machines in their hospital laboratory.

London, 1605. Plague stalks the land, leading to unrest… and a plot to blow up the King and Parliament. Guy Fawkes is arrested and the race begins to track the rest of Gunpowder Plotters.

Remember, Remember tells the amazing story of how three Healthcare scientists set out to foil the Gunpowder Plot, with the help of nine year old Princess Elizabeth, a malfunctioning MALDI-TOF machine and the weird and wonderful mysteries of Microbiology, Haematology, Biochemistry, Immunology, hand-washing, and… time travel.

And they need your help.


LILY / SIR JASPER – Jennifer Daley

ROSA / TOWER GUARD – Becky Simon

FRANK / GUY FAWKES – Jonny Wright


Produced by NOSOCOMIAL

By playwright Nicola Baldwin and Dr Elaine Cloutman-Green, Lead Healthcare Scientist at GOSH. Activity Packs created with Anthony Manuel DeSouza, with input from Fionnuala Wilkins at GOSH school, and Amy Sutton of GOSH Youth Forum.

Thanks to Hannah Jones, Peter Hamilton Dyer, Abi Bown.

Originally produced for Pathology Week 2019, supported by HSEWG and The Royal College of Pathologists (RCPath) as an online drama for children and families in hospital isolation due to illness, revived in 2020, and made available thanks to the Society for Applied Microbiology, as the whole country went into isolation..

We hope it will provide an informative and entertaining way to learn about viruses and bacteria, and that you enjoy watching it at home.

Book here

IF I DON’T PLAY I WON’T UNDERSTAND. Plus PPI panel -an interactive drama experience for the whole family

Sat, 5 June 2021 – 14:00 – 15:00

Welcome to the “Bacterial Leisure Centre”! We are the best fitness centre for bacteria in the microbiome to train for bacterial success!

Our Leisure Centre is located in the heart of the breathtaking Microbiome Resort, set in a 2,700 square feet of the Gut. The Centre is provided with anatomy room, gym, quorum sensing zone, reproduction area, and many other 1st class facilities.

Our team of experienced trainers will coach and guide you in this adventure of becoming bacteria, and they will make sure you will have an unforgettable experience.

What do you need to do?

Sign up to a free virtual taster session on Saturday the 5th of June @2pm.

Be prepared to renounce your humanity for the duration of the taster session.

As part of our fitness activity, we will ask you to play games and move your body.

No previous fitness experience is required, but be ready for a lot of fun and games activity.

“If I don’t play I won’t understand” is an interactive digital game performance, combining transmedia storytelling and fictional reality with games and movement activities.

Inspired by choose-your-own-adventure books, audiences are invited to sign up to a virtual “Bacterial Leisure Centre” where they renounce their humanity to train to become bacterias.

After a welcoming virtual tour of the Centre, the audience can choose their own adventure by deciding which training room they want to enter. Once in the room, the audience will meet a specialized trainer that will train them to become bacterias by using games and participatory activities.

“If I don’t play I won’t understand” is designed and directed by Monika Gravagno, the AD of Facciocose Physical Theatre company.

This will be a participatory physical theatre/workshop to explore communication and expression from a microbial perspective.

Followed by a panel discussion: How To Engage An Audience With ‘Difficult’ Science

After the workshop, stay for a panel discussion and Q&A with the makers and invited guests, to explore the outer limits of public engagement; the mutual benefits of PPI to artists and scientists in framing research questions, and creating new forms of work.

Book here

For Those Interested in Talking Science Supported by Drama

SPIRALLING & How Do We Begin The Conversation?

Fri, 4 June 2021, 14:00 – 15:00

In a time when views are drastically polarised, could questions potentially bring us together and not drive us further apart?

Screening of SPIRALLING by Jimena Larraguivel, followed by a panel discussion with Dr James Hatcher, Dr Melisa Canales, Professor Brendan Gilmore, Sue Lee: on PPI, clinical trials, and how do we begin the conversation on AMR?

“The idea behind this short film emerged in response to the overwhelming amount of information available on social media, which has undoubtedly had an impact in the way I navigate motherhood and take decisions in the best interest of my children. In a time where cancel culture seems to be the norm, it’s daunting asking questions. However, in a time where views are drastically polarised, aren’t questions what could potentially bring us together and not further apart?”

Book here

INTO THE BREACH & Bugs v. Behaviour

Fri, 4 June 2021 – 16:00 – 17:00

The doctors want to be sure that I’m not using. Fair play, I get it, course, I do. But I’ve been with heroin since I was 17. It’s up here.

Screening of INTO THE BREACH by David Milner, followed by a panel discussion with Dr Jane Freeman, Angela Mwape, Ruth Thomsen and Francis Yongblah on bugs, behaviour, their impact on on AMR, and what we really mean by ‘hard to reach patients’.

“Hostel dweller COLIN reflects on his past life and uncertain future while negotiating the reality of London’s streets. Colin’s in limbo, awaiting an operation; his body must be drug-free for surgery, but addiction has been the one constant in his life.”

Adapted from a short story by David Milner.

Book here

ME AND HER & Human and Animal Impact of Infection

Sat, 5 June 2021 – 15:30 – 16:30

How do we cope with the total disruption of infection? What’s the prognosis for the things we take for granted in our lives?

Screening of ME AND HER by Rebecca Simon, followed by a panel discussion with Professor Mark Fielder, Dr Elaine Cloutman-Green and Professor Nicola Williams, on the impact on, and of, human and animal behaviour in AMR, and the need to focus on One Health.

Home is where the heart is, where we feel most like ourselves. After almost seven months living in a ten by twelve foot hospital room with her sick daughter, Zoe escapes to home. To feel like herself again and that she still exists outside of that hospital room, outside of being a mum. But home doesn’t feel like home anymore, there’s been a shift, things are not as she would have them. She feels displaced and lost.

ME AND HER is a short film exploring the experiences of parents, carers and their families whose lives are profoundly altered by long term hospital stays. When suffering through a difficult and challenging time in their life, how do parents who are carers cope with the total disruption of their lives? What’s the prognosis for their careers, relationships and sense of identity?

Created and performed by Rebecca Simon

Produced by NOSOCOMIAL

Book here

For Those Who Want Some Drama About Science

The Piece That Started It All – NOSOCOMIAL & Collaboration within Public Engagement

Fri, 4 June 2021 – 20:00 – 21:00

Verbatim drama premiere. There is nothing weird or wonderful you can imagine in human experience I haven’t seen. I’m a Researcher in Humans

When I say I’m a healthcare scientist, they ask “do you work with animals?”When I tell them I work in a hospital, they say “are you a nurse?”There is nothing weird or wonderful you can imagine in human experience I haven’t seen. I’m a Researcher in Humans.

Screening of NOSOCOMIAL followed by panel discussion on Collaboration within Public Engagement with Dr Lena Ciric, Saskia Marland and Monika Gravagno.

Jo is not well. Something strange is happening. As a scientist, she can resolve this. Unless the world is infected. Unless it’s everywhere….

Kitty, Helena and Paul work through the night. An hour can make all the difference. Part thriller, part puzzle, the science of life and death.

Join us for the online premiere of our short film.

JO – Jimena Larraguivel

HELENA – Becky Simon

KITTY – Nicola Sanderson

PAUL – Peter Clements

Healthcare Scientists are 5% of the NHS workforce, responsible for 80% of diagnoses.

Forensic pathologists are a staple of TV crime drama and Healthcare Science has dominated news headlines during months of pandemic, yet the role of Healthcare Scientists themselves remains largely unknown. You don’t see us on Holby. Science is too ‘difficult’ without explanation. Yet working in basement labs,working with patients, working with families over years, the HCS experience is varied, vital, and their personal stories are remarkable.

Nosocomial began as a collaboration between playwright Nicola Baldwin and Dr Elaine Cloutman-Green, Lead Healthcare Scientist at Great Ormond Street Hospital. In summer 2018, over 30 Healthcare Scientists from various hospitals took time out of their schedules to join writing workshops, which later grew to involve artists and actors, to tell their stories.

Performed at Camden Peoples’ Theatre and site-specific events in NHS buildings, museums, and other public spaces. Winner of 2019 CSO Partnering Patients and Citizens award, and 2020 Antibiotic Guardian award for Public Engagement, this is the online premiere of our new short film, updated for 2021.

The Nosocomial project has been made possible thanks to SfAM and HIS public engagement grants.

Book here


Sat, 5 June 2021 – 20:00 – 21:30

Inspired by classic 1963 thriller by Val Guest (from book by Elleston Trevor) about scientists battling a smallpox outbreak

A Healthcare Scientist’s already-shaky marriage is tested to an even greater extent when he has to contend with a smallpox epidemic.

Inspired by the classic 1963 British black and white medical thriller adapted and directed by Val Guest (from the book Pillars Of Midnight by Elleston Trevor) about Healthcare Scientists battling a smallpox outbreak

For one night only, this live zoom script reading will pay homage to the iconic black and white movie experience.

Please dress appropriately, and return with us to a bygone era of Saturday night cinema-going, reimagined for the digital age, via the medium of Zoom in your own sitting room.

A unique experiment in co-creation involving a virtual company of actors, artists, scientists, researchers, and you, the audience.

It’s New Year’s eve. You get a call to go into the lab.

A patient is showing signs of a mystery illness

They just want you to run a few tests….

What could possibly go wrong?

Book here

And Now Something for the Adults

KLEBSIELLA showcase plus Q&A with creative team

Fri, 4 June 2021 – 19:00 – 20:00

Microbial shapeshifter. Compulsive stealer of DNA. Who is she? Why does she do it? In a crisis of identity Klebsiella seeks psychotherapy…

Screening of KLEBSIELLA by Peter Clements, a new performance in development, followed by a panel discussion with costume designer Pam Tait and Healthcare Scientist Dr Elaine Cloutman-Green: on performance, playfulness and the need for novel approaches to engaging with AMR.

“A portrait of Klebsiella through a psychoanalytic session.

Klebsiella is the shapeshifter of the microbial world. A compulsive stealer of DNA. Who is she? Why does she do these things? In a crisis of identity , Klebsiella seeks psychotherapy to get to the bottom of what’s bugging her.

Vivienne Westwood meets Diana Vreeland meets Bouffant clown meets Riot Grrrrrrl meets Pat Butcher.

Klebsiella and Analyst meet to determine if Klebsiella is suitable for in depth psychoanalysis. Klebsiella resolves that she’s impossible to cure. She’s determined to find the love of her life, even if it means leaving a trail of destruction behind her.”

Book here

Science Showoff’s STAND-UP FOR SCIENCE

Sat, 5 June 2021. 18:00 – 19:30

Comedy and Cabaret from the ‘best minds in science’…. A partnership with the popular Science Showoff comedy night hosted by Steve Cross.

Healthcare Scientists become comedians for one night only.

Tonight they’ll put aside their microscopes, computers, samples and equipment for one night to tell you jokes about their work.

The show will be hosted by comedy veteran Steve Cross, who has MCed hundreds of comedy shows of all kinds across the world, and who has trained these brave brainiacs to take to the stage. I say stage, they’ll be on a videolink from their own homes.

The gig will be made available to to ticket holders via a live stream from all of the performers’ houses. Ticket holders will be emailed details of the stream on the day of the show.

The show is on 5th of June and starts at 6pm prompt.

Book here


Thursday 3 June 20.00 – No booking needed, live on the YouTube link below

To kick off Rise of the Resistance Festival in style, join us for a live panel show combining comedy and science

Live stream here

Dealing with Writer’s Block: How I Write When it’s the Last Thing I Want to Do

It’s just gone 6am on a Saturday morning and I need to get some writing done this weekend for a project that is overdue and has a final final deadline on Monday. It’s been a really long week and I don’t have much in the tank. To be honest, all I want to do is sit on the sofa with a pot of tea and spend the weekend watching Netflix with my hubby. I think we all have moments like this, and, to get me into the right head space, I’m starting my morning by writing this blog. I hope this might help some of you who are in the same place.

Know When Procrastination is Part of the Process and When You Are Just Wasting Time

When I was writing papers and my PhD thesis, I used to get really angry at myself for wasting time.I would spend the first three days wandering around and doing anything but putting words to paper. When I did sit down, I would just get words out. In general it takes me about two days to write a paper. I would then be even madder at myself for not getting to it earlier as I felt that I could achieve so much more if I just focussed.

Over the years I’ve discovered that the reason the words come easily when I sit down at a laptop is precisely because I’ve spent three days prevaricating. During that period of wandering around I’m thinking. Thinking about the story I want to tell with my results. Thinking about my top points. Finally, thinking about structure. It is all of this thinking, not all of it active, that enables me to hit the ground running when I come to actually write.

This isn’t to say that I’m not guilty of procrastination. There’s a reason this book chapter is late. I’m tired and finding it difficult to concentrate, which means that everything just makes my mind wander. It is really important to know yourself enough to know when you are in ‘preparation phase’ vs ‘procrastination’: one is useful to you and the other isn’t.

The Fear of a Blank Page

I find blank pages intimidating. I do. I know that I should see them as full of possibility and exciting, but I see them as a physical representation of how far I have to go. One of the first things I have to do, therefore, is get stuff onto that page in the least stressful way possible. How to do this depends on what the project is. For papers, I often just start by getting headers down. If I’m lucky enough to have some previous text on the subject I will copy and paste bits in as reminders. Usually I keep these highlighted so I know they are old text that needs re-working/replacing. If it’s something completely new, I will populate with lines from papers that I’m going to build reference structure around.

When I was writing my thesis, I wouldn’t even start chapter writing until I’d done a reading phase to help avoid the ‘blank page fear’. I would spend a week reading all the papers linked to the chapter I was about to write. During that reading phase, I would write the key points and linked references down in a Word document. I’d then shuffle them by topic. When I got to the week allocated for writing I would then have lots of text to import into my structure so I could avoid the blank page terror.

Structure is King

I’ve spent quite a lot of time writing different types of documents and I’ve discovered that there are only so many types of underlying structure, even though they often look different. Papers are a great example of this. One main advantage to them is that you can clearly see what that structure is, and you have access to all the information you need to help you.

When writing papers (and I’ve blogged about this before) you can look and see how many paragraphs that journal tends to have under discussion vs methods vs results. This helps you know where you need to focus the majority of your words. The same is true for grant applications: if you look at a section’s word count, it gives you a clue about what the readers will want to see. For less formal writing, I still tend to look at other pieces of content that have come out and decide if any of them fit what I want to write. It saves re-drafting and focusses the mind.

Structure will help you write. I will use bullet points under headers to show what my structure is, i.e. a bullet point per paragraph. If there are three paragraphs (such as tends to be used for an introduction) I will use them as follows:

  • Paragraph 1 – What’s the setting/problem?
  • Paragraph 2 – What are the knowns and what are the unknowns?
  • Paragraph 3 – What am I going to do? what’s the plan of action?

By planning my paragraph structure I try to avoid falling down too many rabbit holes and maintain the story of what I’m telling. I am then able to do the same with each of the paragraphs:

  • Line 1 – State what I’m going to tell you.
  • Line 2 – Tell you what I’m telling you with all the detail.
  • Line 3 – Reinforce my key point and link to the paragraph that will follow.

Doing this means that I’m not worrying about what comes next when I’m writing. I’m just hanging words off a structure that helps me as well as leading the reader.

Sometimes The Only Way Is Through

There are times that, no matter how much research I’ve done, no matter how prepped I am, I just can’t make the writing work. I’m lucky. it doesn’t happen to me very often but the pandemic has made it a more frequent event. Normally I hate working in silence. I’m not good at doing one thing at a time. I need music or TV when I work to actually help me focus. I know this may sound odd to many people. When I hit a particular wall, however, I’ve learnt that I have to shift from the way working normally works for me. In these circumstances I call upon my husband, Jon. I tell him what I need, i.e. I must work for 3 hours to break the back of this document. I tell him the night before and let him know the timeline. The next day he banishes me to the office, frequently supplying me with tea. On these occasions I work in silence and need enough dedicated time to get into ‘the zone’. Because I don’t want to do it, anything that can make me distracted, will make me distracted. I therefore retreat to a space where all the things that usually help me aren’t present. This shift allows me to trick my brain enough to make progress. Finding your Jon to push you when you can’t push yourself is super helpful.

The other thing I do is make deals with myself and – most importantly – stick to them ,i.e. I am allowed to go and bake that cake I want to if I’ve done three hours. I am not allowed to do it if I do less than that. There’s no letting me off for good behaviour. This is a Yoda moment ‘Do or do not, there is no try!’. Being honest with yourself is key: after all, there is a good chance you’ll know when you’re lying. Make the reward proportional to the effort, i.e. when I run a half marathon successfully I buy myself a nice dress, for 3 hours work I get a new pot of tea.

Know When to Walk Away

Some days, be aware that writing is just not going to happen. This can happen for a bunch of reasons: tiredness, illness, last minute invitations to a cocktail bar. It is only possible to enjoy the freedom of walking away if it’s a) not a project that has to happen or b) you’ve left yourself enough deadline time so that you can come back to it later. If either a or b are true then sometimes it is better to just not punish yourself and return to it later. That’s completely OK. You may need more thinking time; you may be having a super bad day. Lets not punish ourselves more than we already do. Embrace the fact that you have project-managed well enough to let it go for a bit. Also, be aware that you only have so many free passes before you are sitting here early on a Saturday morning and there are no more to take. Use them wisely!

Top Tips:

  • Let the frustration with yourself go as it doesn’t get you anywhere. Work out the source and find a way through or around.
  • If you do the research on structures beforehand you may find the writing process easier and more efficient.
  • Know when you have time to defer and when you need to push through. Make an active choice rather than defaulting to the last minute.

All opinions on this blog are my own