The Sound of Deadlines Rushing Past: Surviving in a world where deadlines are constant and there’s never enough time

I was fairly unwell before Christmas and was off sick and then struggling for a while. This was particularly traumatic as there were all the inevitable end of year deadlines that just wouldn’t stop coming, and frankly, I was in no position to be able to meet them. The thing is, it is now January, and I didn’t meet those deadlines, many of them I still haven’t delivered on. The other thing to note is that I am both a) still alive, and b) still employed. As someone who has a fairly visceral fear of the deadline, this is pretty shocking to me. So I wanted to kick off the year with what this experience has taught me and what I’m taking from this moving forward. Many of these things the rest of the universe probably already know, but sometimes I take a while to catch up.

Know when a deadline is a deadline and when it is more of a suggestion

The first thing to say is that I have never really taken the time to explore whether the dates or other information given to me are even true deadlines. Give me a date and a time and I will agonise and feel guilt if I fail to deliver.  I work on the assumption that if you give me a cut-off then it really is a task that has one. Reflecting on my Christmas experience however, I have learnt there are probably three scenarios where I will be given deadlines:

  • True deadlines – papers for committee meetings, grant deadlines etc. This is where a number of subsequent actions are riding on yours and if you don’t deliver, the domino effect is both real and important in the wider scheme of things
  • Gate keeping deadlines – manuscript review deadlines for other authors, 1st draft deadlines for policies, etc. This is where the task needs to happen, and in a timely fashion. The exact date itself, however, is arbitrary and so as long as communication is good and the time period doesn’t substantially extend the process itself is unharmed
  • Courtesy deadlines – submitting a conference presentation 3 days ahead (normally), arranging planning meetings etc. These often get given dates to ensure that they happen, but in reality as long as they get done before they evolve into a true deadline i.e. before presenting at the conference, then the timescale is actually flexible

It is really important to understand what kind of deadline you’re dealing with, otherwise you will treat everything as a true deadline (exhibit no. 1 = me) and that means you may deliver on a courtesy deadline over a true deadline, with the associated consequences. Without understanding what type of deadline you have you can also not really be truly aware of all of the possible options you can take when you are truly over whelmed and unable to deliver on everything.

Did you know you can just ask for an extension?

I’m just throwing this out there because it’s something I’ve only recently discovered. Did you know you can ask for an extension? This seems like a really bizarre statement I know, but I knew this was a theoretical possibility when a student but I had no idea it translated to real life. I really didn’t.  When I talk about understanding what your options might be if you can’t manage all of your deadlines, this is what I’m talking about. I didn’t even know this was an option that I could action.

During the pandemic I was forced to write to people on a number of occasions as I kept getting pulled into various last minute urgent events, and thus had no choice. The first few times I emailed to say I wouldn’t make X deadline but I can get it to you at Y, I came close to panic. Every single time I got an email back saying ‘thanks for letting us know, we’re looking forward to getting it on Y’. Not a single angry response. Not a single ‘we’ll find someone better/more available’. Nope. Every time, a chilled out ‘that’s fine’. Now this is just me being me, but why didn’t I know this? Why didn’t someone tell me years ago? All those nights working till midnight as I promised something that day!

The other thing that my husband has been telling me for years and I didn’t believe. Friday deadlines aren’t real (unless it’s an automatic form that could close or a grant deadline where they really mean it). Again, this is something I just didn’t believe, but I now realise. No one is going to go into their inbox to check at 8am on a Saturday morning. The number of midnight’s when I could have been sat on the sofa doing it on Saturday afternoon instead. Friday deadlines, I now realise, are purely there so the info is in someone’s inbox at 9am on Monday morning. Unless the situation is one of the exceptions, no one is impacted. This has even led to a few occasions recently where, because I’m trying not to work on weekends, I’ve just done something at 8am on Monday morning and sent before 9. Shocker, no one has cared.

Prioritise, and sometimes that includes your wellbeing

The other aspect of this is being aware of when sometimes the deadlines are for other people not for you. Courtesy deadlines are often there to make other peoples lives or processes run more smoothly, and I would always support being a good colleague. That said if meeting a courtesy deadline means that you will incur a substantial personal cost, then this is a time to put your communication skills to the test and think about re-framing the deadline.

Once you know which deadlines are really deadlines and which are deadlines can be negotiated, you are then in a position to be able to prioritise. Now, this isn’t just about juggling all those deadline balls, it’s also about when you have to prioritise yourself. It’s important to take ownership, it’s important to be accountable, but not at the expense of your health and mental well being. This can often be challenging, as working out where we are on the list of prioritise is frequently hard to determine when you are in it. This is why checking in with others, and finding helpful critical friends who can give context and perspective may help. I’m reading this out whilst my husband looks at me and roll his eyes – apparently you must also listen to the advice not just seek it.

Failing to meet deadlines is not the end of the world

I don’t really think of myself as being senior, it’s just not really important to me or part of my identity as long as I have a voice. That means it has only been a recent thing that I’ve reflected on my experience over the years with the mentors, Consultants, professors etc in my life. None of them every managed to turn the things I needed around to any deadline I ever set. I sat there and reminded them, sent diary invites to discuss and frequently in the end wrote things for them or submitted anyway. This wasn’t because they didn’t care, it’s just they had so much on their plate and they couldn’t manage it all. Now I don’t want to be that person but we don’t get everything we want in this life, there are only so many hours in a day. Sometimes, therefore, I feel like I am this girl. Why did I think I was special enough to be able to achieve what all those ahead of me could not. Context is key and denial is not always helpful. I can only aim to do better but beating myself up if I fail is not helpful. As my wise DIPC says to me ‘did anyone die?’ If the answer is no, if what actually happened was I disappointed myself, then I have to have perspective and we have to be kinder to ourselves.

There were a few times over the past three years when I had to unexpectedly put my work laptop and phone in a cupboard and step away completely to deal with other life stuff. I missed deadlines, I missed emails, but nothing that I missed still haunts me. Things just didn’t get done. People weren’t angry, people were super understanding, and my teams were wonderful and helped so much. The world continued to turn. Sometimes, it’s easy to forget, as humans are so ego centric, that the world does not stop if we are not in it, the void gets filled. I failed, I survived and so will you.

Tips that I’ve learnt to manage a world filled with deadline pot holes

  • Share the load – be clear that you will need email or calendar reminders – if it is important others will help you get there
  • Aim for clear communication to support prioritisation – if they only email you about it once it probably isn’t that key. Be clear about the fact that you will need prompts or chasers
  • Clear diary time and include it as a specific hold to do the task, rather than just having it on a to do list
  • Ask about deadlines up front before you take on something and be prepared to negotiate your involvement.  Do you still want to be involved? Can you meet their deadlines? Can you adjust their deadlines so they work for you too?
  • Know when deadlines are part of your agenda or part of someone else’s 

All opinions in this blog are my own

Mouth Open Should Be Shut: My challenges with openly contributing to meetings and the fear of oversharing

It’s 7:30 on a Tuesday night, and I’ve just come off a Clinical Senate meeting. It’s late and I’m tired and I’m having quite the shame spiral. Let me explain why. I talked. Sounds a bit silly when you write it down, but it’s the truth. The problem is that no one else did very much, and I’m never sure that I either have the right to speak or that I make any sense when I do. This means whenever I go to these things and contribute, I never really know whether my actual job in the room is really to be seen and not heard. As a person, I know I should talk less and listen more, and so when I do speak I have a tendency to destroy myself with guilt when it’s over. So, as I sit here writing this on the tube on the way home it seems to be a good time to work through some of these processes ahead of a week full of, what will likely be, situations that could result in the same self recrimination.

Trained into a way of thinking

I don’t know about you, but when I was growing up the ‘be seen and not heard’ response was pretty much embedded. Good girls, good children do not make waves or draw attention to themselves. We are often trained into a certain way of thinking about how our presence in those rooms should be. As we become more senior or spend increasing amounts of time in meeting rooms, especially in meeting rooms where we don’t really have relationships with people, this can cause a certain amount of cognitive conflict. Our presence in the room is to contribute, but we don’t necessarily understand the unwritten rules associated with that contribution. How will we be judged? What measures will be used to benchmark our contribution? Will we be judged if we speak too much or too little? Who are the key decision makers in the room? In the absence of this knowledge, at least in my case, I default back to those childhood rules. Thus uncertainty of the rules can lead to me starting to shame spiral when the meeting is over. I don’t find this such an issue when I’ve developed relationships with the people in the meeting, or when I better understand the relationships and my role. I also find it less of an issue during in person meetings, it may just be that it’s easier to read some of the body language in the space when face to face. When I leave the room, and I feel like I do tonight, I try to tell myself to focus on looking forward to what I can contribute rather than looking back to behaviours of the past, but sometimes that is harder than it should be.

My mind is always so full of stuff

Where do some of these insecurities come from? I am horribly aware of the fact that I talk too much, that I talk over people and can be seen to not be paying attention or really listening. There are a couple of underlying reasons for this. The first is that my hearing isn’t that great, as I spend about 6 months of the year with varying levels of ear infection. This means that I spend quite a lot of the time completing sections of dialogue based on social cues, lip reading or extrapolation. The downside to this is that I often finish off sections of dialogue or meaning from other people before they finish fully articulating, or I think they have finished when they have only actually paused for emphasis or breath. This can mean that I end up responding before other peoples thoughts are truly finished. I really don’t mean it as rude, it drives my husband crazy, and most of the time I don’t even realise I’ve done it. Because I have an awareness of how rude this is, even if without intent, I therefore feel a lot of guilt in response – especially if it’s pointed out to me.

The second thing is that I’m not very good at doing one thing at a time, even in my head. I tend to have a LOT of thoughts flying around my mind at any one time. Sometimes that means I feel the need to get thoughts out of brain before I lose track and move onto the next thing. There are lots of things that I’m trying to do to get better about this, active note taking for example so that I don’t fear losing my train of thought. I do find that this is even harder these days though as I’m not only having multiple trains of thought at the same time, but I’m also trying to manage multiple work demands at the same time. This means my focus on being a good listening is often split between other tasks which I know is none ideal. I’m a work in progress. One of the things that enables me to be a success is that I can manage to spin a lot of plates, the down side to that is that I’m actually very poor at doing one thing at a time, and sometimes that makes me a less good listener than I’d like. Knowing these things about myself means that I tend to run action replays of all of the moments in meetings when I have succeeded less well and struggle, initially at least, to take the learning from the moments rather than the guilt.

Owning the invite

One of the things I try to remember when I feel like this is that I was invited into the room. For the Clinical Senate I had to go through an application and interview process to even be there. I was invited into the room because, no matter how I feel in the moment, someone felt like I had something to contribute otherwise I wouldn’t have been asked. The thing I have to remind myself is that there is no point in being in the room if you don’t participate, otherwise your chair could be better used by someone else. In many ways it’s not for you (or in this case me) to question your purpose. If I am no longer required, if I don’t perform up to expectations, if I don’t adhere to those unwritten rules, then there are people who can rescind that invite and mean I’m no longer included. This may be something that subconsciously adds to my fear, as the humiliation would sting, but it also something that has never (knowingly) happened to me and so I need to put it into that context.

Part of the other scenario where I really feel the pressure is when I’m in a multidisciplinary space, especially one that is not frequently occupied by Healthcare Scientists/women/Clinical Academics. I feel the pressure to represent all of those groups well and to not let others down. What I don’t want is for the others around the table to engage less with these super important groups because they’ve extrapolated from any failures of mine in the room, and thus impact wider engagement. At the same point I am a proud member of all those those less prominent groups and I have the opportunity to raise awareness and have been given a voice. It would therefore be a waste to get in my own way and not use it. This is the part where, if you put your rationale brain on, you realise that no one is likely to discredit a whole group because you talk over someone or asked a stupid question in a meeting, perspective and understanding that you are probably just not that important can sometimes help.

Who the hell am I

My imposter syndrome tends to kick in prior to me being in the room, I’m frequently to be found hiding in toilets ahead of face to face meetings psyching myself up. I tend to hit the shame spiral hard after I leave the room. When I’m in the room however I tend to be OK and pretty task focussed. Sometimes I’m so focussed on the intellectual question or balancing the evidence that I have been called ‘The Destroyer’ by a dear academic colleague – I’m hoping in jest, but from the look of my PhD students faces perhaps not entirely. I think this means that in the moment I can mostly hold my own, whoever else is the room. Once I’m in the room I worry less about how I got there, than what the discussion is before me. It also means that I sometimes ask the questions that people may not want me to ask, because I’m interested in understanding more and getting the answers. Most of the time I hope my curiosity comes across as just that, I am aware that when I’m puzzling over thoughts in my mind or putting pieces together I can have a face that looks intimidating rather than welcoming. Perhaps the scientific version of resting bitch face? I can therefore come over as an interrogator rather than a supportive enquirer which may impact how people respond to the query.

One of the other reasons I ask a lot of questions is that I spend a lot of time in mixed discipline, mixed professional rooms. I therefore have to be OK with asking the stupid question as I may not have the understanding of the others around the table. In these meetings people often use the same words. but in different contexts. I’ve learnt therefore that I have to be brave and ask the questions so that I understand enough to be able to contribute. I also sometimes feel that I have to contribute in order to justify the fact that I’m there, something that I know is not necessarily needed and may be driven by a need to prove that I should be there. Contributions however shouldn’t be driven by uncertainty about worth but linked to gaining clarity around task, in order to move things forward. Again, I’m working on it.

The importance of connection

The other thing, for me, about feeling uncertain and off kilter is that I will often try to deal with this by forming connections. As I said earlier, feeling more connected with the others in the room can reduce feelings of risk as you can get feedback and will be better placed to understand the unwritten rules. The problem with this is that I have a habit of oversharing when trying to connect. This probably surprises none of you, I’ve been writing a blog that lays bare my soul for over 2 years now after all. The other times that I tend to over share is when I read cues that make me think that the other person is not gelling with me, be that a different value set or just not pleased with what I have to say. This is a dangerous game, in searching for that connection, that shared experience, or shared journey, you can open yourself up to all kinds of responses and take a big risk in terms of your emotional wellbeing. Interestingly, when I’m in the moment and responding to the body language, or signals, of others I often feel comfortable. Again, it’s when I walk away from the moment and lose that reinforcement of connection that the self doubt creeps in and the action replays start.

Always the weird one

Let’s be honest. On top of everything else, my brain is a bit weird. I’ve gradually become aware over the years that I just see the world in a slightly odd way and therefore have a tendency to think a bit differently. This means that the comments and questions that strike me listening to a room full of people can come off as a little strange or out there when I vocalise them. It feels like there are two main responses to this, depending on the room. You have rooms where those who hear my oddness respond with equal curiosity and I get to walk out of the room feeling like I’ve made a difference. There are other rooms are not always so receptive to being engaged in what can be seen as a distracting train of thought. In these rooms it means I have a tendency to ask questions and see a sea of slightly baffled faces and then feel bad for asking the question or making the point. The response to such a moments is often to dismiss the comment actively by minimising it, or passively by just not acknowledging it happened. These are the meetings that I struggle most with. I feel like I’m there because I can contribute, because I think differently or have a different set of experiences, but that contribution is unacknowledged. I also think that despite this I need to continue to input and find my voice, even if it is hard, as if I’m not going to I should give up my space to someone else who might be braver in the moment. I’d be lying if I didn’t say I find it hard however.

Putting it out there

The long and short of these reflections is that, like so many things, you have to take a risk in order to achieve. You have to be in the room and take the risk of being seen in order to create change. Putting yourself out there by being in spaces that you feel less comfortable in, where you may not know the people or the rules well, opens you up to conflict and criticism. It also means that you have to face the fact that you are not going to be everyone’s cup of tea, rather than living in the fluffy land of denial (I rather like it there BTW). You have to have strategies that will allow you to deal with the consequences of that risk, or to allow you to come to terms with that the fact that some people will just not like/gel with you. We have to walk the walk, and know that sometimes disagreements and being in rooms with people who are not like us is required for us to get the best outcomes. Sometimes, it is only by being uncomfortable that we can find clarity of thought and/or purpose.

If life becomes too much it is always possible to remove yourself from the space, from the place, people or meeting that you are struggling to deal with. The thing is that by doing that you may not achieve all you could achieve, you may not grow and learn the most you can as a person. It’s always worth coming back to why you are in the room to start with. I’m not saying you can never walk away, just that walking away from something purely because it feels uncomfortable may not always be serving you or the room in the best way. I’m sure there are healthier ways of doing this than shame spiralling and writing a blog to process the thoughts that it triggers, but I don’t have any easy answers. What I do have is the faith that if you are invited into the room it’s because you have something to offer that room which is needed, and that by being honest about the challenges that we sometimes face maybe we can remove some of that uncertainty/risk that makes the room feel like it’s not for people like us.

All opinions on this blog are my own

Changing of the Guard: When your mentor leaves and you have very large shoes to fill

This week is pretty momentous for me.  My boss and mentor of over 18 years officially retires.  His name is Dr John Hartley and to be honest he’s a bit of a microbiology legend, so much so we are talking about having a sign up in the IPC office that says ‘what would John do?’.  He is a completely different personality type to me, he’s an efficient, detail orientated perfectionist and most of all completely calm.  When John is in a meeting he sits there in calm contemplation and then swoops in to ask the one question that cuts right through all the noise, right to the heart of the matter.

John has been my boss from my first day as a trainee Clinical Scientist 18 years ago, when i didn’t even know what S. aureus was, right through till last year when I got my Consultant post and became his replacement as Infection Control Doctor.  He has been with me through marriage, deaths, PhD, FRCPath and every other significant career moment and so to say that I’m affected by his going is somewhat of an understatement.  So how do we cope when these moments of big change come around and we have to find a new way forward?

Trying to remember I am enough

John is loved by so many people and I have looked up to him for most of my adult life. It is normal therefore that everyone is mourning his moving on, it is almost like we are all grieving the loss of the familiar.  I definitely feel this.  I also find it hard in another regard, as we all grieve as part of the change there is a lot of understandable discussion about how amazing he is both as a person and in his job.  I feel this keenly.  I also feel very exposed by it as the person who is stepping into the space he occupied. It plays into all of those aspects of imposter syndrome where you ask ‘am I good enough?’.  As I said, we are very different people, John has an eye for details that I just don’t, he is calm and measured whilst I have a tendency to jump first and process everything of the fly.  This means that I will never live up to ‘what would John do?’ and still be authentically me.  There is therefore the inevitable chain of thought that if John is amazing at his job and I can’t be like John, does that mean that I will never be able to be equally amazing at that job?  Am I doomed to mediocrity before I even start?  It’s not like I’m a little bit ‘not like John’, the way we interact with the world is quite obviously different and so I’m very obviously not like him in every meeting I have and every interaction I’m involved with.  It’s easy therefore to let the self doubt and panic set in.

So how am I managing it?  I’m trying to not get too sucked into the John conversations. Not because I don’t think he is truly one of the most inspirational people I’ve ever met, but because for the sake of my sanity I can’t get drawn into comparisons.   I’m trying to remember that despite the fact that he has occupied that role for my entire career that his way isn’t the only way of doing things, and that I have to try and play to my own strengths rather than attempting to imitate someone elses.  I am also trying to hold onto the fact that at no point in the last year where I have had the role instead of him has anyone questioned my right to be in it, or has he disagreed with any of my decisions when I’ve sat down and chatted them through with him.  He has been nothing but supportive of me being in post, and therefore if I’m going to emulate anything it should be the faith that he has in me that I struggle to have in myself.

I don’t have to have all the answers…….yet

John was Infection Control Doctor at my Trust for over 20 years, I have been ICD for 18 months, so what I need to ask myself is ‘am I comparing like with like?’.  It’s tempting to benchmark in the moment, it’s tempting to compare how well respected and how established he is against how I feel I’m perceived.  The thing is I’m benchmarking in completely the wrong way, I need to be benchmarking against how he was 20+ years ago.  Otherwise I’m setting myself an impossible task; I can’t benchmark against him now as I’m setting myself up to fail, and I can’t benchmark against him all that time ago as I don’t have the data.  That said, I suspect that Dr Hartley was probably born amazing and so it would be a challenging thing either way.  So, should I be benchmarking against him at all?  Should I instead be taking the time to reach out to my contemporaries to see how they are feeling and how they are dealing with similar changes?

The other thing that occurs to me whilst I write this post is whether anything has in fact changed, and whether benchmarking is actually the way to go at all.  You see, the thing is, I’m not really comparing like with like. John is a Consultant Microbiologist from a traditional medical background, I’m a Healthcare Scientist.  I’ve spent my entire career being the only person who was doing quite what I was doing and carving my own path.  Why suddenly now that John is leaving am I abandoning the approach that has stood me in good stead and trying to be the same as everyone else, instead of embracing that difference in a way I always have?  Why am I so tempting to discard everything that has previously made me, me?  The more I question, the more I doubt and so I need to return to embracing my gut and knowing that I am exactly where I always wanted to end up, and stop being so scared that it will all be somehow taken away from me.

Take a leaf out of his book

If I’m not going to benchmark against him, what am I going to do?  Well, first things first I’m going to reflect on what it is about him as a boss, a clinician and a leader that makes me and others respect him so much.  I want to do this not in order to copy him or compare myself to him, but in order to be inspired by him to be better. 

One of the things that John has done for me be, ever since I joined, is that he has championed me in rooms where I wasn’t present or wasn’t invited into.  He has never let our difference in professional backgrounds stand as an obstacle to what he thought I could achieve and, when I’ve needed him, he’s fought tooth and nail to guard my corner.  He has also sometimes been more honest with me than I could handle in the moment, and never stopped pushing and challenging me to be better than I believed I could be.

No matter what room he has been in John has always been his honest and authentic self, he’s not tried to curry favours, he’s not tried to manipulate or play power games.  He has always gone into every room with both his staff and his patients at the centre of his decision making.  The ability he has therefore demonstrated to handle conflict and disagreement is something that I can but admire.  He’s not scared of being the lone voice in a room if he believes that he is doing it to give a voice to others.

All of these things are things that I want to do, want to be better at and strive towards every day.  There will be times when I don’t achieve them, but by using him as a continued source of inspiration, rather than a benchmarking tool I use to beat myself up, I hope to become a better version of myself rather than a shadow of John.

Find my new allies

One of the other actions I’ve realised will be important for me in moving forward is be proactive in identifying new mentors and allies. People who will push and support me in being brave, and in standing up for both myself and others.  Losing a keystone of your network and support mechanisms is always jarring, but it is also an opportunity to evaluate what your needs are now, and where you need to develop your networks further for the fresh challenges ahead of you.  Finding mentors is often a fortunate accident, but there are also times when you need to actively seek out those people who will be able to help in any new phase of your career.

I’m also beginning to realise that I need to maximise my horizontal networks as well as looking upward for improved learning and guidance from those ahead of me.  I’ve always found peer support like this organically, but I think the time has come to undertake deliberate action and to actively invest resources into it.  This has been of great benefit in my role as Lead Healthcare Scientist but isn’t something I’ve attempted so much in my clinical role, partly because I suspect I’ve been too comfortable and had such great existing support.  I have plenty of connections in this area, but turning those connections into something more requires time and the building up of trust and shared experiences.

I will have different battles and different challenges

Firming up networks and identifying new sources of support is important as well because I think the challenges ahead of me are going to be different to the challenges I’ve already faced.  John has done an amazing job of leading the way and has built excellent foundations for me to stand upon, but the world of healthcare has changed so much in the 20+ years he’s been in post, and it would be naive of me to think it won’t continue to fluctuate.  All of this means that if I am going to be able to tackle these new challenges and prepare for a dynamic future, I can’t just rely on what has been before.  I need to have my toolbox ready to enable me to deal with what lies ahead, and a really important part of that is making sure that I have people around me who will challenge my thinking and inspire new ideas.  If we want to create real change and improvement we have to be prepared to take a leap into the unknown.  Sometimes this is helped if you have people around you who are both supportive but who can als give you a little push to get over any hesitancy. Although, in my case, it’s more likely they may need to stop me gambolling down the road with too much alacrity.   Finding your tribe has always and will continue to be important to me.

Perhaps one of the reasons I find this all so hard is that the reality is hitting me that I’m no longer the new kid on the block. I’m no longer the young whippersnapper who is coming in and seeing the world in a completely different way.  I myself am becoming the old guard, I’m becoming the person who has been somewhere long enough to harken back to different times when things weren’t the same.  This presents a lot of cognitive dissonance when at the same point you still feel like you are new and haven’t quite got a handle on things.  Just merely realising this helps, it helps to see the strength in where I’m at.  I am still young, I am still new, and the position is novel enough to me that I can see 101 ways where I would like to grow it and me for (fingers crossed) the better.  I have also been in the Trust for long enough that I know how things work, I know who to speak to, I know where the barriers and opportunities might be.  If you look at it in this light, I am in the best possible position to embrace what is to come.  So, although I am still grieving the loss of the past, I am beginning to be excited about the future.

All opinions in this blog are my own

Speaking Truth to Power: Learning the hard truth of when science and politics collide

Over the last few years there have been a number of, well let’s be kind and call them learning moments, for me about how life works. I guess I’ve spent my life being pretty naive and thinking that if my evidence was good that was all that was needed to win people over or for my version of ‘good decisions’ to be made. The transition from that to knowing that a lot of decisions are not made due to evidence but due to scenario, relationships and people has been harder than I can properly describe before cocktails. Recent events, including some of the Infection Prevention kickback on social media, has led me to take this post out of my drafts section and forced me to finish it.

My hope is that by putting this out there others will be more prepared than I was for some of the conversations they will inevitably have as leaders down the line.

Know your remit

Just before Christmas last year I walked into a room as ‘the expert’ thinking that my expertise would lead to the outcome which I had deemed to be the most sensible. Worse than that, I hadn’t considered my role in that room before I stepped into it. Usually when I’m in a room I’m there to make decisions, it’s what I spend most of my day doing. My upset therefore when the information I presented was heard but my recommendation was not acted upon was pretty visceral, this was high stakes stuff after all. I hadn’t spent enough time considering my remit before I went in. My remit in that room was as an advisor, it wasn’t as a decision maker. Therefore I had set myself up to fail. I needed to set my success criteria (more on this later) linked to my presentation of information, not about the decision itself.

That day was an object lesson in being an expert in one piece of the puzzle, but not being able to access the whole picture. Not because I hadn’t done my research but because often as advisors and not decision makers in a space we are not given the full picture to understand how the decision is actually being made. This can leave someone, like me, who works based on evidence base and data, feeling lost when a decision is made that appears to contraindicate what we’ve put forward. I find it especially challenging as often I am in the room as a decision maker, and the switch in remit from one to another is not always well defined. Trying to understand what role you are occupying before you enter a space is therefore key to both the outcome and your mental wellbeing.

Sometimes you also need to understand where your remit of influence lies. Something may be happening you don’t agree with but it is not within your remit of influence to change. Knowing when this is the case and acknowledging it means that you are more likely to be able to find a way forward. Can you offer a support role? Is it something that is right for you to be involved with, or do you not have insight or expertise in that area? In which case do you need to upskill or acknowledge your involvement might be unhelpful? If we wade in without being prepared we can make situations worse for those that are actually impacted.

Collect your evidence

Having said that having evidence and information will not always change the outcome it must be acknowledged that without it you have probably lost the battle before even entering the room.

Why is this? Well without information what you are doing is appealing to emotion. This may be a good thing in politics but is unlikely to be a successful approach when you are in a position to influence due to your expertise. Hearts and minds is an important moto for change but the foundation needs to be solid. It could just be the scientist in me, but I want to enter a situation with as much information as I can access to hand so I can flex my argument and respond to challenge and come back with data.

Another thing is that by going in with information you set the expectation that you anticipate data and evidence in response. This can help in situations where you expect to be fobbed off. It can also help in emotive situations, where instead of adding fuel to the fire you are removing the judgement/emotion and presenting just the information to respond to. It can also give a way out to both sides in terms of changing their position. It is a sign of good leadership to acknowledge new information and react to it. Remember this goes both ways however, and so we should also not use evidence that is sub-selected to maintain a dogmatic argument.

Talk to your stakeholders

A key part of gathering your evidence and sense checking your argument is talking to people who are involved. This is important for a number if reasons:

  • Understand the landscape the decision is being made within
  • Understand the drivers of the key decision makers, this will help you understand whether the decision is within your sphere of influence
  • Understand the impacts of the decision, particularly on those you are engaging with
  • Help you to identify evidence gaps or other holes in your thinking
  • Help you to identify the potential consequences of speaking up for you and others

Its important when speaking to stakeholders that you speak not just to people who are likely to think the same way as you, this way leads to group think. You need to try and speak to people who are likely to disagree with your position, people who have a more strategic view of the landscape who may be able to tell you what you’re missing, and people who are likely to have influence in the room. The last are particularly key in terms of preparation as you are removing some of the unknowns. Best case, you may win over a decision maker so you know that they will support you, worst case you’ll be able to prepare for what streams of thought they might introduce during discussions.

The most important thing here is that if you are representing others as a leader, that you have spoken to those you represent enough to make sure that you are genuinely reflecting their position and thoughts within the room, not just your own.

Practice your argument

I can’t emphaise this one enough. If you are going into a high stakes meeting you need to practice your argument, preferably with others beforehand. To me there are a few reasons for this:

  • Identify flaws in your chain of thoughts, or weaknesses that you can address
  • Work through any emotion linked to what is about to happen before you get into the space
  • Find the rhythm of what you are going to say, who you will look at when, how you will evaluate how your argument is landing and flex if necessary

These situations are often emotionally charged and for the sake of the outcomes you can rarely let that emotion, be it fear or upset, show. These need to be adult – adult conversations, as the situations are often complex. I found the infographic below, which is aimed at having difficult situations with family, but I think a lot of the questions can help formulate thinking around any difficult/high stakes conversation. Things like starting out by finding common ground are so important, people are much more likely to negotiate once you’ve established similarity. Therefore, practicing structure and order, as well as content, can make all the difference.

Pick the right when and why

No one wants to be the girl who cries wolf, who constantly involves themselves in issues that don’t involve them and become perceived as a meddler, or worse than that…..a drama queen *gasp*. At the same time there are things that you do have to stand up and speak up for, be that for your team, your patients or yourself. Knowing when and why to speak up is therefore key.

Let’s start with the why. Well firstly we’ve covered remit, is it something you have the facts and information about in order to appropriately escalate? Ideally, is this somewhere within your sphere of influence? If not you may be better placed in a support role whilst someone who fulfils the above does the speaking out. There’s also something here about authentic leadership and living your values. It’s not enough to say what your values are but you have to live them and follow through. When these three things align then it is definitely time to act.

The when can be more challenging as there are multiple ways this can play out:

  • Formal meetings
  • Informal meetings
  • 1:1 discussions
  • Email
  • Public vs private

The right when/where can depend. Challenging bullying behaviour for instance may be best done in the moment but there are times when it might be better to pull the individual to one side to have a private 1:1 first. Some of this depends on what your success criteria look like and so you may not know initially until you’ve decide what it is you are trying to achieve.

Know your success criteria

This is one of those things I should have thought about more before going into the meeting discussed at the start of this post. Success criteria have to somewhat depend on your level of influence and decision making in any situation. In that case I had some influence and no decision making remit, the best I could hope for was to influence the discussion. Therefore basing my mental wellbeing on the outcome was foolish, as I had limited capacity to change the outcome. My success criteria should have been to go in and clearly define the scenario and give my recommendations as eloquently as possible. Then I would have left the room less disillusioned and questioning my role.

Success criteria can look like all kinds of things, depending on the situation:

  • Influence the decision
  • Achieve an outcome
  • Shine a light
  • Escalate to a more appropriate/different group
  • Demonstrate support
  • Achieve a change
  • Identify support/supporters

Knowing what you are trying to achieve is a key part of developing a strategy and being able to prepare properly. Sometimes we can only achieve a statement of ‘this is not right’, other times you may be able to change an outcome. It is best to be realistic about what the best case scenario actually looks like and aim for that, rather than aiming for something unrealistic and achieving nothing.

Be prepared to pay the piper

#realtalk all of this comes will come with a cost. No one likes the person who is disruptive and speaks out, at least not in my experience. They may respect you for it, but they won’t like you. There have been times when I have sat down and had serious conversations with myself about whether I am prepared to live with the consequences. I’m usually more sure of myself when I’m advocating for others rather than for myself, as that usually aligns so strongly with my values. The times I’ve had to step up and advocate for myself have been both hard and terrifying. When I have conversations with people about advocating for others, I tell them I see it as part of the job. I am here as a leader, I am here to represent my workforce, I am paid to quite literally ‘take one for the team’ on occasion. If I then have to manage the fact that I am not always well liked for giving a voice to others that is a price I decided I was willing to pay before I took the job. If I ever feel like I don’t have it in me to pay that price then that is the time I need to reconsider whether I can fulfil the job role that I am in. The role is too important to not do it well, to not step up and advocate for others. If you can’t stand the heat then it’s time to get out of the kitchen.

Be bold, be brave

So here is the truth of the matter, speaking up requires you to be brave and be bold. It requires you to put your head above the parapet for the benefit of others, even if it comes at a personal cost to you. It’s worth it because you are living your values, it’s worth it because you are advocating for change and for the benefit of others. No matter the cost to you the impact you will have will out way it. It’s in these moments we know who we really are, especially when we fail. That said, all of it can be easier if you do the work beforehand to understand what you advocating for, so you have the data to back your arguments and to ensure that you are the right person to be in the room waving the flag. We are all much braver than we think and we are many, so reach out to those who will you hold you up and support you in speaking out for those that don’t have a voice without you.

All opinions in this blog are my own

Clothes Maketh the Man or Do They? Why I want my clothes to show me, not some version of who I should be

Shortly after I was 14 I went for tea with my Great Aunt. I had long black hair (I was a goth for over a decade) and when I went into her house and we were away from the street she started to berate me: my hair was down, it wasn’t up, it wasn’t dressed. I was 14 now, I was a woman, what would people think if I wore my hair down. People would question what kind of woman I was, how would I get a husband? who would look after me? If I didn’t dress properly, learn to cook and clean and behave properly no one would want me.

Needless to say, this probably had the opposite of any intended effect  I pointed out that I would wear my hair how I wished and that I didn’t ‘need a man to take care of me’ and that I ‘was jolly well able to take care of myself’. Thus was my first introduction to how the way I dressed would be used to judge both me, and my current and future potential for success. This was only emphasised further at my girls school, where being a goth was treated as a one way street to failure at life, rather than a means of self expression. Like applying black lipstick or having black hair would immediately consign me to the rubbish heap of life. I continued to wear black lipstick and have black hair far into my 20’s in part to prove that their expectations were nonsense. 

Imagine my surprise then to find, when working at a council as my first job post university, to hear one of the inspiring female leaders there spending her time preaching a similar message. I remember her so clearly 20 years later, even though I don’t remember her name. She was very senior in the council and was on her way to Westminster to speak. I noticed that she always wore trouser suits with small shoulder pads and so I asked her whether she wore them as she felt more comfortable or empowered in them. She replied she didn’t even like them, but she’d long ago learnt that she had to dress like the men in order to succeed or be taken seriously. No long hair, no skirts, you must have makeup but it must be natural etc.

That’s politics you say, in healthcare we meet patients from all walks of life and therefore we should be able to represent ourselves and reflect back at them that same sense of diversity………….Well that is what I’ve always thought too. Until I went on my first senior leadership course run by the King’s Fund. Now this course was so hilarious in so many ways that at some point I will write a separate blog entitled ‘Taking a walk with the wheel of my life’ but for now let me share that it was the worst £9000 I have ever spent.

The course was called the Athena programme and was specifically aimed at women in senior leadership positions in healthcare. The first three day retreat involved many horrors that occurred within a monastery with no phone reception or Internet access. On the second evening there there was a three hour session on dressing for success. As part of this I was made to endure an extensive slide presentation showing that successful female leaders all wear ‘a uniform’. The uniform being a box jacket, skirt suit, chunky statement necklace and a broach. They included a picture of Margaret Thatcher and the epitome of ‘the uniform’. At this point I should have collected my things and left but as £9000 is a lot of money and I have a thing for certificates, so I stuck it out for the whole 4 modules over a year.

Why am I so offended by this?

The fact that I go by Girlymicro has probably not passed you by. In 2012 when I setting up my twitter account the name was fairly deliberately chosen. I was surrounded by successful men but I hadn’t really met any senior women that I could access for mentorship (thankfully that has now changed and I know loads). I was saddened by the continuous messaging that I needed to be someone other than who I was if I ever wanted to succeed. It wasn’t good enough to be smart, it wasn’t good enough to be driven, it wasn’t good enough to succeed at the tick boxes, instead I had to look the right way to have doors opened for me. This went one of two ways, I could be ‘the pretty one’ where doors could be opened as I was appealing to men, or I could be ‘one of the guys’ where I was accepted because I tried to be one of them, look like one of them, behave or talk like one of them.

Well sadly most days you’re lucky if I get out of bed and brush my hair, so I was never going to be one of the pretty ones. That said I don’t wear trousers, I like kooky shoes and maxi dresses, I’m not being caught dead wearing a statement necklace and you don’t have enough money to make me cut my hair.  I am not therefore ever going to be one of the guys. So where did that leave someone like me? Destined to be pretty much invisible as I didn’t fit the mould? Screw that, it left me making a deliberate decision to try to break that mould by just being me, as publicly as possible. Choosing Girlymicro as my twitter handle was the first step in this journey.

Does this mean I’m saying wear what you want?

Let’s get this one out of the way, I’m not advocating you turn up to clinic naked or in a bikini.  What I am saying is that you can be both respectful and wear clothes that represent who you are as a person rather than being forced to conform to a standard set by ‘others’.

I really believe that dress is one of those things where we use it judge whether people fit our cultural norms. If someone doesn’t fit then no matter how good they are at the role it will always be a challenge. I’ve lost count of the number of times it’s been made clear to me that if I only fit in more, played the game more that I would go further. Dress is just one example of how this is acted out in a way that it easy to assess.

Why is all of this important?

All of this matters because we don’t sit in isolation from our patients, or from our students.  We are the people that stand in front of them. This may be why you tell me that I need to dress a certain way, but is it really?

Is dressing a certain way actually only a reflection of an older version of healthcare where it was about clinician authority? If we are moving towards a model of healthcare that is more based in co-creation isn’t it actually more important that our patients and trainees see diversity and representation in us that reflects them?

I think this is also especially important when we’re talking about progression and recruitment. If people can’t see themselves in a position they will often discount the fact that it is for them. Dressing in ‘the uniform’ isn’t just exclusive in terms of making in and out crowds visible. It also requires privilege.  None of those clothing items are cheap, most of them would have been incredibly inaccessible to me until I was on a consultant salary. To be honest even now I’m on a consultant salary there are things I would rather spend my money on. Why are we making a job that is already difficult to access and viewed as inaccessible even harder, by requiring you have have money to merely fit in.

My other question is whether this reflects our diversity and inclusion aspirations? Where do braids fit into this or choosing to wear a hijab? What about those people who have alopecia or are allergic to make up? If we are serious about representation and moving towards a more inclusive working environment should we be setting implicit standards which require others to change who they are in order to conform if they wish to succeed? What kind of message are we sending about what we require to work with us, if we are saying you have to leave who you are at the entry of where you work.

Wear what empowers you!

I am always going to be the kind of person who looks like they’ve walked through a hedge on the way to work and if I manage 3 hours without dropping food or drink down myself it’s probably because I haven’t found time to have either. This is what I’ve landed on however. I will wear things that empower me. Some days that means I may wear a jacket, sometimes that means I will wear an inspirational slogan and sometimes it just means that I will wear something comfortable that will get me through the day.

I will also not judge the clothing of those who work around or for me. If you are wearing jeans in the lab I do not care. The only place you will receive judgement from me on the matter of dress is if you are working on a clinical unit and are covered with bangles and other things that mean you are increasing transmission risk to others. Even my ‘you do you’ attitude has limits when it comes to patient safety.

I want to finish however with a story that shows that you don’t need to conform to be a success. Many of you will know Dr Kerrie Davies. If you don’t she’s a truly inspirational woman, and don’t just believe me, she won last years Healthcare Scientist of the year award from the CSO, so people who are waaaaaay more senior and brighter than me agree.

I met Kerrie when we were both trainee Clinical Scientists over 10 years ago. Since then she’s won million pound grants, been a Lead Scientific Advisor for the UKHSA during the COVID-19 pandemic and been awarded a PhD. All with blue hair! Kerrie expresses who she is and is unapologetic about it, whilst simultaneously being both a super bright and empathetic leader. All I can say is that we should all ‘be more Kerrie’ and the world would be a better place.

Whilst you think about your outfit for tomorrow and how you are going to start wearing something that will help you be just a little bit more you, I’m off to have a serious think about whether I could pull off blue hair.

All opinions in this blog are my own.

Happy but Struggling: Welcome to my third year of the SARS CoV2 pandemic

Its 6am and I’m sitting listening to fire alarms go off in my hotel room at FIS/HIS. I’ve been up since just before 3 in a shame spiral of all the stupid things I said during day one of the conference and only just got back to sleep at gone 5am when the alarms started sounding. Frankly this feels like a metaphor for how my life has felt for the last 2 years, long and short the constant sound is exhausting and stressful. An hour later the alarms are still going and I’m now doing the only thing possible, which is to leave my room in some highly elegant nightwear and take myself, a laptop and a cup of tea to sit in reception to write. I may be looking a humiliating level of baggy eyed exhausted shell but at least it quieter and I have caffeine; which brings this metaphor all the way up to 2022. It’s better, I’m happier but oh lordy am I still broken. So as we sit in our 3rd year of dealing with the pandemic how are things different and how are they the same?

The things I love doing are so close to being back

One of the things that is currently saving my mental health and well being is that you can almost now envision the point where normality could return, or the new normal anyway. I know that if you have listened to politicians and social commentators recently you would think that normal is already here, but for me we’re not there yet. I can however do things like think about booking tickets for the future events (I cannot wait for Eurovision!) and hope they will go ahead, I’m contemplating planning trips and have started seeing friends in slightly less controlled ways. I’m even sitting here typing this at an in person conference, which has been surprising lovely and not stressed me out in the way I thought it would.

This being able to vision is important to me, it’s also important to me in the day job. For a long time all there was was SARS CoV2, you couldn’t plan, you couldn’t see a time when you would be able to do anything else. Now though things that give me so much joy in terms of education and research are coming back, papers are being drafted, grants are going in. I can see that we can begin to focus on other things with changes and improvements that need to happen. It may still feel like a shock but after all healthcare is NOT all about respiratory viruses and there are things beyond that which impact patient care that we need to take some time to focus on as well. All this said however, I have to re-state how tired I am and it is yet to be seen whether I have the inner resources to hit the ground running in the way that I would like.

Back on the carousel

Having just said how happy I am to be getting back to doing some of the ‘normal’ work of Infection Prevention and Control, there’s no getting away from the elephant in the room. We’re still dealing with a global pandemic, which a lot of the world seems to have forgotten. We’re still managing guidance changes, testing cases, investigating and managing hospital cases, but now with all of the funding support withdrawn and whilst being expected to also manage ‘business as usual’ on top of everything else. All that with having had 2 years of no sleep and no rest. In some ways, and this could be me, everything else is also more of a mess as we’ve been in crisis mode for so long. It’s not even as if the ‘business as usual’ is straight forward no even taking into account how much re-training needs to be undertaken.

Because of all of this sometimes it’s hard to tell whether you are on a nice gentle carousel or are actually on the waltzers, trying to manage everything thrown at you in a landscape that is still constantly changing it’s priorities and demanding responsiveness to everything that is being put in front of you.

Single interventions don’t work

Everyone in the world still appears to be an expert in IPC and there still seems to be so much reductionism linked to the idea that a single change will revolutionise everything. I’m a little ‘over’ trying to have the discussion with people that covers the fact that almost all IPC is about introducing packages of measures/interventions. It’s what is often frustrating as a researcher, in that single interventions are therefore quite difficult to evaluate for their impact, but the world we live in clinically requires us to be able to control multiple risks and therefore manage multiple risk mitigation strategies simultaneously. The truth of the matter is that a single change will rarely control risk in the complex environments that our patients are in, even without adding the complexities of human behaviours and human interactions. I’ve written about this before, but I strongly believe we need to become comfortable with complexity and that part of our role in IPC is to assimilate complex multicomponent information, process it to make a balanced risk based set of decisions to establish a strategy, and then to implement that strategy in a way that appears simple and practical to those that are implementing. Taking the complex and processing it so that it can be disseminated in an accessible way is, I believe, one of the key talents of many IPC teams. We need to communicate this better as being one of our strengths and move away from single intervention focuses.

Could do with a little less ‘interesting’

I don’t know about anyone else but i could do with less (take your pick) of monkeypox/lassa fever/polio/Burkholderia/invasive Group A Strep or any of the other ‘interesting’ alerts that we have had lately. I would normally love something novel to get my teeth into, but right now the ‘interesting’ seem to be coming thick and fast and I for one am only just managing getting back to MRSA and resistant Gram negatives. The constant ‘organism of the week’ just means that any return to balance feels like it’s going to be slow coming. I hate routine, it’s one of the reason I got into IPC, but even I could do with a little routine and boring for a while to find my centre and recover a little and recharge those batteries before embarking on the next new thing.

Summer down time isn’t so quiet

I think this has all been compounded by everything that has happened over spring/summer. Summer is usually the time in IPC where you can catch your breath a little, where you can plan for the inevitable challenges of winter and do the visioning piece to work out how you want to develop the service and move it forward so that everything works just a little better. This summer though there’s been little to no respite really, between new variants and waves earlier in the year and the new and ‘interesting’ since. Summer has been anything but quiet. This means that you know you are going to go into, what is predicted to be, a difficult winter without catching your breath and still trying to spin plates, with even more work having been pushed back to 2023. I think we will all still pull it off and I truly believe we will manage most of the things we were all hoping to achieve during the summer lull, I just fear that to make that happen we will carry ourselves into another winter running on empty. I think therefore we need to have the conversation with ourselves now about being kind, not just to other people but also to ourselves, and where you can plan accordingly.

Do more with less

All of this comes at a time when we are all very aware of the pressures on services and the resource limitation issues we are all facing. We can’t just do the same with less but we have to do more with less. The COVID-19 money has gone, the extra staffing support linked to it has gone, but a lot of that work hasn’t disappeared as we are all playing catch up on waiting lists and clinical work. It is easy therefore to feel pretty disheartened about the hill we need to climb, having already given up so much, both as individuals and as a collective.

The truth of this however is that some of the very pressures that sometimes feel like they are crushing us are also bringing some benefits. I am closer to my team than I’ve ever been. I’m more certain of the things that matter to both me and my service. I have significantly more clarity than I’ve ever had before both about my professional and personal life. Limitations on resource access have meant that we’ve had to worked harder to develop networks and build connections in order to use what we have better, and that connectivity has other benefits. So as much as I hate the words ‘better value’ I can see both sides of the coin, and not just about the money. I can see that it will make how we move forward better as we will move forward more together than we have ever been before.

The inevitable post mortem

One of the things that struck me when I went through my first pandemic, swine flu in 2009, was the way that you could do nothing right for doing wrong. One minute you are heroes and the next you are villains because it’s politically expedient and someone has to be the focus of dissent. I know people that were upset by headlines during the Tory leadership contest that basically went after many of us who had stepped up on top of our standard roles to offer help and support. We stepped up because we felt it was the right thing to do and despite (in many cases) significant personal cost. Sadly, having been here before i was not surprised. Worse than that, I think we need to prepare for the fact that this will be the theme over the next 12 to 24 months, and that we will be used as a political football by many people. Hindsight is 20:20 and retrospective data analysis is a very different beast to prospective decision making. So my advice on this one is that we all need to develop a thick skin, understand what the drivers are for the headlines, and let it wash over you rather than taking it as the personal attack it can sometimes appear to be.

So having said all of this what do I think the next few months will hold? I think we will continue to be challenged, both in terms of the patients that present in front of us and in managing the service demands this places upon us. I do think that IPC teams and healthcare professionals will continue to step up and do what needs to be done to make care happen. As leaders however, we need to be aware of what that ask looks like and have strategies for managing it in an already tired work force. For me being able to focus on the future is how I get through the present, therefore planning for normal times is key to my survival. People ask how I’m putting in grants, drafting papers and planning change. I do it not because I have time and capacity, I do it because I have no other choice. I’m aware that it’s key to my survival, to keeping me grounded and enabling me to cope with the stress that exists in the now. Some people ostrich, I plan. As people are different however, I also know that my planning can stress others and so I try to be aware of how much I talk about the future to those people who are opposite and survive by living in the present. Dealing in the best way possible right now is mostly about knowing who you are. The clarity provided by the last two years of the pandemic has helped me in this by forcing me to know more about who I am and how best to manage myself. I have learnt and I hope to continue to use this learning to grow. So I will continue to hit the day dream button and drink tea……….I hope you find a way that works for you.

All opinions in this blog are my own

Stepping Up and Stepping Out: Making the shift into a senior role

It feels like the time of year when people start new things in their lives, new jobs, new courses, new career paths. So many people I’ve been speaking to lately are moving onto bigger and better things, with many of them starting their journeys as senior leaders both within academia and the NHS. I’ve spent some time talking to them about what I found might be different and some of the challenges about stepping up into a leadership role. Now, my journey to consultant and Lead Healthcare Scientist was not particularly linear so I may have some thoughts about this that aren’t universal, but after doing some thinking the below are what I’ve come up with in terms of how I think senior leadership roles are different and how my thinking has changed whilst in post.

It’s no longer all about you

First and foremost this is the most important thing that I feel is at the heart of what I try to make my leadership decisions based on. I’m now out there representing more than myself, I’m representing a team or even a whole workforce and sometimes therefore my wants and needs will have to take a back seat. I’ve been in meetings where I have given up something I want because actually it enabled something to happen for the wider good of my workforce. I personally don’t think there’s a place for selfishness once you are in a band 8 + position, although I’m also sure that I’m not perfect and probably don’t always make the best calls, it just means I make a conscious effort to keep it in mind. That doesn’t mean that sometimes things don’t work out so you get the best of both worlds, but when you are representing more than yourself you have to do exactly that, represent.

It’s no longer all about doing

One of the things that I think can be especially challenging when stepping up into a senior role, when you are more used to an operational or service provision role, is making the switch from being the person who does to being the person who sees. What I mean by that is that a lot if my job is about constantly having one eye to the future. Where are we going next? What are our current strengths and weaknesses and how do we manage them moving forward? What are the challenges coming down the road and what can we do now to prepare as much as possible? Not only that but once I have a path in mind I have to develop how we are going to get there and communicate that vision as broadly as possible. Obviously this isn’t done in isolation, it needs to always be an inclusive process, but a lot of the thinking sits with me. If you continue to only have an operational view, it can rabbit hole you into the present, it can then be a struggle to emerge for long enough to do that vision piece. So, although it may be comforting to get back to the bed side or to the bench, you have to make sure you’re doing it to maintain skills when needed rather than avoiding seeing the landscape laid out in front of you.

It’s no longer about picking and choosing who you work with

We all have people we love working with and some people where, because we don’t necessarily share the same vision, it is more challenging. As you become more senior you have less and less choice about who you work/collaborate with, those decisions are made due to the work and not due to personal preferences. This may sound odd but I genuinely believe that this is not only right but a good thing. If you only work with people who are easy, who see the world the same way you do, are you really working to reflect the wider attitudes of your staff? Although not easy some of the best project outcomes I’ve had have come from working with people who have very different attitudes, values and objectives. If done well and professionally these relationships enable you to have constructive challenge and see work or scenarios in a way you never would alone. They may not lead you to change your direction but they will always help your thinking as to why, and often help you to develop and articulate your arguments in a way you may have not gotten to on your own. Best case, you’ll get an outcome you couldn’t have achieved on your own, worst case you’ll have clarified your thinking. This doesn’t mean that I don’t (as someone who likes to be liked) find this a particularly challenging aspect of leadership, it’s just that I also really see the value in it. Hiding is no longer an option.

All those people you thought were on top of it probably weren’t

If you are like me you probably spent a lot of time in previous roles being amazed at how productive your seniors were and at how much they achieved. Now I’m probably biased here, but rather than judge myself harshly I’m going to extrapolate instead that all those people I looked up to just covered up their failures better than I do. My experience of stepping up to leadership is that you will have more work than you can manage at any one time, you will never clear the decks and you probably won’t ever ‘finish’ anything. That’s because you will move from a task based role to one that is much more far reaching and often conceptual. Some days I really miss just being able to spend a Friday doing 16S rDNA sequencing, unless I screwed it up I knew that at the end of the day I knew that I would have achieved something and that I would then action a patient result. Now most of my days are moving things forward by inches, or if I get to the point where I get a task off my list it is so rapidly replaced by something else I barely notice it, let alone have satisfaction as a result. This isn’t to bemoan this way of working, it’s just different and if you come from a very task orientated role it can be a little demoralising at the start as it can be hard to see progress. It’s really worth therefore finding other ways to track your progress so that you can still find a way to visualise it. I sometimes try an annual wish list for instance where I check in over a period of months rather than days to see how things are coming together.

You will spend more time than you thought possible on emails and calls

It’s currently 6pm and I’m just trying to get some words down here before I leave work. I have spent since 8am this morning trying to recover from the email backlog from 3 days off work last week, I’m proudly down to 283 which need actioning. Email is the quicksand of my working life, when combined with days that often have meetings back to back from 8 – 6, they are almost impossible to keep on top of. The main thing I’ve tried to develop are some tools to try to ensure that I don’t miss anything devastating and urgent. That said if it is devastating and urgent you should probably be calling rather than sending me an email. I’m quite up front with people. If your email comes in whilst I happen to have a window and I’m staring at an inbox you will probably get a response within 5 minutes, if not it could be 5 months. If you need a response send it at least 3 times, preferably with a red flag and then at least it will get to the top of my to do list. At the height of SARS CoV2 I was getting upwards of 600 emails a day, thank god that’s reduced, I just couldn’t keep up. Over time I’ve also tried some strategies to protect my diary where I can. My fab IPC team suggested a 1.5 hold in my diary every day for urgent meetings so that they should (almost) always have a slot which they know is theirs to put it meetings when needed. I also try to go to less meetings that are just for information and not for action, otherwise to be honest I would never manage to eat or go to the bathroom. Feeling out of control is therefore pretty normal and it’s about strategising so you keep on top of the key things. You will also develop language that will help you cope and politely deflect some of the things that could be handled by someone else. I used to feel bad about delegating, but actually a lot of the time it offers development and learning opportunities for others. If done appropriately it will not only buy you a little breathing space but it will enable others to continue their own career journeys.

Sometimes it’s your job to be the shield

One of the things that comes with being the one to develop the vision is that you also (often) are the one that can see the storm approaching. This one for me goes hand in hand about the role no longer being all about you. Sometimes it’s my job to stand in the front and take the hit, sometimes that’s being shouted at by a family for the tough call, sometimes it’s dealing with the response of other senior leaders. This is why it is sometimes lonely being in a senior role and you will need support for you as an individual. Senior roles are often not that linked up and so you won’t necessarily have someone who is doing the same post as you, you will therefore need to be pro active in building your own support networks. These will also help with the visioning piece as the more connected you are the more pieces of the jigsaw you will see. The more you understand the drivers of what is going on in any particular situation the more you will be able to respond with understanding, and the greater the chance of improving a situation rather than making it worse. There is no getting away from the fact however that sometimes you just have to don your big person pants, stand your ground and deal with whatever has come your way with as much integrity and grace as you can muster.

There are weights you don’t see

I recently took hubby away for his big birthday to Disneyland Paris. Towards the end of the holiday I looked at him and I suddenly realised how different I felt. For 6 days I had not been Dr Cloutman-Green, I’d just been Dream. I’d made no decision bigger than what I wanted to eat/drink or what ride I wanted to go on next. I felt stones lighter and so much freer. I hadn’t realised the weights I’d been carrying with me. I don’t know how much of this is COVID but I find there is an unseen, and some days unbearable, weight that I carry with me and that I don’t even realise it’s there until I put it down for a while and take off my healthcare hat. This may just be a me thing, it may be a pandemic thing, but if you get afflicted you have to make sure you that you put the weights down from time to time and do whatever it takes to make you feel free again, for me it was going to a mad hatters tea party!

You will always be more than your job, you will have other roles (mother, wife, carer, sister, father, son, brother etc) and we can’t always sacrifice these for a job that can become all encompassing if we let it. In the long term it will make us poorer both at the job and as human beings. Some of these weights we will put upon ourselves and so need to work on ourselves to resolve. You will not have all the answers on day one in your new role, you are constantly going to learn and develop, in fact I hate to break it to you but you will never have all of the answers. You will fail at things more than you’d like. This is part of life, it’s part of leadership and it’s part of learning. It’s OK. The sooner you come to terms with that the sooner you can remove an unnecessary thing that might weigh you down.

I for one didn’t realise any of the above, in fact I didn’t even really realise I was a senior leader, it kind of just snuck up on me. I think the capacity to influence and lead change is worth so much more than the challenges that come with it. For me as a Trust Lead Healthcare Scientist I get the immense privilege of seeing so many people develop and flourish, who will hopefully one day give me a job, I wouldn’t change it for the world. If you have just stepped into a senior post or are thinking about it I hope the above helps and makes your realise you are not alone in the challenges you face and that overcoming them makes us better, even if the path is sometimes bumpy. For those of you not yet at that point I give you the advice that I wish someone had given me, enjoy the freedom, enjoy focussing on you and your career pathway, enjoy making choices that are your own and don’t be in too much of a rush to get to the top of the mountain.

All opinions on this blog are my own

The Power of Winning: Why I think the reason you are playing the game is as important as the outcome

Many of us spent a glorious evening last weekend watching the Lionesses (England Woman’s Football team) finally ‘bring football home’ by winning the European Championship. If you don’t watch or have no interest in football this is significant as it’s the first Championship win for any English football squad in my lifetime and something that the male side failed to replicate last year. Listening to some of the commentary made me reflect on the power of winning to support change and why outside of sport sometimes winning can make some of us feel so uncomfortable.

I’m going to put this out there. I get called competitive A LOT. If I’m in, I’m all in. Not for the winning but for the being part of the process. For me it’s all about the learning and the growth. I’m not therefore so competitive with other people but I have a tendancy to, perhaps, push myself a little hard. I come from a family of super competitive siblings, my brother cannot stand to lose and my sister was a superwoman,  she was going to start a PhD with a newborn afterall. So I suppose I grade on a curve and when compared to them I was always the one who was happy to lose at cards/games. Still, I was raised in an environment where every dinner discussion was basically debate club and so I carry that with me.

Growing up in this environment means that being competitive is a trait in myself that I’m not particularly comfortable with. Frankly I don’t think it’s a very attractive part of my personality. It does mean that I can single mindedly focus on task though, which has advantages for exams etc. It was interesting therefore for me to see the winning of something being talked about as a really positive thing, not just for the winners, but to enable and support change. Change not just in attitudes but in the way things actually work. I’ve always told myself it’s the taking part that counts (and I stand by this) but is winning something that does enables us to achieve change beyond ourselves? If it does, is this something we should think differently about and actively use more if we are fortunate enough to have it happen to us?

Winning can be seen as superficial achievement, but is it?

Winning something, especially on a large scale, has the capacity to change us. I’ve been thinking about the difference that change makes in us that might enable us to then support the wider change we want to see elsewhere.

There are some people who have an innate confidence that they are where they need to be, there are others who are over confident and come off as arrogant. For the vast majority of people I speak to however, we spend a lot of time striving and reaching to feel like we deserve to be where we are and to belong. It struck me whilst I was watching how much these girls are likely to be the same as me. There’s been a lot of ‘well they are only girls’ and ‘when it comes to it they’ll crumble’. When you’ve spent year after year hearing words like that, I’m not sure that winning is superficial.  I know that for me having concrete markers of achievement, especially when given by or measured against my peers, really helps me feel like im doing something right and increases my sense of purpose and belonging. We shouldn’t need external reinforcement but when you have worked so hard having that acknowledged by those you benchmark against matters. It can change the way you feel about yourself and quieten some of those inner voices of doubt, at least for a while. That change in ourselves can embolden us to action,  to feel more able to make the change for others, to feel worthy enough to enter the fight. So maybe winning isn’t as superficial for some of us than I had previously thought.

Why does visibility matter?

‘You can’t be what you can’t see’ (or become aware of to be less ableist)…….for me one of the amazing bi-products of this game is that I am writing this blog or more widely that people are talking about it. I’m a Aston Villa fan so I am used to supporting teams that win little and I am certainly not the kind of girl who switches her loyalties in order to follow success. I do get however that winning draws people in. There will be a lot of people who have never watched women’s football who watched that game. There will be a lot of people who don’t normally watch football, or maybe sport at all, who watched that game. Those people who aren’t normally reached, who aren’t normally impacted are now part of a conversation that might have happened anyway but with much smaller numbers. Winning may not just have changed the conversation but also changed the reach of that conversation. Girls who may not have thought that sport was a career option for them will now know that it is something that could be on the list. Wider than that though, girls who have heard that they will never be able to compete on the same stage as men in general will now have evidence that is just not true. The change that can be born out of that one moment in history has the capacity to impact beyond sport and that really matters.

Why am I sometimes ashamed of winning?

Worse than being seen as superficial, winning can actually be seen as an act of selfishness. I’m sure that this is true for a lot of men too but growing up in a competitive household it was still not seen as a particularly gracious trait to talk about winning, you won and you moved on to the next thing. I think on a wider level there has always been that thing that good girls are seen and not heard, you don’t rock the boat, talking too much about success is seen as rubbing others nose in if rather than a way to inspire others. This hit home for me as last week when the Lionesses won I was in a bit of a quandary about whether to share my own success. I was lucky enough to be on The Pathologist magazines 2022 Power List. This is really nice but also as there aren’t that many Clinical Scientists on it I wanted to share it so that more people are aware of it, so next year when nominations open we can work to get more of us nominated.

It came up on my LinkedIn and I stared at it for ages trying to decide whether resharing it was an act of indulgent arrogance or not. Then I went on the twitter and I saw the joy with which other were sharing their listings.  So I decided the right route was to share and congratulate everyone I saw who was posting as well as my own. That felt right to me as it was about joining in the celebration of others and working together to try and raise awareness of the wonderful scope of our profession and the list itself.

Like all things the why is important

The why, therefore, to me is as important as the winning. Why was I involved to begin with? What were my motivations? Why am I choosing to share or not what the result was? I think one of the things I often challenge myself to do is share as many of those things I fail at as I succeed at. To remind myself that failure is not shameful as it is often where I get my best learning. I have to challenge myself that if failure is not shameful than succeeding should also not be shameful. As long as I’m being equally visible with both then I’m not doing it for the wrong reasons. My reasons for sharing winning and success should never be to stand on a pedestal and go ‘didn’t I do well’ but to stand where I can be seen in order to offer a hand up to others. Sharing success is not an intrinsically selfish act or an act of arrogance that should elicit eye rolling.

The other way that I reflect on whether success is something to be shared is to challenge myself about how I would respond to it if that post was coming from someone else. I love seeing and resharing the success of others on Twitter and other platforms. I get joy from seeing others succeed. If I get to the point where I am not amplifying others, hopefully more than myself, then I would need to really start questioning why I am putting info out into the world. At that point I feel I would have slipped into self congratulation rather than doing it for the right reasons and I hope I would stop and give myself a talking to.

Haters gonna hate

Having said all of the above let’s just get a reality check. Someone is going to hate whatever you do. That’s just the way of the world, especially as you work to raise the visibility of yourselves and others. The Lionesses are already getting grief and are being told that their success is worth less as they are women. In my opinion this is just more reason to celebrate and push for change. I have been told that my success makes others feel uncomfortable and that I’m only a Lead Healthcare Scientist in order to laud my success over others, that I’m all about winning. The thing is that all of that only matters if its true. If it is true then it gives you the opportunity to reflect, to change and grow. If it’s not true then no one else knows your motivations and so they don’t know your why, they therefore can’t really judge the results.

So my thoughts are that winning can be just as important to others as it is for you. Sometimes the winning itself can empower you to make a change happen far more widely than you would have been able to do otherwise, either due to increased visibility or just feeling worthy to have a voice. We will always be judged but that isn’t the reason to not play the game. Just make sure that you take the time to check in with yourself to know that whatever the outcome you’re doing things for the right reason. If you are lucky enough to win, shout about it, celebrate it, just make sure you celebrate others with the same energy and enthusiasm that you use to celebrate yourself.  Winner is not a dirty word.

Anyway, I’m off to the Commonwealth Games this weekend to see more amazing individuals push themselves, break records and win. I may reflect a little more as I admire everything they’ve given to get to this point and you can be sure I will be celebrating them, win or lose, with every step they take.

All opinions on this blog are my own

You Can’t Please Everyone: Why I try to remember the rule of thirds

I don’t think that anyone enjoys being disliked, but some people are much better at dealing with it when it inevitably happens than others. That’s because trying to please everyone people is frankly exhausting and ultimately futile as people are so varied as to make it impossible. I don’t know about you but after 2 years of COVID-19 I’m too tired to do it anymore. I think having reached acceptance that I can’t and won’t be everyone’s cup of tea has come with a feeling of freedom, so I thought I’d share some thoughts of how I got here.

How do you know if you are a people pleaser?

For many years I didn’t realise that everyone wasn’t like me. It meant I also didn’t understand why some people were able to behave like they did (not always badly but with independence) without suffering the crippling shame spirals that happened to me. So how do you know if you are a people pleaser? Some great examples are below.

https://www.scienceofpeople.com/people-pleaser/

You may not be a dyed in the wool people pleaser all the time. It’s true primate behaviour to become more extreme in this behaviour during times of stress, meeting new groups or in high stakes situations. Which is why I suspect that for me it’s been made worse by COVID-19. Being aware of your tendencies so you can undertake a review of whether or not they are helping you is key. For instance I have a tendency to over compensate initially when I’m annoyed at someone whilst I process that irritation. This can lead to me having less good outcomes in the long than if I’d taken a more neutral stance, as I am guilty therefore of sending mixed signals.

Playing well with others

This pleasing people can be especially challenging when it comes to working on group projects or when running events. I’ve been running events and working in groups/teams for most of my life and for all of my NHS career. Most of you won’t know this but for many years, even in my spare time, I ran role playing conventions or live role-playing events for dozens or even hundreds of people. The main thing that I have learnt in my time doing these is that it is actually impossible to please everyone. The things that were one person’s highlight will inevitably end up on the list of another’s persons disappointments – especially when events reach a certain size. Everyone is different and therefore it is almost impossible to tick the boxes of everyone attending.

When I was putting myself through the ringer and getting upset about the not universal love for a freeform I’d spent a year and over 150,000 words writing a good friend turned round, hugged me and whispered in my ear ‘remember the rule of thirds’.

Now I had never heard about this but on follow up questioning it turns out as follows:

  • A third of the people will love it
  • A third of the people will be ambivalent or think its OK
  • A third of the people will hate it

You will hear most from the lovers and the haters but what you actually need to know is how many of the ‘good enough’ people there were. If you manage to get over over a third you are probably doing something right (unless the extras all come from the lovers category). Those are the people you won’t be able to judge the numbers of unless you specifically go out there and seek their feedback – otherwise you respond to the most vocal and may react incorrectly.

The thing is as I go through my career I think the last part is really becoming a key part of my thinking. Am I or do I respond to the things that are shouted loudest or do I take the time to actually evaluate the situation that is beyond the noise to make an action plan which may work for the quiet majority?

It isn’t just about groups

I’ve started off talking about groups but obviously people pleasing can have challenging aspects in 1:1 settings. In fact overcoming people pleasing tendencies in these 1:1 settings can be key to maximising your own effectiveness both at work and at home. I’d like to state for the record that this is very different from me advocating for selfishness. We should absolutely all be team players, but it is important to also ensure that you have the capacity and reserves left to be the best version of yourself so that you deliver as fully as possible.

Below are some of the things I’ve been thinking about/learning in order to handle some of these 1:1 settings better.

Set your success criteria without bias

When I have someone in front of me asking for something I find it incredibly challenging in the moment to say no. Especially when each individual request doesn’t feel unreasonable or large. This year though I’ve been trying to move towards not seeing these 1:1 moments in isolation, but rather to measure them against a holistic whole of what is happening in my life. One important step towards being able to judge whether taking something on is people pleasing or appropriate, is to set boundaries and measure your responses against these.

These decisions can be very challenging in the moment and so one of the things I’ve started to do is to set my own success criteria, before I start projects, but also for my year. These are not another rod for my own back but are a way of checking in with myself about whether something is going in the right direction and whether the decisions I’ve been making are actually serving me and the goal.

It’s important to do this before being in the moment. When I’m in the moment emotions and other pulls can make it difficult for me to evaluate. By having a list that is done before I get into the situation it enables me to have made an unbiased set of judgements that are more reliable for me to use as benchmarks.

One example of this happened recently. This year I had promised myself and my family that after the last 2 years of work coming first I would start to regain a balance where actually my family would be my priority for a while. In May we had some news that meant that this was even more important. In that moment I was able to go back to my list and goals and re-evaluate commitments against my stated aim for this year. Although it was sad I then stepped away from a number of things I was agreeing to that were interfering with my top goal for the year, spending time with my family.

I’m aware other people may think I’m barmy to have to do things this way, but I really easily slip into a default of yes, and in many ways that’s great and where I aspire to be. Not at the costs of my main goals however.

Communicate and manage expectations

If you are going to do this though, communication is key. One of the reasons that I can get more drawn into things than I originally intended is because either myself or the other side haven’t accurately communicated their expectations.

One of the things I dropped in the above example was being a school governor. I only started the role in September 2021 and I had been told that it involved 3 2 hour meetings a year. This I had decided I could manage even in a pandemic and that giving back to my community was sufficiently important to me that I could make it work. Then the mission creep occurred. Suddenly it was 3 meetings a year plus a governor monitoring day per term, then that plus, as Health and Safety governor, I needed to do an inspection visit per term, and finally I became governor with responsibility for science teaching review. Suddenly my 3 evening meetings a year were replaced by at least 2 day visits a term plus the other meetings. Something that was simply incompatible with my goal for this year. In previous years I would have just made it work, I’d signed up after all. This year I reviewed against my goals and found that it just didn’t fit with me achieving the things I’d prioritised for my life so I quit.

The lesson for me from this is that we have to be very clear in communicating our expectations and what the situation will actually look like. That works for both sides. I should have been clearer about the commitment I could actually make and they should have been clearer about what they needed. So many things in my career have been subject to mission creep and I’m trying to be much more aware when I take on new things what they should look like and how much variability from that I’m prepared to accept.

You can’t fix everything

One of the situations that I know is a real challenge for me and my people pleasing tendancies is when I’m presented with a situation where I feel like I should help or ‘fix’. At times like this I become a real helicopter friend/manager and I try to ride in on my white horse and make things better (mixing my metaphors all over the shop and I don’t care – see that’s what I call growth). It comes from a good place, I don’t like seeing people upset or struggling. The problem with this is that a) I often then take on unexpected extra work as part of the response and b) I actually take the learning away from the person I’m trying to help. There is a big difference between assistance/support that enables learning and development and ‘fixing’ which then takes the learning experience away, although fixes the situation in the short term. I struggle to know when in the midst of these situations when to step away or hold my ground to allow space for development to occur and how much help is too much.

This brings me onto something I’ve mentioned previously. It is sometimes just not possible to please everyone. Sometimes you have to have the courage to be disliked and honestly this is definitely harder 1:1. This can happen for a number of reasons: sometimes it’s because it’s a collective decision and not everyone in the group is going to be on board, sometimes you have to make a decision that is in the best interest long term but may not garner immediate approval or understanding, and sometimes (especially in IPC) you make difficult decisions on the basis of safety. I have found this the most challenging aspect of leadership, but I have come to one conclusion and that is I need to acknowledge the noise but not be deafened by it. I have to put it into context to be able to deal with it. If I believe that have done all I can, communicated/collaborated as well as I possibly can, then I have done the best I can in the moment and I have to put my people pleasing aside.

Remember context is key

You can only control you, your responses and what you have decided to put out there. You can’t control how it is received and you definitely can’t control the responses of others. Often these responses are not even about you or what you have put into the world. They will be intrinsically caught up in the perceptions of others, their prior experiences and their current emotional state. Fundamentally it is not all about you and you have little to no control over the people you are trying to please. The more we recognise this, the more we can put our energy into focussing on success criteria and moving forward in the wider landscape.

I’ve found the below image really useful in addition to checking against my success criteria. If my only motivation in saying yes is to please, then actually my answer is really no and the sooner I deal with that the better it will be for all involved.

People pleasing isn’t a zero sum game, by prioritising something over something else there is always a resource cost. If you like me have spent energy for years trying to please in situations where you have little or no control of the outcome my plea is to stop. Think. Why I am doing this? Is it actually helpful? Does it align with my values? Does it move things forward? If the answer is no, then the answer is no. You are allowed to decline, you are allowed to choose where to focus your energies, you are allowed to have your own goals. So say it with me now ‘No’ ‘Thank you for thinking of me, but I can’t right now’ ‘It isn’t the right time for me right now, but please do contact me again in the future in case I can help then’. Your world will be a better place for embracing the power of N O, you will succeed more, do more and in my case I will get to spend time with the people I love who are, after all my reason for being.