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

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

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

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

So why am I posting this now?

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

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

Impacts on dignity and right to choose

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

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

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

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

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

Importance of communication assumptions about levels of understanding

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

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

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

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

Who are we making COVID-19 decisions for?

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

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

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

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

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

All opinion on this blog are my own

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

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

It’s All About the Shades of Grey

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

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

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

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

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

Risk Assessment and Personal Choice

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

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

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

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

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

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

Mixed Messages

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

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

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

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

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

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

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

All opinions in this blog are my own

I’ve just come off a Sunday morning Zoom call for Rise of the Resistance, a digital festival I’m involved in that will be happening on the 4th and 5th June 2021 about Antimicrobial Resistance. It’s been a long week and this blog is late because I’m super tired, but what struck me when I came off the call is that whilst on it (and for a while after) I’ve actually felt energised and enthusiastic. That’s not to say I don’t love my work and I never feel like this about my job. I do. But I’ve noticed that, after a year plus of the pandemic, I don’t feel it as much as I used to. This made me reflect on why that is, and what feeds my energy and enthusiasm and where I feel drained.

Now, I’m not the biggest fan of Myers-Briggs but I do think that it can be a useful start in terms of reflecting what energises and what drains you. I flip between ENFP and ENFJ, depending on the test and how stressed out I am. Where I never vary is on the feeling dynamic: I need to feel connected to people in order to feel inspired, creative and like ‘me’.

One of the issues I’ve experienced during the pandemic is the ‘feeling connected’ part. I get this through being creative, working collaboratively with others and spending time with people who enable me to feel secure and support free thinking. I find routine to be draining. It seems weird to describe the pandemic as routine, but in many ways it’s been the worst combination for me. There’s been no time, thinking space, or resources for true creativity and innovation. Whilst at the same time everything has been constantly changing and so most of my available intellectual and physical resource has been focussed on administration and reacting to change, rather than driving it.

True change and innovation require time for self reflection and the establishing of partnerships. This has definitely been something that has been resource-limited.

If you use DISC profiling I’m about as strongly DI as it’s possible to be, with an additional focus on collaboration. A lot of my team are much more C (see below) and so react to the challenges faced by this change in working structure very differently to me. For them, they haven’t enjoyed the ever-changing guidance but for a different reason, as they prefer routine and structure. Interestingly, no matter who you are, this way of working has probably been draining for us all, rather than energising us.

It feels to me that all of us are therefore coming out of the last 12 months plus in a drained rather than energised state, both as individuals and as teams. If we are able to continue for the next 12 months, we probably need to take some time that we don’t have to reflect on what our working lives are like right now and how we can change them to build in some of the activities that energise rather than drain us. For me I’ve found things like Myers-Briggs and DISC a useful starting point. But they are just that: a starting point.

I’ve spent a lot of time thinking about where my passion lies over the last 12 months. I have the best job in the world but there’s no getting away from the fact that it has been hard and frequently draining lately. Not just that, but it is likely to continue to be so for some time. I’m incredibly lucky to have projects like Nosocomial and to be involved in teaching, which enables me to visualise and see impact and change, as well as to build connections and networks that are super important to me. A lot of these projects have been on hold for some time, but – as the things that energise rather than drain – now is the time to dust these off and make the deliberate choice to re-engage.

My thoughts on what energises me:

• One to one or small group chats in non-hierarchical settings (like tea and cake catch ups) where connections are developed/sustained.
• Making plans for the future.
• Having time to throw around ideas and discuss concepts.
• Time spent with people where I don’t fear judgement.
• Creation – whether a project or idea.
• Passion projects about communicating science.
• Teaching/educational activities where you can engage and see the impact on those involved.

Time and resources are no less limited now than last year.But, if we are going to survive to the end of this marathon,now is the time to invest in what makes us better at all we do. So for yourselves and your teams, find what it is that energises you and support each other in making the room to make it happen.

All opinions in this blog are my own

It’s Easter Monday and tomorrow I get to start a post which in many ways I had never thought would become a reality.. I get to start as a Consultant Clinical Scientist in Infection Prevention and Control! For 16 years I’ve been training towards this. John, my Consultant, and I have been actively aiming for this moment since I started my NIHR Doctoral Fellowship in 2010, but there have been a lot of bumps along the way. The past two years I had really begun to question if it would ever happen.

I am over the moon but I wanted to mark the occasion by acknowledging some of the barriers that have existed, so others know they are not alone in facing them. I also want to talk about some of my hopes and fears in starting such a big phase of my career.

Acknowledging the Barriers

I started my training in October 2004. when I started I was told I was on an 11 year journey to consultant practice. As it transpired, it really wasn’t that straightforward. Although there are now great training schemes for post registration Clinical Scientists to take them through FRCPath and a PhD, they didn’t exist at the time. I am grateful and fortunate to have been able to become an NIHR Doctoral Fellow, which gave me the time and money to undertake both a PhD and achieve FRCPath by examination over 5 years. In the end I was able to get around the barriers by taking a novel route that enabled me to gain equivalent qualifications to those on the current structured schemes. Speaking of equivalence, getting this novel route acknowledged was also not possible for a number of years after I passed my exams in 2015/2016. Last year, however, I was able to get these formally acknowledged due to the existence of the Academy of Healthcare Science equivalence route, so now I sit on the same register as those now qualifying through the National School of Healthcare Science route.

For me the biggest barrier is that I always wanted to be a Consultant Clinical Scientist in Infection Prevention and Control, as this was the field I had specialised in since 2007. Over the last few years, however, I had begun to doubt that this would be possible. I am qualified to apply for Consultant roles in Medical Microbiology and although these used to be rare they are becoming much more common place. These roles are great but they didn’t represent the dream job that I had been working towards. As these roles don’t really exist, and certainly didn’t exist in my current organisation, I agonised whether I should go for the standard route or continue to fight for a dream that may or may not ever happen. Needless to say, I fought. This is nothing new as, when I started in IPC, I was the only person I knew fulfilling that role and change doesn’t happen unless someone creates that new pathway. It has not been easy but, boy, is it worth it now the moment is here! So for all of you doubting (like I did!), continue to fight the good fight, follow your dreams: the pay off will be even better than you think!

Lets Start with the Fears

As I’ve covered above, this is my dream job and I’m so excited about it. Like many scientists, however, I have a tendency towards perfectionism and, as it means so much to me, I really don’t want to mess it up. I am embarking on something new and part of the fear is that I don’t know how much of it is new and how much change there will be. As with all things new there’s is always some level of adjustment required.

My new job description actually consists of bits that I mostly already do, although there will be expansion into new areas like surgical site infections. It will require me to develop new networks and new relationships, to build up credibility and to become comfortable with being the final point of clinical escalation.

This means I will inevitably make mistakes, both in terms of individual acts but also in relationships as I get to know people in a new context. I have a tendency to enter a shame loop even with very minor errors, which leads to fear in terms of making errors and impacts on my stress levels. I want myself and the team to understand that we will support each other through those mistakes and make deliberate, thoughtful choices in relation to the below to support reflection, learning and moving forward.

There is also a tendency when we step up to a new role to worry about what others think of us and whether we are capable of performing. This can drive me to over-question myself and to obsess about details. Working in healthcare, I think it’s key to not let this get in the way of constantly questioning ‘why?’ To be flexible in our thinking and learning from every interaction. I can’t go into this new post thinking I know it all, as much as I want to arrive at work tomorrow in a super-hero outfit fully formed, the reality is there will be a period of transition. I am going to need to grow into this and, therefore, I need to enter the role with a growth mindset:

So What are My Hopes?

My hope has and will always be the same: to make a difference. It doesn’t have to revolutionise mankind but I want to make a difference, one moment, one interaction at a time. That could be making someone smile, it could be getting that result out faster, it could be changing national guidance to make patients safer. I am fortunate enough to have been given the opportunity to make that difference. To have a job that means that my passion for change and my profession aligns with the post I have been offered. I don’t want to waste that opportunity, not for one single minute!

On a professional basis I want to continue to ensure that progress is made by improving patient pathways linked to bringing evidence based practice on line, and advancing what we do with the research I undertake in my academic world. I also want to continue to raise the profile of what Healthcare Scientists can bring. I am a passionate believer in how much my profession can benefit healthcare and Infection Prevention and Control/Microbiology in particular. Healthcare systems are changing, becoming more complex The impact of science is greater than ever before. I intend to continue to advocate and shout about the benefits of HCS, so those coming behind me won’t have to fight the same fights that I have fought. They will get to fight different ones for the ones that follow them!

Finally, I want to continue to learn. I want to rise to the challenge and not be stopped by fear. I want to remain brave and unafraid to ask the stupid questions. To take onboard the wealth of knowledge and experience that others have and to become better because of it.

So, yes it has been a long road, but every step has been worth it. I’ve learned so much by encountering barriers and I’m stronger in my commitment to the role because of it. Whatever journey you are on I hope that the same can be said by you when you reach the finishing line.

All opinions on this blog are my own.

I think that it’s only natural during a stressful time like a pandemic that we feel the need to reflect and re-evaluate the direction of our lives and careers. For me this has been very much about the next stage of my career and how or when I should take the leap to trying to secure a consultant grade post.

For those of you who are less familiar with Healthcare Science career paths, when I joined in 2004 I was told I was on an 9 – 11 year pathway to Consultant grade (equivalent to my medical colleagues). In reality that pathway is anything other than transparent or straight forward.

The stages were due to be:

• Train for three years and complete Clinical Scientist training
• Take MRCPath part 1 in medical microbiology and, after 4th anniversary, gain Health and Care Professionals Council registration
• Spend five years doing a part time PhD whilst in clinical service to become research accredited
• Years 9-11 take FRCPath in medical microbiology and become clinically qualified, equivalent to medical colleagues
• Get consultant post

Sounds Straightforward. Right?

For the main part, the pathway for me worked out OK. Mostly because I was awarded fellowship money from the National Institute of Health Research (NIHR), which brought me out time to do both FRCPath by exam and attain a PhD. I completed my PhD and passed FRCPath in 2015,11 years after starting my training.

Five Years Later and I Don’t Have a Consultant Post. Why is that?

Partly, it’s not that simple. Consultant Clinical Scientist posts are just not that common. It’s also because from 2016 – 2019 I was undertaking another fellowship from the NIHR, a Clinical Lectureship, and so was continuing my training as I didn’t feel ready. Since finishing that I’ve been somewhat held up by a global pandemic but also, and I’m being honest here, by deciding what the right step forward was for me.

What Does Success Mean to Me?

When we talk about pathways it always appears clear-cut: after a certain number of years of service and training we should step up. Success is about getting acknowledged at the right banding and in the right job. In the last couple of years I’ve been forced to realise that it’s so much more complicated than that. Our professional careers do not live in isolation outside of our lives. For me I’ve been forced to realise that I’m not Superwoman. I have some physical health issues that mean, these days, I can only push myself so hard without paying the consequences. When I was doing (simultaneously) a PGCert, PhD and FRCPath I didn’t have a weekend off in three years. I developed alopecia and lost sections of hair and exacerbated my autoimmune condition. I’ve been made to realise that I clearly cannot keep up that pace. There are also costs I’m no longer willing to pay in terms of my family life. My husband and family have put up with missed birthdays, anniversaries and just being absent. My husband has taken the majority of the load in keeping our lives together and, at some point, I have to take back my share of the load. My sister and niece also died during this time and reminded me how short the time we have with people is. I suppose my point is that I realised I didn’t want a consultant post ‘at any cost’. It had to be the right consultant post, one that I could balance with my family and health commitments and also one that was professionally satisfying.

By the time I felt that I was psychologically ready to take up a consultant post I became increasingly aware that, although the situation was changing, it really wasn’t like they were sitting around waiting for me, at least in the areas that I could currently make work with all the considerations I talked about above. Once you have defined what your version of success looks like, you then have to go about starting to fight to make it happen. I’ve been pretty lucky in terms of having advocates and mentors to support me, but it has been a deliberate effort to go and find both. There’s no getting around the fact that even when you’ve decided what your end point looks like you won’t be able to get there on your own. That said, no one else can make it happen for you. You need to drive the process and seize upon the opportunities presented to you. Sometimes that means sticking to your boundaries and making a space for yourself at the table that works for you. As women we often feel uncomfortable negotiating and setting expectations, but if you want to achieve your version of success there’s no way of getting around the fact that you will have to be prepared to lead and embody the senior position you wish to attain.

So I’ve decided I’m ready now, ready to go, ready to take the leap from where I am now to a consultant post. Now I just need to find the one that is right for me. I’m working on it, but only time will tell if I will succeed. Even thinking about taking that next step makes me feel fear. It makes me question whether I am good enough. Whether people will respect me. Whether I will succeed as a scientist in the world of medics. You know what? That doesn’t matter. I feel the fear, I acknowledge it, and then when my moment comes I intend to do it anyway!

So, if you too are reflecting on next steps, be that because of the pandemic or for other reasons, my thoughts are these: don’t let others peoples definition of success define yours, spend time working out what your success criteria look like, but once you know what they are don’t let fear stop you. Find the people who will help lift you up and rationalise that fear. Look over that cliff edge and jump.

All thoughts in this blog are my own