Guest Blog by Nicola Baldwin: Where Is Everybody? Patient and public involvement in the time of pandemic

January 30, 2022 girlymicro Guest blog, Science Communication

This week we are lucky enough to have a wonderful guest blog from Nicola Baldwin. Nicola is a playwright and scriptwriter, Royal Literary Fund fellow and a Visiting Fellow at UCL, and co-director of The Nosocomial Project with Dr Elaine Cloutman-Green.

https://www.nicolabaldwin.work/

https://www.nosocomial.online/

Where Is Everybody? Patient and Public Involvement (PPI) in the time of pandemic

As a regular reader and devoted fan of Girlymicro’s excellent blog, writing a guest post is exciting and daunting. The project I’m going to consider was a collaboration with Girlymicro, Sue Lee, and – as you’ll hear – many other people. But these reflections are my own.

In February 2020, I stood in front of assembled Healthcare Scientists and researchers at the Precision AMR launch as PPI Coordinator, and enthused over the workshops, discussions, and Festival of public events which would be available to the 25+ research teams participating in this initiative. Within a month, the UK entered lockdown, universities closed to all but Covid research, public buildings lay empty. PPE no longer represented ‘public and patient engagement’ but preventing human contact and keeping yourself and your patients alive. But our project’s funding was time-limited, its purpose was important, and the genuine need to communicate and raise awareness of AMR central to its aims.

Thus began a two-year adventure in the strange new world of PPPI – Pandemic Public and Patient Involvement.

Defining the challenge

After a 4-month hiatus in which seed-funding application deadline and start date were paused, it was time to review our PPI strategy, factoring in the following changes:

No face to face workshops
No patient groups
No contact at all with patients
No science fairs, school visits, open days or usual channels for PPI
No public spaces or performance venues
Many research teams couldn’t start their projects owing to labs, personnel or priorities being reallocated

On top of which…

No one wants to hear about another looming global health crisis during a pandemic

During the delayed start, I began trialling our ‘message’ on AMR informally with friends and contacts who were – like me – non-scientists. I discovered that – like me – none of them understood what AMR was. Explaining antimicrobial resistance enough to discuss it, was a 2 or 3 stage process something like this….

Friend: I’m pretty sure I’m not antibiotic resistant. I hardly ever take antibiotics

Me: It’s not that you become resistant, it’s the bacteria themselves

Friend: The bacteria? Are you sure?

Me (nodding): The bugs that cause infection after you have a tooth out, or an operation, become resistant to the antimicrobials prescribed to treat them

Friend: Ok, so from now on, I won’t take antimicrobials, just regular antibiotics

Me: They’re the same. And bugs learn to resist them over time.

Friend: So if I have a tooth out, or an operation in future…?

Me: It might take a longer to find a treatment that works, or in a worst case –

Friend: (interrupting) THAT’S TERRIBLE! HOW COME NOBODY TOLD US!

Our PPI strategy needed to enable this conversation, over and over, for each new person to absorb what AMR is, and what it might mean for them before any other targeted messaging about antibiotic stewardship or behaviour change could happen.

This forced me to rethink what PPI means. Involving patients and public in research should be more than a tick-box exercise or add-on. It’s about encouraging public and patients to invest time understanding your processes and objectives. When scientists take part in public open days and fairs, they don’t just demonstrate experiments, they demonstrate enthusiasm; talking about their work, inviting participation, sharing ideas – all of which engages patients and public to invest time in understanding.

I’m a playwright. When I began this PPI project, I was an inaugural Creative Fellow at UCL exploring how drama could build new audiences for academic research. There’s a misconception that as a playwright, your medium is words; really, your medium is the audience. Someone once described it as ‘cooking the room’. Every action, every line of dialogue, every kiss, secret or betrayal, every silent pause or heartfelt song is there to raise or lower the emotional temperature in the room and effect a response in the audience; to involve them, make them care.

Designing a strategy

Given the obstacles outlined about, we needed a PPI strategy which could:

Be received remotely
Be engaging enough to spark conversations around AMR without us being present
Provide a PPI legacy that would have value after the project
Encourage and equip researchers to create their own digital PPI

We decided to focus on short films. We commissioned actors, writers and filmmakers with an interest in Healthcare Science and encouraged collaborations between scientists working on AMR with artists who could involve the public emotionally. Some of these artists were, or had been, patients potentially impacted by AMR.

And we discovered that, having been forced to micro-manage our overall PPI strategy, we could be more …strategic, by commissioning artists and film makers with knowledge and experience of areas such as migration and migrant health, homelessness, negotiating the health system as a mother without a UK support network, practical experience of working with puppets, or Under 5s. We started the artist films first to encourage researchers to make films, and to relieve the PPI pressure on Healthcare Scientists and researchers who were facing increased clinical or academic workloads during the pandemic.

Over time, another aim was added to the PPI strategy:

To actively support researchers, by offering regular contact time

The drop-ins were small, tending to attract only 1- 5 people, but the researchers who went on to not only make short thesis films but present work in person and/ or perform in the festival, all came through these sessions. In hindsight we should have started these sooner.

Sue Lee and I ran a weekly lunchtime drop-in session on zoom for any Precision AMR researchers to discuss their PPI, their micro-thesis films, or talk about their projects. This reminded us that the benefits of conversation and involvement which PPI enables, work both ways. Taking part in a science fair or going on a school visit, reminds Healthcare Scientists why they loved this stuff in the first place. Enthusiasm is rekindled. PPI involves you more closely with your research.

Reviewing our results

Looking back almost 2 years, we did everything we promised, albeit in radically different ways. In fact, we did rather more than we originally intended. We hosted a series of live public engagement events, screenings and discussions in not one, but two, festivals:

Rise of the Resistance 1, June 2021, online
Rise of the Resistance 2, September 2021, livestreamed from Bloomsbury Theatre
4 Workshops for Seed Project Awardees on PPI training
12 films by artists, 13 films by scientists, 4 zoom debates, three Q&As, a filmed tour and numerous zoom conversations and related video clips
500 people engaged directly with festival events online or in person
PPI participants reported significant changes in their understanding of AMR
Requests for Rise of the Resistance links and AMR content received from Hospital Trusts, charities, schools and nurseries for staff, patients, and pupils, including timetabled activities for 2022

My personal highlights? Our interactive AMR puppet show for Under 5s, Sock The Puppet performed by Stephanie Houtman (‘Peppa’ from Peppa Pig Live) receiving videos and photos from children of their Sock puppets, or them explaining AMR; Peter Clements’ incredible drag creation / film Klebsiella – both hilarious and 100% scientifically accurate; Rahila Gupta’s La Biotique, an aria from Puccini’s opera La Boheme which updated Mimi from a seamstress in 1830s Paris dying of incurable TB, to a migrant textile worker in the streets of London’s East End in 2022. Each appealed to different audiences and drew them into the AMR conversation. What Is AMR and What Can We Do About It? a show interweaving dramatic scenes, monologues, and Precision AMR research presentations, performed by a combined company of scientists and actors, succeeded in both raising awareness of AMR, and involving audiences in understanding new research – using gold nano-particles, targeted testing, combatting bacteria in hospital showers – which Precision AMR was supporting.

In Conclusion…?

Having got to the end of the last two years, we are only at the beginning – of a longer conversation with public and patients on AMR, and a global research and stewardship response. Undertaking PPI during a pandemic has made me understand what PPI really is. And how it takes time, planning, effort and commitment on all sides to make involvement happen. It is hard work.

Healthcare Scientists wanting to add a PPI component to their project for the first time really benefit from individual support throughout the process. Public engagement and PPI employ a distinct set of skills for planning and delivery, but ‘cooking the room’ has many similarities with doing an experiment. PPI – especially in a pandemic – asks much of us, but in return offers new insights, new contacts, increased confidence, a sense of personal achievement, and occasionally, amazement at what everyone has achieved.

All opinions on this blog are my own

Guest Blog from Sam Watkin: Starting a PhD in a Pandemic

January 17, 2022 girlymicro Academic Life, Guest blog

The wonderful Sam Watkin has volunteered to do a blog post for me this week. He has the dubious fortune of being one of my PhD students and has only known working for me during a global pandemic. He volunteered to share his experience of what this has meant for him and his learning.

I remember on the 4^th of January 2021, sitting down at my desk in my bedroom, excited for the first day starting my PhD. I had got a new pad of paper and a fresh set of pens and highlighters. I turned on my laptop, opened my emails and pulled up a paper from the reading list I had been sent a few weeks prior. After about 6 hours of reading and making notes, I turned off my laptop and watched ‘A New Life in the Sun’ on Channel 4.

I had known for a while before being accepted to do a PhD that this was the path I wanted to go down. What I didn’t know was that I would start it remotely in my childhood bedroom. Overall, it felt rather anticlimactic. By this point though, I was pretty used to anticlimactic events. I had written and submitted my master’s thesis, done my masters viva and attended a virtual graduation all from this same desk, mostly wearing pajamas. So, starting my PhD had a similar feeling to it, a sense of “well, that was that I guess”.

From what I had heard from people already deep in their PhD journeys, the beginning few months were mostly spent reading and getting to grips with the subject area. I suppose, looking back on it, the lockdown that was in place at the beginning of 2021 helped with that a fair bit. All there really was to do was read around the subject area… and watch daytime TV. Not that it was a chore to do this (the reading, not watching telly) – it is a subject area I am really interested in and passionate about.

As time went on though, there was a growing feeling of missing out on the “PhD experience”. It wasn’t until around May 2021 that I actually met my supervisors face-to-face, and didn’t meet everyone in the research group till a few weeks after that. It felt as though the social aspect of it had been in slow-motion, never mind the feeling I can only really sum up as “Oh my god I’m almost 6 months in and haven’t picked up a pipette yet!”. Once I was able to start in the lab, the rules in place to make sure it was safe for us all to work in meant that work was, at times, painfully slow. All in all, while I was able to make progress, everything felt slower, more drawn out and more frustrating than I would have thought it would be.

If it isn’t obvious, I sometimes feel pressure to be overly-productive. This is something that I’m fairly sure is common among PhD students – especially as there was a whole lecture series put on about how to manage PhD pressure and workload. I’m horribly paraphrasing it, but the gist of it all was “you’re all good enough, stop stressing!”. I’ve got to give credit to my supervisors though – throughout all of this they have reassured me that this is all fairly normal to feel at the beginning of a PhD and, even with the challenges thrown up by the pandemic, I am making good progress.

While I think it is fair to say the pandemic has made starting a PhD very… different, to how it would have been otherwise, it hasn’t all been stress and doom. A few other people started PhD’s in our research group a few months before me, meaning we all have been going through this “Pandemic PhD” rollercoaster at more-or-less the same pace. Having this shared experience, with all its very unique challenges, has for certain made us closer as a group. At the very least, it has shown us all that we aren’t alone in going through this process, with all the additional stresses and strains a pandemic brings to the first year of a doctorate.

Aside from the work itself, starting this PhD has had some amazingly positive aspects to it. It has afforded me the chance to learn so much more than I thought I could about a subject I am fascinated by, pick up new skills, speak in a theatre production and present my own work at conferences. I was also able to move to London, then move straight back out of London (not enough countryside for me) and meet some of the most interesting and clever people I have ever met. While starting a PhD in a pandemic has presented many challenges, most of which I never expected to come across, the experience has been overall a really rewarding and enjoyable one, and I am looking forward to the next few years of it. Famous last words…

All opinions on this blog are my own

50 Shades of Grey: The realities of working in Infection Prevention and Control

January 10, 2022January 10, 2022 girlymicro Microbiology (Clinical)

It’s another early start in the world of Infection Prevention and Control (IPC) following on from another rather restless night. The thing that has been playing on my mind a lot lately is the perception of vs the reality of IPC, and medicine in general.

Some of this has been sparked by seeing the discussion, opinions and commentary by medical colleagues on twitter linked to IPC response. I’ve been trying to read them as a member of the public would on this public forum. The thing that strikes me more than anything is that it is no wonder people are confused, we all post from a position of absolutes, often from very contrary stand points. What we do very poorly is communicate the nuance, discuss the technicalities and travel any middle ground. Possibly because its so hard in 240 characters, but also I think because we work with an implicit understanding that we know that nuance exists. On the face of it these conversations therefore come off as black and white positions, when in actuality IPC is very much 50 shades of grey, where there is accuracy in many of the positions in between.

So why is IPC not clear cut? Why might you get a different set if rules and experiences from one Trust to another or even one phone call to another? Well the fundamental tool of IPC is risk assessment. Every scenario includes slightly different exposures, different organisms and different patients, all of which will impact on that risk assessment. Just as no two scenarios are ever really the same therefore, no two risk assessments look identical. This also leads to disagreements on things like social media, as the experience, setting and drivers of those commenting are also just as varied.

What Do I Mean When I Talk About Risk Assessment?

Risk assessment is the process we go through to identify what risks are present to patients, and from patients to staff, visitors and carers. It also includes the things we do to control those risks, things called control measures. I want to start out by saying that I believe we are all aiming for the same goal i.e. providing safe high quality clinical care. Like many things there are often multiple options to deliver this goal and individuals may use slightly different processes in order to achieve it. The below is an example of the way that I structure my thinking.

There are 2 main aspects to risk assessment:

For the patient – if an organism is detected in a site on a patient what risk does that pose i.e. an E. coli urinary tract infection if not managed well in certain patients is a risk of progressing to E. coli blood stream infection
For other patients, staff and families – what does the detection of an organism mean for others, what counts as an exposure, what would the clinical consequences of acquisition mean for those exposed?

At some point I’ll do a fuller post on risk assessment in IPC and what different options there are for creating your risk assessment tool, but for now these are the kinds of things I consider when putting together risk assessments:

Routes of transmission – how do infections spread? Water/Surfaces/Contact/Air
Patient loads – when someone has an organism how much do they have, viruses usually higher numbers than bacteria
Environmental persistence – how long can an organism survive in water/air/on surfaces
Infectious dose – how many copies of an organism does it take to give an infection
Colonised/infectious state – can I carry an organism without harm or does it always make me unwell MRSA vs measles for instance
Patient susceptibility – is the patient immune i.e. vaccination/prior infection, are they more at risk if they get infected because they have no immune system?
Timing of infection (community vs hospital acquired)
Endogenous vs exogenous – is the infection spread from one site to another in the same patient i.e. from nose where doing no harm to a surgical wound? Or has the patient got it from outside?
Surveillance programmes in place – what kind of searching for organisms is being undertaken i.e. within the environment/based on symptoms, or as part of routine regular testing

When I’m talking about risk assessment for the rest of this blog I’m also going to be including what we call control measures which are linked to that risk assessment. These are things you do to prevent or reduce risk i.e. wearing personal protective equipment, putting patients isolation, prophylaxis etc.

I think we need to acknowledge that as well as different information, there is also an impact from the person handling that information and making the risk assessment. As a Healthcare Scientist I tend to feel much more comfortable focussing on the organism aspects and on control measures such as ventilation. Some of my colleagues will feel more comfortable in other aspects, especially in terms of scenarios such as surgical site infections and dressing management for instance. We all cover the same ground and should have the same core fundamentals, but we should acknowledge that different people will handle information in slightly different ways. This can be a strength, as long as it’s acknowledged.

So Why Do Risk Assessments Change?

As you can see from above, risk assessments are anything but straight forward. They include a lot of information, some of which you won’t always have at the start. There are some scenarios where we have quite a lot of information where responses are pretty much standardised and you would think everyone would do very similar things i.e. detection of MRSA in a surgical patient. Even for something like this that happens often and we have quite a lot of good information about what the risks and the control actions might be, there isn’t a one size fits all approach. In paediatrics we manage these patients differently to how they might be treated when they become adults. This is because their risk of continuing to carry MRSA as they interact more with people and the environment means that trying to remove it with antibiotics and chemicals (decolonisation) may be less effective and they may also have delicate skin which means using these chemicals may cause skin problems. So even in a straight forward situation, setting and scenario matters.

We often get asked why the way we manage something in my hospital may look different to how it might get managed somewhere else, even at another children’s hospital. This can be for a number of reasons. I may have access to resources in terms of cubicles or diagnostics that enable me the option of managing a scenario differently. My Trust is in England and the guidance in other parts of the devolved nations may be different i.e. Scotland and England don’t always do things the same way. Finally, my Trust also looks after children who have complicated conditions and who may have little to no immune system, so the consequences for patients if I get it wrong may be higher than somewhere seeing other types of patients. Setting, not just organism matters.

The other thing is bear in mind is that information and settings are not static. Often in medical dramas something is either X or Y, all of the information comes at the same time. This isn’t how things work in real life, information comes in pieces and the decisions you make about the next question you ask are actually as important as how you manage actions based on the data already in your possession. In some ways House was right…….it could be Lupus.

Although I don’t want this post to be about SARS CoV2, it is a good example of the fact the more information you have the more your decisions might change and you know more about where your risks are. Omicron has led to different risk being recognised when compared to Delta, because of impacts such as staff shortages, but also because of the amount of it that is currently circulating. This has impacted testing decisions and risk vs benefit discussions linked to patient harm. This is particularly challenging as these judgements about risk are actually being made with incomplete data sets as we don’t have the luxury of waiting it out. This makes at least this IPC professional uncomfortable, as lets be honest you are unlikely to love IPC if you aren’t in someway risk averse as a personality type. You don’t always have the luxury of time however and therefore we need to act, do the best we can with the information we have and make sure we also capture the learning as we go to enable improved decisions next time.

Who Pays?

So, resource matters. Everything about IPC comes with a cost. The thing is not all of those costs are financial.

Some examples of when even interventions, like putting patients in isolation can be challenging or have adverse consequences for everyone involved:

Its hard to know once you put someone into isolation when the right time is to take them out
Putting patients into isolation has been linked with decreases in staff time, increase in perceived concerns over care, and increase in prescribing errors
In paediatric patients isolation can affect inpatient developmental milestones.
In adults isolation has been linked to increased levels of anxiety and depression
Isolation can negatively impact on staff caring for patients due to isolation from colleagues and strain of dealing with sick patients single handed

Risk assessments therefore are influenced by who bears the cost. Individuals often pay the price of keeping others safe. This is a social contract that we see playing out on a much larger scale during the pandemic. Other methods to impact risk assessments, such as installation of mechanical ventilation, have a high financial cost that not all centres are able to afford. It is naïve therefore to say that any of these choices are easy, someone somewhere always bears the cost and the impacts of decisions.

After all of the above what is it that I want you take away?

Firstly IPC is anything but easy or straight forward, no matter what some of the reporting or social media commentary makes it appear. Decisions are complicated and every single one comes with impacts, be it for patients or budgets.
Secondly, the right decision for one centre may not therefore be the right decision for another. Comparison between one centre or one set of scenarios and another are not always valid, as the needs of the patient population or risks involved are unlikely to be identical.
Lastly, risk assessments change, they change as scenarios change, they change as more information becomes available. This isn’t a failing, this is responding to evolving situations and although difficult this is a strength

IPC is not black and white, it is 50 shades of grey and dealing with this is both the strength of the amazing people working in this field and the daily challenge they face, embrace and respond to!

All opinions on this blog are my own

Turning a Day Dream into a Reality: Trying out a technique to make concrete steps towards a secret ambition

January 3, 2022January 3, 2022 girlymicro Education, General, Science Communication Co-production, Healthcare Science, Infection Prevention and Control, public engagement, Science Communication, scientific writing

I’ve been thinking a lot about next steps in recent weeks. Thinking about what it is that I want, what do I want to achieve. I’ve been really fortunate to have achieved a lot of professional success. I’ve attained my Consultant post, which has been the aim for 16+ years. The question that I keep getting asked therefore is, what next?

Now I’ve been saying, and I think this is true, that I need to be in a holding pattern for a while. Like most people during the pandemic I’ve become tired and burn out and even when we get to the point where life becomes the ‘new normal’, whatever that is, it will take time to recover. The problem being that although those words come out of my mouth, my brain has other plans and ideas.

I’m beginning to think that this next goal will be more personal and less professional. It feels like a long time since I had a goal that was for the whole of me, rather than for Dr Cloutman-Green. So I’m going to write it here. Not because I think I will manage to achieve it any time soon, but because I want to make a commitment to myself. I want to write a book. I know, I know, it would make me spit out my tea too, but there I’ve said it. I’ve put it out into the world.

There are two schools of thought on whether sharing this is a wise move or not. One suggests that by sending it out into the world is the first stage in crystallising a thought or dream into reality. The other is that you are setting yourself up to fail as if you don’t then take the steps needed you appear as someone who can’t deliver, thus actually making your dream harder to achieve. I’m a glass is half full kind of girl and so I’m going with the making my dream more likely option. I am also being very clear and boundaried about what I am saying. I am saying I wish to write a book, that is under my control. I am not stating that such an item would ever get published, let alone earn money, as those things are less under my remit. My dream is to have the time and energy to create and produce, anything more would be a bonus.

Now, I acknowledge that my grammar is appalling and I don’t claim to be the best writer in the world. Writing the blog for the last year however has reminded me of how much I have always just loved to write. I find it cathartic and a much needed creative outlet. During the pandemic, where opportunities to network have been limited, I’ve also found it a great way to feel connected. I know I come across as very extroverted but in reality there’s little I love more than having my own space and so this blog has allowed me to connect without feeling the pressure of in person.

Now I wouldn’t be me if I didn’t have a plan. Afterall, a dream needs action in order to become a reality. This is something that is completely outside of my knowledge base so the first steps are about thinking and research in order to inform action:

Further formulate the concept i.e. what kind of book? I actually have 2 ideas. One is turning this blog into a book format. The second is that I also have an outline structure for a Pathology murder mystery. I’m excited by both, but right now I think option 1 is more achievable with my current resources (Norman I also haven’t forgotten about our project – sorry for being rubbish)
Review what I already have. If I go for a non fiction book I need to undertake a gap analysis of what I have, what can be modified and what new content is needed. For the fiction version I need to start getting my concepts down so that I know how viable they are
What good resources are available to me? This is an ambition of plenty of people and there is a wealth of information out there. I need to explore, quality assess and curate what there is so I dont waste time and energy making unforced errors. There is no point in reinventing the wheel, modify it so it works for me, but let’s not start from square one.
Undertake some appreciative enquiry. Success is often about asking the right questions and making the right connections in order to increase your odds. I have some friends in this field but not in the area I’m thinking of working in. I need to be brave and put myself out there to gain insight into the ‘Known Unknowns’
Use the knowledge and information gained to put together a project plan. Establish some small steps that can make the project as a whole less overwhelming
Establish my success criteria. What does success look like? For right now it’s the process of creating that will feel like a success with a stretch goal of sharing what is produced, but that might change based on what I discover
Research your audience. If I decided to include sharing what is produced as part of my success criteria who would like to see such a book? If I were to share the content what would that look like and what would be needed?

For me any dream is achievable, the main thing is to be realistic about what the dream actually is and what resource and commitment it will take. Dreams don’t just happen, they require work and so to understand what is needed takes some time. That is not a reason to not aim high. So here I am, at the start of the process knowing it might take years but excited to see where it might take me. Dream big people and take it one day at a time.

All opinions in this blog are my own

Girlymicro 2021: A Year in Review

January 1, 2022January 1, 2022 girlymicro Academic Life, General, Microbiology (Clinical), Microbiology (Research), Science Communication Healthcare Science, Infection Prevention and Control, public engagement, Work Life Balance

Firstly, before I begin I want to start by saying thank you all so much for being here. This blog and all of you have really helped with many of the challenges described below. It’s given me a focus and output that has enabled me to both reflect and feel like I have a voice. Despite not having been able to post much in November and December ~10,000 of you have visited the blog this year, with over 13,500 views. Numbers I would never have dreamt of. This community, your responses and sharing have really kept me going. My sincerest hope for 2022 is that we will be able to continue to find a way through together, supporting each other and sharing the learning.

It seems to be the thing to do a New Years post. I’m not really big on New Year, I’m much more of a Christmas kind of girl but this year has been A LOT and so I thought I should take a few minutes at the start of 2022 to at least acknowledge it happened; and to give some reflection on all it contained: the good, the bad and the oh so very ugly.

I want to end in a positive way so we are going to take a deep breath, drink a cup of tea and do this is reverse order.

The Ugly

I discovered this year that I am oh so very human. I used to think I could push through anything with enough willpower. It worked for my PhD, it worked for FRCPath. I have discovered that that doesn’t work for pandemics.

I think part of it is something to do with a lack of a defined end point. With an end point you can plan, you know when you can take breaks, you can plan downtime. There has been nothing planned about this. My first break away was the one and only time I’ve been pinged (I’m basically a hermit) and so my time away involved self isolating in a very small cottage, albeit with an amazing view. Christmas, which is my joy, involved working and being broken by the time it arrived. The constant responsive mode means you feel like you achieve nothing and that the ‘Control’ in Infection Prevention and Control has been lost and you don’t know when it will come back.

The other part of it, for me, is that there has been hardly any of the diversity that is the thing I love about Infection Prevention and Control. When the non SARS CoV2 work does escalate up the priority list it is on top of everything else and is therefore a burden rather than problem to be solved. It is the diversity of the role in normal times that energises me. This year therefore, has just felt like one constant drain on my batteries rather than the normal peaks and troughs that give recovery time.

So what am I going to do about it? Long and short I need to carve out some professional me time. I can’t manage a third year of just pushing through. I’ve hit a wall and something needs to change. I need to find time to write a paper, use a pipette, write a talk in more than 5 minutes. I need to feel like I’m making a difference again, making an impact. I need to end 2022 feeling like I’ve moved forward, even if the pandemic is still with us. I think collaboration for this is key, working together is one of the things I’ve missed, so if you’re up for a project give me a shout.

The Bad

The worst and most shocking thing of 2021 was that we lost Lee, the guru who made the grammar on this blog bearable, but who also helped run the Environment Network and some of my other events. He went from fine to deceased in a matter of weeks and to be really honest it’s been quite the wake up call. He was ~10 years older than me and still had so very much to give to the world. I don’t want my tombstone to say ‘She pulled a lot of hours’ I need to make time for the people and activities I love. I hadn’t seen him anywhere near enough since the pandemic started as I have prioritised work so much. Going into year 3 that has to change.

In 2020/1 I learnt to fail, spectacularly. I learnt to fail at managing my workload, my inbox and my deadlines. I’ve failed to manage to keep on top of, let alone ahead of anything. I’ve learnt that this leads to 3am panic and exhaustion and after a year I’m trying to also learn to just let it go. Being a perfectionist in a pandemic is not a survival strategy. Assuming that everyone is judging you as harshly as you are judging yourself is not a wellness technique. Just working harder no longer cuts it, as to be honest there are simply just not enough hours in the day.

Over the last 2 years I’ve let myself be defined by work. I’ve stopped running and I basically am working, rushing to catch a meal or trying to sleep in order to prepare to do it all again. Between getting shingles and the number of angio oedema flares my body has basically let me know that this is not sustainable. To be honest I don’t think I could continue this way even if I wanted to, my body feels like it has given up on me. I need to cut it a break and heed the warning signs.

Having discovered I am not professionally or physically superwoman I have decided that I need to make some decisions about putting me first. No one benefits if I break, not me and not my team. I need to do my hours and come home in time to do something other than eat and sleep. I need to have some time for me, be that to read a book or go for a run. I cannot work every weekend. I need to trust that others will not judge me for stepping away and that the only person who is holding me to this standard is me. I’m going to walk in the sun, take bubble baths, drink tea and learn to be kinder to myself. I’m also making a commitment to give explicit permission to others to do the same, so that our head weasels have less power over us.

The Good

Well enough with the hard stuff, its really easy to forgot with so much challenge, the amount of good that has actually occurred. All the more reason to take the time to reflect. Times of challenge are when we learn most, not just in terms of academic knowledge but also about ourselves, and I have learnt a lot that I intend to build on in 2022.

I started 2021 announcing that I’d been awarded the British Empire Medal in the Queens New Years Honour list. Something that was always going to be difficult to top.

In this respect 2021 out did itself and was the year that I firmly set down roots to continue at GOSH, after a period of not really knowing what my future would hold and where my career would go. I got my dream job, as a Consultant Clinical Scientist in Infection Prevention and Control. I have a solid foundation for my future, I no longer need to have a plan A B and C about where I might end up. I work in an organisation aligned to my values with 2 amazing teams and in a job I love. I will always be grateful for that.

There have been some great moments from an education perspective. I’ve done podcasts, made it onto power lists and had mentees grow and develop in ways that have made me beyond proud. There are some wonderful projects in the pipeline that will give opportunities to my team and I believe will support change across the infection workforce. One of them is on whole genome sequencing and if you’re interested in learning more check it out and input on what you’d like included here. Being able to plan for the future is key to my mental wellbeing and so I’m so excited to have something that forces me to look forward, not just be in the moment.

Project Nosocomial has continued to grow and despite, or possibly because of, the unique demands on artistic and scientific collaboration in 2021 delivered some truly exciting new content. We ran 2 festivals to raise awareness of antimicrobial resistance. We ran comedy shows, quizzes, panels and featured poetry, drag, opera and gamification. If the pandemic has shown me anything its that we need to work harder to engage with and have dialogue with the public and wider communities. Science communication should no longer be seen as an indulgence but a central part of our roles. In 2022 I’m determined to continue to fight for this work to be valued and to increase the impact of our conversations.

So there you have it, despite feeling I’ve been standing still there has been a surprising amount of moving forward. I have learnt a lot and to summarise what from that I want to bring into 2022, it is simply this:

All opinions on this blog are my own.

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

December 13, 2021December 13, 2021 girlymicro General, Microbiology (Clinical), Science Communication

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

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

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

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

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

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

A little respect goes a long way

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

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

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

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

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

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

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

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

Wellness programmes are not going to fix this

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

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

All opinions on this blog are my own

Absence Makes the Heart Grow Fonder?: My month spent with shingles and the Varicella Zoster virus

December 11, 2021 girlymicro Microbiology (Clinical)

Well my friends, it’s been an age. I think I have a reasonable excuse but I am sorry to have left everyone in the lurch by not being well enough to post. I’ve been laid up with Shingles. It was the first time I’ve had it, although as many as 1/3 of us (who have previously had Chickenpox) might have it at some point in our lives. My father pointed out that this whole event might be karma (I believe he was *mostly* joking) as he had Shingles for the first time earlier this year and I responded as a typical medical child in terms of management, without really acknowledging the pain and discomfort. I’m now 4 weeks in and functioning OK most of the time on pain killers but it has certainly been much more of an experience than I had accounted for when I saw the rash appear. Working in what I do I knew a lot about the Shingles experience on paper. Having now been through it however; I thought I would share not only some Shingles facts but also about the difference between ‘knowing’ and ‘Knowing’, as there are probably lessons to be reminded of for all of us when we see all our patients (or in my case supporting my father).

Shingles, otherwise known as Zoster, is caused by the Varicella Zoster virus or VZV. VZV is also the causative agent of Chickenpox, which is also known as Varicella. VZV looks like a fried egg under electron microscopy (a high powered way of viewing virus) and is part of the human herpes virus family, related to the same viruses that cause cold sores. Chickenpox and Shingles are intrinsically linked, with Varicella being the primary infection and Zoster being the reactivation of the virus.

See the source image — Herpes viruses have a fried egg appearance under electron microscopy

What do these terms actually mean? Well, to ever get Shingles you need to have had Chickenpox at some point in your life, you can’t get Shingles without ever having the other. Once you have been infected with the virus for the first time (primary infection) and develop Chickenpox the virus then goes dormant when you recover in the nervous system (trigeminal and dorsal root ganglia). The virus is held in check (held dormant) and stopped from replicating by the immune system. It is when this immune system fails to hold the virus in check that it begins replicating again (reactivation), leading to the development of Shingles.

Most people is temperate climates i.e. non tropical, tend to get Chickenpox in childhood, but the infection is much more severe if acquired in adulthood. When you get your first infection you are infectious by the respiratory route for 48 hours before the vesicular (pus filled) lesions appear. After this the main infectious route is via contact with the rash itself, although some groups are still an airborne risk. Those exposed to the virus have an incubation period of 8 days (10 till rash appearance) – 21 days, with up to 28 days if prophylactically treated as a contact. Groups such as the immunosuppressed and pregnant woman are at increased risk of complications, such as pneumonia if infected.

Shingles presents in a similar way to Chickenpox, but is more localised. In my case I had sore and painful area on my back, which over the course of ~ 5 days spread around to my front, all on my right side. On Friday I went shopping with my mum and when I arrived home at 5pm I was so exhausted all I could do was sleep. I wasn’t feeling great the next day and by the evening the painful area of skin began to be itchy and I noticed a small red patch. I’m super allergic to just about everything under the sun so I assumed it was a local reaction. When i woke the next morning the rash had spread and I had a characteristic set of lesions, which meant I called 111 and got a referral for treatment. The pain then increased alongside the itching and 4 weeks later I am still suffering from radiating pain down my right arm, sensitive and painful skin where the rash has just about healed and tiredness.

How is it diagnosed?

The Shingles rash is fairly characteristic. It appears in a band along something called a dermatome (see image). The dermatome where the lesions are present are linked to the nerve where the virus has reactivated and is replicating, which leads to the virus travelling to the skin and forming lesions. The pictures of the rash below are some of my lesions on day 1 when I presented to the GP. Over the course of several days more lesions appeared and the rash continued to spread, in what we call cropping. It always stays on one side of the body and is highly localised.

Often, as the presentation is fairly clear, diagnosis can be made just by taking a history and examining the rash. Vesicular fluid can also be taken from the lesions themselves by removing the top of the lesion and using a swab to get at the fluid; which is then placed into viral transport medium (VTM) for further processing. Historically this was via tissue culture and visualisation of the virus, but more commonly now is by polymerase chain reaction (or PCR), so looking for the DNA of the virus itself. This is much more sensitive and rapid. These additional tests are usually only undertaken in cases where the presentation is less clear cut i.e. the immunosuppressed or to allow follow up in case of vaccine failure/response.

What is the treatment/management?

I hate going to any form of healthcare, I think I’ve mentioned this before. The fact that I called 111 was therefore a huge thing for me, so why did I? One of the biggest risks linked to Shingles is the risk of post herpetic neuralgia i.e. nerve pain. There has been data collected to show that treatment, in the form of aciclovir, can help reduce the risk of this, but only if commenced within the first 72 hours. A Cochrane Review in 2014 stated that oral aciclovir did not significantly reduce the risk of long term pain but helped in reducing it during the 1st 4 weeks. My rash was so classic that I knew either way that I needed to ensure I started treatment as soon as possible for either outcome to be impacted.

Interestingly when I said to my father that the pain could easily last 6 weeks + I didn’t know why he sounded so horrified, now I do. Although the pain hadn’t properly kicked in at the point where I got treatment, if it hadn’t started to reduce by the point I’m now writing this I wouldn’t have known what to do. One of the main delays in getting any blog out has been the significant pain when using my right arm, and I’ve only just been getting through work. This blog for instance even now has had to be written in small chunks across a day, whereas I would normally have just knocked it out. I am therefore super glad that I started treatment as soon as possible, even though the tablets were ENORMOUS!

How do I stop myself having a recurrence?

There are vaccines available to help prevent Shingles which are aimed at those aged 70 to 79. The vaccines should aid in prevention of shingles for ~5 years and there are 2 shingles vaccines used in the UK:

Zostavax, a live vaccine given as 1 dose (similar, but not identical to the Chickenpox vaccine)
Shingrix, a non-live vaccine given as 2 doses, 2 months apart (used for those people who can’t have the live vaccine)

I have spoken previously about having poor viral immunity and so it’s been recommended that I should consider having the Shingrix vaccine by my local immunologist; which may be a way forward. The main way to reduce the risk of this happening again however is to learn to take better care of myself so that I don’t get so run down. This is easier said than done, being an Infection Control Doctor during a global pandemic, but I need to make room to sleep and at least eat better when I’m not on service. I always worry that if I stop I may never get going again, but this recent experience has shown me that if I don’t make time for some rest and relaxation by body will take that choice away from me.

Top tips:

Beware of whom you come into contact with whilst you have Shingles, non Chickenpox immune people may be at transmission risk
Make sure you loosely cover the rash if you can to prevent risk of contact transmission to others
If you have a rash develop on your face ensure that you see medical support
If you suspect you have Shingles make sure you get it reviewed within 72 hours to support management
If eligible for the vaccine make sure you get it to reduce your risk of developing Shingles in the first place
The pain is substantial and if you are a daughter, probably don’t minimise it’s impact to your father 🙂

Anyway, I’m back, even if not 100% and I’m so glad to be posting again. I may just need to take it a little slower for a while. If you are on the edge of exhaustion, learn the lesson I did not and take some time for you, you owe it to yourself!

All opinions in this blog are my own.

Changing Our Pathways: What are T-Levels and why should I care about them?

November 23, 2021 girlymicro Education

I’m still in the land of the shingles lesions and so not up to drafting some of the many ideas I have brewing for blog posts, but I thought I’d share something I recently wrote for the Association of Clinical Biochemistry and Laboratory Medicine (ACB) on T-Levels. The ACB are one of my professional bodies and they are doing a great job of trying to raise awareness of different routes into Healthcare Science, these routes won’t just feed into HCS however and so I think we should all know a little more about T-Levels.

What are T-Levels and Why Should I Care About Them?

In 2017 I saw an advert from the Department of Education looking for an employer representative to sit on a panel to develop a new vocational qualification, known as the Technical Level or T-Level, for Healthcare Science. This came about as part of a wider educational review looking at how to change vocational qualifications so they aligned better with what employers were looking for, and to fit in better with other routes such as apprenticeships and A-Levels. I was lucky enough to be selected and for the next year a panel of fellow Healthcare Scientists, Educators and Department for Education representatives met monthly to design a new qualification to help budding scientists access the Healthcare Science profession. Since then we have been working with Further Education teams to roll out the qualification and the T-Level launching for early adopters in September 2021 is the result.

So What is A T-Level?

T-Levels are equivalent to 3 A-Levels and offer an intermediate choice between traditional academic routes into Healthcare Science i.e. A-Levels followed by undergraduate study and Healthcare Science Apprenticeships, which are 80% workplace based and 20% further education based. T-Levels are 80% based in a further education institution but have a 20% work placement. They are broadly split into 3 components:

Technical Qualification = the main, classroom-based element. Students will learn about different areas of Healthcare Science through a curriculum designed by employers and developed by an awarding organisation.
Industry Placement = runs for a minimum of 315 hours (45 days) overall and will give students practical insights into their sector and an opportunity to embed the knowledge and skills learned in the classroom.
English, maths and digital provision = built into the classroom-based element of the T Level, meaning students will be given a solid foundation of transferable skills.

As T-levels are also eligible for UKAS points, when a student completes the T-Level they can either choose to progress to further education, via an undergraduate degree, or can enter a degree level apprenticeship scheme and continue via work place based progression.

Why Should We Care?

One of the problems faced by the Healthcare Science profession is that routes into it are becoming much more structured than they were when I entered 17 years ago. In many ways this is great and provides a much better quality of training and structured career progression. The downside of it is that students need to be aware that Healthcare Science exists as an option in order to be choosing the right degree or entry point. By providing a course like this early to students before university it will enable them to make more informed choices about the courses that are right for them, as well as raising awareness of the profession. For those students who opt to continue onto the apprenticeship route, it provides employers with a growing pool of students who will be well placed to apply for these roles, who will have knowledge and experience of what it means to be a Healthcare Scientist.

What Does All This Require of Me?

In order to make the new T-Level work we will need to engage with it as a profession. This will include linking in with further education establishments to offer expertise to support the launch, in order to ensure high quality delivery. The main thing we need to think about however is whether we can provide sites for the work based placements. T-Levels will help improve our candidate pool and ensure that we have access to improved recruitment in the long term. To get that however will require us to ensure that students really do get a good idea of what we do and what a job in this great profession could look like. We can only deliver on this if they get to meet us.

The ask therefore is to reach out to the communities our Trusts support and see if we can strengthen those ties by supporting not just in our remit of health, but also by supporting education via work placements. The reward for this is not only financial (you will get a payment per student) but also in terms of staff development. This is a great opportunity for junior members of staff to gain experience in supervision and managing small projects. It’s a chance for them to get more experience with training, and especially those who are still in training to get their own competencies signed off.

By 2022 the Health and Science T Level will be available for delivery by all providers that want to and meet the criteria. By 2024 it is expected that the vast majority of providers will be delivering this T Level. This is a great opportunity for our profession to rise to the challenge and help support the development of the next generation of Healthcare Scientists. More information about T-Levels across subjects can be found here.

All opinions on this blog are my own

Guest Book Review by Dr Julie Winnard: How Bad Are Bananas? by Mike Berners Lee

November 17, 2021 girlymicro Book Reviews, Guest blog

Dr Julie Winnard works flexibly with clients to identify and deliver their sustainability projects, from creating resilient strategies, business cases or innovation plans, to reporting and targets for transport energy and carbon. Finding practical and appropriate ways to deliver real-world improvements in carbon emissions, other environmental impacts or risk and opportunity management.

Dream has been poorly recently so appealed for science-related guest reviews. “How Bad Are Bananas? The Carbon Footprint of Everything” from 2009 I find very interesting and useful, and just post COP26 kinda topical.

Guest Book Review – Dr Julie Winnard

I’m a engineer-turned-sustainability consultant, and over the past ten years quite a lot of what I do has been encouraging all kinds of business people to educate themselves about carbon emissions; what matters, and what they needn’t worry about too much. With the aim of getting them to focus on the bigger stuff that they can reduce. I mostly read fiction in my own time, but I do like a good readable bit of non-fiction, especially one that distils a whole bunch of new science in a way that lets me educate myself, and that I usefully might be able to direct other people towards. This is definitely one of those.

I was sold on this book in the original intro when Mike Berners Lee (yes, son of that guy who invented the internet) -also a sustainability professional- commented he’d become fed up with CEOs angsting about how to dry their hands (the different methods of towel, paper towel and air-dryer aren’t as far apart in CO₂ terms as you might expect) yet getting on planes every few days- waaay worse. Like, 10g compared to 1 tonne worse. So, he wrote the book to help people develop “carbon literacy”; basically an instinct for what matters in terms of what to change. The memorable title comes from the fact that if you’re green, you might worry about shipping bananas round the planet. Spoiler alert- not a huge issue, but having a blowout Christmas? Yes, big.

The book is not so much a narrative story but a sort of directory, starting at the smallest stuff like bananas and working up to the biggies like flying. Berners-Lee doesn’t go into lots of mathsy detail often, just gives you the main facts and a bit of explanation for each item, sometimes with an interesting anecdote about his own journey of change. Doing carbon footprints is complex, so all you really need to know is clever people did stuff with data and spreadsheets and science. If you want to know more, there are extensive notes at the back of the first edition, and doubtless the new one from 2020.

This book helped me calibrate my own greening efforts, and I use it to show clients that there are easy-to-use references out there, when they want to change for the better. Until recently I would explain that although the exact footprints change as, say, electricity grids get greener, the rough order of impacts doesn’t move that much so the original book was still a good reference. And now I know there’s an updated one with new footprints and new things in, I can’t wait to find out about Bitcoin and hopefully, avocados!

All opinions on this blog are my own

Guest Book Review by Dr Claire Walker: Girl One by Sara Flannery Murphy

November 12, 2021November 12, 2021 girlymicro Book Reviews, Guest blog

Girlymicro is currently laid up with shingles and despite having tried to negotiate with the virus, it appears they have not been able to come to terms in order for her to be able to be well enough to blog. The ever inspiring Dr Walker has leapt into the breach to ensure that you are not forced to spend a week without science based entertainment. She is, as ever, wonderful.

Guest Book Review – Dr Claire Walker

Paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered clinical scientist in immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci) and indecisiveness (everything else). Now a senior lecturer in immunology at University of Lincoln.

Girl One by Sara Flannery Murphy. A genre bending thriller about female power and a fun take on the premise of asexual reproduction.

Judging a book by its cover?

What draws you to pick up a new book? In my limited time post baby two, I look at a few one line reviews on my Amazon account and hope for the best. Girl One By Sara Flannery Murphy caught my attention for being described as ‘Orphan Black meets Margret Atwood’. One of my favourite pseudo-scientific TV shows and my favourite speculative fiction author? Sold.

The Story

In Girl One Murphy focuses on a group of women who are the subject of a fertility experiment in rural America. She tells the story of the nine ‘miracle babies’ born without male DNA, the result of ‘virgin birth’, or to use the scientific term, parthenogenesis. The premise of the book is that a massive leap forward was made in reproductive science in the 1970s allowing human parthenogenesis. The actual process of human parthenogenesis is shrouded in mystery and lost with the untimely death of the rather shady scientist and would be father figure, Dr Joseph Bellinger. The progeny of the experiment scatter after this event and try to live normal lives away from zealots who target them for being against the natural order of things. The unexpected disappearance of her mother leads the first of these children, Girl One, on a road trip of discovery unlocking the secrets of their origins.

The Science

This is a science blog, so let’s put the superpowers and 1970s feminist manifesto to one-side for a moment. In the natural world, parthenogenesis is business as usual for some species of plants, insects, lizards and, most recently documented, California Condors. But what about humans? Has Murphy taken speculative fiction a step too far?

Until relatively recently, it was believed that parthenogenesis in humans never produced viable embryos. Human parthenogenesis itself is not actually such a rare event. The spontaneous activation of a woman’s egg without the presence of sperm is well documented. Unfortunately, this process results in the development of an ovarian teratoma. These tumours present as anatomically disorganised structures that have been documented to contain hair, limbs and even teeth.

In his review On human parthenogenesis Dr Gabriel de Carli, discusses the serendipitous discovery of chimeric human parthenotes, or in plain English, children who have two cell lineages in their bodies – the closest thing to human parthenogenesis identified thus far. These children have cells that are the result of the normal fertilisation process, and cells that are the result of human parthenogenesis that have fused together. The first child, described in 1995, was a little boy whose white blood cells were shown to contain no Y chromosome whilst the other cells of his body were genetically male. The X chromosomes in the boy’s white blood cells were shown to be identical to each other, and both were derived from his mother revealing their origin to be from a ‘virgin birth’ event. So, whilst incredibly rare, we now know a form of parthenogenesis is possible, and more importantly, viable in humans.

Perhaps even more interestingly, Dr de Carli believes that rare cases of full human parthenogenesis occur and pass unnoticed. In fact, he thinks that as we enter the era of whole genome sequencing of all new babies, we are on the cusp of identifying these individuals. Only time will tell if they have the superpowers described in Girl One.

TLDR: A superhero take on 1970s feminism with a pinch of dystopian gender politics and smattering of not-quite-totally-fictional science. Not at all bad.

All opinions on this blog are my own

Celebrating National Pathology Week: What is a clinical microbiologist?

November 4, 2021June 25, 2022 girlymicro Microbiology (Clinical), Science Communication

To celebrate this week being National Pathology Week , I thought I should take some time to post about what a clinical microbiologist is. I do this because, when I was at university, I really didn’t know that this career path existed. So here is a shout out to all those students who are trying to decide their next steps. You too will find your way.

When I googled microbiologist this is the first item that comes up

Microbiologists study microorganisms (microbes) in order to understand how they affect our lives and how we can exploit them
Prospects.ac.uk

This seems like a pretty good cover-all description. It goes on to discuss that there are microbiologists in many different areas:

medicine.
healthcare (I’m not sure how they differentiate this from medicine or visa versa).
research.
agriculture and food safety.
environment and climate change.

I must admit that when I was at university most of the options I encountered were linked to the food and drink industry or pure research. I think that their list missed things like Pharmaceuticals (although they may count that as medicine) and other forms of production, i.e. cosmetics.

At university I only did one module of microbiology (I was reading Zoology) and that module was about environmental bacteria and plating out bacteria onto agar plates to see what grew.

How did I go from Zoology to Microbiology?

I really wanted to work in an area of science where I could work to make a difference. I wanted to work somewhere that I could see that difference being made. Working in research felt too abstract to me. When I discovered, through a friend, that I could become a scientist in healthcare I knew it was what I wanted to be.

The National Careers service says you need to have two to three A-levels to become a microbiologist, plus a post-graduate degree. That is mostly true. However, in a world of apprenticeships and T-Levels, that is no longer the only route.

When I became a Healthcare Scientist I became a Clinical Microbiology trainee. So, what was the difference between that and what I’d done at University? The main difference with clinical microbiology is that I focus on organisms that cause infection: parasites, viruses, fungi and bacteria.

I also discovered that there was so much more to microbiology than agar plates. Although – don’t get me wrong – agar plates are still a mainstay of life within the bacteriology laboratory.

One of the techniques I learnt to love was polymerase chain reaction (PCR), which enables us to look for the DNA or RNA of a microorganism instead of growing it. Viruses and parasites don’t grow on agar plates and bacteria and fungi may not grow well if exposed to antibiotics or if present in low levels. PCR allows us to diagnose patients with infections that would not be diagnosed otherwise, or to speed up the process so patients get put on the right treatment faster.

Variable number tandem repeat typing of *Klebsiella pneumoniae*

PCR also enables us to do things that are harder to do using traditional bacterial techniques such as culture. The picture is of patterns that are like bacterial fingerprints so that they can be clustered into similar groups. This enables me, as a clinical microbiologist, to tell whether bacteria within the same species are the same or not. This is important when deciding whether a bacteria has spread from one patient to another. It helps in acting like a hospital detective, which is a lot of my work in Infection Prevention and Control.

As a trainee I spent four years rotating within laboratory settings. I spent one year in a molecular laboratory, diagnosing patients using PCR. I then spent six months rotating between benches (each sample type has its own laboratory bench) in bacteriology: wounds, respiratory samples, faecal samples, blood cultures, urines, fluids (cerebral spinal fluid etc.) and the primary bench where samples were put onto agar plates. Six months in virology, a year in research and time in food and water, parasitology and mycology (fungal) labs.

The diagnostic process is pretty similar in principle between the specialisms:

collect specimen from possible site of infection.
select the most appropriate test to detect any organisms (agar plate for bacteria, PCR primers for viruses, etc.)
evaluate whether the result (positive or negative) is accurate and whether there are other tests that should be done, i.e. further characterisation of positives such as antimicrobial sensitivity.
decide on treatment or management of the infectious cause, i.e. antimicrobials or non-antibiotic management such as surgery.
advise on infection control if actions are needed to investigate where the infection came from or to protect others from risk.

During my first four years I spent most of my time in the laboratory doing the first three bullet points.

Time goes on. I’ve been in the NHS for 17 years. Most of my time is spent at my desk in the on-call bathroom. Since 2010, most of my time has been spent either in Infection Prevention and Control undertaking the final bullet point or increasing my skills by gaining Fellowship of the Royal College of Pathologists to do bullet point four.

I still support the lab and, occasionally, get my lab coat on – but not as much as I’d like. It is, therefore, possible to be a clinical microbiologist and be anywhere on the spectrum. You can go as far as you’d like and do the type of work that makes you happy. It’s why being a clinical microbiologist is a great career!

Modernising Scientific Careers Framework

All opinions on this blog are my own

Saturday Morning Zombies: how infection is portrayed in the genre

October 30, 2021October 30, 2021 girlymicro General, Science Communication

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

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

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

Three reasons:

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

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

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

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

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

zombie-rendezvous-printable Download

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

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

A virus?
A bacteria
A fungus?

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

How do infectious causes affect zombie characteristics?

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

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

Zombie outbreak handout Download

Zombie outbreak handout – pics Download

Design A Zombie activity Download

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

All opinions on this blog are my own.

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

October 28, 2021October 28, 2021 girlymicro General

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

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

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

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

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

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

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

Try to be self aware and remind yourself of the cause

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

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

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

Try to change your inner dialogue

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

Reach out to trusted advisors and get a reality check

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

Know tomorrow is another day

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

Remember the good times

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

Do something you love

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

Put your feelings into context

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

Stop fighting it

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

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

All opinions on this blog are my own

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

October 22, 2021October 22, 2021 girlymicro General

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

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

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

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

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

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

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

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

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

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

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

So where is the system letting me down?

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

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

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

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

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

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

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

All opinions on this blog are my own.

Laboratory Testing for SARS CoV2 (COVID-19): Is all testing the same and why should I care?

October 16, 2021 girlymicro Microbiology (Clinical), Science Communication

Why Am I Posting This Now?

In light of the news that came out yesterday linked to the withdrawal of the testing service in Wolverhampton, I think that this post from April still has relevance so I have decided to re-post.

Every tube is a person
This week Panorama aired an episode about how testing is undertaken in some community testing laboratories. They didn’t really cover the differences in testing between hospital and community testing streams.and I’m concerned, as others are, that this programme will create the impression that all testing is done in the way it was portrayed in this episode.
BBC iPlayer – Panorama – Undercover: Inside the Covid Testing Lab

Mention is made in passing to the high quality NHS system that existed prior to the COVID-19 pandemic and is still providing world class care. It doesn’t go into the difference between the 2 parallel lab systems in any way that would be clear to the audience, or reassuring to those not being treated by the so called ‘mega labs’. They also only really refer to academics vs the recent science graduates running laboratories. No mention is made of the army of highly trained, highly qualified Healthcare Scientists who have spent years providing high quality, rapid, advanced testing who have been the backbone of scientific testing in healthcare for decades. No Healthcare Scientists were even featured to comment on the practice.This is such an upsetting oversight that it I felt like I needed to put something out there in order to raise awareness of how all of this works in practice.

This hidden profession deserves to be seen and recognised for the amazing work they do, and not conflated with the bad practice seen in this programme

Before I go any further, I need to be clear that this post isn’t talking about point of care testing (POCT) i.e. the lateral flow testing which I am going to cover in another post; nor is it looking at the technical aspects such as how PCR works as I’ve already covered this in another post. This post is about the different testing streams and why the service and quality they offer may not be the same in all circumstances. This is clearly only my view of the situation and others may see it differently.

How Did We Get Here and How Does the Testing System Work?

When the pandemic started, the government released a document called Coronavirus (COVID-19): scaling up our testing programmes. This document was last updated in April 2020, basically setting out how we were going to enable the country to go from testing a few hundred virus samples a day in each local hospital for patient management to 700,000 plus swabs per day: from both hospitals and the community for: patient management (pillar 1) and epidemiology and surveillance (pillar 2).

The decision was made not to scale up the local hospital and public health networks that already existed (pillar 1), but to bring on line a second parallel system for community testing which would be called pillar 2.

English Government Testing

Tests in the UK are carried out through a number of different routes:

pillar 1: swab testing in Public Health England (PHE) labs and NHS hospitals for those with a clinical need, and health and care workers.
pillar 2: swab testing for the wider population, as set out in government guidance.
pillar 3: serology testing to show if people have antibodies from having had COVID-19.
pillar 4: blood and swab testing for national surveillance supported by PHE, the Office for National Statistics (ONS), and research, academic, and scientific partners to learn more about the prevalence and spread of the virus and for other testing research purposes, such as the accuracy and ease of use of home testing.

The 5 pillars of testing shown as a building

The decision to scale up using multiple pillars was made to improve capacity and was supposed to be designed with the following in mind:

Accuracy and reliability of tests.
Getting the right supply of people, lab space, equipment and chemicals.
Logistics.

What Points Did the Panorama Programme Make?

The Panorama programme asked the question, ‘Can we trust testing to keep people safe’. As mentioned , it focussed on pillar 2 testing in one of the ‘mega labs’, a not for profit lab in Milton Keynes set up to process 70,000 samples a day. The 7 lighthouse labs should between them be able to process 700,000 tests a day. To put this in context my lab in pillar 1 processes up to 600 SARS CoV2 tests a day at maximum capacity, but it is a comparatively small lab. I know other centres are running 10,000 tests, but still the numbers are smaller: mostly due to the context in which we are running, i.e. patient management and staff testing.

The woman who investigated worked 18 shifts over the course of the programme and was a life science graduate given 4 and 1/2 days of training before she started on the job (bear this in mind when we talk staffing and training later).

The programme showed a large number of quality and technical issues (I needed a glass of gin afterwards), such as failing to check sample details so samples needed to be discarded, safety failings in the way they were using hoods and dealing with leaking samples and substantial issues with quality controlling results prior to release. This last point meant that the reliability of the result given could be questioned, with a number of potentially false positives being sent out.

Many of these issues are linked to what we call quality assurance, so here’s the CDC definition:

Laboratory Quality Assurance (QA) encompasses a range of activities that enable laboratories to achieve and maintain high levels of accuracy and proficiency despite changes in test methods and the volume of specimens tested. A good QA system does these four things:

establishes standard operating procedures (SOPs) for each step of the laboratory testing process, ranging from specimen handling to instrument performance validation.
defines administrative requirements, such as mandatory recordkeeping, data evaluation, and internal audits to monitor adherence to SOPs.
specifies corrective actions, documentation, and the persons responsible for carrying out corrective actions when problems are identified.
sustains high-quality employee performance.

In summary, it’s how we feel sure that the result we give you is the right one, is accurate, and is given within an acceptable time frame that means it is useful to you.

The issues shown were mostly therefore linked with the pillar 2 lab failing at being able to undertake the quality assurance that meant that you got the right result on the right person at the right time. This links back to the stated aims in the government document linked to the need for ‘Accuracy and reliability of tests‘. So why did this happen and why is this quality assurance different in pillar 1 testing?

Why are There Differences Between the Labs in Pillar 1 Testing and the Labs in Pillar 2?

It is worth stating here that (my understanding) the aims of pillar 1 and pillar 2 testing are different. I am in no way excusing the poor practice as discussed in the episode but it is worth remembering that. Pillar 1 testing requires highly accurate repeatable results on an individual level as we are using it to monitor and make clinical decisions such as treatment options for the individual. The level of accuracy and repeatability required is therefore extremely high. Pillar 2 testing feels, to me, to have different aims. Although individual results are processed through the community system, in many ways it feels like it is there to get national and regional data to inform policy decision making on a large scale, such as containment choices. This is much more of an epidemiological approach where individual results matter less, as the data input into the system reaches hundreds of thousands. The focus on each tube being a patient therefore feels like it gets lost.

Staffing and Training

Pillar 1 testing is run and managed by Healthcare Scientists. To become a Healthcare Scientist requires at least degree level qualification and most of my staff have masters degrees. Healthcare Scientists in laboratories also need to be registered in a similar way to nurses and doctors on a professional register where their fitness to practice is monitored. This register is called the Health and Care Professionals Council (HCPC) register and you can either be on it as a Biomedical Scientist or a Clinical Scientist, depending on how much clinical advice you give, but both groups are Healthcare Scientists. Registration take a minimum of a year post degree (and for some routes 6 years plus) with completion of training competencies. Then as part of this professional registration you have to maintain your training, but also fulfil scientific and professional standards. This would mean that some of the things seen in the programme could result in professional sanction and possibly loss of license to practice.

Pillar 2 testing was initially mainly run by academics who were able to be seconded over or volunteer due to university closures. As a Clinical Academic I live in both worlds and my academic colleagues are amazing. However, they are used to working in very different environments without the same standardization and quality assurance checks that are utilised in a clinical laboratories. Most of these highly-skilled academics have now returned to working at their universities as courses have re-opened and so it appears much less experienced graduates have taken their place. This means that despite best intentions and good will they are unlikely to have the experience and training required to fulfil the complex and high standards of laboratory practice required in clinical settings.

This is why the ‘getting the right supply of people‘ piece in the document is so key. Healthcare Scientists like medical staff, however, require years of training prior to independent practice and so I acknowledge that within the timescales we have faced this has been a challenge and is a strategic issue that needs addressing in the years to come.

Quality Monitoring

In theory there should be no difference in the quality monitoring or quality assurance between pillar 1 and pillar 2 testing. It was stated in the documentary that the lab featured has been recommended for accreditation, but what does this mean?

Within England labs are assessed against a set of standards known as ISO 15189 Medical laboratories. These standards set out a list of requirements for quality and competence and were developed by the International Organisation for Standardization’s Technical Committee. If a lab demonstrates they meet these standards they are known as accredited labs, meaning that they are able to provide high quality accurate results. The accreditation body is called UKAS and it works in a similar way to the CQC for hospitals and OFSTED for schools.

All pillar 1 clinical laboratories are required to have UKAS accreditation to run. The process of getting accreditation is highly time-consuming, requires specialist knowledge, and a LOT of paperwork. Most labs have at least one full-time quality lead in order to keep on top of it, and to undertake crucial monitoring like auditing to provide the assurance part of quality assurance.

To set up the monitoring systems and get accreditation, even for one test, is not fast and it seemed to me that this is where the lab featured was failing. It is almost impossible to do high quality work when it is undertaken in a factory setting with hourly targets and when the staff present aren’t trained to a high enough level (4 and 1/2 days). Obviously, this is just a view from a set of data given through the lens of a specific piece of reporting. Having been through the accreditation process numerous times myself, it is of no surprise to me that centres set up so quickly with limited staff training are struggling to comply or even to truly understand the issues.

So Where Does that Leave Us?

Firstly I want to clearly state that this post is not an attack on the people working in the mega labs, they are doing their best under tremendous strain with what they have available.It isn’t even an attack on the mega labs themselves as I understand how we have gotten to where we are with them. This is a post to explain what we already had in place and how we might in the immediate and longer term look to do things differently.

These labs have been created at pace and utilising what resource could be sourced to set up a completely separate stream. In many ways I understand this, as just the logistics of getting 70,000 specimens a day into a building in terms of vehicle access are huge. Healthcare Scientists also cannot be magicked out of thin air. The problem is that this is being treated as a factory, without (it feels) acknowledging that the work we do is highly-skilled and technical: that this needs to be acknowledged in order to achieve high quality outputs.

As stated in the programme:
‘If we’d spent the money supporting the existing system we would have been better off’

That may not have been possible for reasons of speed and logistics at the start, but it is certainly possible now. The answer to the question in the programme ‘Can we trust testing to keep people safe?’ is yes, but maybe not in the situation we’re in right now. So let’s acknowledge the workforce that have the expertise in this, who can deliver the quality required and build the infrastructure to ensure that no matter where you are tested, for whatever reason a sample is taken, you are acknowledged as the patient behind the tube!

As to whether you should care about testing and where your sample is processed. We should all care: results and quality should not depend upon testing site. We should also care about the plans for how this is done in the future, as this will be a key legacy that the pandemic leaves behind.

All opinions in this blog are my own.

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

October 11, 2021October 12, 2021 girlymicro General

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

It’s OK to break the rules

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

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

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

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

Numbers only have meaning if you give it to them

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

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

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

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

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

Once you start it’s hard to stop

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

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

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

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

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

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

All opinions on this blog are my own.

Healthcare Science Education 2021: Innovation in Education

October 5, 2021October 5, 2021 girlymicro Education, Science Communication

Yesterday the NCL Education Partnership hosted our 4th annual (bar COVID-19 related 2020) Healthcare Science Education conference (#HCSEd). These meetings came about as way to encourage and support Healthcare Scientists to recognise themselves as educators, in the widest possible context, not linked to specific training schemes or disciplines. It’s something we continue to be passionate about and if you’d like to get involved in future events please drop either myself, Ant De Souza or Vicki Heath a message.

This years theme was innovation in education and ended up including a lot about how we innovate, not just in terms of the technology, but in terms of our approaches in working with trainees, teams, workforce and the public.

The day was chaired by the Vicky Nash who is an established leader within medical education and is a great supporter of the Healthcare Science workforce. (NB apologies for my poor photography skills, all the good ones are from Rabbit Hole Photography and when the other ones come through. I will swap them out)

Nicola Baldwin, playwright and screen writer, kicked off our first talk on ‘Public perceptions of Healthcare Scientists during the pandemic’

Her talk was about her experience both as a member of the public and someone who works with Healthcare Scientists about how that perception has changed over the course of the pandemic and what some of the drivers for that change has been.

She told the story of how at the start people were engaged and interested, they felt part of the narrative and then they began to get lost as part of the conversation. We (Healthcare Scientists) lost our place in the story in the same way that the general public lost their ability to engage in the conversation as it became politicised and increasingly focussed on strategy and technicalities.

As someone who has previously written for Holby City she discussed that one of the reasons Healthcare Scientists are not represented on TV in the same way that doctors and nurses frequently are, is that doctors and nurses are presented as flawed human beings. They get the tests and they ignore them or they react to crash calls for good or ill, and frequently lack the information they need to make decisions. They are effectively glorified members of the public and therefore fulfil that role within the narrative of connecting with the view. In medical drama the guest stories i.e. patients, are only there to challenge the flaws or impact on the regulars i.e. the cast. In reality Healthcare Scientists do not visibly battle but work hard to remove their flaws from the equation, and therefore leave their emotions at the door. They live in a data driven world where patients do not always get better and we all die. Because of this Healthcare Scientists do not obfuscate and do not hope for the best, but make evidence based decisions and work in a world of these facts and may therefore make less attractive heroes for fictionalised drama. In the real world the longer the pandemic has gone on the more that scientists have been seen as messengers of doom as they deliver fact, not necessarily a message of deliverance.

So how do we move towards speaking the same language and engage?

The challenge outside of the Healthcare Science profession is that the pandemic has laid bare a lack of scientific literacy and connection between scientists and the public domain and has therefore left reservoirs of fear. Our most basic measures of literacy are to read and obey basic instructions. Above this level educationalists have said is the ability to read and engage with newspapers and other sources. Above even this is the ability to compare, digest and analyse in order to support meaningful engagement. The same thing is needed in terms of scientific literacy and engagement. Connections between science and the public are needed to enable people to navigate the space and literacy is required to support analysis and evaluation of the information is available. Sometimes the connection between the Healthcare Scientist workforce and the general public is limited by a culture emphasises teamwork and there is a lack of individual promotion. In many ways this is great but it is important to be out there and therefore some form of promotion is needed.

Public perceptions have been changeable and volatile, opportunities to explain that from early in the pandemic were missed and that has resulted in public scepticism. To change this engagement of Healthcare Scientists is key to ensure that scientific literacy and the best way to do this is to not be afraid to promote and make connections. You and your stories can change the world!

Dr Steve Cross, science communicator, talked about ‘Science and science communicators’

Following on really nicely from Nicola with her call to arms in terms of the need to start and be part of the conversation, Steve talks about the practical aspects and challenges of engaging as a science communicator.

The big challenge for UK science communication infrastructure is that is consumed by 13% of the population which mostly consists of white, wealthy, males, who are 35 – 50. This doesn’t reflect our population, patients or future workforce so how do we communicate outside of the 13%? Some of this stems from the official science communication structures, such as the media, believing that ‘The public love debates about genomics’.

As nobody has to engage you have to make it engaging? How do you make something that actually works rather than ticking a box?

So how do we go about thinking how we undertake engagement activity? A good place to start is using Design Theory.

Empathise with the audience – remember ‘the public does not exist’ they are vastly different. Think about who you are trying to reach and why
Define the problem – put in work to really understand what you are trying to address, what are the barriers, who are your stakeholders, what are the reasons why things haven’t work before and what have people already tried
Have ideas – have lots of ideas, sensible ideas, crazy ideas, out of the box ideas
Prototype – come up with lots of approaches to those ideas and try them out, be prepared to try loads of them and throw them away in order to refine the prototype
Test and evaluate – once you have a prototype make sure you continue to test and ensure you evaluate and improve

Dr Rowan Myron, associate professor of healthcare management, gave our keynote on ‘Qualitative data collection’

Rowan started out talking about the pros and cons of quantitative vs qualitative data: qualitative may not be generalisable but gives rich data set exploring how and why, whereas quantitative may enable extrapolation but may be less deep and doesn’t normally explore motivations.

Traditionally Healthcare Scientists are considered to be Positivists, believing that data should give answers and therefore leaning towards quantitative data collection. Professionals that work with qualitative data are often considered to have more of a constructivist approach, where each piece of learning develops from the last and therefore permits exploration of how and why that development occurs.

It is also possible to have a mixed methods approach where some aspects of the work lend themselves to a quantitative approach, with other project components lending themselves to a qualitative collection method i.e. where you may use surveys to explore underlying attitudes but relate it to comparative quantitative bench marks.

The best approach for facilitating these conversations can vary from free – semi structured – structured and the style of facilitation matters. Directive interventions may be appropriate in some clinical meetings but is less likely to be successful in terms of gaining information and insights in a qualitative research setting.

Being in the room can sometimes change what people tell you – as a qualitative researcher you can get some of the best responses when you turn the data recorder off and so how you record and capture some of that which doesn’t fit into your framework, however it is important to consider the ethics of this. It is also key to ensure that you are recording accurately and not interpreting, and therefore checking in with participants to ensure that recordings are accurate is key.

Using some of these techniques can also help in non-research settings, such as team meetings and 1:1 in order to improve communication quality

BAME Scientist Trainee Network gave a really important session on ‘Diversity in access to education’

The session was really impactful for me and I believe having these kinds of sessions and conversations is key if we are going to address some of the issues raised.

For those coming into the healthcare system as staff members, white applicants for posts across the NHS are 1.5x more likely to be appointed from shortlisting than non white applicants. In order to change the system that permits this we need to start with education and therefore understand the biases of the system that recruits into it. This challenge was shown to also be reflected in the STP appointment scheme, where the average success rate was ~5% but for Black/Black British – African applicants the success rate was ~1%.

When in post 1/3 of BAME staff report having been harassed or bullied at work either by patients or their colleagues.

For those coming into the NHS and healthcare systems as patients healthcare inequalities exist and are often based on myths that emerged from 18th century studies linked to slavery, such as black people feel less pain as they have less nerve endings. Within the NHS black women are 5x more likely to die in child birth and black patients at half as likely to receive pain medication.

Not only are the issues backed up by research and other evidence but there is also data to show that promoting equality, diversity and inclusion does not just benefit BAME groups, and therefore benefits the workforce and patient population as a whole.

So what can we do to support our BAME colleagues?

The following suggestions were taken as part of a qualitative research study from BAME and white Healthcare Scientists, rooted in their lived experiences (as we learnt from Rowen, this permits the exploring of why and how questions).

Advice for leaders:

Unconscious bias training – manager and leaders have the biggest influence and it was felt could have the biggest impact on as inclusive environment, and that active allyship was key
Diverse influence panels – decreases the collective effects of unconscious bias
Monitoring for training opportunities – ensuring equality , measure and monitor metrics and review access
Mentorship, including reverse mentorship
Diverse teams
Zero tolerance of inappropriate language, awareness of micro aggressions
Equal opportunities for showcasing skills – ensuring that extra curricular activities or additional responsibilities were accessible to everyone, not based on connection to a manager
Practical advice to address specific needs i.e prayer room location, halal food options, joining staff inclusion networks

Advice for non-leaders:

Read WRES reports workplace race equality standards
Actively learn about others perspectives
Check in with colleagues when incidents witnessed
Advocate for others
Target outreach to schools in disadvantaged areas
Review clinical practices and ask whether they are contributing to health inequalities

No matter what your role you have the ability to take steps to counter the data shown and so this is a call to action and take steps as individuals, teams and organisations to address these issues.

Dr Jane Freeman and Dr Kerrie Davies, NIHR clinical lecturers and clinical scientists, ‘Communicating differently’

To finish off the morning with a bang Jane and Kerrie called on us to really think who are we, and not just our scientific credentials……. what is our talent, not just our ability to plate 200 samples and hour…….and to think who are the audience we’re trying to reach? What is the message your trying to get across? How can you make it memorable? One size does not fit all??

Communication is about connecting with people and that involves taking risks, doing the unconventional, bringing whole self to work………..not just Dr XXXX but all of you. As I have said in a previous blog I do my best science over a cup of tea and Jane and Kerrie emphasized that talking is key, with conversations being the starting point to any success piece of work.

Actions however speak louder than words and so below is my (rather shoddy) recording of one way that Jane and Kerry show that actions speak louder than words. Enjoy the Small Faeces discussing ‘Quality’!

For the afternoon session we moved onto the workshops. There were three streams to choose from:

Stream One – Innovation in outreach by Victoria Heath and James Harkin, followed by Royal Literary Fund – Rooftop writers by Nicola Baldwin

Stream Two – Top tips for delivering educational activities online by Justin Poisson, followed by Evaluation of digital education by Ian Davies and Matt Coombes-Boxall

A starting reflection on the transition to digital delivery from face to face learning. A move from reactive remote learning to blended learning. Sessions were put together to lecturers and students. ‘Moving your lectures online’. Online induction resources’, ‘Talking into the void’.

The session then talked about learning technologists, and translating practice to the educational environment. Opportunities were given for staff to showcase how they moved their online to a digital format.

Retention research has highlighted that regular feedback was important and that to support this the community of inquiry model was encouraged as something to think about when delivering sessions.

There was also a demo different learning software’s that could to help with engagement: Flip grid, Wakelett, Mural

Stream Three – Maintaining your education during a pandemic by the London Healthcare Scientist Trainee Network, followed by Influencing upwards by Cherie Beckett

I was lucky enough to be supporting the stream three session which was kicked off by the LHCSTN who ran a really interactive session getting everyone in the room to explore and score (1 – 10) whether the pandemic had impacted on 7 key areas, either as a trainee or a trainer:

Redeployment/role changes
Exposure to practical clinical skills
Rotations and placements
Research projects
Staying connected
Virtual learning
Wellbeing

We then talked through the learning and different ways those in the room has dealt with the high scoring impacts they had experienced.

Cherie then followed on with an equally interactive session exploring everything from how we introduce ourselves i.e. ‘just a trainee’ or using banding, to how to expand your influence. The group spent time identifying barriers to influencing up and reflecting on whether some of those were self imposed. Then we moved onto to talking about how to navigate around those barriers or coping strategies for the internal ones.

The final session of the day was the plenary given by Vivienne Parry, Science writer and broadcaster (and all around Healthcare Scientist champion)

Viv finished the day in inspiring style by reminding us all of why what we do matters, the impact that we have but also re-iterated the message of the day – that we have to be seen! We need to talk to people like we do to our families and explain what we do and why it’s important. Not speak like we do to our colleagues, not like we are speaking to a Guardian science reporter, but like we do when we are outside work. That is how we talk in a way that is heard and received. We are too important to be invisible and now is our time to shine!

NB – these are the meaning of the sessions as I received them as a member of the audience, hearing through my own lens, these are not verbatim notes, although I’ve tried to be as accurate as I can. All opinions on this blog are therefore my own

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

October 3, 2021October 5, 2021 girlymicro General, Microbiology (Clinical)

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

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

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

Things to know as you start out on your journey

Have a plan

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

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

It’s OK to re-plan your route

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

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

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

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

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

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

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

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

Influence is not about seniority

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

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

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

We rise by lifting others

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

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

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

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

What to do when you hit your original destination

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

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

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

Sit back, smell the roses and take time to celebrate

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

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

I am the one thing in life I can control
(Wait for it, wait for it, wait for it, wait for it)
I am inimitable
I am an original
I’m not falling behind or running late
(Wait for it, wait for it, wait for it, wait for it)
I’m not standing still
I am lying in wait (Wait, wait, wait)
Wait For It – Hamilton

All opinions on this blog are my own

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

September 23, 2021November 1, 2025 girlymicro Education, General

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

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

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

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

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

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

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

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

Designing your brief

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

You need to decide:

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

Your brief will dictate:

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

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

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

Venue is everything

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

Find your team

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

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

Evaluation

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

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

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

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

All opinions on this blog are my own

If you would like more tips and advice linked to your PhD journey then the first every Girlymicrobiologist book is here to help!

This book goes beyond the typical academic handbook, acknowledging the unique challenges and triumphs faced by PhD students and offering relatable, real-world advice to help you:

Master the art of effective research and time management to stay organized and on track.
Build a supportive network of peers, mentors, and supervisors to overcome challenges and foster collaboration.
Maintain a healthy work-life balance by prioritizing self-care and avoiding burnout.
Embrace the unexpected and view setbacks as opportunities for growth and innovation.
Navigate the complexities of academia with confidence and build a strong professional network

This book starts at the very beginning, with why you might want to do a PhD, how you might decide what route to PhD is right for you, and what a successful application might look like.

It then takes you through your PhD journey, year by year, with tips about how to approach and succeed during significant moments, such as attending your first conference, or writing your first academic paper.

Finally, you will discover what other skills you need to develop during your PhD to give you the best route to success after your viva. All of this supported by links to activities on The Girlymicrobiologist blog, to help you with practical exercises in order to apply what you have learned.

Take a look on Amazon to find out more

Guest Blog Dr Claire Walker: From academia to the bench, and back again. An immunologists journey.

September 16, 2021April 14, 2024 girlymicro Education, Guest blog

Whilst Girlymicro is away trying to find some of this work life balance people keep talking about, the charming and wonderful Claire has stepped into the breach to keep you informed and amused. Isn’t she lovely!?

Blog By Dr Claire Walker

Paid up member of the Dream Team since 2013, token immunologist and occasional defector from the Immunology Mafia. Registered Clinical Scientist in Immunology with a background in genetics (PhD), microbiology and immunology (MSc), biological sciences (mBiolSci) and indecisiveness (everything else). Now a Senior Lecturer in Immunology at University of Lincoln.

From the Bench

More than a few years back I took my good friend Kip for a drink and told her that I’d decided to undertake a post graduate certificate in clinical and professional education. Her response was something along the lines of, whilst choking on her drink and laughing at me, ‘but you hate education and training, you only like research, who on earth got you to agree to this one?’ And based on my backstory she wasn’t totally wrong. I’d always felt that healthcare scientists fell into one of two groups when it came to training and education. The first had the best possible training, adored their mentors, and want to share their wealth of knowledge. The second group viewed training as a rite of passage, had every corner knocked off on the way up and want everyone to suffer for their art just as they have. Historically, I had fallen firmly into the second camp. My gruelling but formative experience had, in my humble opinion, made me an excellent and extremely driven clinical scientist who didn’t need any spoon feeding or hand holding thank you very much.

So, who had got me to agree to this? The one and only GirlyMicro. GirlyMicro has the delightful quality of not always recognising what a huge deal she is in the world of pathology, so when she stopped me in a corridor at work and said, ‘I’ve picked up some funding for a PgCert, is education your bag? Fancy applying?’. I, of course, responded with ‘yes please, thank you for noticing me and I will jump through literally any hoop to make this happen’. Then left the conversation, head in hands wondering exactly what I had let myself in for.

Drinking the Kool Aid

So off I went to study education theory and practice. To begin with I told myself this was all about improving my section of the laboratory. Each senior scientist in a department runs their own bench; a set of scientific tests staffed by a selection of junior staff members and trainees. I ran the research and development bench. In my opinion, this is the most exciting work done in a clinical laboratory but I have to confess my trainees at that time rarely shared my enthusiasm. But that couldn’t have possibly had anything to do with my diffident approach to training, could it?

With each lecture, I found myself struggling to justify my approach (or lack thereof) and why I had resisted this for so long? Why wouldn’t I want to learn techniques to disseminate information well, why couldn’t I improve my communication skills, and why was I so resistant to helping our students become the very best healthcare scientists they could be? With the benefits of hindsight, I had bought in to a toxic culture based on exceptionalism and prestige. Why was I expecting every junior member of staff to learn exactly the same way I had? Could I not see that there were far less painful routes to success available to them? And that we might lose fewer trainees if I paid a little attention to this? I put theory into practice, and within months my bench was full of happy and appreciated staff members. I found myself reflecting daily on just how important educating our next generation of healthcare scientists was, and why this needs to be done properly. Why we shouldn’t be putting our trainees through some trial by fire if we expect our profession to survive the oncoming storm of privatisation, pandemics, and real time pay cuts, to name but a few challenges. It transpires that by nurturing our talented students we only improve all our positions.

And Back to Academia

A fortuitous turn of events in my personal life put me in a position move from my senior scientist gig to a senior lecturing gig. Not the best year for it thanks to the pandemic. But surrounded by inspiring new colleagues I have jumped feet first into educating our next generation of registered healthcare scientists on a fabulous accredited Biomedical Science course, even if I do say so myself.

As healthcare scientists, we are forever dipping in and out of education be it through engaging in our undergraduate degrees, Masters courses, PhDs, specialist portfolios, equivalence portfolios and fellowship exams (to name but a few!). Let’s take the time to share our knowledge. GirlyMicro has been telling me for years that we must lift others to lift ourselves. What do you know? Turns out she was right all along.

TLDR. Those who can, teach.

A note to my friend Kip – Who’s laughing now? Congratulations on your PgCert in Health Professions Education awarded with Merit this year! Welcome to the cult.

Where Is Everybody? Patient and Public Involvement (PPI) in the time of pandemic

Defining the challenge

Designing a strategy

Reviewing our results

In Conclusion…?

What Do I Mean When I Talk About Risk Assessment?

So Why Do Risk Assessments Change?

Who Pays?

The Ugly

The Bad

The Good

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

A little respect goes a long way

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

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

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

Wellness programmes are not going to fix this

What is shingles and how is it related to chickenpox?

How is it diagnosed?

What is the treatment/management?

How do I stop myself having a recurrence?

Top tips:

Guest Book Review – Dr Julie Winnard

Guest Book Review – Dr Claire Walker

Girl One by Sara Flannery Murphy. A genre bending thriller about female power and a fun take on the premise of asexual reproduction.

Judging a book by its cover?

The Story

The Science

Try to be self aware and remind yourself of the cause

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

Try to change your inner dialogue

Reach out to trusted advisors and get a reality check

Know tomorrow is another day

Remember the good times

Do something you love

Put your feelings into context

Stop fighting it

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

So where is the system letting me down?

Why Am I Posting This Now?

How Did We Get Here and How Does the Testing System Work?

What Points Did the Panorama Programme Make?

Laboratory Quality Assurance (QA) encompasses a range of activities that enable laboratories to achieve and maintain high levels of accuracy and proficiency despite changes in test methods and the volume of specimens tested. A good QA system does these four things:

Why are There Differences Between the Labs in Pillar 1 Testing and the Labs in Pillar 2?

So Where Does that Leave Us?

It’s OK to break the rules

Numbers only have meaning if you give it to them

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

Once you start it’s hard to stop

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

Nicola Baldwin, playwright and screen writer, kicked off our first talk on ‘Public perceptions of Healthcare Scientists during the pandemic’

Dr Steve Cross, science communicator, talked about ‘Science and science communicators’

Dr Rowan Myron, associate professor of healthcare management, gave our keynote on ‘Qualitative data collection’

BAME Scientist Trainee Network gave a really important session on ‘Diversity in access to education’

Dr Jane Freeman and Dr Kerrie Davies, NIHR clinical lecturers and clinical scientists, ‘Communicating differently’

Stream One – Innovation in outreach by Victoria Heath and James Harkin, followed by Royal Literary Fund – Rooftop writers by Nicola Baldwin

Stream Two – Top tips for delivering educational activities online by Justin Poisson, followed by Evaluation of digital education by Ian Davies and Matt Coombes-Boxall

Stream Three – Maintaining your education during a pandemic by the London Healthcare Scientist Trainee Network, followed by Influencing upwards by Cherie Beckett

The final session of the day was the plenary given by Vivienne Parry, Science writer and broadcaster (and all around Healthcare Scientist champion)

Things to know as you start out on your journey

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

What to do when you hit your original destination

Designing your brief

Venue is everything

Find your team

Evaluation

From the Bench

Drinking the Kool Aid

And Back to Academia

TLDR. Those who can, teach.