Is it only March?

I’m starting to write this on day 1 of my leave. It’s Friday the 5th of March and already it feels like its been a very full year. This has been incredibly therapeutic to write, the process of putting ink to paper is something I advocate for everyone but I know that some of what I write is not all what I feel. What I mean is that, part of exploring the thoughts that come to me when writing these blogs is assessing if they are really what I felt or are they how I saw my emotions on some pretty awful days…feelings seen through a distorting lense…I got mixed feedback from previous blogs, mostly positive but my honesty/ candidness about emotions I think worried some people. I continued to write but it largely stayed in ink and not shared wider..therefore less blogs made it here.

So, week one of no new outbreaks since October…..that’s somewhere in the region of 140 days of outbreak reporting and managing within this part/wave of the pandemic and the day I’m writing this marks the end to a welcome but slightly un-nerving week. It has been full gas since February 2020 but more so since October. The pace of change and demand for information meant that there needed to be an industry developed behind IPC just to keep pace. We now find ourselves moved from daily IPC Cell meetings, though to weekly and now every other week. Outbreak meetings have changed from twice daily, to daily and now every other day. Tactical cell meetings have also tailed off and the need for IPC input gradually reduced.

This week saw a marked and obvious change the number of new cases presenting at the Trust and being identified whilst an inpatient, even more so than over the summer months of 2020. Its felt like someone has turned the wind off. The hum in my ears no longer there with less meetings to attend and, apart from the steady trickle of air into our office from the windows open, the atmosphere has been still. Time to reflect, gather thoughts without the bluster of another major issue to manage blowing everything off our conversation table. Within my team we have found time to look at Post Infection Reviews for alert organisms other then SARS CoV-2. We have even started to plan for the coming year and actually look in earnest at the gifts and challenges of a merged/ merging team.

Prior to this, in October, I’d started coaching to explore some of my thoughts on the future, the merging of the two Trusts to become UHD and how my role would fit into this. I had accepted the post of Head of IPC and was starting to look at how to lead this newly formed team across several sites bringing together the thoughts and cultures around IPC from two Trusts all of which during a very busy time for the NHS and Dorset. I had some doubts, not confidence doubts but questioning if I’m the right person to be in the role. I’ve got the qualifications, the training and the experience but was I the right person? I really wanted to see the post as a successful, influential post and I needed to know if I could be the person to deliver that.

As the coaching started the number of SARS CoV-2 cases rose exponentially and available time for anything but the response to this rapidly disappeared. The coaching therefore abruptly stopped but the questions still circulated for me to try and explore myself.

The questions I had were on the lines of – am I the right person to lead? Have I got the skills to do it well? What do I need to do in order to succeed? As with the many other stages of my life the questions I had were answered through the opportunities and challenges life offered me. The more I asked, the more came to me in answers. I don’t mean mystically but just in the opportunities to fail, learn, try again and succeed.

October’s change meant that admissions of cases rapidly increased and clusters were identified in pockets of staff and in clinical areas. Although these were limited to low case numbers these still impacted on patients, staff and the Trust as a whole. October, November and most of December were really busy and then leading up to the Christmas day case numbers dwindled and admissions started to decrease.

Within days of January starting the rate of infections increased exponentially. October was busy but the first few months of 2021 were like nothing else I’ve ever experienced, it was like every crazy day in my career rolled into one – the day in ED when the ALF threatened the Grand National with glue bombs, the day a bomb threat occurred outside the ITU I was working in at the same time that the oxygen supplies were about to run out, the time we admitted a patient whose choice of overdose poison was actually going to be as harmful to staff as it was for the patient. All of these rolled into one, with no let up, every day – crazy paced start to crazy paced finish. Almost every day required additional work and additional hours at the end/ beginning of the day just to meet the demand, just to keep patients and staff safe, the hospital functioning.

The time and the energy required to constantly working at that pace took its toll despite additional staff, different ways of working and us doing all we could to control the demands. At one point this meant we were templated to work 5 days per week but covering 7 days plus on call as well as being 50% down in the team. I know we are not alone in that pressure, there were many others teams stretched with the pressure and the volume of work as well as trying to cope with the personal impacts of COVID-19. But that does not lesson the impact. I really like my job. I’m hugely proud of my team. I have great support both in and out of my core working partnerships but there was 1 point in all of this where I felt like throwing the towel in. For 12 hours I railed against the thought of keeping this up but was able to talk it through and return with a new plan of attack.

I sought support, accepted leadership change and adapted to each different shift in tide and wind. I honestly strived to meet each demand and just as honestly stated when we were unable to meet a request. I actively listened when I needed to and challenged allowing challenge back. I pushed hard to express my gut responses to difficult situations, many “wicked” problems required longer thought but even those I tried to work through at pace.

I can be open and state that my resilience collapsed on several occasions during these 5 months. The volume of hours, the impact on patients, my team and colleagues just became too much let alone being at work when home needed me more than work. Those near and around me were wonderful. The support was genuine, beneficial, growing and helpful. I have been able to work closer (virtually) with many more people and teams as a result so despite the pressure there are a huge number of positives I will take away from this period of my career.

These months tested me, taught me and allowed me to work through many different observations. There are many points of pressure that I won’t mention in this blog but I do note them as really important learning points that will shape my future. I am well aware that colleagues saw me at my best and worst and that allowed me to learn from their reflections back to me. Coming across the same types of challenges day after day allowed me to work through, how to respond in different ways either to get to the point I needed to get across or to explain the complexities of IPC decisions which are rarely binary, yes or no, choices.

So, am I the right person? You need to be flexible, adaptive, a good listener and know who to talk to get issues resolved, to know how to break apart problems and be confident that decisions are those taken at the time with the available answers and available options…there is no text book to refer to. Confidence and self doubt in equal measure….and a desire to want to get things right. To trust that a bad day is just that, one day and know that every day brings something new and therefore a new approach. I think I am and I want to be. I also know that where I am missing a skill I have a team around me who fill that gap (and some!).

I’m still not sure how to judge my success…more honestly written would be that I’m looking for data to judge my success as I naturally doubt any positive feedback. Something to work on there!

So, a week has passed since I rewrote this to post it and 2 weeks since I initially wrote it.

I still benefit from writing it out in ink. It allows me to explore the ends of my thoughts. Typing it out then allows me to put those thoughts in order and then remove the ones that are no longer relevant or just passion fuelled ponderings! Then to read again and reflect. What did I learn in this period of my life?

A deep breath and a plan can get you through anything. No matter how huge and impossible it may seem or be.

What lessons did it teach me? To allow the wind to blow, keep leaning with it….it has to stop at some point.

What do I want to know more about? What I will do differently next time.

Is it beneficial to anyone else? It is still relevant? It is worthy of posting. I’ll leave those questions to the people reading this…

let me know what you think in the comments.