Leadership, nhs, Uncategorized

Everything is awesome

I have always considered myself a positive and naturally optimistic person but several events this week sought to test that.  To be fair some were truly awful. However there were some things that, in my opinion, restored an equilibrium.

The first was the news story about mental health as championed by William, Harry and Kate:


I quite liked the honesty with which they talked about the British ‘stiff upper lip’ culture. This is such a ridiculous notion when faced with the tragedy of losing your mum at such a young age.  There is no silver lining or looking on the bright side.  It’s just bloody awful and should be treated as such.  That said I do think how they have channelled it into something good is remarkable.


They are not the only people who are able to do such things.  Look around and you’ll see people from all walks of life trying to create something good from terrible circumstances. It could be running a marathon for charity or volunteering.

There are parallels with our daily NHS life.  Recently I helped one of my trainees complete a near miss incident form. There was no harm and the patient and family were informed. The main thing from my perspective was to identify exactly what went wrong and more importantly how to make sure it doesn’t happen again.

The process of documenting failure is, by its nature, long, depressing and overwhelming negative.  There is no way to make it a positive experience for anyone. What you have to do though is pick everyone up and somehow turn it around. It’s a difficult one to balance as you want people to feel empowered to make a change but equally you’re trying not to diminish the mistake in the first place.

I believe we managed to achieve this balance.  A plan was made and over the next few weeks I am optimistic we will have something in place that ensures this particular incident will not be repeated.

Which then brought me to this quote that I saw the following day on my twitter feed (thank you @johnwalsh88): C91f2UvW0AAZKbu.jpg-large

This to me is much more reflective of who I am nowadays. I think it’s what we should all be to be honest. So with the glass half full I would argue that for every situation you hope for the best but plan for the worst.  To me that is about having plan A, B, C, D etc etc

This philosophy is reflected in a postcard I have on my wall at work that says ‘Failure is not an option’  It’s from the Apollo 13 mission. It makes me smile every time.  Now you may think I am deluded or living in denial but I agree with the statement. Failure is not an option.  You just haven’t found the option that works.  It is true of the NHS and in life that you will need to try out many different options until you find the one that works.

So on that note I go into another week with my eyes wide open, optimistic that it will be a good one. If it’s not, well, that’s just a chance to try out Plan B…




Leadership, nhs, Uncategorized

Enjoy the Silence


I’m on holiday. Hallelujah!

When I eventually got home on Friday night I felt like I had literally crawled over the finish line and collapsed in a heap.

Cross covering colleagues immediately increases your workload however there is an understanding and clarity of what is expected during this time. My job is to keep our patients safe and lead the team.  I become much more directive Dr Copeland in order to manage my time to its maximum efficiency. This is especially important given I work 3 days. I also expect the team to know their role.  What is crucial is that we check in with each other just to make sure.

This clarification of understanding and expectation is something I do whenever I meet a new patient too. If you don’t and instead assume you will get something wrong.  I’m not talking about clinical mistakes where patient harm occurs. What I mean is the type of mental harm that comes from not explaining things properly or giving opportunities to ask questions.  Most importantly it is about setting expectations e.g. when a test will happen or when you might get home.

It also applies to non clinical situations.  This week I had the joy of manning the middle grade rota for the first time.  When I say manning, fire fighting is probably a more accurate term.  Without getting into detail, there have been issues.  I’ve done rota management in all of my jobs so this one didn’t particularly phase me. Yes, it’s complicated with all the rules around rest days, number of hours worked, days in a row, etc etc but not overly so.  What was surprising to me was the virtual tsunami of emails that came after it was distributed. No one was happy.

After a while a pattern emerged. It seemed to me what was missing was this fundamental clarification of understanding and expectation.  The specifics of promised swaps and annual/study leave requests while obviously important did not seem to be as important as acknowledgement of the request and when to expect a definitive answer.

I have come to hate the ‘death by email silence’ that occurs in the NHS.  In that vacuum a person can create all kinds of scenarios that may (or more likely) may not be happening in response to sending an email.  These assumptions can lead to all kinds of behaviours.  In a rota situation some may take that silence to mean ‘yes, have that week off’. Or it can have the opposite effect so the person can’t get to a family wedding, for example. Either way it leads to both an unhappy workforce and rota management team.  In my experience a simple ‘your email has been acknowledged. We hope to have an answer for you by X date’ can go a long way to defusing a volatile situation.

So as I put my out of office on there is an understanding that I will not be checking my emails.  My annual leave week is a time to relax in the company of family and friends.  The expectation is that when I get back to work I will be refreshed and ready to go again…

education, Uncategorized

Learning to fly…

Loch Lomond

After 18 months of hard work the first paper I’ve ever properly written up was finally submitted.  It wasn’t a solo effort by any stretch of the imagination.  I was lucky enough to work with James Fisher and Andy Teodorczuk in putting it together.

I’m also under no illusion that it has a long way to go yet and may not even be published at the end of the day. However the sense of achievement once I clicked submit was amazing!

That said it was a project that pushed me well out of my comfort zone.  I’ve always liked the idea of being involved in academic medicine but thought I wasn’t really a good fit for it.  I have many preconceptions about my academic colleagues. For one they are very smart.  They make it look easy.  Also they must be very patient people given how long  research projects can take to bring to fruition.

It also seemed I was making similar assumptions about myself – I get bored easily. I like detail but only so much. I have no patience.

Here’s the thing though, while my own personal attributes may be based on the gazzilion psycho-analysis questionnaires I’ve done over the years, they are by no means set in stone.

Over this past year or so I have become much more patient. No really, I have! I still have a low boredom threshold but it’s definitely higher than it used to be. However the ability to spend literally hours on detail is something that I have come to enjoy.  I’m not sure it’s fair to say my brain has slowed down but it definitely has an ability to concentrate for longer.

I think I may’ve managed to modify some of my fundamental personality traits.

Now you could argue that will happen when you are doing something you care passionately about.  I’m not so sure.  I have seen people work in the same way, doing the same thing their whole lives and I don’t remember seeing any fundamental change happen to them. I’m not even convinced they were all that happy either but that’s just my opinion…

I think you need to slightly step out of your comfort zone.  It could be that you work in the same speciality but perhaps try a different facet of it like I have with the delirium education work.

Or you could be like some of my colleagues who have moved their work environment to say the community or ED.  Some are changing hospitals but staying within the same Health Board. I also know colleagues who have taken up work with the Scottish Ombudsman, GMC and the Scottish Government.

I’m pretty sure if you asked them 20 or even 10 years ago what they would be doing in the future, it wouldn’t be what they are now.

This idea of a mobile workforce has been around for a few years now.  However how doctors define their working career is beginning to evolve.  The challenge for organisations is how to adapt to this.

Perhaps we all need to challenge preconceived notions of ourselves from time to time. Try something new or just a teeny bit different from the norm.  Who knows what you might be capable of…..