Let’s get up

It’s the getting back up that defines us, not the falling over.

PTSD & ACP journeys

Did you know that there is common ground in recovering from PTSD and becoming an ACP? Ironically unaware at the time, reflection is a powerful teacher and recent improvements in my own well being have granted some insights into standing back up.

In a previous post (Click here to read) I urged “keeping walking” as a strategy. What about when we have fallen over? It is in the getting up that we define ourselves, to fall is human, to stand up more so.

So where is this parallel? Let us examine the experience of a trainee ACP. I have seen this from the side of the learner, as well as the university tutor.

Day one of the MSc. Everyone is shiny. Well, at least mostly shiny on the outside. Every induction I would always suggest “when not if” the fall, the crisis of confidence comes to reach out to peers and faculty for help. These crises tend to occur after placements have started. At the point at which a trainee sees what is really going to be expected of them. The immediate response is often one of fear that the mountain is too high to climb.

Expert to Novice to Expert

Benner had a very useful fame for understanding this – the novice to expert journey in clinical (nursing) practice. The frame describes how one starts as a novice, becomes an advanced beginner, competent, proficient, and finally an expert. The frame indicates a level of clinical autonomy and decision making as the key axes to define progression.

To become a trainee ACP, one must be an expert in one’s field (at a lower level of practice). The commencement of the MSc essentially wipes this slate clean and trainees find themselves feeling like novices in a significantly bigger world.

The journey from expert to novice is often unexpected, at least on an emotional level. Trainees who struggle to embrace this journey will be very lilkely to struggle with the transition to ACP.

So, what does it take to embrace this change?

The golden lesson

Having the humility and confidence to accept the vulnerability of knowing that you don’t know. The next step is the transformational one – taking that awareness and seeking to do the work necessary to acquire competence in advanced practice.

When does that happen?

Humility and self confidence do not grow on trees. Sadly, my experience as a leadership coach and consultant across multiple healthcare organisations has demonstrated just how rare they are to find in clinicians. When we do encounter them, we are inspired and elevated. I have the joy of that experience when interacting with many of the St Emlyn’s team – and my gratitude knows no bounds.

What can we do to support our trainees? And let’s widen this to pre-registration healthcare professionals, medical students, and anyone in a training or learning post.

Learning Cultures

Learning culture is the other end of the spectrum from blame culture. There’s been plenty of talk about learning cultures in various media.

What is actionable for us – what can we do?

Firstly: Be consistent in your authenticity. Be yourself, not anyone else. Nor anyone else’s expectations. From this consistently trust will develop. Trust is the seed of learning cultures – do what you can to nurture it!

Secondly: Model humility. Say “I don’t know”, and apologise when you are wrong (and you will be probably daily). I recently had to process some negative feedback from instructing on an ALS course that I was “unapproachable”. After reflection (and some support from a marvelous colleague) we concluded it was one comment – just one! Be aware of your power. In another blog, I will be exploring this one more, so come on back.

Thirdly: Be grateful – say thank you. Express your gratitude in personal and meaningful ways. This is also modeling wonderful behaviour in support of learning culture.

You be you, let them be them

Inclusion is simple really, just let everyone have some pace to be their authentic selves. Safe space. Let people have the space to fall, then offer them an open and supportive hand back up again. Learning to stand back up starts with leadership.

The parallels with PTSD? Keep standing up. It is as alternatively as hard and as simple as that.

References & Links

Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, Calif: Addison-Wesley; 1984.