Leading in a new environment

Begin with the end in mind

I recently was given the opportunity to work in an other health board area in a senior leadership role.  It was easy to understand this role as a leadership one as the post directly managed only a handful of staff, and yet it’s impact should be felt on the greatest number of staff working in the Board.  What was less easy was to understand what impact I could have in only three months (the length of my secondment); for me the important aspect of this dovetails with my last blog and my re acquaintance with Covey – Begin with the end in mind.

What was the end I had in mind, what did the Chief Executive have in mind and what would the individuals within the teams I would be working with have in mind.

Week one was hectic, there were people keen to meet me (which was nice), meetings that had to be attended, papers that had to be read.  The Chief Executive drafted my objectives for the three months secondment (based on our conversations), and I was all set.  However, my role as a leader demands more than what can be captured in a set of objectives.

If you don’t know where you are ..

In some ways the opportunity I’ve been given is to support others as they travel towards their destination – that’s a privilege and a responsibility.  That said however, this involves individuals and teams knowing where they want to be, the destination, the shared vision.  It involves ‘starting with the end in mind’ – what is the passion of the individual clinicians (as its mainly with clinicians I’ll be working), what do they truly want to deliver every day they come to work?   Are each one of us focussed on the individual in front of us, the next person who will walk through the door.  For each of us, it’s important to have a vision, to understand our personal/professional values, to understand our impact.

While I am a great believer in having a vision, an understanding of where you want to be, it is also important to know where you are.  If you don’t know where you are, how do you know which way to go?  Think of it as a road map.  You might know the destination but without a starting point you are unable to determine the direction you need to head, where should that first step fall.  Once we have accept where we are, good and bad, we can determine the steps needed to achieve our goal.

Pushing down or pulling up

Booker Washington said “There are two ways of exerting one’s strength: one is pushing down, the other is pulling up”.  Leadership isn’t about pushing others down, it’s about pulling them up.

I recently read a blog by Todd Neilson about Leaders in ‘beta’ being a mixture of ambition with humility (beta refers to the IT term of things being in testing stage).  He noted that it was ok for leaders not to know everything, this reminded me of Hawkins and Smith four stages of leadership  – experimentation, the leader needs to understanding that it is ok not to know everything.  Stage two starts with accepting that as a leader you are always in beta mode, always learning always testing.  As you put that testing, learning and self reflection into action the next stage is evidenced by experience accumulation, you start to gain confidence in putting into actions the things you have learnt.  Full leadership is more difficult to achieve, but people who have moved into this phase are obvious by their actions, they focus less on what they can get out of a situation and more on what they can put in, the outputs are more important than their person accolades.  Their motivation is ‘what is the difference I want to make’, Covey described this as one of his four basic needs- To Live, To Love, To Learn, to Leave a Legacy: not the legacy of  self serving obsession of fame, but rather the difference that the leader supports others to achieve, even when they are no longer there. Hawkins and Smith describe Eldership as the final stage in the development of a leader, many do not get there.  The feature of this leadership stage is a detachment from the difference the leader can make and a focus on what has to be done, creating an environment for others to achieve.  In this respect it follows a similar theme to Greenleaf’s concept of Servant Leadership. The perspective of:

• - caring for others
• - being mentor minded
• - having the passion to develop others
• - being the compassionate collaborator

There have been few times in my personal leadership journey when I can reflect with any certainty where I am in relation to the stages described.  However I am confident that my role, over the next three months, is not about me, it’s about creating the environment for others, it absolutely isn’t about pushing others down, it’s about pulling them up.

This role I’m in is about Eldership, it about supporting others to ‘be all they can be’, to help set their path for the future.

It’s about finding leaders, but it’s also about finding followers - concepts that are not mutually exclusive, although the wisdom to know when, to be which at what point, can in many circumstances be elusive.

www.twitter.com/dtbarron/status/324975604137082880

Whatever else, I’m looking forward to working with many new colleagues.

Leaders – where ‘why’ meets understanding

Sharpen the saw

A couple of unrelated (in space and time) but interesting things happened last week, firstly my daughter took a feng-shui approach to one of the rooms in her flat – to be honest, I’m sure this was more accurately described as picking things off the floor: however let’s not be unkind. For the purposes of this blog the relevance lies in her discovery.  As she tidied her academic books and related resources she came across a manual she had been given and used on a course she attended – Covey’s Seven Habits of Highly Effective People.

The opportunity to ‘sharpen the saw’ had presented itself to me and I wasn’t about to pass on it.  Over the next two days I read the handbook, alongside my own copy of Covey’s book, which provided a more in depth explanation.

There was an unmistakable relevance and challenge for me in Covey’s work as I reflected on my impact and influence as a leader :

• was I always ‘proactive? (habit 1),
• did I always ‘start with the end in mind’? (habit 2),
• did I ‘always put first things first’? (habit 3).

After some self review I think I’m pretty good with habit 2, I use this as a guide in my day to day work, it has a synergy with my belief in having a vision and working diligently and enthusiastically towards it.  As a leader having a vision is critical, without it how can you expect anyone to follow you?  Perhaps more accurately how can you truly expect high calibre followers to follow you – people who will challenge you, who will rise to your challenges, who have as their driving principle ‘excellence’?  A leader without followers …..?

Quadrants of activity

On the whiteboard in my office I have Covey’s four quadrants of activity as a frequent and ongoing reminder to engage with habits 3 – put first things first.  The diagram has been there for some time, and, rather like the habit itself it would benefit from being rewritten and refreshed – an early task I set myself for Monday (yesterday) morning.

When considering my activities I aim to keep them above the line, when I don’t manage to achieve that I know I’m not always putting first things first and that pro-activity is perhaps slipping a little.

Post Interview feedback

However this blog isn’t simply about a refreshed encounter with Covey, it’s also about the second ‘event’ I referred to in the opening paragraph.  It’s relates to a meeting with a new and emerging leader and one specific aspect of the conversation.  The meeting was focused on post interview feedback – an activity I highly commend to everyone, whether successful or unsuccessful in a job interview.  Indeed those that are successful at job interview quite possibly have as much to gain from this feedback as those that were not, it’s an area we would do well to consider in terms of staff development and supporting people into new posts.  However, I digress.

During the conversation I was asked about one of the questions that I had posed at interview “what would you do on day one, if you were successful today?”.  What was I looking for with that question, what answer was I expecting?

Seek first to understand

The simple answer is I wasn’t looking for a specific answer, it was a people question, I was trying to understand if the candidates had considered a future where they would be in that position, did they have a vision to share.  If a candidate hasn’t consider what success might look and feel like, are they really in a strong position to influence an interview panel that they are right for the job?  I know people will grow into a job, that people take time to develop and mature, but day one is also an important day, it can set your path for the future.

The second thing I was perhaps expecting (but also hoping to avoid) from that question was the rather clichéd ‘I’ll listen to people, hear what they have to say etc etc’. Of course listening is extremely important, we all need to practice it more, however I expect successful candidates to have an understanding of the role they are about to take on, as well as an understanding of what they are going to contribute to the role and, importantly, to be able to share that with their new team.  This brings me to the dichotomy inherent in Covey’s fifth habit ‘seek first to understand, then to be understood”

Golden Circle

As a new leader people will be looking for an indication of what impact the change is going to have on them, what will this mean for the services they provide.  A new leader simply saying ‘Im going to listen’ is a disappointment for teams.

Day one is an opportunity to share the vision, Sinek in his Tedtalk (and his book) talks about the Golden Circle – Why, How, What – day one is a day to involve teams in the ‘why’, it’s an opportunity for the new leader to share their ‘why’, it’s an opportunity to inspire.

The ‘how’ is where listening comes in, we all need to listen to team members, we all need to feel we’ve been listened to.

As a new leader, or a leader of a new team, Covey isn’t encouraging us to inaction, he’s encouraging us to recognise the value in understanding your team, to get underneath their ‘why’, only then can the team move forward together with ‘how’ to address the ‘what’ that is needing done: remember however they also need to understand your ‘why’.

Strengthening the Commitments – LD nursing in Scotland

Strengthening the Commitments

This blog is a reflection on the Modernising Learning Disability Nursing conference held last week (26th March) – it also a celebration of the recent promotion of Sam Abdulla and myself: I’ll explain that in a little more detail in a moment.

Political will

Michael Matheson, Minister for Health for Public Health gave the keynote speech.  He underlined that LD nurses are fundamental to making action plan work for people in Scotland, they need to take ownership of the actions and deliver real outcomes: no-one will do it for them, but others will do it with them.  ‘Others’ in this context include people with learning disability as they are experts in the support they need.

The Minister recognised and noted that preventative and anticipatory care are central roles of LD nurses, roles he recognised from his own previous clinical experience that LD Nurses currently deliver – his challenge was to continue to develop and expand these within and across the new integrated health and social care landscape that Scotland is heading into.

Of note was when the minister said he will be taking personal interest in the action plan being taken forward. As this is the second time he has attended and spoken at events related the the LD Nursing action plan, there’s a reason to believe he may indeed be taking a personal interest.

Experts by experience

Most importantly was the demonstration of clear involvement of people with lived experience in shaping the development agenda – evident in their co-chairing the event and in the role in the programme itself through the “Co-production” steering group.  Ann, lead spokesperson for the steering group stated “we think co-production is just jargon”, the implication being, without action it’s just words.

'Co-production' is jargon it's just working together- very well said! #STCScot—
  (@LDnursechat) March 26, 2013

Everyone has to engage proactively to make it a reality – Ann guided (or should that be instructed) us that whenever co-production was mentioned we all had to make the imaginary quotation mark, in mid air, with the first two fingers.  This was a visual and active physical reminder to us all that “co-production” is only a reality when we act upon it and engage with it.

A more organic approach

In my career I have organised a number of conference, ranging from 50 delegates to 800.  I’m a ‘little’ controlling at these events (ok, that’s probably a massive understatement), I always have presentations preloaded, always have them tested and always have backed up.

@dtbarron could do with a test card!—
sam abdulla (@samabdulla) March 26, 2013

On one slightly extended interlude, rather than the chair person filling in with a few general observations or witticisms Ann took the microphone and sang to the audience.  She was never going to win the Voice or the X-Factor (she was far to good for that) her song was heartfelt and just so real, something her dad had taught her many years before.  To me, it underlined that “co-production” meant ownership in all aspects, including filling in a gap in conference proceedings.  I’m glad they had to change the computers, I would have missed Ann’s song otherwise, and would have been the poorer for it.

I can’t promise I’ll be less controlling, but it’s made me reflect on the value of allowing a more organic approach to prevail.

Education

Dr Colette Ferguson from NHS Education for Scotland the launched two important documents which underpin the Action Plan. These documents are the roadmap for education in LD nursing I’ve the next few years.

The pre-registration framework lays out the knowledge and skills that are required from our undergraduates in order that they progress to registration. The document captures the vision and values of the Learning Disability Nurse, it is the Sat-Nav for future registrants, without which they will not reach their destination armed with the necessary skills, knowledge and attributes.

The second document, the career and development framework, rather than being a roadmap, is more akin to an architects drawings.  Each aspect is interrelated and each linking together, building on what went before to create the whole building.  It is perhaps a little disappointing that more nurses (not just LD nurses) do not build their careers around the four pillars of practice:

• Clinical practice
• Education and teaching
• Leadership
• Research and development

These pillars, captured in POST REG DOC are the building blocks that have the potential to guide LD nurses from newly qualified nurses, through first first level clinical practice to advanced practice and on to nurse consultant roles.

A story of new beginnings

The final speaker at the event Professor Angela Wallace (chair of the national action group) reflected on the progress that is already evident in ‘A story of new beginnings’ – moving from foundations into delivering actions for change.  The beginning has ended, now each LD Nurse must take ownership of their own actions, they must deliver individually if they expect to deliver collectively.  The message was very clear, now is a perfect time to deliver change, innovation and quality wrapped around personcentredness.   There are too many stories of getting it wrong, it’s time to address that balance.  Angela’s observations included “LD Nurses can ‘teach’ others in the nursing family about personcentredness as it is the very essence of being an LD Nurse”.  Change and will require leadership and courage, to challenge each other for improvement, indeed to challenge ourselves to ensure personcentredness in every day services.

June Brown closed the morning reemphasising the message previous message that everyone must take ownership of their own actions and deliver individually, to deliver together.

My final thought on the event focuses on the use of Twitter.  From then outset the organisers encouraged delegates to tweet their thoughts, their observations, questions and commitments to action.  On each of the tables there was an upright card placed centrally to encourage delegates to tweet, to explain not just the #tag for the day, but also what a #tag is and how to follow the events tweets using the #tag.  Although it seems that the LD nurses at the event have been slow to pick up on Twitter, the ability to share information widely was clearly demonstrated – perhaps after this they will.

Loving the feed coming through guys, feels like I'm a part of #stcscot even from Nuneaton! Break over, back to work #busynurse—
Sally Wilson (@salsa442) March 26, 2013

Additionally the twitter feed for the day has been #storified by @ldnursechat and can be accessed here

Statistics for the event (on Twitter) can be accessed via the healthcare hash tag project, available on Symplur.  An overview of them are shown below.

I did promise to return to celebrate the joint promotion of Sam and I.  The title Heed’o'tweeting is not given out lightly, in fact we were delighted with our new responsibilities: 

I hope you enjoy the execution of our duties captured in the Storify account above.

Creativity and its place in recovery

Last week I had the privilege to attend the Principles into Practice Network Awards and Conference  - to be honest I get to attend a fair number of conferences, the question really is why blog about this one.  Followers of my blog will notice of course that I blogged last week about a conference, however my purpose in that blog was to highlight the power and reach of Twitter, this is different.

The Mental Welfare Commission for Scotland, through their Principles into Practice Network hold this bi-annual event.  It is there to celebrate innovative and good practice from services and projects across Scotland in exemplifying the principles that underpin the Mental Health (Care and Treatment) (Scotland) Act 2003. For ease these principles are noted in the table below:

• Non-discrimination
• Equality
• Respect for diversity
• Reciprocity
• Informal care
• Participation
• Respect for carers
• Least restrictive alternative
• Benefit
• Child welfare

The conference opened with Lorraine telling us of her journey with mental illness, through the dark days of depression which she described as a Sunami sweeping over her, an overwhelming darkness where she lost hope.  For me one of the powerful messages from her was her explanation of others hold her ‘hope’ for her, as she had lost it.  One of the critical aspects of this is the ‘temporary’ loss of hope and of others holding it for her was the need to enable her to take back that hope as she progressed through her recovery.

Lorraine Nicholson explaining the critical importance of #hope in her own #recovery The Creative Self as a tool for recovery #PipAwards13—
Derek T Barron (@dtbarron) March 01, 2013

Lorraine talking about the sunami she experience with her depression and the role of poetry and #hope that others held for her #PipAwards13—
Derek T Barron (@dtbarron) March 01, 2013

In her discourse with the audience Lorraine (Renaissance woman) allowed us insights into how she “gained strength though vulnerability”

Renaissance woman (Lorraine's explanation) of Rebirth – #hope became a reality: poetry, art were self evidence of her recovery #PipAwards13—
Derek T Barron (@dtbarron) March 01, 2013

Lorraine 'I've gained strength through vulnerability' #pipawards13—
Simon Bradstreet (@SimonSRN) March 01, 2013

In her pictorial presentation she vividly described the fragile road she travelled, how creativity had given her a path of hope and a way to self reflect on her recovery.  For absolute clarity, Lorraine was not saying recovery was the absence of mental illness, it was the ability to live well in the presence or absence of it.   See http://www.hope4recovery.co.uk for details of Lorraine’s story.

“People outwith ‘art circles’ may not recognise or appreciate the immense value of art and creativity in recovery” – it seemed that lots of people agreed with that!  Underpinning this statement from Lorraine is her explanation that creativity is one of the first ‘gifts’ we develop as children, is it therefore any wonder that if nurtured and encouraged that it should not be one of the first keys in the process of recovery – it’s not “just a nice hobby”.  For those of us in health or social care services please take a few minutes to reflect on how (if) your service supports this aspect of a persons wellbeing.

My Life

At lunchtime I was near to tears, I went into the lunchtime film showing of ‘My Life’ a film made by Peter McMahon.  Peter’s film explores the many way that he was bullied and ridiculed simply for because he had a learning disability.  The film was a wonderful portrayal of how Peter rose above the bullies and engaged with a wide group of individuals and organisations.  I was also immensely saddened as some of Peter’s contemporaries described how remained a feature of their lives.

Chilling aspect of the film were when Peter’s friends aid “most people have experienced being bullied because they had a learning disability’.  The film has also some poignant moments of triumph – when Peter speaks on the local radio station, when he influences the local bus company to taking seriously what happens on their buses.  Making the film meant that Peter. for the first time was really able to speak to his own family about it and thereby tap into the natural support that was there for him.  A powerful film, made by a larger than life character.

The film is available for use for education purposes – if you are in education or work with groups of people where you think the message of respect, of embracing of ‘different’ could be enhanced this film can support your work.

Twitters facts

Finally, it wouldn’t be me if I didn’t give you a few Twitter facts from the conference:

PREP requirements and #tag chats

Tweetchats

Last week I took part in two tweetchats (pre planned discussions on Twitter which are access by following a #tag).  On Monday I was an active participant in #demphd, which is a Twitter discussion organised around people undertaking a PhD in dementia, although, as with all Tweetchats others are welcome to join in irrespective of their own area of study or simply out of interest: the full chat can be viewed here.

The second tweetchat was the one that actually lead to this blog, #nhssm.

Starting the discussion @gemma_finnegan asked:

Storify

The resultant discussion is worth of further reading, it can be access here courtesy of @a_double_tt (Alex Talbott).

Discussion ensued on whether a tweetchat could count toward CPD, or in the case of nurses towards their learning requirements for their PREP portfolio. (All nurses (and midwives) must complete 450 hours of registered practice in the previous three years and have undertaken 35 hours of learning activity (CPD) during the same period).  In addition to direct patient care roles the practice standard can be achieved through a variety of other roles including “administrative, supervisory, teaching, research and managerial roles”.

@dgfoord then went on to asked the question about interaction with others or can it be self directed.

As Mike Cook says in the final comment – CPD has to involve interaction with the materials being discussed, even if that doesn’t mean with other people.  In other words it’s not simply a passive ‘I was there’, it requires engagement with the materials, a reflection on what was learnt and a plan of how that will be put into practice, either now or in the future.

ePortfolio evidence

The two graphs below are screendumps from my personal ePortfolio using the NHS Education for Scotland ePortfolio that is available for every nurse and midwife in Scotland.  It provides a career long portfolio than can be linked to the KSF (Knowledge and Skills Framework) that form the basis of CPD of most healthcare practitioners in Scotland

I’ve taken a simple approach to these to demonstrate that learning doesn’t need to be an earth shattering break through, it simply requires that the  practitioner reflects on their learning, that they demonstrate their ongoing learning/development and that they think about how they will apply their learning related to their professional responsibilities/practice.

The NMC does not specify what our learning activities are, they do however expect that we continue to learn, that we record that learning and that we apply the learning in our practice.

Win: win

The final point relates to evidence  - my next step is to .pdf the Storify of the #demphd and add that to my portfolio along with my reflection on my learning.  That’s one hour of my PREP learning requirements completed, and somewhat critically I enjoyed the experience – win:win anyone?

Impressions and sharing #tags

Learning Session 2

Last week I attended two events that led me to reflect on progress and engagement with social media within some areas of healthcare, in Scotland. When I say engagement with, in some respect,  more accurately I mean lack of engagement with social media.

The Scottish Patient Safety Programme Mental Health Learning Session 2 took place on Valentine’s Day, there were over two  hundred and fifty delegates from each of the territorial Scottish Health Boards (x14), as well as service users organisations and the Scottish Government:  Healthcare Improvement Scotland were hosting the event.

Healthcare Hashtag Project

I was surprised to note that there were so very few delegates tweeting from the event, especially when compared with what happens at the ‘generic’ SPSP events.  However in fairness the generic events cover more workstreams are are larger, realistically therefore the potential ‘tweeps’ in the audience would increase.

Using the Healthcare Hashtag Project I analysed a few of the stats from the event.  On the basis that there were so few people tweeting, the potential messages from the conference still had a reasonably impressive reach, and certainly greater than any single conference report would have.  Admittedly the depth of analysis in 140 characters cannot be compared with an actual conference report.  The answer is of course one of balance – balance between key, simple messages reaching a wider audience, who can later on access the conference report, versus relatively few people knowing where a conference report is published and when it is published.

The main tweeters from the conference are listed below.

On the day of the conference and the following day the conference made 64,453 twitter impressions, reaching over 32,ooo Twitter accounts (NB since downloading the above information the total number of ‘impressions’ has risen to 74,576).  If, like me you initially don’t know what ‘impressions’ means I’ll try and explain my understanding, having looked into it a little.  Firstly let me say that this is my understanding, it might not be right and you would do well to check this out with people who know for more about this than me.

Impressions

I think of impressions like having having a billboard (tweet) in a street, or in this case several billboards (tweets).  We know (via Twitter) the number of people who walk past the billboard and we know how many times they walked past it, therefore we know the number of times the may have seen the billboards (tweets).  We don’t know if they actually saw them, or if they actually read them.

Realistically however we are no worse off than printing a flyer or conference programme/report and leave it lying around – we don’t know if anyone has/will every read it.  However we now know the potential audience of our tweets, and therefore the potential to engage with them or direct them to where they may get more information e.g. SPSPMH website.  This itself is considered to be a positive thing for us as the key messages we want to engage people in are being spread far and wide.  Additionally the breadth and the speed of communication is substantially greater than can be achieved by traditional means.

Here is an overview of the conference, the input/outputs from participant tweeters.

Critically however I’m not suggesting (in fact I don’t know anyone who is suggesting) that we only use social media to share and engage, I am suggesting however that where we don’t use it we miss an opportunity to engage with people in a way that they chose to engage, in a way that gives them power and control over the communication.

Engagement strategy

This takes me to the second meeting of the week where the topic of social media was ‘briefly’ discussed.  Another member of the advisory board I am am member of, suggested that social media needed to be used more effectively.  While having the greatest respect for the organisation I was left considering why they did not engage with social media as a way to engage with a much wider audience than they could by face to face methods or even by issuing learning bulletins or through their website.  Is it possible than the inherent conservatism is disadvantaging people who may chose or have greater access to this form of communication?  In a #nursechat (a Twitter chat) a few months ago the point was made that in social media, traditional hierarchies need to be given up and that people take control of their own communication. Is it possible that this scares us a little?

Social media doesn’t need embraced by everyone at conferences, it doesn’t need adopted by everyone within organisations, but it does need adopted by a few in each setting – the more the greater the impact.  It does need to be used to engage, to share to enthuse others in the messages of improvement and development, but critically it also needs to be used to listen.

Final Thought

Susan Went, at SPSP MH conference presented evidence that organisations (NHS Boards) that spend 25% of their time focused on quality outperform in ever area those that don’t.  This made me wonder how much time my team and I spend on quality – how much time do you and your team spend focused on quality?

 

Epicurus and a simply PhD lesson

I think I’m becoming rather sophisticated in my dotage – yet again I found myself listening to BBC Radio 4 (while traveling to a meeting) an activity I must confess I’ve never really indulged in prior to the past few months (other radios stations are available, but some are rather tedious). I say sophisticated as I presume erudite people listen to Radio 4, some of the stuff though is decidedly clever and often understanding passes me by.

It was rather like that this week as I listened to Melvin Bragg discussing philosophy with his guests – the discussion centred on Epicurus. Initially this confused me a little, surely an Epicurist is someone who purveys gourmet food or drink, or one who enjoys such delights from the perspective of having a palate that appreciates the finery of food and drink? Apparently this doesn’t mean the deli counter at Asda!

Epicurus

The Epicurus being discussed was a philosopher who founded his system of beliefs (Epicureanism) around 307 BC. His teachings were about the pursuit of pleasure, believing that pleasure itself is the only intrinsic good. As the programme developed it became clear that this ‘pleasure’ was a state of being, less physical, more a state of mental tranquility, a freedom from fear and the absence of pain.

Initially I was only half listening as my mind was considering my PhD supervision session that was hurtling round the corner towards me; what had I achieved, was I any clearer since the last time I had met with my programme director and supervisors? If you have read my last blog you will understand that, in relation to my PhD, I haven’t yet reached a state of ‘tranquility’. My literature search wasn’t revealing the ‘ta-da’ moment.

It was in relation to my PhD that I started to consider what I could learn or adapt from Epicurus. His philosophy considered that the way to reach tranquility (pleasure) included the gaining of knowledge related to the workings of the world around us and the limits of one’s desires. The state of tranquility was only possible in the absence of fear and pain. In this context PhD mental fear – what if what I have done isn’t good enough, or I’ve headed down a blind alley? – it all seemed rather self imposed doubt and rather self defeating.

Keep it simple

What struck me about Epicurus was that he considered simplicity as the path to the tranquility he sought, it made me reflect on my current PhD journey thus far, perhaps I wasn’t keeping it simple enough, perhaps I was over complicating things – as I said in a previous blog, I was too intent on getting it right from the start, rather than allowing myself to grow into it . Perhaps the ‘pain’ and ‘fear’ about progress and clarity were of my own making – the way to achieve a level of tranquility was to ‘keep it simple‘.

At my supervision the following day I had a clearer map to explore, I felt I understood the aspects of my search that sparked my interest – the ‘pleasure’ in Epicurus’ speak.

This mindmap is less cluttered than my previous mind dump, this one narrows my focus onto two main areas of interest – impact on staff and impact on the individual. Neither area exists in isolation, however in pursuit of tranquility, at this point, it was agreed to keep it simply. Infection, as a topic has been sidelined, although it may return later. Ethnography is ‘parked’ while I read more about it and other methods of enquiry.

Overall it’s too soon to claim tranquility has been captured, however simplicity has brought a decided reduction in the fear factor, a more tangible sense of ‘the possible’. Perhaps pleasure will be the next step.