<p>Louise is a Nurse by background and Quality Improvement Advisor in Northern Ireland.  She shares how the SQSF helped her come back from burnout.</p>

Kate: Today we have Louise O Dalaigh, who works in Northern Ireland. And you are a fellow in Cohort eleven, is that right, Louise?

Louise: I was indeed. Kate. Yes. Cohort eleven.

Kate: Well, thanks so much for joining us. You're our first fellow from Northern Ireland that we've had to chat about their experience. So could you tell me a little bit about yourself?

Louise: Okay, so, my name is Louise. I'm currently working in one of the trusts in Northern Ireland, the Western Trust. So I started in health care over 30 years ago, first qualifying as a nurse, and have worked in various roles in the last few decades. Ward sister, mostly in acute care. I was a service manager for a number of years, and my current role is I'm the Qi lead for the Western Trust here in Northern Ireland.

Kate: Oh, great. And what brought you to the fellowship?

Louise: So what brought me to the fellowship? Well, it was a bit of a bumpy bump. I landed there not realizing what I had put myself in for, I suppose. I suppose my journey, how I got there was a couple of years beforehand, I had been on a journey for myself as a result of burnout, working in the NHS for a number of years and being a working mom, etc. And I had went and done, outside of work, a coaching course and got very involved in that and was really intrigued by it. My years as well as in health service, up into that, I was always involved in improvements. I was always kind of getting involved in new areas of where we can make improvements. Quite often. I often say that I kind of planted seeds, got to sapling, but never really yielded the fruit of the trees, if that makes sense.

Kate: So very common for everyone, I think.

Louise: Yeah. Just there was always so much more to kind of do, so kind of running on and trying to sort the next thing. So after I had done my coaching, I had got involved. I got in contact with a number of people, and one of which was a person that had done the fellowship. So it was from a previous cohort, and she had become like, a mentor and had introduced me to Qi methodology and made reference to it. And around that time, she had said, Why don't you apply for this? And I had no idea really what I was getting into. So ended up then making the application and getting a place successfully. So it kind of was a bit bumpy bump. But what really interested me was that around the improvement about getting a methodology to support, because quite often in the improvements that I've been involved in, how are we able to really demonstrate and articulate the longevity of and the sustainability of the improvements? Because quite often we made improvements and went on, and then maybe a number of years later, they fell back to where they were before. So that kind of methodology around it really interested me.

Kate: Yeah. Oh, great. What did you think that the fellowship would be and how did it compare in reality?

Louise: Well, I suppose I thought that it was going to be a program really about the quality improvement methodology, so all the data and the charts and just the whole science of it. But actually it was very different. It was very much about human behaviors, about the whole culture, about leadership, about being part of that kind of change agent. So the human behavior is part of it really did interest me. And probably when I think back, that's the bit that I kind of tended to really get so much from. But yeah, going into it, I kind of thought it was going to be very much around the improvement science.

Kate: Yeah. It's so eye opening, isn't it, when you start to try to understand the behaviors about why people behave a certain way or maybe aren't that keen on change or improvement and then the first time you kind of put it to work, how transformative it can be.

Louise: Yeah, absolutely. Absolutely. Yeah.

Kate: And what was your favorite part of it?

Louise: I suppose around that whole psychology of change and what was my favorite part of it as well was actually being in a program with a real diverse bunch of people that were very likeminded and each and every one of us in the cohort that I was I was part of cohort eleven. And each and every one of us in the cohort had our own stories of why we got there on the actual cohort. So that really togetherness and being part of a tribe, so to speak, that for various reasons, when we all exchanged stories, we had been involved in various improvements and we had had various challenges in our careers, et cetera. So actually I'm going to talk that tribalism of us all together and bouncing off each other and supporting each other is probably the best bit for me.

Kate: It's kind of the tribalism, the antitribalism from what you're used to at work, isn't it? Because we're so used to working in our silos and then to get that bigger picture of people across the system and from different countries, a lot of people have said is really inspiring. What was it like to bring it back to your practice, to put all that new learning into practice?

Louise: Yeah, I think one of the things I reflect on as well is about putting into practice was sometimes when you're in your own organization and your own teams, when you come into it with a curious mindset, it can be more challenging. So I think the thing that I brought back was increased confidence that actually yeah, this is okay to be really curious. Yeah. It's okay to always keep pushing and asking those curious questions. So I think that increased level of confidence is something I can kind of relate to that I brought back. I think that was kind of the main things. And again, also what I brought back was this increased knowledge around the methodology that I was able to apply to, projects that I was doing and improvements that I was doing. A mixture of both. And the other thing is an increased network. So we're a small area in Northern Ireland and the overall NHS population in the UK, so to speak. Actually having that network of people as well, to really understand and hear how people are doing things and the barriers that they face and the challenges they face is very, very similar. So that was really kind of I felt that really beneficial as well to bring back that. Yeah. At the time that I was doing the program, I was working within Ophthalmology and Optometry Services, and there was an Ophthalmologist on the program. So comparing stories of the challenges that we were facing at the time realized that they were and learning from each other. So that space of shared learning as well was huge.

Kate: Yeah, I work in quite a remote health board in the north of Scotland, and it's so lovely to go and be able to say, oh, well, they're trying this here, maybe we could adapt that. Or bringing new ideas from out with when you are a bit more like geographically isolated is so beneficial, isn't it? Tell me about how it's affected you professionally.

Louise: Yes, so professionally, when I came back after completing the fellowship, I realized that it was going to be really challenging for me to take what I had learned and use it in the role that I was doing at that time. So I made a conscious decision to apply for a job that was very, very different. It wasn't a career plan I had ever had, but at the time it seemed really the right thing to do because I found that it was going to be difficult to because the relentless nature of the job I was doing that, how was I going to be able to utilize and maximize these skills? Also, one of the things when I went for the fellowship interview around that time, I'd realized that probably I was about the halfway juncture of my career in the NHS. And I felt that I spent the first half of my career helping to make improve services for patients, et cetera. Whereas I had this strong sense of I want to spend the second half of my career helping people in the worked in health and social care to do that for patients. So I then applied for a post in the Qi team in the Trust and then successfully got that. And then that has led me to the post that I'm doing today. So now, as I say, as the Qi lead, I quite often say to people when people ask, what's your job? Well, I help people to make things better, I suppose, both personally and professionally. It's had a huge made a huge difference in both home and work life.

Kate: Yeah. And how have you found that transition to, like are you now nine to five, Monday to Friday?

Louise: On paper, yes, on paper, I think that's what we're supposed to be. But yeah, one of the biggest things for me was I didn't have to be part of an on call rotor, so that was one of the biggest factors. After a number of years, I've been on various on call rotors, so that was one thing. But yeah, I'm in a kind of no weekends.

Kate: Yeah. But these kind of roles are all consuming, aren't they? So you think about them day and night if an idea comes to you. But I think that's how work should be. It should be enjoyable and you look forward to it. And the NHS is a lot of people who have had difficult times recently with Burnout and everything we've been through with the Pandemic and even before that, and having a feeling that you kind of belong in a good team and you're contributing to something that you're really passionate about is so good, and then you just want to give more. But I think a lot of people don't feel that. But I think from speaking to other people about their experience of the fellowship, it's something that a lot of people, they feel like they've got that back after completing it.

Louise: Yeah, and absolutely. I think that was one of the things when I got involved with it first. And even part of the fellowship, even around that whole joy and work framework that actually people being involved in Qi gets them back, links them back to that purpose and passion of why they come into the roles in the beginning. So it really does have that kind of antidote to burn out. And that's where I wanted to be. I wanted to be helping people to shine the light towards that, to get them more involved. Because I suppose my own journey as well, I've been kind of dark for a few years, that actually, if I can help other people see the light of that sooner rather than later, that would be all kind of worthwhile.

Kate: Yeah, absolutely. I've been asking some of the other fellows, what is one thing you now believe that before the fellowship, the Louise before the fellowship would never have believed?

Louise: I think probably what comes to mind, maybe around impostor syndrome, before the fellowship, maybe I just thought that it was only certain people that had imposter syndrome. But one of the things is that everyone has it, everyone suffers with it from time to time, that we're all human. And during the fellowship, as I say, when we built that kind of trust within our cohort, and we shared stories that you really see that it doesn't matter whether what role you play, what discipline, et cetera, what professional body you belong to, that people do have periods of it, and actually, that's okay, that's kind of normal. So I think that kind of when I think back of before, I would have thought, oh, not certain people and, you know, myself, maybe, but yeah, maybe maybe around Imposter syndrome might be something that I wouldn't have believed that people experience and feel that as wide as people do.

Kate: Yeah, absolutely. And then when we do experience it, quite often, like, there's a moment where we're made to be humble again. And it usually happens just when you're getting confident with something and you think one of the surgeons at my work said told me about a story where he did not anticipate how big the surgery he was going to do and how long it would take. And he felt really silly at the end of the day when he'd overbooked the list. And I said, well, he's been a surgeon for 30 years. And I said, well, it's really such a good example to our junior colleagues that even when you've been in for 30 years, you can still get it wrong, and that's okay as long as you react in a safe and appropriate way. And he was like, yes. So everyone gets imposter syndrome. Definitely.

Louise: Yeah. And even adding to that, the whole concept of having psychological safe environments for people to air that and feel comfortable around, that is another, I suppose, huge learning that I took away from the fellowship, how important that is. I'd probably been exploring a little bit before I started the fellowship, but, yeah, that's another bit of it, is that that whole psychological safe space is really important. And for improvers that, they feel that they're open if they've got a wacky idea or that they have the safe space to be able to air it because quite often somebody's only dying to air it, but they just don't want to say it out loud.

Kate: Yeah, absolutely. Great. Well, have you got any advice or tips you want to share with anyone who's thinking about applying?

Louise: Yeah, I think anyone that's thinking of applying, talk to somebody that has been on the fellowship before. Link out, reach out to people, because if you're thinking of doing it, just go with it. Go with your gut and go for it. Because most people or any people I've spoken to that have done it have always felt the feedback is always it was so much better than they had ever anticipated. So probably for me, it's definitely in my career, it's the best program that I have ever completed, the fellowship program. So, yes, go with your gut and seek out people if you need to get that reinforced, but go for it.

Kate: Yeah, absolutely. Oh, well, thanks so much for talking about us today.

Louise: Thanks very much, Kate, for the opportunity.

Why Apply? Reflections on the Scottish Quality & Safety Fellowship (SQSF)

Why Apply? Louise O Dalaigh