Sally Howard

In this updated blog (first published in 2020), Sally Howard talks again about psychological types and why understanding our preferences and how they differ to others can be incredibly valuable. This knowledge can be used to strengthen teams, encouraging people to value diversity and work more effectively together. Ever have one of those days when you feel you are constantly walking up the down escalator, when it just feels tougher than it should? In these current times, when there’s so much to be done, our stress levels will rise and its easy to fly off the handle or simply not listen to those around us. Taking a moment to think about the way you are naturally wired, and how others may be wired differently, can help us better understand and get the best out of each other. Or, to put it in the words of Swiss psychiatrist, Carl Jung, "everything that irritates us about others can lead to an understanding of ourselves". We all have a ‘type’… The theory of psychological type comes from Jung who said that what appears to be random behaviour is actually the result of differences in the way people prefer to use their mental capacities. In 1921 he published Psychological Types, introducing the idea that each person has a psychological type. However, the academic language of the book made it hard to read and few people could understand and use the ideas for practical purposes. Isabel Briggs Myers and her mother Katharine Cook Briggs set out to find an easier way for people to use Jung's ideas in everyday life. The Myers-Briggs Type Indicator (MBTI) personality inventory makes the theory of psychological types described by Jung understandable and useful. I have used this both with individuals and teams over the years. To complete an MBTI assessment properly you do need to complete a questionnaire and have a follow up conversation with an MBTI practitioner. However, having a basic understanding of the principles can really help ensure we get the best out of each other. The four ‘dimensions’ of MBTI 1 How you gain your energy and re-charge your batteries Some of us gain energy through interaction with others, others through quiet reflection. Our work settings are often designed for extroverts, the noise and the constant interaction, not great for introverts who do their best work in a quieter setting. People with an extroverted preference will ‘speak think speak’, whereas those with an introverted preference will ‘think speak think’. Those of us who do a lot of the talking in ‘online ‘and face to face meetings are natural extroverts. The downside of course is that others cannot get a word in edge ways and, as a team, we miss out on a lot of key information. So make space for both preferences. If you don’t know what an extrovert is thinking, you have not listened, in fact you have probably switched off. If you don’t know what an introvert is thinking, you have not asked but you really should. 2 What type of information you prefer to take in, trust and offer to others When I talk to people about this dimension, I often show them a Salvador Dali picture. People who have a strong preference for factual concrete information will give me a list of the painting contents—an apple, a knife, a bird, etc. Others will be reading between the lines and creating possibilities, "something has happened here, it’s unsettling". If I prefer the big picture, any presentation of ideas with a compelling vision will grab my attention. For those of us with a strong preference for concrete information an absence of detail to back it up is going to raise more questions than it answers. We need to pay attention to both. Check in with those around you to explore "what’s missing here?". Its so very relevant when we are working together to provide the best care and treatment for our patients. 3 How you prefer to make important decisions Some of us prefer a logical ‘thinking’ lens. We look at the pros and the cons, we want to help people to solve their problem. Others are concerned about how what is about to happen and how it will impact on others, their values, the ‘feeling lens’. If you always start your decision making with a ‘thinking’ lens, you will struggle to have a pros and cons conversation with someone who you think is taking this all a little too personally. The challenge is that they have a different starting point. They prefer to begin with their ‘feeling lens’. There is simply a difference in your preferences. Once you realise this, its so much easier to work together. This is simply about where you start your decision making. People with a thinking preference take a big step back, start with a detached view and then step in. People with a feeling preference do this in reverse. Both are equally important. 4 How you prefer to live your life Some of us are natural planners, others spontaneous, sometimes VERY last minute. I learnt many years ago that asking for things at the last minute was a great way to hack off your colleagues. We don’t live in a perfect planful world, but a little consideration goes along way. If you like structure, if the word ‘finished’ inspires you, spare a thought for others who may lob something in at the last minute. Your last minute contributor may have come up with the best idea since sliced bread. If you shut them down they may not bother you again with their great ideas. Your loss. And if you love the words ’just finishing’, try where you can to minimise how often you let things run on until the last possible moment and apologise when you do—it can very stressful for colleagues, friends and family who like to plan. In MBTI, all these four dimensions come together for us into 16 different types. MBTI then paves the way for us to better understand our responses to conflict, stress, our contributions within our team and how we can be even better. And, it can also help us understand why some are really wired to deal with change and others less so. Final thoughts And finally, I wanted to add a few more things that are useful to bear in mind: This is simply about understanding your natural preferences and sometimes adjusting them. People sometimes say "I do both of these". We learn that adjustments to our natural preferences can be helpful. For example, I am very planful in work settings, but for me at home it’s all a bit last minute.com unless I try very hard! Which leads into my last point. Expect to be more tired on occasions. If you are required to deal with a lot of detail when you prefer the big picture, be aware it may feel surprisingly tiring. It takes your full concentration, just like folding your arms the other way, also surprisingly tricky for most people I know. Try it! In the meantime, I hope my blog helps you to get your head around why you may find some of the super people around you not so super at times and how you can adjust your approach to accept and value their differences. If you are interested to learn more, go to your local NHS Leadership Academy to find your local MBTI practitioners and take a look at the Myers Briggs website. More blog from Sally Leading for improvement Immunity to change Getting to grips with your imposter syndrome Are you having to bite off more than you can chew? How a single piece of paper could help solve complex patient safety issues The art of wobbling: Part 1 The art of wobbling: Part 2 Looking after each other in times of change

The current challenges in the NHS are leading to staff burnout and staff leaving their jobs. In a new blog, hub topic lead Sally Howard asks us to take a few minutes out of our day to day work to reflect and re-calibrate. How is your 2024 going thus far? Are you on top of the world or has it landed with a dull thud? Goodness knows there are challenges. Staff shortages are persistent and, even with the extra mile from so many staff, our patients are waiting longer than they should. When we are at our best we have that clarity of purpose, we enjoy what we do (even though it can be very tough), we relish a challenge or five and, if truth be told, we’ll be looking for the next. Being asked to bite off more than we can chew and it’s a whole other dimension. We can keep going with our noses against the grindstone but it’s not normally what people sign up for and it’s a very short term solution. So what can we do? If this is resonating and your mojo is at risk of leaving the building, please close the door before it does and just take a moment to consider these three questions: How do I feel when I am at my very best? What does it look like? Just a few adjectives will suffice – a picture, whatever works for you What can I do to reconnect to that picture of me? Just three things. A proper break at work, noticing and appreciating the good stuff; you’ll know what works for you, and nothing outside your gift to do. How will I know when I’ve got there? A simple description. It’s just between you and whoever you want to share it with. Take stock in a month or two to see how you are doing. There are some things that we can change, some things that we can influence and others that we may have to accept (at least for now). The things we can regulate is our own response, whatever comes our way. I have never ever met anyone who is always at the top of the game but a little time on re-calibration always goes along way. More blogs from Sally: Igniting your inner spirit Keep your light shining bright Swimming with the tide

NHS and social care continues to have significant challenges. This blog cannot change that but it offers food for thought on how to stay afloat.  It’s been a while since I have posted a blog. I continue to coach NHS colleagues – their calmness, focus, resilience, professionalism and ‘can do’ shining through in spades. Inspirational, appreciative leaders of teams, small and large. Our current systems and challenges are too complex to have one person at the helm taking all the decisions. We need leadership at all levels. Great leaders inspire people to have confidence in themselves. Whether you are part of a team, a team leader or leader of many, here’s four things to contemplate: 1. Reality check The Covid aftermath, understandable unrest and general distress and frustration have impacted, of course they have, but we have a dedicated, professional, caring workforce. 2. The power of appreciation Take a moment to identify and reflect on your contributions and those of your colleagues. Appreciate those contributions. Make time to share them with each other. Individually and collectively feel proud. 3. Strengthen your resilience I can’t remember where I read this, but a simple way to focus the mind and build your resilience is to start each day with this simple reminder: I am … add in the words that best describe your talent and experience. I have … add in things that support and energise you at work and home. I will ………..your intentions for that day, this week. 4. Look out for each other Tune in. Sometimes we just want someone who will listen, a space to talk to a colleague, friend, coach, mentor. If you don’t already have this, think about who could help. In my experience, how we care for each other and appreciate our respective contributions helps to sustain us on the brightest days and the not so bright. Thanks for reading this. I have used this quote before but it seems apposite just now: "She stood in the storm and when the wind did not blow her away, she adjusted her sails." Elizabeth Edwards. Further blogs from Sally: Keep your light shining bright – three tips Swimming with the tide Standing tall in the storm

We know the link between anxiety, stress, burnout and patient safety. This blog from Sally Howard suggests four things we can do to help us stand tall and continue to grow from strength to strength, both for ourselves and for our teams. I originally penned this blog in February 22. There was a storm raging, many records of wind speed were broken, and our services were standing tall against the odds. And here we are 2 years on, a storm is raging, we have an even greater demand for services, our services are still standing tall - well quite tall - and you and your colleagues are the many sails keeping it afloat. Here’s four things that I hope will continue to help you stand tall: 1. Take a moment to reflect on your contributions The last 2 years have been tough, exhausting, but you have offered your best under the most challenging of circumstances. Take a step back, just for a moment. Take a proper look at your contributions. There will be things you say you could have done better (we are often our own harshest critics) but you have made a real difference. Allow yourself the opportunity to appreciate your contribution, how you kept your patients safe. Talk to your colleagues about this. Individually and collectively, you can feel very proud. 2. Seek out feedback Sometimes people say they don’t receive feedback; it maybe they are too overwhelmed to receive it, others may be too busy to offer it. Whatever the reason, seek it out. Appraisal meetings are a good starting point. Prepare for it, ask that all important question "How am I doing?". Check in in with colleagues – how did that go, what else could I be doing? The Healthcare Leadership Model also offers a great structured 360 opportunity. 3. What’s next? As a coach, I often reference the magic triangle, especially when I work with people who have lost their mojo or are just secretly wondering whether it’s time for a new opportunity. A great job will give you: Enjoyment – you can’t wait to get to work. Challenge – you may have this daily, weekly. It can be exhausting but it’s also exhilarating. Supporting your team through the tough stuff, problem solving, enabling the right response. It’s what you do best. Learning – in the right role for you, there will be learning. If these three things are still very much in balance, great. If not it may be time to be thinking about your next role. No rush but it may be a consideration. 4. Look after yourself and each other As I have said before in earlier blogs, seeking support is a sign of strength not weakness. There are services both internally and outside your organisation. In terms of external support, coaching and mentoring support is available via the NHS Leadership Academy: Coaching and Mentoring – Leadership Academy – just click on local coaching and mentoring offers. "She stood in the storm and when the wind did not blow her away, she adjusted her sails" Elizabeth Edwards "She stood in the storm and when the wind did not blow her away, she adjusted her sails" Elizabeth Edwards Read some of Sally's other blogs: Swimming with the tide Getting to grips with your imposter syndrome Keep your light shining bright – three tips I think you’re on mute… The art of wobbling: Part 1 The art of wobbling: Part 2

 We have an overwhelming demand for our healthcare services. This blog from Sally Howard suggests some things we can do to keep afloat.  We have an overwhelming demand for services, both emergency and planned. It was already there, but then Covid landed and it has all being exacerbated by the loss of experienced practitioners and an unhealthy dose of disillusionment. There are very comprehensive reports on the numbers if you need details on the size of the challenge including .[1] We know the link between anxiety, stress, burnout of staff and poorer patient safety. So here are some thoughts on what we can do: 1. Do be 100% clear and honest about the size of the challenge for your team The numbers will speak for themselves. If you have capacity for 10 service requests a day and receive 15, either your long queue will grow by 5 a day or you will be spending time trying to divert them elsewhere. Understand the whole picture and don’t be persuaded to over promise on what you can do; be realistic. Our services have brilliant teams. This is a team activity, especially as some colleagues will have experience of what has and hasn’t worked in the past. The team’s ownership will give you a strong foundation from which to move forward. 2. Make best use of the talent and resources you do have Tracking your activity daily can help ensure you are using the resources you do have. Taking a moment to look around and see where you may be missing contributions from other colleagues. And celebrating the good stuff – the thanks you receive, how well that patient pathway change you made during Covid is working, appreciating the brilliance of those around you. 3. Do look after yourself and each other If you are one of those people finding that your workday is always following you home for a glass of wine, notice how often this is happening. Now and then maybe, but every day is worrying and habit forming. There are support services there that you can use, both internally and outside your organisation. In the South East, the NHS Leadership Academy has just launched a ‘crisis coaching’ service: Coaching in a Crisis – South East Leadership Academy. Seeking this support is a sign of strength, not weakness. Coaching offers a safe confidential thinking space to work things through. Other parts of the country also have coaching networks – just search on the NHS Leadership Academy for the link to your local coaches or support within your own organisation. 4. And finally, don’t compromise safety in the process There will be pressure to drive faster and harder. While waits for any treatment are not what we want to offer, this cannot be at any cost. Equally if you are feeling great about the response of your team to your everyday challenges – fantastic. Do share your story. “Do not let what you cannot do interfere with what you can do.” – John Wooden Reference 1. Rocks S, Boccarini G, Charlesworth A, et al. Health and social care funding to 2024/25. The Health Foundation, September 2021. Further reading: Leading for improvement Keep your light shining bright - three tips Hidden wounds Tackling the care and treatment backlog safely: Part 1

We have probably all suffered from imposter syndrome at some point during our career. Doubted our self and our abilities. However, if we aren't confident in ourselves and how we do our jobs it could impact on the patients we look after. Here are my tips on how to get to grips with your imposter syndrome. Imposter syndrome – that feeling of being not enough and the more you notice it the bigger it becomes. It lands in the pit of your stomach, it’s that voice that says "you, really?". And rather than going away, it shouts a little louder and risks being a real interference to you being at your absolute best. It's common in high achievers, perfectionists. A friend recently asked me if we are born with it. I don’t think so but I do think it has its roots in early labelling – he’s the bright one, she’s the kind one. And we learn to hide it. I did a quick straw poll last week. Everyone I spoke to shared their experiences of imposter syndrome with a range of triggers: moving from being ‘in training’ to someone who is expected to know all the answers, being invited to give a big presentation, leading a new team, starting a new job, chairing an expert committee (expert – now there’s a scary word). In my experience it crops up all the time in coaching sessions. Often at work, people are concerned they may appear weak or not quite up to the job. It may be easier to simply keep quiet. Coaching is a safer space, you won’t be judged, you will be encouraged to find a solution for your imposter syndrome. You can choose to ignore it, but please don’t. At worst case it could mean that your most important lifesaving contribution, that key piece of information that changes the approach the team is taking for the better may not surface. "Its ok, they know better than me" is not the answer. So here’s my three tips drawn from my experience of working this through with others. 1. Get to know your imposter syndrome better It’s really hard to work on something you don’t really understand. Some of us like to talk things through with a trusted friend or colleague, others favour quiet reflection. Whatever your preference, take time to get to know your version of imposter syndrome a little better: when it lands how often what triggers it how it makes you feel. Start to build that picture. This information is essential. It is worth investing the time. 2. Name it This may strike you as weird, but the simple act of naming something helps us to have a shorthand to use when it joins us (and it will be back) and gives a pass through to dealing with it. I have worked with people who use a christian name, a cartoon character, the weather. For me it is a jackdaw (heavy landing – solid - stays a little while). Use whatever works for you. 3. Work on it Armed with this new level of understanding: Remind yourself why you were appointed/asked/whatever your situation. Talking it through may be enough. Sometimes it is worth writing down the skills: knowledge and ingenuity that you bring to the table so you can bring it to mind at a moment’s notice. Re-connect to the great feedback you have received, solicited and unsolicited. Appraisals, 360s, that lovely email or phone call thanking you, the one that turned a rotten day into one with a better ending. Once these are centre stage, they will help to quieten that doubting thomas of a voice. And if you know there are particular triggers for you – that meeting, that person – work out your own private handling strategy. A little re-framing works wonders, especially when served with a bit of humour. Then the next time your imposter syndrome pays you a visit: remember the expertise you bring to the table, that great feedback prepare as you always would and show your best self stay calm, stand tall, make your voice count. Oh and if you really are out of your depth, an honest answer, "that’s a new one on me", and a commitment to come back with an answer as soon as possible will always help you out. No one can be expected to know everything, not even an expert!