Leadership with A/Prof Lee-anne Chapple

Today we have A/Prof Lee-anne Chapple on the show! Lee-anne is here to discuss her role as Senior Critical Care Dietitian at the Royal Adelaide Hospital, and a Research Fellow at the University of Adelaide in Adelaide, Australia.

She shares stories about starting a research career when you already have an established clinical role. This episode is a great example of how letting your interests guide your career decisions can lead to fantastic opportunities you never expected. 

Go to theleadcandidate.com for more info and the interview transcript.

Transcript

The Lead Candidate with A/Prof Lee-anne Chapple

Simona: [00:00:00] My next guest on The Lead Candidate is Associate Professor Lee-anne Chapple. Lee-anne. Welcome to The Lead Candidate. 

Lee-anne: Thanks so much, Simona. It's great to be here. 

Simona: So this is a pretty special episode for me because Lee-anne and I used to study together medical science back in the day. And we actually haven't had a proper conversation in a very long time.

I'm going to say it's 15 years or something crazy like that. So this is really fun. I'd say 

Lee-anne: so. 

Simona: Yeah. Lee-anne, now you are a senior critical care dietitian at the Royal Adelaide hospital, and you're also a research fellow at the university of Adelaide in Australia. You lead the intensive care nutrition research program at the Royal Adelaide hospital where you're conducting research that focuses on nutrition physiology during critical illness and early recovery.

So I like to start off this podcast by asking people to give just a quick pitch quick overview about their research and their role. So for you, you've got two roles to cover. Do you mind taking us through that? 

Lee-anne: [00:01:00] Yes, sure. They do cross over a little bit, which is nice. My desk is the same regardless of what position I'm in.

So I guess yeah, my research role which is the one that I've probably been doing for the longest since, Just after I finished my PhD, I got that position. So as a senior critical care, there's a team of about five dieticians that cover our 48 bed ICU. So the RAH, even though Adelaide is one of the smaller cities across Australia, it does have the biggest throughput of ICU patients.

So we have about 4, 000 patients a year. And as a senior critical care dietician, it's our role to provide nutrition for those patients. So most of them will be comatose providing liquid. nutrition support and managing, yeah, their complex needs. We're the major trauma center for Northern Territory, South Australia.

So we see all types of patient conditions. So it's a very varied role that I really enjoy. So I do that two days a week split across three days. So it's a bit of a messy position in some ways. I have to wear different hats at different times. [00:02:00] But it's yeah, a really enjoyable and varied. job to have.

And obviously we have some other dietitians working with the team and I support them as they train up to become critical care dietitian. 

I guess within that role, we do a few different things like an extended scope of practice. I was one of the first dietitians in Australia to be able to place post pyloric tubes at the bedside.

So I get my hands a little bit dirty as well, which is quite nice. 

Simona: Yeah, I am. I'm glad you brought that up. And that's something I definitely want to come back to talking about the leadership involved in getting that started and getting that going. Because I think that's a really amazing part of your story so far.

If we just take it back, because obviously you're. Doing all these different roles. I'm glad you at least have the same desk. So that's one constant. How do you manage to juggle all of these different positions when you have to switch tasks? Do you try to bunch activities together [00:03:00] or do you have to be really flexible and agile?

Lee-anne: Yeah. I think a bit of both. So from a rostering perspective, I have Set days and hours that I do from a clinical and workload. My research is a bit more flexible as most research can be if we're not actively recruiting patients. I work from home a little bit where I can being in an open plan office, writing is much easier from my home office than it is with 30 other people around.

But I think even if you have those hours, there will always be a researcher sitting right next to you that has a question, or, you start new recruitments and you've got students around and they don't wait until you're suddenly in your different hats. And patients are there to recruit.

And often when you're doing next of kin consent, you've got to jump on when the family's there face to face, because that's always nicer than doing a phone call. consent. So yeah, I treat it with a bit of flexibility. I like to try and keep them as separate as I can, but recognizing that's not realistic and yeah, there's an ebb [00:04:00] and flow between the two.

Simona: Absolutely. Yeah. I can see that. So in terms of your research responsibility, you've just touched on things like writing. So you're doing the standard typical, even though you're based in a hospital, things of writing grants, writing papers and writing up your work and things like that. Yeah.

Lee-anne: Definitely. Yeah. I think, if I think my clinical roles vary, then research is completely different as well. It's yeah, writing protocols, predominantly writing grant applications, just had the investigative grants go in. So try to get my own salary, which is always great fun. And yeah, supporting students.

So I have now about five PhD students, one's just submitted and started a postdoc as well. So supporting them through their studies. And I was lucky enough last year to get a clinician researcher MRF grant as well. Trying to get that started on my consumer groups for that embedded and lots of different pieces like that.

Simona: I [00:05:00] 

Lee-anne: think we'll touch on it a little bit later as well, but a lot of the work I do As any researcher is the volunteer work as well. So society involvement and those sorts of things. 

Simona: Yeah, absolutely. Yeah. I want to get back to that part about stakeholders and the different people who you're speaking to, because one thing that is really clear looking at your profile is that you're an excellent science communicator.

And I imagine that has to do with all the different. Groups that you speak with, but we'll get into that bit more in a second. The other opening question that I have for people in this podcast is where you've born a leader or have you become one over the course of your career? 

Lee-anne: Yeah, I find this quite a funny question because if you asked me if I was a leader, I wouldn't say yes.

I don't think of myself as a stereotypical leader in any way. I wouldn't claim that. I definitely, if I am a leader now, I definitely wasn't when I was growing up. All my school reports would Lee-anne needs to ask more questions, Lee-anne needs to make up her own mind and not be a [00:06:00] follower. So I was definitely not a leader when I was younger.

Yeah. And I think 

Simona: No, I was gonna say, that's so funny. So that's not how it appeal. You, me, . Yeah, , yeah. 

Lee-anne: That's hilarious. I think that's often the way, and I don't know if that's a female thing or. Or what it is, but I think a lot of people don't see themselves as leaders and they've been thrown into that position and they're just doing their job and don't really see it as a leadership role necessarily.

Simona: Yep. Fair enough. So you would say your answer is that you weren't born a leader and you're not necessarily one willingly now. 

Lee-anne: On a podcast. 

Simona: The fact you're applying for investigators, so the investigator scheme for international audience that's run through so the medical research grant scheme, the national health, the medical research council has a series of fellowships that will specifically fund different tiers of researchers and the investigator scheme is [00:07:00] Is yeah, for fellowship specifically, not, it has a bit of good grant money, but it's mainly to pay for the person's salary.

And it's a very prestigious thing to go for. And I don't envy you having that. You've just written one for sure. Definitely not. All so if we track back over your career and how you started and how you got to where you are now, just briefly. So we met. When you're studying medical science, we're both studying medical science.

You then went on to do your master's in nutrition and dietetics. This is a Flinders university. You did that at Flinders too. Yeah. 

And you became an accredited practicing dietitian. You've had a couple of different roles, but they all seem to be quite clinically based in terms of where you headed.

Was that right at the start? You went into more of the clinical side of things. 

Lee-anne: Yeah, I did, which was funny because when I first graduated, I didn't do so well. I actually failed my clinical placements, which was not uncommon at that time for dietitians. But yeah, I ended up resitting and then [00:08:00] ended up moving to the country for one of my first roles, which was quite common back then to get a sort of a more community based position.

But I lived in Swan Hill for three months. It felt like a very long three months being in a small country town again even though I grew up in one. And was responsible for, a renal dialysis unit, outpatients, inpatients, nursing homes it was a really varied role, nothing too challenging, I don't think, but being the sole hospital dietitian and having lots of difference to where it was quite a nice insight as a new grad to get involved in.

Simona: Yeah, absolutely. What a great learning experience to Be thrown into the country environment, have exposure to all different sides of things. I imagine that would have set you up quite well. Just hearing you say that you actually failed that subject, what do you think failing actually taught you?

And did it provide any drive at all to come back and actually get into the clinical side of things? 

Lee-anne: I think at the time after I'd done it, I [00:09:00] was, I definitely didn't ever want to go to the RAH again. I had limited PTSD, I think about that environment it was quite challenging and I think a lot of dietitians are type A personality, perfectionist.

So to not do well at something was really difficult. Even though it was something that was relatively common and I knew from the outset that I was going to struggle, not from a knowledge perspective but I was an overthinker and I was anxious and those sort of personality traits didn't go well in that sort of environment where you have to be a quick learner, you Do 10 weeks and suddenly go from just knowing the knowledge to be able to be a practicing dietitian.

So that's what it learning. I don't think worked well with how I learn my personality traits, but it did teach me a lot of resilience. And I think that's something that has probably got me to where I am now is just persistence . 

Simona: That's really amazing to hear you say that. This is a topic that I was going to come back to in a minute, but I think we might as well [00:10:00] touch on it now.

So one thing I wanted to discuss was the fact that I knew you beforehand and to see what you've achieved now I was going to comment on the kind of student that I thought you were when we were. Colleagues, I guess together. And it was like, I had, you always wanted to do nutrition and dietetics was where you were headed.

But from the first day that we met each other, that's exactly where you knew you wanted to go. And in my mind, there was not an ounce of doubt that's exactly where you were headed. You were smart, you were diligent and you did the work and you did really well as a result of that. Hearing me say that, what does that what do you think hearing me say that about you?

Lee-anne: Yeah, I definitely think I'm diligent. I've always worked hard. I think that sort of my family upbringing was to do the best you can and do really well. I don't, I wouldn't say that I'm smart. I don't think I'm stupid. But there are definitely a lot of smarter people out there [00:11:00] and I see that working in the healthcare industry.

I wouldn't put myself up there with the smartest. So I think that I've worked hard to overcome some of those. deficits, or things that I don't think are my strengths as much. 

Simona: That's really interesting because I definitely would say you're really smart. A hundred percent, just like a real natural.

I guess it's your diligence, right? That makes it seem so natural. Cause even it's interesting. In preparation for this, I can see how diligent you are because of the fact, you mentioned that there's podcasts you've gone back and listened to a few episodes you've come back with questions and things, and not every guest is like that.

So I can see how that diligence it's interesting because I feel like that as well for myself, particularly now and it comes from that place of being worried about making a mistake because I too failed subjects in medical science. And so you don't want to do that. And so now I prepare so much to protect against that from happening again.

[00:12:00] Yeah. So it's interesting to hear you say that's the kind of, I think that's the kind of smart as well, that prepare being prepared. 

Lee-anne: Yeah, it's different, isn't it? Yeah, I definitely wouldn't be someone that could sit on an exam without studying like I've always had to put in extra work to do well.

Yeah, I just, yeah. Just what I've had to do. I've always noticed that, going through school that I would study more than other people, but get the same result. So I don't think I've got that natural. Maybe it's not intelligence. Maybe it's memory. I really struggle with memorizing things. As you get older, that gets a little bit harder as well.

But yeah, I think that I've had to work extra hard to do well. 

Simona: So having gotten that resilience from. From not doing so well in that initial subject. And then also I imagine working in a country hospital where you're new would require a bit more resilience as well. It need to develop [00:13:00] quickly in that situation.

Then were you having to learn quite quickly as well? Or was it okay in that setting? 

Lee-anne: Yeah, I think so. I think like from a caseload perspective, it was pretty straightforward sort of things, anything too high level would go to a bigger hospital. But it was a very varied job and you've done 10 weeks of placement and two years of uni specific to nutrition and then suddenly you're managing it yourself.

But I would reach out to people, at the Royal Melbourne hospital or for complex patients. I knew where to go for help. And I only did it for three months as well. So that time goes pretty quickly. Pretty quickly. Yep. 

Simona: Yep. Yep. Yep. Yep. and then after that, so you have After that, you went to the Alfred, is that right?

Lee-anne: No. So then I moved back to Adelaide and I worked a little bit of memorial hospital, which is a private hospital in Adelaide. And then I worked on a pregnancy research study at the Women's and Children's Hospital through University of Adelaide with Jodie Dodd. So it was looking at limiting weight gain in overweight and obese pregnant [00:14:00] women through, through diet and healthy lifestyle advice.

So I think that's probably where I got. A little bit of an interest in research because I learned how to take blood samples and do body compositions on like newborn babies and did a lot more than I think just the dietitian normally would. My job was the intervention, but I learned some of those other skills.

So I think that sort of was the first thing that set me up to, to think about research as a career. 

Simona: That's really interesting because I don't remember when we were going through medical science, that research was at all something that you were interested in.

It was never something that seemed to click for you at all. And so it was really interesting that you have very much a research focused role now. So do you think it was being in a right kind of environment that triggered the interest or was it the project itself that, that got you interested in thinking about research?

Lee-anne: I think the sort of acute side of it I really liked and the patient contact as well. Like really merge [00:15:00] together the clinical dietetics and more of the research mind. So I was just delivering the intervention. So I didn't have any idea about writing protocols or anything like that.

Although I did work through a paper that ended up getting published a couple of years after I left. So I had started to think a little bit outside the box, I think in that role. More than maybe what I realized at the time. Yeah. 

Simona: Just for the audience who might not be familiar, when you say writing the protocols, could you explain what you mean by writing the protocols?

Lee-anne: Yeah, so I guess it's developing a research study. So working out the questions that you want to ask, the methods you want to use to answer those questions what type of patients you want to recruit, really just everything up until the point where you would start doing the research. It was a study that had already been designed and already up and running.

And I was just slipping in to deliver the intervention as part of the study. 

Simona: Yeah. And it's important to mention. So this is something that's particularly important when you're working with with [00:16:00] human patients, but patients humans that is not something that typically happens in your wet lab research where you have to write a full protocol out beforehand.

It's often connected to ethics, for example or can be published as well. So that's worth noting too. You, I know you've also had a period where you were a clinical educator at the university of Canberra. Yeah. Yeah. And I was thinking that seems like quite an aside type role compared to everything else that you've described up to this point.

What made you take on that role and what's something that you learned from having that position? 

Lee-anne: Yeah so I'd worked in Melbourne for a couple of years at the. Alfred. And then so I moved to Melbourne and then to Canberra with my partner at the time. So it wasn't somewhere that I would have necessarily chosen to move to.

But personal circumstances took me there. And I think it was really just, that's what was around. And I hadn't really done any clinical education before I'd supervised students as part of my clinical role as as we all do as [00:17:00] clinicians but Yeah, it was just something that was there and I applied for the clinical educator role.

I'd been doing it just short for maybe two or three weeks for an ongoing. And the professor at the time, Lauren Williams, ended up saying, we've offered you the job, but we don't want you to take it. We think you should enroll in a PhD instead. Wow. So that's why I started the PhD. I did both.

I took the job and then started a PhD at the same time. 

Simona: I love that. That's amazing. Okay. So hang on. Just trying to follow your progress and where you've gone. I've jumped around a little bit. You have, but you, so you were thinking of doing a PhD when you're at the University of Canberra. And very cool that people thought that you.

Yeah, I'd 

Lee-anne: actually been told it earlier during the pregnancy study, they didn't want me to leave to go to Melbourne cause they wanted me to enroll so I clearly had some sort of research mind that people could s 

Simona: okay. So you've been told a couple of times that you should do your PhD, which is really cool to hear. [00:18:00] Do you, what do you think it was that that people saw? Did they mention anything specifically that they saw in you?

Lee-anne: Not that I remember, I think when I started the position in Canberra, I had been working in trauma unit in Melbourne, and I was a little bit frustrated in that for patients that had these major traumas, mostly with head injuries, there wasn't really any evidence to support good nutrition practice.

And I found that it really just depended on what consultant was on as to what decisions got made. And so it was really ad hoc. There was no consistency. I felt like my views weren't really. Being heard with some of those health professionals as well. And so I did want to get involved in research at that time.

So I think I'd raised that when I'd moved to uni of Canberra that's something that I was interested in doing. But I hadn't really thought too much about a PhD. A PhD is pretty daunting to, to think that you're going to dedicate three years of your life to research. And what does that even look like?

Yeah I do feel like I just, fell into [00:19:00] it right place, right time, maybe, but I probably did have some of those skills early on, maybe. 

Simona: Amazing. What I really like about what you've brought up is because I think it's quite a different thing when you start a PhD straight after your undergraduate and in Australia, we have an honor system, or if you do it after masters, if you're overseas there's just like a natural role of still studying.

And so you just keep going. But in your case, you've already worked as a professional. So to go back to that's quite a shift in In thinking and the position that you're in as well. So I was wondering whether that, those thoughts come into play about going back to being a student again.

Lee-anne: I think not so much. I definitely was used to being out of my comfort zone in that I've worked in so many different places that doing something new wasn't really a daunting thing for me. I think financially, it, that's probably one of the biggest problems in that if you've worked for a bit, particularly as a [00:20:00] healthcare professional it's hard to go back to, a quarter or a third or maybe even less of your salary.

But I was in a good position at the time that I could make that happen. Yeah. Yeah. So I didn't really think about it going backwards. I really thought about it opening up opportunities. And at the time I didn't know if I'd been living overseas and a lot of dietetic qualifications aren't recognized in other countries.

So I thought that it would open up some doors for me. I didn't really think about it as a research career, but more that I could go into academia or lecturing or sort of other roles, 

Simona: amazing. That's really interesting. Those things that you're bringing up, definitely things that you need to consider when you're wanting to take on something like this, for sure.

The other really interesting thing to hear you talk about is you've very much had an idea of what it was that you wanted your PhD . area to be in. And I've heard another podcast that you were on and you mentioned that word here, the frustration that you felt, 

Wanting evidence to help patients in [00:21:00] critical care post ICU.

So was there like a particular aha moment that this is what I want my PhD to be on? Or was it more like a slow growing frustration that you noticed? 

Lee-anne: I think I really liked the clinical area. A traumatic brain injury, one minute the person is just living their normal life, often young teenagers or young men, and suddenly the whole world has changed.

And it's an injury that you can't see that affects people. So significantly for such a long length of time one of the worst injuries, I think that people can get because often there isn't anything coming back from the deficits that people experience. So I really enjoyed the clinical space.

I found it interesting. And there just wasn't anything done from a nutrition perspective. So it really was just, I wanted to, find answers for myself to, to make me a better clinician, I think, but also to support other clinicians to be able to practice better in the future. So in that 

Simona: instance where you [00:22:00] identify that there's a knowledge gap in your, in the, in your area, your field of expertise, how do you choose a PhD supervisor then in that instance?

Lee-anne: Yeah. So I actually changed supervisors throughout my period. So I started at the uni of Canberra with Lauren Williams, who was the professor of dietetics at the time has since moved up to Griffith university. But she'd never worked in acute care dietetics. So I think maybe for a couple of years when she first graduated and realized very quickly, it wasn't for her.

So she did a lot of sort of weight loss or, Preventing weight gain for menopausal women. So very different dietetics to what I was suggesting, but she was a very good research support. And so I started with her, one of the surgeons who I work quite closely with at the Alfred Russell Gruen as well.

He was always good advocate, I think for me as a dietitian let me go in and watch a couple of surgeries and things like that, which I always enjoyed. And then Fiona Lathander, who also [00:23:00] hadn't really done a whole lot of acute care dietetics, but was a nutritionist that had just moved over to Australia from Ireland at the time.

So really just piecing together who was around and who was willing to support me more than anyone, particularly in that field of interest. 

Simona: I love that. And when you say support you, what were the things that you felt like, can you cite some things you felt like you needed to be able to. Get this program going and yeah, to get, to feel like you were in a secure place to actually do the PhD and do the program.

Lee-anne: Yeah. I think it really was just and understanding of the research methods. I hadn't really done a whole lot of research up to that point. Definitely not things that I've been leading myself. And I had an idea about what I wanted to do, so it was really them working with me to figure out how to answer those questions.

I only enrolled with them for a year before I moved back to Adelaide also for personal reasons. And When I'd moved away from the University of Canberra, my supervisor panel changed. So my PhD [00:24:00] did take quite a different route from what I'd originally proposed. So I think I got a little bit more clinical support, I think from that point on.

Simona: It's interesting hearing you mention like the different names in who've supported you over the way. And it seems and this is obviously going through the lens of quite a Like stereotypical, quite lens is the word I'm after that you seem to have a lot of female support in terms of the nutrition dietetic side of things.

But then you're working in a hospital and I imagine there's different dynamics when you've got different agendas of leaders being involved. Was there a shift at all when you're coming into the more clinical team in terms of the way you're working with different people in different positions of leadership and having to consider.

that kind of support as well? 

Lee-anne: I think from a clinical perspective I think the gender is, yeah, there's quite a mismatch. I think, as a dietitian, we're so female heavy as [00:25:00] a discipline. If there's a male working in your department, it's it makes a massive difference. It's quite an exciting thing.

But then the medical side is very heavy. Male, particularly in ICU, particularly at the higher level, sort of consultant level. But from a research perspective, moving across to Adelaide I had Marianne Chapman as my primary supervisor as an intensivist, one of two intensivists at the time at the hospital that were female.

But then I also accrued Adam Dean who was also an intensivist and probably the biggest support for me during my PhD and early postdoc. And then I had a Canadian intensivist, Darren Highland as well. So I had a mix of male and female. And I have felt in research, I don't think the female versus male has made as big a difference as what it does maybe clinically.

I think some of my biggest advocates and biggest mentors or support have been males which, yeah, would not be what I would have expected, I guess. 

Simona: That's really cool to hear. I [00:26:00] think the reason why having clinical support is so important is because of what you were trying to achieve. So it touched on that a little bit at start.

And it's really funny to hear you comment that you don't feel like you're a leader because you have been leading in terms of the way you've been extending the scope of practice for your patients. And so if you could explain a little bit more about that. The placing the post pyloric feeding tubes into the critically ill patients.

So what is that exactly? Why did you want to do that or want to have that as part of practice and what difference has that made? 

Lee-anne: Yeah. So it was something actually the Rosalie Andel, who was the dietitian in ICU before I came on board, we job shared for a little bit. She'd done some work with Adam Dean, my PhD supervisor around dietitians placing the tubes.

I think that. Historically, anything hands on, the doctors do but I think that we felt that there were delays because it's a bit of a frustrating procedure to do it. It doesn't [00:27:00] work as you would want it to and I can explain a bit why, but I think Rosalie had yeah, led that. Opportunity first.

So she'd done a little bit of research around it. I was actually placing them as part of my research role. But then wasn't legally, allowed to do that within the clinical role without having an extended scope of practice. So it was a big process. I think some, sometimes hospitals are quite risk adverse areas and any change is seen as a even if that's A change that's less risky or a positive change.

I think change is just often seen as a challenge. Did take about two years of pushing and support from some of the intensivists to really get that over the line. Yeah. So basically, yeah, sorry. 

Simona: No, I was going to say again, I can imagine to try to change. The way things are done in a hospital already when you're trying to introduce something and it's just in a research setting that can be, quite a process to go to, but to actually change the way practice is done within the [00:28:00] hospital.

I can only imagine the yeah, the way that must have gone about. So how did you. Navigate that pro. I feel like we do also need to go back and just explain again, like why, explain 

Lee-anne: what it is. Yeah. Why, 

Simona: What it is and why you wanted to do it anyway. 

Lee-anne: Yeah. So patients that in comas often the injuries that they have or the sedatives that they receive to keep them asleep slow the GI tract.

And so when we are feeding them. The nutrition will build up in the stomach and because they're not awake, they can't cough it out. And so then that can go regurgitate up and go into the lung. So a way of potentially managing that is to put the feeding tube rather than into the stomach as you push it further down into the small bowel.

So there's bedside techniques that we have available at the Royal Adelaide Hospital that means you can do that in ICU with the patient. So it was something that. I'd had a bit of exposure to the doctors were doing it at the hospital at the time. But they're busy and, they're [00:29:00] saving people's lives and there's other more important things in nutrition for them, but for me, there wasn't.

And so I thought that could be something that I could do. Amazing. Yeah. 

Simona: Amazing. And this is, this came as an extension of your research because you were testing a different like types of protein, the way that they are absorbed. Is that correct? Yeah. So we 

Lee-anne: did one of my favorite studies, it was very involved looking at muscle protein synthesis.

So we, we put the tube. Into the bowel, gave some proteins that we got from the Netherlands in collaboration with Wijk van Loon's muscle metabolism group there. So it's an intrinsically labeled trait. So which means that they gave some labeled amino acids to a cow and then that gets incorporated into the cow's milk.

And then you can use that milk to feed to patients. So instead of it being just individual labeled amino acids, it looks at how the body digests a whole milk protein. That's super cool. That's super cool. It was a great study and it involved, [00:30:00] taking bloods from an arterial line Like a catheter to insert the amino acids the feeding tube.

And then we took muscle biopsies as well. So we did that in healthy volunteers, which those volunteers are just amazing because they literally every limb was attacked during the study. And it was about 12 hours where they had to lie in bed for that whole time. Yeah, 17 blood samples. It was a huge amount for them to go through.

And then obviously the ICU patients and the next of kin consent involved in that and training up the doctors. So our doctors hadn't done these muscle biopsies before. And so I was the first one to have them do that on to learn how to do it. So I think that sort of helped with the consent process a little bit, because if I, as a small female can have a muscle biopsy, then it mustn't be too bad.

And that's something that people were willing to support, but it was a great study and incredible results. And I think it will change the way that we practice in ICU [00:31:00] and the research directions that we go in. So I think, yeah, the burden on the patients and the families, I think has been worthwhile for the science and the benefit to future patients.

Simona: Amazing. I love it. Just like really impactful because it's not only you're creating impact in the actual research program, what you're doing, you've also extended that to change the practice for patients within the hospital as well. And I just, I love it. It's awesome. The thing you can hear, just as you're describing.

So you're talking about the doctors that you're working with. You've got the patients and the families that you're speaking to. And, we touched on just briefly talking about trying to change the scope of practice. So I imagine you're talking to it would be some sort of ethics administration or regulatory board within the hospital.

They're all very different groups of people with very different sets of understanding. One thing I noticed about you in the way that you explain your work, and there's some great videos, which I'll share links [00:32:00] to in in the show notes where you explain your research and you've explained it. So now it's very clear that you're an excellent communicator of your science and your research program.

And so I was wondering. Has this come off the back of, I don't know, maybe even the clinical educator role or because you're talking to patients that where, how have you developed your craft? Is it something conscious that you've done? 

Lee-anne: Yeah I don't know. I I actually think it comes back to what we were talking about personality traits earlier on in the.

I struggle to understand difficult concepts. The, that muscle biopsy study, I still struggle with the statistics and the science behind it. The physiology, all things that I wish I was better at, and I'm not, but. Yeah, I struggle. And so I think I have to explain it to myself in simple terms in order to understand.

But I also think if you can't explain what you're doing enough for a child or, someone from an a background where, [00:33:00] English isn't their primary language or or people that haven't had the same level of education as you, if you can't do that, then how do you involve people in your work?

Like it's a necessity when you're doing this sort of research where people from all different backgrounds potential participants. Yeah, it's also something I really enjoy. I do enjoy talking about my research cause I do love it. And I think it's, yeah, you want to make it something that people could understand.

Simona: Absolutely. And just you mentioned right at the top about the ICU at the Royal Adelaide Hospital having such a large number of patients coming through, 

I imagine that it's not necessarily because of the adelaide has a particularly high number of ICU patients because of the catchment, because of the number of hospitals in South Australia and Northern territory. So that would mean quite a varied demographic of people that are coming through as well. Yeah, 

Lee-anne: definitely. Like even for some of my follow up studies for patients that have survived an ICU admission, sometimes I'll get them to come back three or six months later.

I had one [00:34:00] participant without any financial support or anything like that, drive nine hours to come to an appointment as part of a clinic. So yeah, I think our catchment is huge. And when you talk about that to European researchers, they're like that's five countries away. Yeah. Yeah.

Yeah. 

Simona: Yeah. Yeah. Wow. Gosh, that's really really special. Has, do you think then. That ability to explain things. Did that serve you well in trying to establish the changing practice within the hospital in terms of trying to explain to different people higher up as well? Can you cite an example where it helped maybe?

Lee-anne: I think for the extended scope of practice, not so much. I think being able to have support and having good relationships with the medical team, I think was the thing that supported that. And I had a incredible dietetics manager, Rhiannon Crane, who was incredibly persistent with that. And she made a lot of the administration process work.

So yeah. It was less verbal [00:35:00] and maybe through the written work, it was knowing what people need and being able to sell things as well, which you have to do as a researcher, sell your work. So maybe part of that, but yeah, I think it was having the right people on my side as well, on the side of the extended scope of practice.

Simona: Yeah, it's it's funny hearing you say that having the right people on your side and it's something that some people take for granted how it can seem like such a simple thing. Do you think, is there something that you do necessarily that assists in you getting people on side? Do you think? 

Lee-anne: I don't know.

I think because I am very passionate about what I do, I think that helps. There are definitely. people that aren't on my side. Nutrition is not something that a lot of healthcare professionals are interested in. Surprisingly, I don't know why. But I think there has been a lot of evidence more recently that doesn't show benefit of nutrition early in ICU.

And [00:36:00] sometimes people misinterpret that or extend that out to mean that it never matters. And so I think that, and I think some of it's a little bit like. Having a go and being cheeky, but I do think that no matter how you communicate, there's always going to be people that aren't that interested in it or just do what they want anyway.

But I think I've generally been able to. So things in a way, or I'm persistent and I will come back and I will have arguments and I'll have evidence to support what I believe in or what I think should be done. So yeah. Wear people down eventually. 

Simona: Yeah. Evidence is always a good one for helping to wear people definitely, for sure.

Yeah. I love your argument. However, here's the evidence. If you still say no, that's fine. It's your choice. Yeah. Yeah. Sorry. Who then. Who then really is on your side in terms of like a group of clinicians, if you've got people who don't necessarily see nutrition as being the most important what's the group of [00:37:00] people that is really on board with what you've got to do?

And why do you think that might be? 

Lee-anne: Yeah I just think it's personal interest really, I think there's so much that happens in an ICU that nutrition is just one component. I do think at the Royal Adelaide they've had quite a focus on nutrition. A lot of our research has been nutrition and in general, Australia and New Zealand do a lot of high quality nutrition ICU research compared to the rest of the world.

It's something that we're quite well known for. And. Yeah. So I think my supervisor, Marian Chapman, her whole career was around nutrition, particularly from a gut failure perspective in ICU. And so our medical teams did have more of an interest or understanding of it than maybe what I've experienced in other places.

But you get a couple of studies that don't work in your favor and then that opinion can change quite quickly. So, yeah, it's just individual personal preferences, I think. 

Simona: That can be fickle, can't it? So now that you [00:38:00] are You're at a point that your leadership expertise has really been established.

If you're changing things in the hospital and you're establishing you've already established your own research program, but you're continuing to move forward with it. What do you see as the next really big challenge for yourself in this dual practitioner research role. 

Lee-anne: Yeah. I do find it difficult the more I try and grow my team.

It's something that in the past I've had one maximum two PhD students. I've only, I've had one completion and one that's about to, or has just submitted. But I'll have maybe four or five towards the start of next year and then a postdoc. And so the more, your time gets thinner. And the more you move up in that sort of world, I guess the less time you have to do things and the further away you get from doing the real sites, I think in that I'm not standing at the bedside taking blood samples anymore.

And I feel a bit disconnected [00:39:00] from that. So I think from a leader leadership perspective, I've found it quite a challenge going from. PhD to full time research as an early career fellow with a good amount of support to having my PhD supervisors have retired or moved interstate. And so I do feel a little bit isolated at times, and I find that quite challenging.

But I have more expectations on myself, to support salary for these staff and give them long term careers as well. Yeah. 

Simona: Yeah, that's absolutely valid. Do you have external mentors then that you're able to go to for general advice, even if they're not within your scope? 

Lee-anne: Yeah, it's something that I think I've always struggled with.

There's looking at the number of ICU dietitians with PhDs, I think I was maybe the second or third for Australia. So there's not really career pathways for that field. And obviously there's other dietitians that have done PhDs and have great careers in other [00:40:00] areas. But I think in that specific field, I have felt that I've had to pave my own way.

And I've got mentors for different reasons some intensivists, some nurses but I don't feel I necessarily have as strong mentors as what I hear other people do. And I really think that my best mentorship and support probably comes from other researchers at the same area or even coming up my PhD students, I learned so much about leadership and mentorship from them and just adapting to different ways of learning, I think.

Simona: Yeah, that's really cool to hear you say that. It's definitely true that if you can be open minded, definitely students can teach you so much. And particularly if you've got the kind of students who've already had a professional background beforehand, I imagine they can teach you so much too.

Lee-anne: Yeah, definitely. Definitely. 

Simona: So then if we go back to you now as a bachelor of medical science student was it anywhere within where you plan to go like at [00:41:00] that was this what you saw your career turning into even remotely or what did that look like in comparison? 

Lee-anne: Yeah, I don't know. I don't think so. I think throughout university, I didn't love the research topics that definitely wouldn't have been something I thought I would have done.

And I wanted to be as far away from clinical as possible. I think you could not be more in it now. It's the complete opposite. I think of what I probably would have thought that I would have wanted to do. But I can't imagine doing anything different. I love the area. And yeah, the research is definitely my passion.

It's. Yeah, so varied and so many opportunities and great people that you get to work with as well. Does 

Simona: that mean then if you were Feeling like it was, nowhere that you wanted to be, going back to the raw was nowhere, you didn't want to be anywhere near that. Did you ever then feel like you shouldn't have been there when you did go back at all, at any stage?

Lee-anne: I don't think so, no. I think because I'd moved around [00:42:00] since then and I'd grown a bit of a tougher shell, I think. I wasn't the same young anxious girl that I was when I left. I think. That helped. I knew that I was capable of things. And everyone has their difficult days that, certain conversations can make you feel very small.

And I know we've spoken a little bit about imposter syndrome, but it's definitely always there. But I think the more you do, the more exposed you expose yourself to different things, the more comfortable you get being outside of your comfort zone. 

Simona: Yeah. Have you, has imposter syndrome come up at particular times for you or is it just something that just bubbles away that you manage?

Lee-anne: Yeah, I think writing investigator grants or getting the results back when you don't get them, the rejections, I think, definitely. Yeah. Makes you think, why haven't I done more? And you just can't do more. I think particularly when you're doing it as a clinician, you have these pools, you've got, two email accounts and all the admin that comes with [00:43:00] having two different roles, switching mindsets and trying to fit everything in.

And I also have struggled a lot. I got long COVID from getting COVID in the end of 2021. And it's something that working from home helps, but I do find it difficult to do as much as I used to do. And that has come with its own, personal and health struggles. Yeah, so I think, yeah, you can always think you can do more, but you have to have a life and you have to not burn out and all of these other things.

Yeah, the imposter syndrome definitely comes up when You're working on those sorts of applications and really diving into what you could have done more. I think. 

Simona: Absolutely. So then to flip it on more of a positive note, what's going through the struggles and having to learn about how you work now post with having had long COVID what's something that you're really proud of that you've learned about yourself then during this period?

Lee-anne: I think that seeing my research team [00:44:00] grow and succeed, I think even when I've had to take a little bit more of a step back, I think means that I've set things up in a nice way and I think I'm still available when support. So yeah, I think it shows a little bit maybe about how I've worked with the right people or not selected, but, encourage the right people to engage in research that have been meant that I aren't needed as much day to day in that space.

And I think that's just part of moving through the research career pathway is letting go. Being there all the time and having faith in your team to be able to do that and come to you when they need support. 

Simona: Yeah, absolutely. That was definitely something that was really hard to do. And it sounds like you're doing a really good job of it.

And if you've got systems in place, even if you've been forced to put them in there it's probably a really good way to test it, so yeah well done. So my closing questions for everyone on the podcast are the same three questions. So who do you learn the [00:45:00] most from about leadership?

Lee-anne: Yeah I don't think it's a one person. I think I learned little bits from all different sorts of people and not necessarily people in the research field. I it's any sort of leadership style podcasts, books students. Yeah, I think I'm quite an internal reflector. And so I think that you would adapt to different scenarios and learn as you go along.

Simona: I love that. Yep. Being open minded is so important. What are you grateful for that being a leader has provided? 

Lee-anne: I really think it is seeing your team flourish. And seeing those like little wins even. So a lot of my work is outside of my, my students or my research team and supporting clinicians to do research.

And that's something that I've spent a lot of time doing over the last few years, maybe to the detriment of My research career from an impact perspective, but I get so much joy seeing, I went overseas [00:46:00] to a European conference with one of our dieticians who'd done her first study that's now had to put two papers out of it, but seeing her present in Vienna and just the joy and the like, Personal satisfaction that, that they get out of that is really enjoyable.

And even I've got a PhD student who's just come on board, who's been working as a physiotherapist for 20 years at the Royal Adelaide, and still thinks that she's not good enough to do a PhD in the area that she's an brilliant expert in and yeah, supporting people to put themselves out there, to, to work.

To achieve and get better. I really enjoy. 

Simona: Very cool. I love that. And what would you want to achieve to feel like a successful leader? 

Lee-anne: Yeah, I think I've never thought too far ahead. I don't see myself in 20 years or 10 years or anything like that. I think for me, success is. Having the people underneath you achieve their goals and being successful, however you define that [00:47:00] themselves.

And I think always going back to why I started the PhD in the first place, it's giving clinicians at the bedside the evidence to, to practice, to make their patients better. I think that's really what it all comes down to. 

Simona: Awesome. That's the end of our questions. Lee-anne, thank you so much for being on the lead candidate.

Lee-anne: Great. Thanks so much for having me. I really enjoyed it.