158 - Becky Love-Kerley Pt 2: Every Single Day is a School Day

Continue with operating theatre nurse, embedded learning facilitator, and Birmingham and Somerset, United Kingdom native Honoured Guest Becky Love-Kerley as she chats about how board gaming fosters and hones real life skills, how a surgery she had at a young age helped her chose nursing, feeling like she was never doing enough in nursing school, the importance of learning about learning, having that doubting voice in your head as a nurse leader, imposter syndrome, and more!

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Transcript

0:01

uh Thank you, Becky, for entertaining our little shenanigans and second episode traditions. So uh we'll just dive right in because this leads to the natural question, what the heck was that introduction about? uh What kind of hobbies do you entertain when you are not working as a nurse? Well, I am a huge board gamer. My husband and I, with a core of close friends, but expanding group of friends, we see each other really regularly and we meet up and play board games. And it is really fun, but the more I play, the more sort of real world benefits I can see from it. think something that I've learned is it's a really safe space to practice those things like confrontation, disagreement, and that kind of self-preservation and sort of necessary selfishness. which have been areas of my life that I've struggled with. em think imposter syndrome has been a real huge sort of thing I've had to carry in my life and sort of people pleasing behaviours. uh It's only really been in the last five years that I've begun to recognise this properly and see how it's shaped my behaviours and choices. And I'm sure many of your listeners have that kind of thing. I'm sorry to say, but I think it's probably true. For those that obviously you can't see I'm sitting here nodding myself because not only have we discussed this on the podcast I've been very open about feeling those things myself, which is why we want to dive into that topic But we do want to kind of inform that discussion ah And so at first let's what I kind of want to know Becky We're gonna take it from the kind of the beginning here this episode You know if we have time for the imposter syndrome great, otherwise, we'll save that for part three But before we dive into that, I want to know about your trajectory. So first of all, the all important question of why nursing? Why did you choose nursing? Well, um I worked in a shop previously and really enjoyed it. It was kind of a sold incense and crystals and crazy baggy trousers and that kind of stuff, which is really fun. And I loved the kind of the personalities that would come in and chatting to people. Yes, the clientele. Yes. um But then when I was 18, I had acute gallstone pancreatitis. which I would not recommend one out of five stars. It is not pleasant. So that resulted at first with a laparoscopic cholecystectomy to remove my gallbladder. But then, because I like to be special, I developed complications, which resulted in a laparotomy and gastrostomy to drain the cyst into my stomach, meaning I had to be fed by a jejunostomy tube for quite some while after I healed. Yeah. So that was a really big old thing to happen when you're 18. big old thing to happen at any age I think to be honest. feel like that's not the way you should want to stand out, absolutely. This is not a, it's nice to be just boring when you're having an operation. I didn't want to be exciting at all. And I remember one of the lovely nurses said to me, you should think about becoming a nurse. And I remember thinking, why on earth would anybody want to do this job? It's, it just looks awful. And really strangely on my first night out, my very first night out with my friends was like a celebratory hooray. You made it through. You lost three stone, which is quite a few pounds in American, but yeah, but you're here. Yeah, we all went out and I ran into the surgical team in one of the pubs we went to and they were all so overjoyed to see me looking healthy and well. Yeah, and I guess it just made me think, actually, do you know what? That must be really, really rewarding to help someone get better. um I think I was probably quite memorable because I was only 18 and their sort of regular client group was maybe 70, 80 year old people. Yeah, so a few years later I applied to um university and the rest is history really. So at that time there was a very specific university application system. So now we have UCAS. I can't remember what the acronym is but that's where everybody applies to go to university and that's how you apply to do nursing now but back when I did it, back in the day because I'm so old, it was called NMASS which was specifically for nursing so I applied. I had absolutely no healthcare experience previous to that. I had a lovely personal statement written for me by a college, further education college teacher who was my music teacher um and he wrote such a lovely thing. And I got accepted and great. um Back then, you got paid a bursary of, I think it was about £520 a month. So your tuition fees were paid for by the NHS. um And you do your 37 and a half hours of uh student work. Half of it is placement, half of it was theory in university. And yeah, but it was quite difficult. You couldn't apply for a normal um student loans and it was quite difficult to do a part-time job because you would be working 37 and half hours so if your placement, say, worked Saturdays which most nursing placements do, you wouldn't be able to do a regular Saturday job. weren't able to say, I'm sorry I can't shadow my mentor on Saturdays because I work. That was not a thing. So yeah, I remember having £520 a month back in 2006 which you could live off. It was okay and I lived in a shared house with person who is now my husband, who wasn't my husband then, and a friend. So yeah, I had like a university lifestyle, but in my hometown without going anywhere. And again, forgive me if you, because I think you mentioned it in the last episode, maybe even just recently here, but just as a summation, how long is, so you went the diploma route. ah so how, three years, thank you. That's what I was, what was the length of time there? And if you wanted to go back for degree or decided to go back, you said there's like an additional six months, is that correct? I don't, you could do the very final, I think it's maybe one, two or perhaps three modules that you could do to top up your diploma to a degree. I think you could do that while you were still working. So doing your three year nursing course, be that diploma or degree, like I they don't offer a diploma anymore, that would entitle you to be a registrant on the Nursing and Midwifery Council, the NMC, and they are our governing body. So you pay £120 a year to be on the NMC register. You may not work as a nurse unless you're on the register. it's not really like they're not protecting you. They are protecting the public from you, which is kind of a weird way to think. So em people would still be encouraged to have a union and all those sorts of things. So the NMC are not working for you. They are the public's kind of... Yeah, they are the registering body. Yeah, similar to our boards of nursing here, providing our licenses and again, basically protecting the public, which I'd love to say that every nurse has got a heart of gold and ready to do all the things, you know what I mean? Like you, like me, like the many nurses I've worked with. Every once in a while, bad apple gets through though, and those are the ones you wanna be protected from. yeah, and the NMC are very, very transparent. So every single case that goes through the NMC is documented and can be looked at. So you can see every single thing that someone is struck off or given. I don't want to say restriction orders, but restrict their practices restricted. So you can this is already clearly documented and you can check anybody's anybody's name. You can type it in on the NMC to see if they are registered. Same here, you can look up any individual, look at their license, see if there's been any what they call actions taken against that license. If those are still, you know, I if they're active, if they've been remediated, all the things. I've never dove too deeply into that. But it sounds like it's a very another similar process by which the public can hopefully have some trust in the people who are taking care of you. yeah, absolutely. And I loved my nursing time at nursing. I say nursing school, that makes it easier for us, it? I loved it. exactly where I was going next. I'm like, talk to us about how that was for you personally. Now, not the nuts and bolts, but yeah. I really loved it. feel like I never felt like I was doing enough, um which is a common theme for me, think. I think age has helped now, but I think having the courage to be open when you don't know what the answer is, really key. Just say you don't know. And I think I've always been quite happy with not looking like I've got all the answers, but I never felt like I was doing enough. All of my friends were always staying late after. classes to go to the library to do their stuff and I was jetting home, was as soon as that bell went off, well there was no bell but I was out of there. em Yeah I just remember feeling like they're gonna find me out, I'm not doing the stuff I should be doing and that was absolutely not em shown in marks and grades, I have always been quite good at achieving a high grade. but that never, that actually made it worse. That made me feel like I'm even pulling the wool over their eyes. my gosh, I'm not doing enough. I don't know the answers to this. Why is everyone else working all the time and I'm not? And at some point someone's gonna know, someone's gonna realise and I'm gonna be shown as a fraud. And that's always been the way. um I think. all my academic stuff and all education stuff has been the same. I'd always try to get home as soon as I could after classes. I'd leave writing essays till the very last second. Literally, the amount of times I've been up until 5 or 6am writing essays on the day they were due. It's just awful. Just awful. And yeah, I'd usually get really good grades and that only fed into my feelings that at some point I'm going to get found out I'm not putting the expected time or effort in. And looking back, I've just realised that I was putting in the same amount of effort. I was just doing mine in a super concentrated kind of chunk. And I need that impending deadline to be able to make myself actually apply myself and get cracking. And it's interesting that years later, I mentioned that to a counsellor and they were really helpful. And they said, if you were in a group of people who'd all been tasked from getting from place A to place B and you got there first, would you think that you were cheated? And of course you wouldn't, you just realised that you'd read the map quicker than anybody else. And that had a massive profound effect on me. And it just made me realise that we've all got different strengths and weaknesses and understanding those character traits in yourself can really help you, help harness your strengths and minimise those weaknesses. And you know, the time I started an essay six weeks early, because that was the proper way to do it and this is how I should be doing it. That was the lowest mark I ever got, ever, ever, ever, because I had done it properly and I'd sat there and I just need that impending deadline. And don't get me wrong, I'm not suggesting that you leave everything to the last minute. That is a risky, risky business because sometimes life can get in the way as it does. But just don't try and force yourself to work in the same way that everybody else does just because it's the correct way. that really made a difference to me, that counsellor saying that. So I think if anybody else gets anything from that, good, because it took me a long time to get there. That is a huge, huge point to be made because comparison, right, is the thief of joy. There's so many cliches, statements about that, but you look at others, and I remember being sitting in nursing school when I was taking my associate's degree those first two years, and we're sitting there taking our exams, and there were always those three or four students who were done in insanely quick amount of time. And I was not one of those. Like you, Becky, I feel like we're kindred spirits on many levels. one of which being I could take advantage of the fact that I was a fairly good student. And in high school, I can't tell you how many all-nighters I pulled or, you know, it's that exact same thing. You just are like, ah, I'm good. I'll procrastinate, I'll procrastinate. it's due tomorrow. All right, let's get this done. And still get good grades. And I made people sick. So fast forward to nursing school. And I'm sitting there and it's the same, so three or four people are getting up, they're done with the exam. And I'm like, I don't even know if I'm halfway through. And I'm just going, what? What am I doing wrong? You know what mean? Like what is wrong with me that I can't get done as quickly as some of those people? Well, you know, everybody's different and you can make yourself, I've said it before, you can make yourself feel better by comparing down and you can make yourself feel worse by comparing quote unquote up. But the truth of the matter is it's not a hierarchy, it's just a difference, right? Yeah. if there's one bit of advice I could give to anybody is A, you know, just realise your strengths and your method. Maybe trust the process might be a little bit, maybe sometimes don't trust the process. Don't sit and wait till 5am, that's not good, but that was the only way I could do it. But I think taking a tiny bit of your very precious time to learn about learning. one ever teaches you how to revise or... the best styles of this and that and the other. The Agile Education course I did on becoming an elf, an embedded learning facilitator, um it's been really, really useful to that. How much angst and discomfort I have felt forcing myself to work in a different way. um And it felt like I cheated my way through the whole thing because I didn't deserve to be there just because my brain worked differently. um Yeah, that's just... Nobody talks about learning. We all go to school and we all have to learn and do the things. you just maybe it's maybe it's different around the world. But in the UK, there's no learning about learning because we assume it's just this kind of, I don't know, osmotic thing. The information is out there and it just, you know, gets sucked into our brains. But that isn't that isn't how it is. That isn't how it is. Yeah, absolutely. get those hypnosis tapes playing underneath your pillow at night, you can suddenly learn all your anatomy and physiology. Sorted. Perfect. my goodness. Well, going to piggyback off this for a minute because in the interest of transparency, mean, you in my, you keep referring yourself as being a really old nurse. And if you're you're if you're really old, I'm I'm positively ancient. But in my nearly 20 years, know, I'm close to selling, by the time this airs, will be officially 19 years old, my nursing career. And so therefore I'm a charge nurse a lot on the floor, things of that nature. And you do all these extra roles. But in that charge, like I literally was charge nurse yesterday. And I still, at my age, which is whatever it is, and with my experience, I still have that voice. that every once in you know, I get done near the end of shift and man, it was a banger of a shift. were, you know, it was, ooh, the call light did not stop for the last four and a half hours of shift. And sometimes it's quiet, sometimes it's not. That day yesterday was not. And so we were all, I had patients as charged. We try not to do that. I have a flex nurse. They're very flexible. They typically won't take an assignment until they get discharges out the door. They had an assignment early on and we all were just, and we worked very well as a team. But. you reach near the end of shift, I'm putting an assignment together approximately 30 minutes before the night shift charge is coming on, before we're to do our report. And in the back of my head, I still have the, gosh, and this is someone who's brand new to night shift charge role, who is a wonderful human being, and in my mind, I'm still like, gosh, I don't want her to think I don't have my stuff together. You know what I mean? Like, I, what you mean. know exactly what you mean. In my role now, it's not particularly a leadership role, but we've had a huge amount of sickness lately and unprecedented levels of sickness. They say this every year, it's the same every year. It's unprecedented from... Yeah, yeah. So some of the other team leaders, the other sort of band of six roles weren't there. So I'm doing quite a lot more now of... sort of leading the unit, suppose, which is a general theatre unit of five theatres. And most of time, I'm just sitting there thinking, okay, gosh, what do we do next? So I'm just sitting here, do I wait for the thing? What you actually realise is that when it was a new guy who just started, who's a fantastic em ODP, I actually had to do clinical for a little while and I felt the pressure because I thought I've not done clinical for a little bit, not anaesthetics anyway. And I said to him, oh, I won't mention his name. I'm relying on you today, dude, because you're going to have to. And he was just, he thought I was joking. And he was like, what can I have to tell you? And I just thought he sees me as a person that knows it all. Oh, blimey. This is a big responsibility now. And then, yeah, when you're coordinating the unit, I think you get better at it because you get better at predicting, I don't know, not predicting what's going to happen, but sniffing the warning signs. That kind of, we don't do. at the end of the bedograms because we don't have people at the end of the bed anymore in theatre, but you get that kind of spidey sense. And I remember nurses telling me about this through my training, you'll develop this spidey sense. And I just thought, shut up. What are you talking about? I want to learn this now. Give me the information to learn. But you don't learn it. That is an osmotic thing, isn't it? I think that you just acquire. And unfortunately, you can't fast track it. There is no fast track knowledge. you just have to experience it. And I think that is something that I definitely felt throughout when I very first qualified and I was in the same theatre that I had been a student in. So was really helpful that everyone around me knew my experience level, knew what I had done and what I hadn't done yet. But I used to have to kind of talk myself down. I remember there's a particular way that you wash your hands in theatre and I'm sure it's the same around the world. And I'd be doing my six step A-lift technique, you know, washing my hands in a certain way, thinking, right, just breathe. you know what they're going to ask you for, this happened. And that took about a year for me not to do that. But I didn't do it out loud, so nobody knew I was doing it, fortunately. Otherwise, they'd probably think you're kind of crazy woman. But that feeling of being an imposter, I shouldn't really be here. I don't think it's to do with my upbringing, but maybe it is because everything generally is, isn't it? I'm the first person in my entire family to go to university and do further education. which everybody was incredibly proud of, which is lovely and I was very proud of, but there is still this little point in the back of my mind that tells me, you're from a, we say council estate in the UK, so that is like an area of social housing. You're from a council estate in Leicester, hobnobbing with all of these exceptionally incredibly intelligent people like surgeons. What are you doing here? This is not. This is not where you're meant to be. This is ridiculous. You don't belong here. And then it's almost a kind of inverse snobbery. So I have a real thing with elitism. can't bear that sort of, I don't know, attitude that some people shouldn't. Class is still a massive thing. I say class. Class is a massive thing in the UK. Where I'm from in the UK, we'd say class, which shows that I'm not high class, I suppose. So the thing is in my accent. So I'm sure I sound very... receive pronunciation British to you guys but em my accent here, if I'm with someone else from the Midlands, will be very quickly re-Midlandised which is a big factor I think in social class. maybe it's to do with that, maybe it had nothing to do with that and I just felt like I haven't done enough to be here. Other people that are here know far more than me. What am I going to do if I'm out of my comfort zone? uh how am going to deal with that? And I think the only thing that I found myself doing was just being open that I didn't know. That's always been my way of dealing with it. Don't try and veneer it, don't try and pretend. And I think especially in surgery, in theatre, you cannot pretend that you know so much is taken on trust, that you're giving the right suture to the surgeon, that you're giving the right, I don't know, prepared thing, prepared bit of kit. you can't pretend that you've done something if you haven't because it could be life or death. There could be a patient safety implication and you just cannot mess with that. So I think I've always been happy to accept... Well, no, I haven't always been happy to say it that I didn't know, but I have taught myself, I have grown acclimatised enough to say, I'm not, I don't know the answer to this. I don't know what this should be. And my experience is people are far more happy to hear that. than to think that you are fudging your way along and you don't really know. Hmm. I I mean I'm just listening to you and you know what mean? I guarantee listeners are going oh my gosh. That's me You know what mean? I I know that feeling everyone knows that you feeling so I you know you talk about maybe it's upbringing Maybe it's class. Maybe it's your you know, it's part nature partner. Sure Well, whatever you want to however you want to summarize it but the truth of the matter is I feel like it's mostly a universal experience Because here I am a quote unquote across the pond thousands of miles away from you and not the first in my family to go on to pursue education. And yet, you still have those feelings of, you know, I start off in pediatric oncology, taking care of kids who are fighting cancer. And, oh, and I loved it. And yet, and yet, when you're there, you know, it's like, again, comparison kills. And I just, couldn't wait to be the more, you know, I can't wait till I'm... at least a couple years and then I don't have that knot in my stomach when I first come to work. I can't wait until I'm five years down the road and I have more answers than needing to search for the answers and yet you're always kicking that can down the road I feel like. At no point in my career can I say that I've been like, you know what, I've got this. You know what I mean? And it's weird. Yes! anybody that's saying, anyone that's trying to project, I know everything about everything, do not trust them. They are secretly scared that they're going to be called out just the same as everybody else. Do not trust them as far as you can throw them because they have the fear inside, I think. I remember the day that I saw myself in the list coordinating box and I wasn't in the junior box, whatever you want to say. And I just thought, oh, but I was absolutely, you know, I am capable enough of doing it. That was fine. I didn't have that kind of, oh, the responsibility is theirs. I'm happy to assist them and very helpful, but no, my name's in the coordinating. Oh, gosh. Right. Let's try not mess this up. But my way of tackling that was always, right gang, how are we going to sort this out? Who's going to broaden it? Resolve yourself of... all of the responsibility because delegation is 100 % a nursing skill I think that everybody needs to develop and it definitely wasn't something that came easily to me at all. A, I don't like asking other people to do things because I feel well why can't you do it yourself? You that sort of feeling of are you asking me to do something that you don't want to do? So I think it's really important whatever level of nurse that you become get the mop and bucket out and mop that floor. that is just for you to do. You are not too posh to wash, you should be doing everything. And I think your junior colleagues appreciate that because it makes them feel that all of the maybe more menial jobs that they're doing are just as important and you're not asking them to do anything that you wouldn't be prepared to do yourself. Mm-hmm. Oh, that's such a good, I could talk for another 20 minutes on that subject alone. Because again, we're not above anything that's required of us. You know what I mean? It's not here, know, every once in you'll get a nurse. Not that I've worked with, but you know, they're like, well, I'm gonna let the nursing assistant do that. They're the ones that turn, they're the ones that take the vitals, they're the one, no, you're a nurse. You do it. We just happen to have assistants who can help us, you know. um But on that point of imposter syndrome, and I don't necessarily want to put a nice tidy bow on it. If there's more to talk about, let's talk about it. But the other thing that comes to mind while you're talking is that while we're in the midst of doing our jobs, and that is whether you're a new nurse taking care of a singular patient or a patient assignment, or if you're now just burgeoning onto the charge nurse scene or the leader nurse and you're responsible for X number of theaters or unit or whatever the case may be, you have to have kind of a top down view. all of those things, you're in the right place when you feel like you're not in the right place. Because it's that false confidence that's like, no, can, you, I guarantee you, if you have not worked with someone like this, you will. But there will be someone that comes along the line that's like, yep, no, I've got this, and they have zero questions. And I've said it before, and I'll say it again, new hires, nursing students, The times we nurses get nervous about you are when you stop asking questions. 100 % Every single day is a school day and if it's not you've not you've not learned anything that day You need to find something you didn't know 100 % and I remember having a student once who was a typical person you couldn't tell her anything Oh, yeah, no, I already knew that and I thought you didn't I know why you're saying that to me because you don't want me to think that you That you didn't know something but when everything I'm telling you you're then telling me. Oh, yeah. Yeah, I knew that I was gonna do that in a minute I know why you're saying it. I totally know why you're saying it because you want to appear. You don't want me to think, why didn't you do this thing? But it just, it's very difficult. It's really difficult. And it makes me not trust you. It makes me not trust that you do know what's coming next because you're trying so hard to pretend that you did and every single day is learning. And we never gonna know everything about something ever, ever, ever. Even, even as I even a surgeon like they're any better than anybody else, but. You know, anatomy changes every day with stuff. Nothing is ever the same. You've got to be open to something being different and it changing because it always will. And if you're so, so structured into this, then this, then this, then you'll be completely thrown when invariably something does come along to mix that up. So I think the... Yeah, fine, have your little, I mean, I'm one for having little flow charts in my mind and little lists. I love all of that. But the biggest caveat has always got to be, this is a dynamic situation. Stuff can change at any given second, and it will because we're all humans and we're looking after humans and humans don't conform to a big list, unfortunately. Oddly enough. And yes, even in anatomical and physiological standpoints, yes, we're all very similar. And yet, you have people with missing organs or things are flipped or whatever. We're all our own unique human being and I love that. I love that you, and I think that's a great way to summarize it. Heck, it's the title of your episode, I think. Every day's a school day. You get to learn. And if you don't, open yourself up to that. And if you are above that, your career will die. Or people will just flock away from you and you'll be an island under yourself and you don't want that to happen. It is really difficult delegating though. Making that transition from being a student or being someone junior, there's a huge kind of protection that you can use. Oh, I'm only new. I'm still a third year or whatever. And it's hard to let go of that, really hard to let go of that because that's when you feel like, I guess a little bit like when you're learning to drive and then your driving instructor is you've passed your test, you go, here's your licence and then they step out of the car. And now you've got all the pedals yourself and you're thinking, my goodness. And you invariably have those near misses, but it's those near misses that do all of the teaching in my experience anyway. Hopefully you're surrounded by maybe an elf in your department or whatever who can kind of help kind of catch you. But I think spoon feeding someone or being spoon fed doesn't actually translate to embedded learning because you've not had to do the figuring out. That's when I have learned the most myself. especially when I was doing anaesthetics. I had a great mentor. One day she wasn't there, so I was working with somebody else. And they had noticed that I hadn't got something on my airway trolley. They did notice that it was near, so it was okay, but they didn't tell me. And I'm so thankful that they didn't tell me because then when I was asked for whatever it was I hadn't got, I did that kind of internal, my goodness, oh, panic, quick, grab the thing. But I have never forgotten, ever forgotten to set my airway trolley up properly again in the future. If she'd have just told me, Becky, you've missed, I can't remember what it is now. That's terrible. uh You know, your 20 ml syringe to inflate your ET cuff. don't know. I think it actually was a 20 ml syringe to inflate my endothelic tube. There you go. But there was one right next to me, so that was fine. But if she'd have just said, don't forget your syringe. That isn't learning, is it? That's just being prompted. So that absolutely is where the learning comes. And there is no hand holding in the definition of the respect that someone will be there to mop up your messes and to, you know, bring you along. But that does bring me to what I think we're going to lead into for a, yes, you're hearing it here first, third episode of the Becky Experience. There's that self-depreciation. I knew it was coming. I knew it was coming. No, not waffling at all. syndrome. Guess what, neither of us do. So we're just gonna be two people who don't deserve to be here to continue to lead you, the listener, in our wonderful conversation. But no, that's a great stepping off point for episode three, and that's where I kinda wanna bring it back around to. And that is, so there's no handholding. So then what the heck is preceptorship? So let's dive into that in the third episode. We'll finish up the Becky experience. And Becky, you game? You ready to go? All right, you guys don't miss part C coming up. first three-parter in quite a while.