Learning resilience through the NIHR Advanced Leadership Programme (ALP)

The Advanced Leadership Programme (ALP) was created by the National Institute for Health and Care Research (NIHR) Clinical Research Network to build a national network of clinical research delivery leaders with a strong emphasis on collaboration with peers, mentors and leaders.

ALP alumni were invited to join one of the Communities of Practice, which were set up to focus on the key areas of learning from the programme: resilience, digital, boundary spanning, authentic leadership.

Jessicca Graysmark, Emma Barbon, Rena Truscott and Julie Foxton are members of the ‘resilience’ Community of Practice. They tell us how they have become resilient and how they help colleagues to be resilient themselves.

Jessica’s story: Creating our own Island of Sanity

A group of four of us met and quickly established that we wanted to help our colleagues. Since COVID-19 our research workforce has delivered the impossible in ways which we didn’t know were possible and we knew this had taken its toll. The question was how - how could we support our colleagues build their resilience when most of us were running on empty?

During our first Community of Practice meeting, Julie asked me where I get my energy and motivation from and I said “others”, but I had been working from home for months without daily contact with a wider team. Then the penny dropped!
Our theme to explore was “resilience” and we were keen to support colleagues to improve theirs. Little did we know just by going through this process we were actually improving our own resilience. Over the few meetings we shared experiences, ideas and encouraged each other with our endeavours.

I would encourage everyone to create their own Island of Sanity; a safe place where you can speak freely with colleagues and friends, free from politics and judgement, where you can reflect upon any current challenges, thoughts or feelings.

Emma’s story: Sharing is Caring

The ALP has made a huge impact on me as a leader, I now look and approach things in a completely different way. It's about having vision and preempting things along the way. During the course we explored many aspects of leadership; the different qualities of what makes a good leader, teams, personalities, values and beliefs and how to create networks and connections.

Networking has been one of the most beneficial outcomes from the programme. Our cohort (2019 to 2021) created a WhatsApp group at our first meeting and it continues today. It provides a support and advisory network where we can be open and honest and is a safe place for us to share information with each other. I find this hugely beneficial. Personally speaking, I feel we wouldn't be able to have these kinds of conversations if it was with people within our own organisations. The WhatsApp group provides support and reassurance that others may be going through the same situation or facing the same challenges. The nature of WhatsApp means we tend to receive immediate answers which is such a benefit when advice or reassurance may be urgently required. Through this group we have come together to share ideas and resources in relation to resilience but also being there for one another and being able to perhaps “off load” to each other in a safe place and for others to provide advice and support.

Throughout this leadership journey I feel privileged to have met many wonderful and inspiring people who have all been so friendly and supportive but the one thing that really stands out is the quality of sharing.

Rena’s story: Activity outside of work helps to build resilience

As part of the group, there was a general consensus that most people are having to build and draw on their resilience due to challenging work environments, compounded by the impact of COVID-19. It was felt that many people feel ‘stress’ and being ‘busy/overstretched’ is an accepted, normal way of working. Individuals who are struggling, are taking it as a personal inability to manage things - despite trusts and organisations encouraging and promoting a culture of wellbeing and looking after oneself.

We felt it important that as a starting point, people should feel ‘safe’ and able to talk about how they are feeling. This would enable affirmation of where you are personally but also identification and acknowledgement of the working difficulties. We have all found our ‘safe space/island of sanity’ within this group as it is outside of our individual organisations. But we are all part of the NIHR family so we have a shared understanding.

It was agreed that we would all share our personal experiences of what resilience means to us individually. We hope by doing this we are reaching out to our colleagues in the network to highlight that It’s ok to talk and share. Hopefully, our experiences may help others.

Personally, I have, for the last 10 years effectively been working day-to-day as a solo entity, being the only permanent member of the research team within our organisation. Year-on-year, I have continued to build up a portfolio through engagement of clinical staff and opportunistic use of resources. However, I was taking on more and more studies and working over-capacity, thinking in some way I was not doing enough. Despite being supported on a personal level, listened to and acknowledged, there did not seem to be a way to change the service situation.

Then COVID-19 hit! At first this presented an all-consuming, positive challenge and I was linked up with my NIHR colleagues in Communities of Practice around the region so we could keep informed about Urgent Public Health studies. However, after doing a huge piece of work, collaborating with the local acute trust, to get a large COVID-19 study up and running, we were told that unfortunately we were unable to be involved in the study.

So what did I do? Feeling utterly shattered, I focused my energies outside of work and onto building my resilience. I increased my physical activity and luckily living in the countryside I was able to go out walking in nature during the COVID restrictions. I started yoga and have continued doing it daily since the middle of 2020. I took pleasure in small achievements, such as repairing an old toaster. I did jigsaw puzzles and made sure I kept in contact with friends. Work-wise, this helped me to find some headspace to step back a little. It helped me to see what was really important, what I value, like/dislike about work, and what I want from work, so that I can once again give my best. I realised I needed, more than ever, to be part of a team and have regular contact with patients and deliver care.

So, timing was on my side and my Occupational Therapy dream job in the community came up. I applied and was offered a full-time job. But, at this point I still wasn’t sure if I could leave research behind so I asked and was given the opportunity to work two days a week from November 2020 and I have continued with this split role. The roles have complimented each other well.

For me, although a daily challenge as I haven’t worked in this role for more than five years, it has given me the boost I needed, both personally and professionally. Sadly, I will be leaving the Community Therapy Team at the end of December, however this is for a positive reason. With my positive mindset and refreshed enthusiasm, I have subsequently been able to capitalise on an opportunity within research and am now in a position of having built a team of four since March this year and enjoying the challenge of being part of and leading a team. It’s been a very long ride, but finally it’s happening.

Julie’s story: ALP alumni are a great source of support

I have been a nurse for over forty years now. I have worked in research for the last fifteen years, as a front line research delivery manager and more recently as a training coordinator, delivering the training programmes that enable researchers to do the research.

I completed the ALP in the first cohort back in 2018/9. I found the group support and networking to be one of the greatest strengths of the programme. I found this to be one of the main mechanisms for my own resilience that I carry with me today. I needed to develop my resilience and bolster my coping mechanisms as during my time on the ALP, my husband suffered a stroke and my father died. Still, you carry on and learn from experiences and take that learning and support with you.

However, nothing can prepare you for the advent of a pandemic. It has been one of the strangest of times for us all to experience.

Resilience has been required in buckets. Or spades.

For the vast majority of us we have managed throughout the pandemic. We've found comfort in our shared experience and have felt supported. We are all individuals and will have different responses to different situations. How we cope with those situations will vary from person to person and we will have developed different coping strategies throughout our lifetime. Yes, we can learn to become more resilient.

We are all aware of the stories in the media of how health care staff have been exposed to huge stresses and traumas during the pandemic. There are no quick answers to these distressing experiences.

My own personal experience during COVID was that I was redeployed to the frontline to help with Urgent Public Health studies and then I was redeployed to work on the vaccine studies. I was grateful to be ‘useful’ during the pandemic and found that going back into clinical settings was a comfort for me - even though it was quite stressful at times. The vaccine studies were a joy to work on as it almost felt ‘normal’ being back in a clinical environment again, albeit wrapped in plastic and masks.

So what have I learnt? I don't have all the answers. I have helped and supported colleagues to develop resilience training resources and information packs. I have trawled through a great deal of information on what you can do and perhaps should do. However, this is a very individual response and each person will find different ways and mechanisms of coping.

My daughter has been living in Canada for the last three years - all through the pandemic. She has written a blog about her experiences living abroad and being cut off from the support of family and friends. She has three great tips that I would like to share with you:

1. Read about Stoicism. It will help you to feel at ease with being subject to a situation you cannot control and will teach you to be grateful for those things which you still have.

2. Practice mindfulness. Whenever you feel yourself slipping into panicked anxiety, tune into your breath. Listen to the noises around you. Be present.

3. Keep a gratitude journal. Regardless of your day – whether it was good, bad, mundane, or truly terrible – write down three things that you were grateful for. Maybe it was catching up with a friend or enjoying a moment of peace and quiet. Whatever it is, documenting those things for which you are grateful truly helps to put things in perspective, and eventually change your mindset for the better.

Good luck with developing your own strategies and support. We would be delighted if you would share them with us.

• Jessica Graysmark is Assistant Research Delivery Manager at CRN West Midlands.
• Emma Barbon is a nurse and Team Leader for Sussex within the CRN Kent, Surrey and Sussex Research Delivery Team.
• Rena Truscott is Lead Research Practitioner at Livewell Southwest (CRN South West Peninsula).
• Julie Foxton is Workforce Development Training Coordinator at CRN Thames Valley and South Midlands.