I remember my first CSF tap; my hands were shaking – not ideal when you are advancing a needle towards the spinal cord.
If you go a couple of millimetres too far, the needle goes into the spinal cord and it could cause the patient to go into respiratory arrest.
Some things I am happy to try on my own after researching, but this was not one of them.
Subjective versus objective
I remember being told you should feel a “pop” when you are entering the right place, but what does feeling a “pop” actually feel like or mean? This subjectiveness is what made CSF taps so stressful for me.
The advantage I had was that my mentor was there, and removed the subjective “pop” and replaced it with an objective “see fluid”. My mentor knew the risks, but understood the importance of emergency vets knowing how to do CSF taps, as an early diagnosis of meningitis can save a patient’s life.
Mentor’s method
What my mentor did was create a way of teaching CSF taps that minimised risks – by teaching to look to see if you actually “see fluid”.
He said to advance the needle 1mm at a time, then stop and look down the hub and the barrel of the needle, and check for CSF. If you’re in the right spot it comes out within a second or two.
This method may take longer, as you are advancing the needle much more slowly, but it makes the whole process safer as you could objectively know when you are in the right spot.
Experience
If you are a mentor, then you are very experienced. However, it is this experience that means we can lose perspective and forget how difficult some of the things we do actually are.
So, if you are faced with a situation where you have to teach a mentee something with high risks, rather than avoiding teaching it and doing it yourself all the time, consider ways of reducing the risks while teaching it, or teach it in a way that has additional steps that are more objective and make it safer for first-timers.
What high-risk procedure or task have you been taught to perform by a good mentor?
Talk of “silver linings” at a time like this can sometimes sound like a bit of a platitude, and an irritating one at that. After all, having more time to yourself and your hobbies can wear a little thin when that is quite literally all you seem to have to do for days on end.
For the same reason, holidays are only special because they end. Too much “you time” can make you long for the busy days of old. To quote a classic: “Isn’t it ironic, don’t you think?”
This being said, I can honestly say that this weird, once-in-a-lifetime situation has gone a long way in teaching me a truly valuable lesson in something I’ve struggled with for the best part of my academic career: switching off, taking a break and not feeling guilty for it.
No off switch
To some it may sound ridiculous, but I do believe a lot of people in the medical field will empathise with me when I say that, for the longest time, I’ve been guilty of nearly working myself into the ground because I considered taking even a few hours off from studying, a project, whatever it may be, was completely unjustified and a luxury I did not deserve.
This is, of course, a horrible way to go about one’s life. If you never give yourself a chance to stop, smell the roses, and enjoy yourself for a little while, then working productively and effectively just is not achievable long term.
Under the hood
The human brain – and, indeed, the human body itself – is not a machine. It is not programmed for optimum efficiency 100% of the time. We’re more like a dodgy old car that needs a good amount of fuel and a lot of TLC every few miles to keep on chugging.
Not the most attractive analogy, I grant you, but I’m sure you get my meaning.
Before lockdown I would feel guilty for taking a short break from revision, let alone a whole day. This certainly made the first few weeks of self-isolation a challenge as there simply was not the same amount of work to do.
New normal
It took a while to convince myself the lack of productivity wasn’t laziness, but a product of a new and changing world – that everyone else in the world was in the same boat, riding the same crazy currents, doing the best they could.
With this slow epiphany it’s become easier to take time off and to divide my time up into periods of work and play; I think I’ve read more books in the past two months than in the past two years – not textbooks, either, but fiction (I’d forgotten there was such a thing).
Stronger
The staggering of work and downtime has also helped me to find that feeling of a scheduled, regular day that I’ve been searching for since this all began – and I’ve noticed I’m much more engaged with my studies as a result.
I hope that when normality returns (in whatever form that may be), I can remember the lessons this time has taught me and be stronger for them.
Are you used to doing things well, with certain skills coming naturally to you?
Often, when you do come up against something that is more of a struggle, or you have to work harder to accomplish your aim, you then doubt your worth and whether you really are good enough. If something is difficult, then are you not as good as you thought?
Embrace the struggle
A strategy to overcome this persona is to embrace the struggle. The truth is, if you are not experiencing struggle, then you are not growing at all.
When we experience difficult situations, it is a sign we are learning new skills and expanding our knowledge. It is important to remember that struggling at something is not a sign of lack of competence or inability, but just a learning phase.
Leap of faith
You should never wait until you feel confidence to start taking action – confidence and competence will only come through action and taking that leap of faith, so it is about changing your behaviour first.
You are a work in progress, and no one on earth knows everything or is skilled in every walk of life.
Strategies
Do you feel like you have to know everything before you can start a project or take action. Perhaps you are endlessly looking for new certifications or training to improve your skills and knowledge? Maybe you only apply for jobs where you meet every bit of criteria, or you may not speak up or ask a question for fear of looking stupid.
Sometimes this can lead to crippling self-doubt where you are letting opportunities pass you by or you miss the boat.
If you say “I should be able to do this”, this could be another sign of impostor behaviour.
Some strategies exist that could help – although this first one is pretty tough, especially if you have the “I should know” mindset.
1. Get comfortable in learning
The first strategy is to get comfortable in learning when you need to learn. Not before, but at the time, when it is needed. Many people would find this stressful, but it is super time efficient and prevents you learning things that are not needed in the now.
Think to yourself: “I will acquire skills and knowledge when I need them, not just in case I need them.” How much time would that free up?
2. Ask for help
Are you someone who has to accomplish everything solo? Do you feel like a failure if you have to ask for support or help? Perhaps you see vulnerability as a weakness, and that if you ask for help it means you have failed or are not good at what you do?
The main tool for overcoming this line of thinking is remembering that vulnerability does not equal failure. In fact, not asking people for help, support or an opinion robs a colleague of being someone of contribution and value.
Flipping this to another perspective, what could you learn from others? How could you improve what you do by getting another perspective and insight? It could save you considerable money, time and pain down the line, even if its makes you feel weak in the moment.
Asking for help is really empowering, as it means you are allowing someone to shine.
3. Have a ‘trusted other’
One tactic I have found that helps overcome impostor syndrome is to share that feeling with a trusted other – it actually weakens its power over you.
An impostor syndrome is usually made up of secret self-talk and thoughts. Giving it a voice can free you up – plus, often saying it aloud will make you realise its triviality.
Impostor syndrome is that overwhelming feeling you don’t deserve to be where you are. It’s the niggling sense that maybe you’re not as intelligent, creative or talented as you may seem to the outside world.
We all have this little voice in our head – your inner dialogue starts to seed the suspicion that maybe your achievements are down to luck, good timing or just being in the “right place at the right time” – and it is accompanied by the fear that, one day, you’ll be exposed as a fraud; that you’ll be “found out”.
Some common thoughts and feelings associated with impostor syndrome include one-liners, such as:
“I must not fail”
“I’m not good enough”
“I can’t make a mistake”
“I feel like a fake”
And when you do well or achieve something, you say:
“Someone made a mistake”
“It’s all down to luck”
“It’s no big deal”
Sound familiar?
Self-sabotage
If you don’t learn to recognise and understand impostor syndrome for what it is, a danger exists that it can start to spiral into deeper seated feelings of self-doubt, such as fear of success, fear of failure, or even self-sabotage – which is where you are creating obstacles in your daily life that interfere with your long-term goals.
Procrastination can become one of those self-sabotage behaviours. People who suffer from the most extreme forms of impostor syndrome live in constant fear of exposure and rejection, and it creates a feeling of isolation.
So, when does the great hammer of impostor syndrome strike most often? Strangely it’s often when we have achieved something, or in moments of success.
The important thing to realise is that those feelings are completely normal. It would actually be abnormal if we didn’t have impostor moments, as it would mean we were not stretching ourselves out of our comfort zone, trying new things or showing any self-awareness.
Why is this important? Because the actions you take in response to these feelings can either inspire you to work harder, leading to further success and recognition, or they can lead to “downshifting”. This is when you revise your goals down, play small and become less ambitious, which, in turn, prevents you from fulfilling your true potential.
Here are two examples of impostor personas, along with some solutions to overcome them:
1. High expectations
Do you set extremely high expectations for yourself? If you meet 99% of your goals, does that 1% still feel like a failure? Often, any small mistake will make you question your own competence. A couple of strategies can help.
First is developing ways of demonstrating self-compassion – remember you are entitled to make small mistakes occasionally and forgive yourself. Don’t forget to reward yourself for getting the big things right. Focus on the bigger picture and what went right, rather than the small things that didn’t.
Also important here is pushing yourself to act before you feel ready. There is no such thing as “perfect” or “100% flawless”, so learn to accept that and focus on taking action – taking action proves you are not a fraud.
2. Harder, better, faster, stronger
Are you someone who pushes himself or herself to work harder and faster than those around you, to prove you’re not an impostor? Do you feel the need to succeed in all aspects of life – at work, as parents, as partners – and often feel stressed when you are not accomplishing something? Perhaps you struggle to relax or take a break?
The first strategy to overcome this is seeking internal validation – start training yourself to veer away from external validation. As you become more attuned to internal validation and able to nurture your inner confidence that states you’re competent and skilled, you won’t feel that need to push to work harder than everyone else just to prove yourself.
Secondly, call out the lies and the limiting beliefs inside your head about what you need to prove. Give yourself credit for your achievements and brilliance, and think about what other people say about you – your clients, colleagues, friends and family.
It is probably only you who sees the negative, so write down your achievements and the positive feedback from those around you into a positivity journal – and when you are having rubbish days, go back and read through it.
Did either of these relate to you?
Next week’s tip will cover three more impostor personas and solutions.
In a world currently filled with sacrifice and compromise, the cancellation of a week’s EMS over the Easter holidays did not, at first glance, seem like a hardship.
Of course I had been looking forward to my first ever farm-practice placement – especially as only a week or so before I had tried my hand at my very first rectal exam and even understood, with sudden and unexpected glee, what some of those lumps and bumps actually were.
But the idea of a little extra time with the family and a whole additional week to focus on upcoming exams meant that, initially, I was not too disheartened.
What does it mean?
Now we’re several weeks deep into lockdown, with no clear end date on the calendar and firm Government advice to “not expect a return to normality anytime soon”, what does this mean for my friends, colleagues and peers at veterinary school – my unlucky year in particular? The situation is different for each year.
First-year students
Poor freshers have had to miss out on Easter lambing season – an unspoken rite of passage into the vet student community. After all, if you’ve never come home without bodily fluids in your hair, are you really one of us?
Second-year students
Second years are having to postpone pre-clinical EMS, compared to those in their fourth year who are sacrificing what could be termed “the good stuff” – that is, real problems in real practices, suturing, injecting, slicing, dicing and all of that (though maybe not the last one). But hopefully the majority of these students will have managed to gain experience in their respective levels of training over the summer of 2019.
Final-year students
Final years have been somewhat of a priority, and rightly so, with special arrangements being made to ensure they graduate fully qualified and at no more of a disadvantage than those who graduated the year before.
My friends and I
Enter now the third years – the year I myself am a part of.
This year marks a transition for us; a stepping stone from sweeping dung from a variety of sources and essentially stepping back to watch the magic happen, to actually doing the magic – or at least attempting it with a sweaty brow under the watchful eye of several veteran professionals.
It’s a big thing. A big, scary, daunting prospect of a thing, but a thing nonetheless – and, given the uncertainty we’re facing in terms of what the future holds for anything and everything, the question is being opened as to what this means for the next generation of vets.
Abnormal
We’ve been told by many officials not to expect “normality” for some time.
“Normality” in this case meaning “the way we’ve always done things” – crowding together in coffee shops, restaurants, and hospital and practice waiting rooms without a care in the world.
“Virus? What virus?” we would say.
But, although certain establishments can change the way they operate – cafés can upregulate hygiene and waiting rooms can impose distancing restrictions – EMS is another matter entirely.
Impractical
Veterinary practices and animal hospitals are undoubtedly some of the cleanest places in the world – because they have to be – and vets themselves are no strangers to singing Happy Birthday twice before eating their lunch. But opening their doors to one or several new vet students each and every week in the coming months might just not be feasibly possible.
A lot of practices – especially independents – are small compared to their human counterparts, which has never really been a problem for us because, luckily, a lot of animals are also rather small. It does mean, however, that, a lot of the time, the two-metre rule just wouldn’t be practical – even if your only purpose is to stand and observe.
For those still needing to undertake pre-clinical placements, a whole new set of challenges exist, including the willingness of farmers to take on students whose help would not be essential, as viral exposure for them could mean a complete loss of livelihood.
Preclinical conundrum
It is an RCVS requirement for all students to complete a minimum of 12 weeks’ preclinical and 26 weeks’ clinical EMS. However, fourth-year students have already had their mandated clinical minimum halved to a mere 12 weeks.
While other years are currently expected to be able to “make up” any missed placements before graduation, the fact the situation is constantly in flux means the RCVS has admitted further reductions may be needed.
While this would certainly be helpful and take some of the pressure off for those of whom meeting the usual requirements would be an impossible feat, one has to worry how this will affect student confidence in the long run.
Key experiences
There is a reason the RCVS has always asked for a certain amount of EMS, and while the number seems daunting at first, it’s only during (or perhaps after) each placement that you can truly see its value.
Practice makes perfect – but, more than that, it builds confidence. It provides an environment in which mistakes are not life-threatening and are safe to be learned from.
With the loss of these key experiences that have helped shape generation after generation of vet students, it is perhaps inevitable that vet schools will have to adapt even further than they already have to limit the knock-on impact of a scenario we have never had to face before.
I feel the phrase “the show must go on” is going to apply heavily to the student community over the coming months – vet students included.
Universities across the country are moving their teaching and examinations to an online platform, which means that for a lot of young academics, come rain or shine (or, it seems, the apocalypse), we will be working until the bitter end.
In other words, the pubs may be shut, but the textbooks are staying open.
Bitter pill
While it may seem cruel that the rest of life has to grind to a halt while studying and exams carry on (as someone who will shortly be spending her 21st birthday in lockdown, let me just say I know – trust me, I know), it’s especially important for professional courses to carry on as best they can.
As medical students we don’t only learn to pass our exams, but to better equip ourselves for a workplace where our decisions can be the difference between life and death.
I strongly commend the staff who’ve had to work tirelessly behind the scenes to reorchestrate an entire term of teaching in a matter of weeks to make sure our learning doesn’t have to suffer.
Analogue girl in a digital world
Not only are the staff having to adapt, but so are the students. As an analogue girl myself I really do fail my generation’s reputation for being “good at technology”, so I can tell you my own experience of moving to an entirely online learning platform has been… shall we say, interesting?
And while it is nice to have a timetable (and, therefore, a reason to remember what day it is, let alone the date), I thought I would share a few pearls of wisdom for making it through one of the weirdest periods of study any of us is probably ever going to experience – and that’s saying something as we stick our hands in some seriously weird places.
No. 1: Maintain boundaries between work and home
You know how some animals, like cats, have a special place for everything? A place to eat, sleep, wash, defecate etc, while naturally roaming animals such as the horse do not have this talent and will happily poo in their freshly made stall as the heart-broken yard worker looks on in anguish?
Well, for as long as this lockdown lark continues, do NOT be like the horse.
Designating different areas in which to work and unwind will not only give you a feeling of routine, but will also help you work hard and switch off when you need to. Just because you can literally wake up, roll over, do a day’s work and then go back to sleep, does not mean you should.
No. 2: Play to your strengths
One of the few silver linings to come out of the change in learning environments is that it puts you, the student, well and truly in the driver’s seat.
Studying has now become a lot more independent – and while this does mean you have to work to motivate yourself a little harder, it also gives you the power to work in the way that’s best for you.
Everyone learns differently, whether it’s visualisation, reading through articles or breaking up the work into lots of manageable chunks. Find which method works for you and own it.
Just because you’re learning from home now doesn’t mean the whole concept of “uni” has disappeared.
You can no longer talk to your lecturers in person, but, let’s be honest, that was quite intimidating anyway. If you have a question, drop your tutors an email; if you don’t understand the new system and need some help, email or phone up your admin team. They may take a little longer to reply than usual, but you are not alone.
With this in mind, if you’re a person who works best in groups, who said FaceTime had to be all fun and games? Virtual study groups can be a great reason to put on actual clothes, brush your hair and work that little bit harder on your assignments.
No. 4: It’s okay not to be okay
Now, this is the most important one, so I’ll say it again for those at the back: It. Is. Okay. Not To. Be. Okay.
Never in the history of civilised society have we experienced anything exactly like this before. It is confusing, lonely and scary at times, and having to study and revise on top of it all can seem like an impossible task.
If you are struggling, please talk to someone; if you know someone who you think might struggle right now, please reach out to them. The veterinary community has a reputation for appalling mental health, and it is more important than ever before to look out for one another.
If you’re having a low day, it’s okay to take it slow to focus on yourself and start feeling okay again. Draw something, write something, buy yourself that dress you’ve been ogling for the past three months.
Or, if you just feel like curling up on the sofa and watching the entire Lord of The Rings trilogy (the extended editions), back to back, with a litre of ice cream and your favourite onesie… that’s okay, too.
Many of us are spending more time at home at the moment. But don’t turn this into a not-getting-dressed, sitting-on-the-sofa, Netflix and ice cream-eating holiday. Although, please, give yourself a break, too.
Establish and stick to your daily rhythm – get up at the same time, don’t hit the snooze button, get dressed, get ready to tackle the day, set your goals for the day and put in the work. Things may have shifted right now, but routine and keeping a sense of normality in this time of uncertainty will be helpful.
Remember, where you will be in the future is very much dependent on the actions you take today.
Self-care
Physical self-care is important; choosing to fuel your body with healthy food, sleep and exercise each day. But mental self-care is also essential, especially in this global crisis, so make sure you are taking the steps to protect your mind. Don’t be too hard on yourself.
While it is important to stay informed, try to focus your attention on positive things that bring you joy – such as dancing to music, a podcast, cooking, playing with your pets or children, listening to an audio book, or going for a walk.
Also, limit your exposure to things that are not so positive. A prime example is the news – sure, we are in a crisis, but do you need it in front of you 10 hours a day, or every 10 minutes? Could you get an update once or twice a day?
If you only surround yourself with negative content, that is where your mindset will be.
Power of contribution
Ask yourself each morning how you want to act, show up and feel that day.
If you are finding it difficult to motivate yourself because of the uncertainty and anxiety, try to focus on contribution. It is one of the biggest antidotes to fear.
Think about how your actions can help and support others – such as checking in with neighbours and the elderly, using some of your knowledge to teach others in a virtual way, starting community groups, and looking for opportunities to connect and collaborate with others in your field.
People want to know who else is in the trenches with them – and if you have got each other’s back, especially at a time like now, that’s really powerful.
If history has taught us anything, it’s that the worst of times can bring out the best in people – both individually and as a collective. It forces us to think differently and move forward with courage.
All great leadership begins with self-leadership – and now is a prime time for leaders at every level to elevate their thinking and ground themselves in the values that define the leader they aspire to be.
This could be compassionate, calm, courageous… what words embody your ideal leader?
Reflection
First, stop and reflect. It is something we rarely do, but it is exactly what is needed right now. Look back and acknowledge the struggles you have faced in the past – with yourself, your business, or with your family or team.
Maybe it was the loss of a family member, a failed business venture, not getting to vet school, losing your job… Look where you are now – you may have survived and moved forward, or are in the process of bouncing back.
Perhaps at that time, like we face now, it felt like you would never come through it. But you did – and you will.
This, too, will pass.
Competence and confidence
You have demonstrated greatness in the past, so acknowledge those moments of courage in your life and remember how you overcame those situations, as well as the exact steps you took along the way.
How can you use what you did then to help you now? How can you pull confidence and competence from those situations?
Take courageous actions every day. Confidence grows from developing competence – for some, it takes an act of courage to take action, to then help you build competence. This act of courage could be:
enrolling on a course
sitting an assessment
learning something or trying something new
forgiving someone
pushing harder with your fitness
reaching out and asking for help
volunteering
In this together
Rally your team or family around a common purpose. We are all facing a common threat right now – and while we may not be coming together physically, let people around you know we are in this together and will get through this together.
This can build trust and strengthen relationships in ways that can never be done in calmer times.
Think of new ways to connect – a virtual dinner party, an online pub quiz, an internet fitness class, a virtual gallery tour – but use this incredible technology to still connect and collaborate.
As much as we’re having to adapt our lives in so many ways during these strange and uncertain times, I think a lot of us take for granted that our pets will always be so reassuringly consistent.
This is mainly because, while our own lives are currently being turned upside down and inside out, our pets haven’t a clue what’s going on.
During this lockdown, most dogs are probably thrilled to have their owners at home to play with them and give them fuss almost 24/7, but the abruptly shortened walks and lack of pet play dates, on the other hand – maybe not so much.
In their shoes
I think a large part of getting through times like these is not to focus on what you don’t have, but to appreciate what you do. As my university moves to an online platform, I feel so lucky to have a supporting family to come home to, a warm house and good food. Thanks to the modern wonder that is social media, I can at least feel updated and informed when everything is so uncertain and confusing.
By comparison, my cat, for example, is at a slight disadvantage. While she also benefits from home comforts, when it comes to being in the know, she, like the rest of our pets, is in the dark.
To be honest, I quite envy her, and certainly the daily routines of a lot of domestic animals hasn’t changed at all. For more sociable pets like dogs, however, this sudden drawing back from the outside world will obviously be incredibly confusing, as well as frustrating, because they’ve no idea why everything has seemingly changed overnight.
Monkey see monkey do
Despite popular belief for so many years, animals can experience a large array of emotions – from elation and excitement to extreme anxiety – and this is partly because of their amazing ability to pick up what we, their owners, are unwittingly putting down.
If you’ve seen a change in your pets’ behaviour over the past few weeks, do a quick self-inventory of your own. If you spend your days anxious, irritable or melancholy, your pets can pick up on this and act in kind, even if you don’t notice it yourself. They can see it in your body language, tone of voice, even in your level of eye contact.
Of course, all emotions are heightened now – and justifiably so – but if you notice your pet mirroring your mood swings, it might be a good sign you need to be kinder to yourself, for the both of you.
Depending on where you are in the country, your local vets might be closed, running shorter hours or a very long journey away.
In cases of the latter, this might make you worry if your need to take an animal to an appointment is justified, or if you’re in a densely populated area or are/live with an “at-risk” individual, you simply may not be comfortable leaving home to make this journey at all.
No matter your current circumstance, I think it important to confirm that veterinary help, should you need it, is still readily available to you – just perhaps not in the form you’re used to.
Changes
A lot of vets are reducing their opening hours, not just to limit person-to-person interactions, but to make more time available for phone or email consultations.
As of right now, emergency cases are still very much a legitimate reason to travel, and if you are unsure if your pet’s medical need constitutes an emergency, all it takes is a quiet phone call to your local vet for advice.
Incredibly innovative changes have been made to the way practices operate in a staggeringly short space of time to help keep everyone safe so that the health of your pets doesn’t suffer, while brave and compassionate veterinary professionals are still going into work every day to ensure your pets are continued to be cared for.
Basically, what I’m saying is: if in doubt, just call – there will always be someone on the other end of the line, willing and wanting to help.
Give and take
It’s of no doubt that our pets have a greatly positive impact on our mental health. Without even knowing it, they are helping us through some potentially isolating and scary times.
With this in mind, I feel it only fair to return that kindness and take care of them in every way we can.
If we all look out for each other, those with two legs and four, we will all get through this and out the other side.
It is inevitable, during times of crisis, that people will look around for reassurance that everything is going to be okay.
So, think of yourself as an emotional barometer where you set the emotional temperature for those in your team – or your family – and it will give them cues on how to respond.
You’ve got the power…
Whether you want to be a role model or not, we should all try to step into the best version of ourselves as much as possible. Why? Because someone you love or respect is watching.
You don’t need to be in a leadership or management position for this to be relevant – at home you could have family (especially those with young children) who are looking to you for guidance.
How incredible if we could be someone who is powerful and impactful, rather than someone who is dramatic, confused, or negative.
Stay positive
Now, no one is invincible, and everyone needs support. However, if you are able to show up with optimism, empathy and positivity, this will reassure and inspire others to do the same.
Make sure you take time often to review and assess how you are showing up each day, and consider the impact of how your emotions, actions and behaviours spread into your team, family or friends. What could you change for the better?
It is important to set intentions for our behaviour, and reflect on how we did during that moment, day or week.
