Compassion - the Authentic Tea podcast with Susy

Susy is trained as a TimeToThink coach and supervisor and currently shares her expertise as Associate Dean and Coaching Lead for Health Education Yorkshire and Humber.

In addition to her amazing roles in medical education and leadership, Susy is also the founder of Hestia Blankets, her textile studio creating beautiful Harris Tweed blankets.

In her leadership roles, Susy supports doctors and healthcare professionals to be their best selves and do their best work.

In Episode 27 I am joined by Susy. We chat about how the quality of what we do is related to the quality of our thinking. Susy shares her thoughts on the value of coaching to provide protected time to think and how compassionate leadership can allow individuals to thrive.

Rachel: (00:00):

Today I am excited to be chatting with Susy. In her leadership role, Susy supports doctors and healthcare professionals to be their best selves and to do their best work. Susy has trained as a Time to Think coach and supervisor and is currently sharing her expertise as associate dean and coaching lead for health education in Yorkshire and Humber. In addition to these amazing roles in medical education and leadership, Susy is also the founder of Hestia Blankets which is her textile studio creating beautiful Harris Tweed blankets. Welcome, Susy.

Susy: (00:33):

Thank you. Thank you for such a lovely intro, Rachel.

Rachel: (00:36):

I'm so excited to be chatting with you today. I have to confess that we came across each other years and years ago, and you're definitely a part of my own path and journey to where I am today. I am so pleased that you've continued that on particularly in supporting other people in their medical education and their leadership development. Maybe we could start with medical education and what you think about the value of coaching and how you think that organizations particularly within the NHS in the UK but other healthcare organizations as well can use coaching to support doctors to be their best selves.

Susy: (01:17):

First of all, thank you for those kind words. It's been a pleasure and a privilege to walk alongside you for some of your decision-making. With regard to coaching and medical education, well, I would ask you two questions I think like a true coach. The first is, when was the last time that you were able to think to the end of your thoughts? I'll just leave that with you to know. And then the second one is, how do you personally answer a question that doesn't have a Googleable answer?

Susy: (01:54):

When we consider those well, let's think about the first one. Mostly we don't think to the end of our thoughts, so we're not enabled to do so. In other words, we're interrupted and then our thinking stops or is at best stifled. Coaching is protected at Time to Think. That's independently of other people, that's thinking for yourself. I think we can see that medical training is excellent at teaching how to follow guidelines, appraise evidence, look at what's been done before, follow the recommendations. All of which are an essential part of good patient care and safe practice.

Susy: (02:33):

But the things that people struggle with once they get further into their professional responsibilities are not how to implement best practice guidelines. They're about working out how to manage challenging relationships and how to work out who they are in their particular role, what they stand for, and therefore what they stand up for.

Susy: (02:53):

These are also all essential components of good patient care. We know that if we have poorly functioning teams, we know now that patients do worse. So that's huge. That's hugely important for a patient well-being and also staff well-being. And yet this examination of how we behave relationally to each other in the workplace is often neglected or you might get a two-day course just before you reach your CCT.

Susy: (03:20):

So I believe that coaching can provide us the space for people to explore some of this stuff and to work out how they're going to tackle it in advance of having to. That's individual coaching in a one-to-one context. I think action learning sets also provide this sort of space for this level of self-inquiry, and then the group element of support and the sharing of wisdom gets built in. So both of those disciplines do the same thing in supporting medical education.

Rachel: (03:51):

Thank you. The action learning sets that you've just explained is something that I was fortunate to be part of when I was going through my public health training. So maybe you can just tell us a little bit more about what an action learning set looks like and how they can support individuals to problem-solve.

Susy: (04:07):

Yes, I'm a big fan of action learning for the same reason as I am as coaching. In working in healthcare, we sign up for huge responsibility and also the possibility that we might harm someone. Obviously we hope we don't, but that possibility exists nonetheless. People are often anxious about that and for good reason, and that's entirely appropriate. We wouldn't want people to take that anxiety lightly, but where do you put it? Where do you put that uncertainty, that risk?

Susy: (04:40):

It's not sustainable to examine it and fret about it every day, but it's also not okay to deny it or laugh about it or ignore it even though those might all be entirely appropriate coping strategies at times. What is necessary is having spaces in your professional life where you can explore this sort of stuff safely. So some people luck out and get it with their partner or their friendship group. But generally often like in coaching there's another agenda there.

Susy: (05:08):

Usually, one of those people will want you to be okay. They'll want to see your distress and soothe it or mend it or solve it. But what we actually need is people who can listen to us acknowledge to ourselves our deepest concerns and to take them seriously. So if you think you might make a mistake, how are you going to address that? What would safe practice look like? What do you need to do differently? Were your actions appropriate? Rather than someone rushing all over you saying, "Oh, I'm sure you're fine. You're great. You're always great. I'm sure you'll be fine." That doesn't really cut the mustard.

Susy: (05:46):

The things that made action learning sets work are trust and the creation of a safe space where it can be okay to say, "I'm not sure I did that right. I need to explore it." So in practice, what that looks like is this small group of between five and eight people. It's usually a closed group with either a facilitator or some training so they understand the setup of the group and the boundaries, and then it's allocated time. It's about making a professional engagement that goes into the diary, and people would meet every couple of months for a year or something like that

Rachel: (06:19):

From my own experience of that action and inset, it definitely gave me that feeling that I could be open and honest and share. But there was a level of respect for everybody, so everybody was also sharing their deepest thoughts. And we were all doing that in a confidential space where we were able to--Yeah, and I suppose creating those relationships and that environment is so important. Looking back on our interaction and the space that you gave me when you were able to give me coaching sessions, and I know that part of your training has been through the Time to Think approach as a Time to Think coach.

Rachel: (06:57):

I remember you sharing with me the book from Nancy Kline at that point in time, and it was the first time that I had started to ever think like that and to see the value of listening and having that space. Could you explain a little bit more about that approach, the Time to Think approach and maybe a little bit more about how you use that to support some of the doctors and healthcare professionals when you're coaching?

Susy: (07:24):

Well, if we think back to that first question I asked, when was the last time you were able to think to the end of your thoughts? It's a bit of an odd question, isn't it? But it's very challenging. That question itself encourages you to think about the quality and importance of your own thinking in solving your own issues. And in coaching, we say the mind with the problem is also the mind with the solution.

Susy: (07:46):

And that's what Nancy Kline is talking to in her work on the thinking environment, so I would recommend her books to anyone listening who hasn't come across them. She's written several; Time to Think, More Time to Think, and recently The Promise which is all about the principle of non interruption. Basically, her work examines how we do our best thinking. She says the quality of everything we do depends on the quality of the thinking we do first. That is both barn door obvious and genius.

Susy: (08:17):

It feels like it shouldn't need pointing out, and yet it does. So what we're talking about here is creating a space where good, independent thinking arises. And in our context, that's so we can improve patient experience and patient outcomes. When I talk about independent thinking, I'm talking about people understanding that their thoughts have value and also understanding that other people's thoughts are valued too. In other words, that's about listening to understand rather than listening to reply.

Susy: (08:43):

How many of us have been in meetings where we've been talked over? Or perhaps we're the ones talking over, and we're interrupting others. Or in meetings where someone has said what they think very forcefully, and there's been no invitation to hear other's thoughts or explore diversity of thinking. Too often, the meeting environment becomes about ego and power over rather than power to or power with.

Susy: (09:13):

If we have a workplace challenge or we want to deliver better patient care or reform a patient pathway or experience in some way, let's be honest, most of the easy solutions are in place by now. We are very often looking at wicked problems in a VUCA environment. I don't know if your listeners have come across VUCA. It stands for volatility, uncertainty, complexity, and ambiguity. We sometimes talk about it in the context of leadership skills.

Susy: (09:42):

We need a way of addressing these issues which brings new thinking and doesn't fall into the traps of cynicism, skepticism, defeatism, or focus on ego or power and power games. The thinking environment creates it as an elegant and effective way of enabling new thinking to emerge. It pays attention to 10 components that she describes. You can read about them in Time to Think or on her website.

Susy: (10:11):

She would say if any of them are present, the quality of thinking increases. But if all of them are present, you can get much, further, much faster in terms of solving problems. And so far, I'm mainly talking about this in the context of meetings. But it does also apply to coaching and interaction learning. If you come to coaching with a challenge, you've probably been wrestling with it for some time. If there was an easy solution, you would have reached it. So it's much more. Coaching tends to be much more about creating a space where that new thinking can emerge. It's much more about the being than the doing, and the being comes about because of the presence of the 10 components.

Susy: (10:38):

If we return to the idea that people tend to struggle with stuff that isn't about implementing nice guidelines, the things people struggle with, their difficulties, with relationships, challenge to their sense of identity, challenge to their values which then means something at work or in a relationship becomes troubling or problematic, we need the safe spaces for people to think through that stuff and find their own solutions. And in doing so, we then support their sense of reward and engagement in the workplace. And we know that there's impact positively on patient care or patient outcomes and experience. So that's the fantastic win-win.

Rachel: (11:34):

How do you think you've been able to find those safe spaces for yourself through your own career progression?

Susy: (11:42):

What I choose to do is put time in the diary for thinking partnerships. So ever since I trained as a Time to Think coach, I have been in a thinking partnership with another Time to Think coach. This is going back a few years now. We meet every sort of six weeks, four weeks. And that is just immensely productive thinking time. I don't think you have to do it for very long to realize that you get out far more than you put in. P