Adverse Life Reactions

I heard something yesterday that I thought was a great way of framing the need to take control of yourself in situations rather than get caught up in the moment.

If a doctor (or other suitably skilled healthcare professional) tells you that you have responded to a medicine you would probably perceive that as a positive thing. Progress toward your goal. Would you still feel that way if they told you you have reacted to a medicine? Unlikely.

We have a choice to respond to situations and circumstances or react. Reacting is natural and emotional and may even feel good in the moment, but does it serve your underlying purpose? Responding can be a challenge and can feel uncomfortable, but it’s likely that it will serve you much better in the long run.

Mind Control

One of the recurring themes of my learning this week (quite accidentally) has been about focusing your energy on what you have control of. You can put in effort to be the best at something and still never be considered number one, because there are other things that influence that beyond talent/skill/effort etc. Maybe politics, maybe poor taste, maybe just pure luck and good timing. You can choose to get bitter and angry about this, or you can acknowledge it, move on and focus on the things within your sphere of influence. But you can’t change it.

The key learning for me is that you put your effort into bettering yourself, not competing with others. Someone whose primary focus is creating a version of themselves that will enable them to achieve extrinsic affirmation of their value doesn’t end the day feeling fulfilled and grateful about their life. Rather, they’re always looking for something else. What they don’t have yet, where they need to get to. That doesn’t sound like the way to live to me. That sounds like anxiety, or a heart attack waiting to happen.

Saul Bellow wrote “Death is the dark backing that a mirror needs if we are to see anything”. Working in PICU and palliative care taught me in a very real and confronting way that life is for living now. Fulfilment isn’t something to put off until you’ve obtained a certain job title or retired. It’s something to work on today. Fulfilment comes from gratitude and continued growth/learning. That can happen now. It takes practice and effort, sure. But it’s worth the mental discipline.

Control your mind or let others control it for you.

Re-scoping scope

I’ve written before about how the phrase ‘practice to full scope’ confuses me. It still does a bit, but I’ve evolved in my thinking. I’ve had a few conversations in the past few weeks that have made me see it from a slightly different angle and challenged my thinking.

When I thought about it previously, I was pretty caught up in my own world. I heard people using these phrases about the profession and I assumed they were applying it to the profession as a whole (I am still not sure if they were or not?). Because I didn’t fit with what they were describing, I didn’t buy into what they were saying and assumed it was all bullshit. But I think that’s where I was wrong.

If we think about how much the profession has evolved over the years, we must keep in mind that the education provided to pharmacy undergraduates has also evolved. True, a graduate from 1995 might need extra training to conduct HMRs, but a graduate from 2019 has already been armed with the skills required. Similarly, other aspects of the curriculum have evolved and will continue to evolve to stay relevant to the times. I might need training to administer a vaccine, but there’s no reason why this couldn’t be addressed at an undergraduate level from now on. Scope of practice isn’t a generalised term.

Defining your individual scope of practice is the core component of what makes you a professional. It’s not about what everyone else can do, it’s about you. Setting your professional boundaries. Because you are an ethical professional you are expected to be able to self identify this. It’s what the whole CPD process is based upon and part of what you’re declaring when you renew your registration each year. I’m kind of a bit embarrassed that I forgot about this to be honest.

So for me sure, vaccinating isn’t within my current scope of practice. But neither is dispensing. I haven’t dispensed since 2011, and I was never very good at it. I am not a stickler for details, I am not meticulous enough and I make too many mistakes if I dispense over a long period. If I was to take on a role that had either of these as core duties I would request some sort of period of supervised practice for dispensing (from a liability perspective) and undertake training on giving vaccines so that I’d feel confident in my ability to perform those roles safely. But undertaking medication reviews, working in a GP practice or RACF? I’m confident they are well within my existing scope and that I have maintained my learning sufficiently to support this.

I think part of why this gets confused is because pharmacy is so obsessed with telling people what they can and can’t do. Certifying everything. Credentials for this that and the other. It’s become a business in itself. I’ve written before about my feelings toward the advanced practice credentialing, I’ve circled around a bit, and I’m back to the original question of what exactly is the point? Where is the public interest? Doesn’t the practice of CPD and being a registered professional mean that all pharmacists should be advancing their practice? Doesn’t telling people exactly what they should do diminish their professional autonomy?

If I apply for a job, I want the panel to assess my merit based upon the evidence supplied in my CV, the quality of my application and whatever interview or presentation they ask me to do. The idea of being judged by the superficiality of my post-nominals doesn’t do it for me. And I’m saying that acknowledging that I am working toward completing a PhD, possibly one example of a post-nominal that has the most variability in quality, other than maybe an MBA. If I provide a service to you, judge me on whether or not I met your needs sufficiently, not on whether I have a certificate showing I’ve completed a workshop. Registration matters, of course. Maintaining CPD matters, of course. Lifelong learning matters. To me, the other bits are either vanity metrics of ways of ensuring you get paid. A humble (or not so humble) brag. Get registered, define your scope of practice, do the work well, and continue to work to do it better. Lets stop over complicating it.

Creative Rehab

As I’ve written before, I’ve been drawing a lot of inspiration from the creative fields these past months. This morning I was listening to the recent Chase Jarvis episode of the James Altucher Show. One of the things they talked about that resonated with me, was how creativity is like a muscle – use it or it will atrophy.

As humans, we are all inherently creative beings. Go into a year one class and see the students work and you will be quickly reminded of that. But sadly for a lot of us, we lose that as we get older. We start thinking of how others may judge what we’re doing rather than focusing on the fulfilment we get from making stuff.

The good news is, just like atrophied muscles, things can be improved with some purposeful rehab. It doesn’t have to be something big. And it doesn’t have to be artistic.

Research is by definition a creative field. It is literally about creating new contributions to fields of knowledge. The same goes with writing – asserting your position, saying something in a thoughtfully structured way, an extremely creative process regardless of the topic area.

I can attest to seeing improvements through practice regularly. Since I’ve been writing this blog my academic writing has significantly improved. My measure of this is the feedback from two of my supervisors regarding my most recent literature review. Over the years I have learned that they are not an easy audience. Whenever I send out a draft for review it’s with some level trepidation and fear. Not bad fear, more like healthy discomfort knowing that it’s going to be uncomfortable but will ultimately lead to a better outcome (still sucks for the moment though). I still felt that way with this paper, but it needed much less surgery to get it ready for publication than previous ones. Part of that is because I now know that writing is a creative process for me, and there is a huge gap between my shitty first draft and one that is ready for review by others. I’m better at judging when to put it out for feedback. The other is that I’m getting to be more confident and concise with my writing.

You don’t have to write regularly, you don’t have to construct a research project. You can do whatever fits with your life to start exercising your creativity. Cook dinner a bit differently than usual. Think about a problem from a different perspective. The what doesn’t matter, it’s the doing it that counts.

Falling short

Today’s post follows on quite nicely from last week’s. This morning my daughter’s class was hosting assembly for the first time. She had a passage to read out and they had a song to sing and dance along to (I will save you the annoyance of getting it stick in your head because I am kind). It was one of those things that wasn’t exactly exciting but was obviously important to her.

The thing was, today was also the day of the final practical exam for a class I’d been working with at uni. Assembly started at 9, uni at 945. So I had to catch the 925 bus to make it on time. She was reading 8th, so I figured I should be able to at least see that bit.

Turns out I forgot how long and drawn out (and boring) school assemblies are. I had to leave without seeing any of her parts and I felt a bit sad about it.

Now I am pretty lucky as far as work goes, I hardly ever have to miss out on stuff. Even if it’s infrequent it still doesn’t feel great. But I need to get over it.

Because the reality is, even though some people tell you it’s possible to have it all in perfect balance if you work hard enough, a lot of the time you just can’t. You have to make a choice one way or the other which may mean fallng short in the other.

It’s ok to fall short every now and then. It’s part of being human. Kids understand that, I don’t think there’s a need to fake it. I think the more honest we are about the struggles we face, the stronger they will be. They’re the only critic that counts in this domain, afterall.