Letter to future self

Dear Future Self

Do not open until 2033

May 2023

Dear me,

Success is not the key to happiness. Happiness is the key to success. If you love what you’re doing, you will be successful.

I hope you’re doing well and proud of all your achievements. I’m writing this letter to remind you of the things that mean the most to you, your values and beliefs and to help you put things into perspective. You have been through so many challenges in life which have made you strong, resilient and determined and you genuinely should be proud of the experiences you’ve had. One of my friends Andy said to me once, ‘You’re going to meet so many people in your life and on your travels and you’ll leave a footprint on the heart of everyone you meet’. 

Present Leonora has been reflecting a lot recently about the last 10 years, but in particularly the last 3 since qualifying as a nurse and felt I couldn’t write about my hopes and dreams for the future without acknowledging what’s brought me to where I am now. I’ve always known I wanted to be a nurse, but during secondary school I came to realise that I didn’t want to go straight to university after school. That’s the direction it felt everyone was pushing me towards and everything was heavily focused on academia rather than soft skills or life experiences. I remember one of my teachers telling me in sixth form to stop doing everything I was doing outside of school to focus on my A-levels, which I chose to disregard. Admittedly I had a part time job waitressing in the evenings, I volunteered for DASH playschemes during Easter and Summer holidays and I regularly would attend events to provide first aid cover as a St John Ambulance Cymru volunteer. These experiences however have made me a better person and nurse as a result so I have no regrets. I actually wonder if my teachers and peers from school could see me now, what would they think? When I was in sixth form, I was nominated to be 1 of 4 cadets to represent St John Cymru Wales at an International Youth Festival in New Zealand. This opportunity changed my life, my priorities and my perception on life and the world, igniting a spark within me. I finished my A-Levels and worked hard to save money to go travelling. 

                                       I worked as a care assistant providing domiciliary care, as a personal assistant looking after severely disabled siblings, worked for DASH playschemes and respite weekends, ran training sessions and provided first aid cover for St John Ambulance Cymru and cared for a fiercely independent 95-year-old lady called Margaret. 

I saved hard, booked a one-way flight to New Zealand, packed my bags and took off to explore the world by myself. I had the experience of a lifetime, meeting so many amazing and inspirational people from all walks of life; from a nurse who lost both her legs to meningitis and sepsis to working with young people who put so much hard work into their development and being the best version of themselves. Upon returning to the UK a few years later, I got a job at the same residential home and volunteered as a Dementia Friends Champion, providing awareness sessions across the county and spent some of my free time looking after the most inspirational woman called Julie and her 2 dogs. Julie had motor neurone disease and was one of the most inspirational people I’ve ever met, and I don’t use that word lightly. I think looking after Julie made me recognise that the time was right to apply for university and go and become a nurse. I looked after Julie up until she passed away, at home, and with her dogs around her, she was the first person I told when I got offered an interview at university and the person I would always look forward to sharing my experiences with whenever I got a chance. Julie left a huge void in my life after she passed away and she confirmed that being a nurse was who I was inside.

Tired of trying to cram her sparkly star-shaped self into society’s beige square holes, she chose to embrace her ridiculous awesomeness and shine like the freaking supernova she was meant to be.

University was exciting, I was in the first ever cohort of BSc nurses at my chosen university, with a modern curriculum and a real focus on self-care and resilience. We had weekly pilates classes in our timetable, had to write a written reflection after every shift, had a semester of mindfulness and even learnt how to give hand massages. I was a very active and engaged student, becoming the course rep for my cohort then student rep for the whole of nursing, working as a student ambassador in my ‘free time’ when not in placement or doing assignments. 

                                  I took every opportunity that came my way; Council of Deans Student Leadership programme, RCN national Students Committee, HEE Future Nurse Oversight board and finalist for Nursing Times Student Nurse of the Year award. I had a range of placements; first year was community hospital and a private hospital, followed by my elective placement in Sri Lanka; second year was community nursing and an acute Upper GI and colorectal surgical ward and then third year was oncology followed by Intensive care… then covid happened. I was 2 weeks into my placement on ICU in Feb/ March 2020 when they removed us and said it was no longer safe for students to be on placement in ICU. I was moved to a gastro medical ward where I spent a couple of weeks before they introduced the ‘opt in’ or ‘opt out’ options. I decided to ‘opt in’, become a paid ‘Aspirant Nurse’ and sacrifice my supernumerary status to help my colleagues on the front line during the first covid lockdown. It was anxiety inducing and I was very much thrown in at the deep end, completing my dissertation alongside. I had my dream job offer on the surgical ward where I’d had a placement and knew that was where I wanted to be initially with a great team and interesting speciality with so much to learn. I was grateful to be allocated the same surgical ward that I would be starting my first post as a registered nurse, smoothing the transition and helping me consolidate my skills in a supportive environment.

Life will only change when you become more committed to your dreams than you are to your comfort zone.

I took some much-needed time off over the summer, between lockdowns and before starting my journey as a newly registered nurse. I definitely felt the change from ‘big fish in a small pond’ to ‘small fish in a big pond’ as I was finding my place, knowing how much I could speak out and how to navigate the world of the NHS. I was grateful to be working on a supportive ward, or at least I found it supportive. Over time I became more aware of the reputation my clinical area had; being ‘cliquey’, not welcoming to visitors, rude and staff who gossip a lot. I kept myself to myself and made sure that I was the exception to the rule, always greeting people with a smile, taking handovers with thanks and remaining non-judgemental and impartial to workplace politics. I felt over time, the pressure grew and became more intense. I was working so hard to remain true to myself, working diligently and to a high standard, brushing off the negative comments and learning to become more resilient. I remember having a conversation with my manager, it could have been my appraisal but I can’t remember it if was specifically, and in this conversation I said ‘I want to be able to do peoples appraisals with them, motivate them and show that they’re valued, have a voice                       and guide them to recognise their potential. The response given to me by my manager was ‘You need to remember that other people aren’t like you Leonora, they have lives outside of work; kids, caring responsibilities and don’t all want to do extra training, courses or masters’. This felt like a kick in the stomach to be honest, it’s not all about releasing staff to go on extra training, it’s about recognising the skills they do have and valuing their contribution to patient care and workplace culture. We know that if staff feel valued, like they have a voice and are recognised for making a positive contribution, not only will they have better job satisfaction, there will be better team morale and patients will have a better experience and better outcomes as a result. Recognising the potential in someone and saying thank you for who you are and what you do can make all the difference. I realised at this point that we were not on the same page, and this environment was not somewhere I would be supported and enabled to flourish and thrive.

When life gets harder, challenge yourself to be stronger.

In July 2021, 10 months after qualifying, I applied for a part time secondment as a Practice Development Nurse, splitting my time between working clinically on the ward and in a corporate role. In September 2021 I started in the newly formed team which was such an eye-opening opportunity. Being honest, I didn’t know exactly what being a Practice Development Nurse was – I don’t think many people do truly understand it. I underestimated the battle which was ahead of us, getting people to understand what Practice Development is to then be able to understand the impact it can make on workplace culture and staff development. Starting in this new role wasn’t an easy transition – I felt guilty for not being on the ward firefighting and it took a while to get used to being an autonomous practitioner and not be in a rush all the time. The attitude from colleagues when they’d see me and the shock from some people that ‘You’ve only been qualified how long?!’ – I avoided that topic at all costs. Instead of being inspirational and motivating (which I certainly was for some), others found it intimidating or threatening and were jealous of my success. Despite these challenges I thoroughly enjoyed the challenge of being a Practice Development Nurse, supporting colleagues through person centred approaches to provide safe and effective care. I was fortunate to attend an International Practice Development school provided by internationally renowned PD nurses Kim Manley and Carrie Jackson. Over 8 intense days, we learnt all about PD methodologies, values clarification exercises, emotional touchpoints, observations of practice and positive workplace cultures; taking part in 360-degree feedback, deep reflections and critical

                            companionship. I absolutely loved it and found it really immersive and actually life changing. As a result of this, we were then able to join the International Practice Development Collaborative being the first hospital in the world to join; others being universities or companies like Foundation of Nursing Studies. In April 2022 I applied to be a Peer Support Guardian, having volunteered for the network since completing my preceptorship. This was on a one day a week basis initially, providing peer support check-ins to those undertaking a preceptorship programme, providing Staff Transition and Retention (STaR) sessions on the preceptorship programmes and chairing a Peer Support council. Working as part of a small team to embed the GloSTaRs network has been hard work and required a lot of perseverance and patience but has been so rewarding and fulfilling. There has been a huge need for the service, providing wellbeing support, career advice and signposting to all colleagues. Over this time, we have inducted (mostly me) over 150 volunteer GloSTaRs Guardians who role model peer support in the workplace, wearing a badge and lanyard to show that they’re happy to be approached and can listen, signpost and refer to other services if required. This intelligence is gathered regularly and brought to our Peer Support council meetings, escalated through the governance structures we put in place and analysed to see where the gaps are and what more needs to be done to support staff. We also use these meetings as an opportunity to share any useful resources, webinars, courses etc with our Guardians who can then disseminate the information to their teams, also offering all other support groups (chaplaincy, Professional Advocates, professional education, Freedom to Speak Up) to share any relevant information with the group, whether that’s themes or information they’d like to cascade to wider teams, all with the focus of staff support. When we go and check in with a colleague, we don’t know what we’ll come across. Asking the question ‘How are you?’ can sometimes result in people breaking down and bursting into tears, it can sometimes make people withdraw and close in on themselves and other times they may be really happy. It’s a real honour to be the person that colleagues can open up with, building that rapport from their first day on the preceptorship and then supporting them through any challenges, encouraging them to reflect and ask for support is rewarding but also emotionally draining.

My secondment was initially only for 6 months and then got extended to 9 months until June 2022. My clinical manager then gave me an ultimatum – to choose between Practice development or clinical, she would no longer support my secondment on a part time basis. The reason given to me was because the ward was very short staffed,

                                       with multiple vacancies. I think, by giving me the ultimatum, the expected response was possibly that I would choose to return to clinical full time. I felt guilt tripped into choosing that option! However, with multiple vacancies and short staffing, surely having me for part time is better than not at all? I think this was the last nail in the coffin, making me realise I wasn’t valued and appreciated – yet I know I’m diligent, compassionate, approachable, friendly, hard working and conscientious. I chose to resign from my clinical role and pursue Practice development and peer support on a full-time basis, even though this meant entering a fixed term contract for a year. I am appreciated, valued, supported and encouraged to be the best version of myself in this role. I knew I made the right decision, challenging myself every day in the role of PD and stepping outside my comfort zone, supporting colleagues to be the best version of themselves and doing my best to make sure other people weren’t made to feel the way I was. This was no easy task – short staffing, high stress environments, low morale, it seemed like post Covid was much worse than the initial peaks. Combined with the lack of patient flow, cost of living, strikes, NHS pressures, the following few months had some tough moments.

On particularly rough days when I’m sure I can’t possibly endure, I like to remind myself that my track record for getting through bad days so far is 100%, and that is pretty good.

It’s currently May and the last 2-3 months have been some of the toughest since I started my nursing career. Although I knew that this was a fixed term contract, I wasn’t prepared for the uncertainty over the last couple of months – “Will there be funding for the team to continue?”. We KNOW that the work both PD and GloSTaRs do is fundamental for staff wellbeing and retention and we KNOW that supported and valued staff have better job satisfaction, provide better patient care and thus improve patient outcomes and patient experience. ‘Happier staff = happier patients’. So WHY is our team not seen as a core service which needs to continue. With restructuring happening with the organisation, it’s been a constant ‘well we need to wait until that person’s in post to see if the work can sit with them and their budget’ and then ‘well, this person’s going to be starting so it may sit better with them’ – back and forth constantly. We created an end of year report to send to NHS England as they funded the contracts initially and that report has been shared between all the Senior Leadership Team within the trust – I’ve even had a meeting with the CEO about it and EVERYONE’s response is – ‘The work you do is crucial, now more than ever. It’d be so short sighted if this work was to stop. There must be         

                                    money somewhere, it’s going to take us years to fill all our vacancies so surely that money can be redirected in the meantime’. I feel like I’ve been grieving for my job that I’ll no longer have, knowing that staff need our support, need people to ask for help who are external to their teams, need evidence based CPD at the bedside, need positive workplace cultures, yet here we are. I was remaining positive for a long time, I’m always glass half full, ever the optimist, however my lead nurse brought me back down to earth one day and made me realise that it doesn’t look like the contracts will get extended. I then decided to look for other jobs, see what’s out there, I thought ‘what’s the harm in looking?’ I found a job which encompasses my skills, knowledge, passion and core values as Lead Nurse for Wellbeing in a hospice. This brought so many feelings to the surface, feeling like a traitor and hypocrite for leaving the NHS and feeling like an imposter as the role of a Lead Nurse seems to be too advanced when I haven’t even Revalidated yet. But once I started sharing the news with people the response was overwhelmingly positive and exciting. “You’re the perfect person for that job, it’s like it was made for you”, “The NHS is losing one of the best”, “You’re going to go far in your nursing career, the world is your oyster”, “That job sounds like it was written for you, I couldn’t think of anyone better” – These are all comments I’ve received and they make me emotional thinking about it. I’ve found myself at this crossroads out of my control essentially but decided to take back the control and apply for a job where I would feel an immense feeling of job satisfaction, value and pride – and I feel like this is the step I needed to take to keep me in nursing for the long term. I know that if I were to get a job as a staff nurse/ sister on a ward with the current clinical pressures, I would burn out, suffer from moral injury and distress and this could ultimately lead to me leaving the profession – and that’s something I never want to do. I love being a nurse, I love nursing and there’s still a part of me that’d recommend it to friends and family, but I know it’s an incredibly challenging profession and I don’t think enough people are prepared for what they’ll come across. I often think that if I’M feeling this way – then how are other people feeling?

It’s not about perfect. It’s about effort. And when you implement that effort into your life… every single day, that’s where transformation happens. That’s how change occurs. Keep going. Remember why you started.

                           So, as I prepare to embark on this new venture in a few weeks, I have so many new ideas and plans; I’m excited for the future and the journey ahead of me. I feel slightly overwhelmed with all I need to do as this job comes to a close, tying up all loose ends, communicating with the right people that I’ll be not only leaving this role but also the NHS, arranging all the paperwork that comes with a new job and making sure I leave my job on a high, because I want to and it was a decision I made; not because it was the only option available.

Every accomplishment starts with the decision to try.

I find the looking forward to the future bit so much harder, what are my hopes and dreams for my career as a nurse? Well, there are so many unknowns aren’t there? In 10 years’ time I hope to be a mother, be married to my wonderful partner Dominic and own a house. I don’t know where I’ll be living or working but I do know at this point in time the things I need from a job in order to be able to flourish. I’m very self-aware, have really got to know myself over the years – what makes me thrive and what makes me shutdown. As a nurse, I hope I’d be in a job where:

  • I have the right balance of autonomy but also support to make those decisions. That probably sounds like I’m contradicting myself but I mean, not to be micromanaged, not have to jump through lots of hoops to make decisions, not have to ask for permission; to be trusted in my role, as a professional, to make decisions related to my job and also take accountability when things go wrong. Having that duty of candour, sometimes being vulnerable and being authentic are values which are really important to me and if I see these traits in someone else, I find them really admirable. 
  • I need to be in a job where I feel respected and valued. Having had experiences as an early career nurse where I haven’t felt respected and where I’m made to feel belittled, like I don’t know what I’m talking about, talked down to and patronised, I don’t want to feel like that again but also vow to never make someone else feel that way. I know not everyone will like me, not everyone likes cheese after all, but I do know that I want and deserve to be respected.  
  • My key interests are around leadership, wellbeing, development and retention therefore I feel like any role that encompasses these elements will be fulfilling. Because these are my core values/ passions, I’ll take these aspects with me into any job however if they’re a key part of the role I’d feel like I have more to offer. 
  • Ultimately, I’d like to continue having a job that I look forward to going to. There’s an age old saying that if you enjoy your work, you’ll never work a day in your life. I don’t think that’s necessarily possible to achieve in the world of nursing but I don’t think I’d find the job as exciting if there wasn’t the occasional rollercoaster to ride.
  • My wish is that I have a job where I’m challenged to grow, develop, learn and influence workplace culture and can have a positive impact on colleagues, patients and the service.

Brené Brown has defined true belonging in a way that really resonates with me and this is what I want to feel in the future in my career as a nurse.

True belonging is the spiritual practice of believing in and belonging to yourself so deeply that you can share your most authentic self with the world and find sacredness in both being a part of something and standing alone in the wilderness. True belonging doesn’t require you to change who you are; it requires you to be who you are.

To draw this letter to a close, as I realise it’s got very long, I really hope you’re happy. Take this moment to write another letter to yourself to open in 2043, as you can see, it’s a really worthwhile thing to do. I hope you don’t have any regrets, have learned from any mistakes you have made and have had some positive influences on people’s lives. I’m going to make a commitment to write a letter to myself every year on my birthday, let’s see if I actually stuck to that. To end with a famous quote from Dr Seuss – ‘You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose’.

Lots of love,

Your younger self 

May 2023

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