1
00:00:00,149 --> 00:00:01,589
The system is broken.

2
00:00:01,829 --> 00:00:02,639
You know it.

3
00:00:02,819 --> 00:00:03,419
I know it.

4
00:00:03,419 --> 00:00:06,119
And nobody is coming to
rescue us anytime soon.

5
00:00:06,119 --> 00:00:10,230
So what do you do when you're stuck
in a system you can't fix, but you

6
00:00:10,230 --> 00:00:12,570
still feel responsible for everything?

7
00:00:12,870 --> 00:00:16,495
So in this episode, we are going to be
diving into a powerful mindset shift,

8
00:00:16,495 --> 00:00:21,265
and we're gonna be talking about how to
move from feeling completely powerless,

9
00:00:21,265 --> 00:00:25,554
like everything's happening to us,
to being powerful, where actually

10
00:00:25,554 --> 00:00:29,455
things are happening because of us,
even when you're working in a system

11
00:00:29,455 --> 00:00:30,925
that feels really, really broken.

12
00:00:30,925 --> 00:00:34,135
So we are gonna talk about why
blaming others, even when it's very

13
00:00:34,135 --> 00:00:36,565
justified, actually keeps you stuck.

14
00:00:36,861 --> 00:00:39,828
We are gonna talk about a simple
model that you can use to, to take

15
00:00:39,828 --> 00:00:42,258
back control and get some clarity.

16
00:00:44,837 --> 00:00:49,517
This is a You Are Not a Frog quick dip,
a tiny taster of the kinds of things we

17
00:00:49,517 --> 00:00:52,187
talk about on our full podcast episodes.

18
00:00:52,487 --> 00:00:55,817
I've chosen today's topic to give
you a helpful boost in the time it

19
00:00:55,817 --> 00:00:59,207
takes to have a cup of tea so you
can return to whatever else you're

20
00:00:59,207 --> 00:01:01,577
up to feeling energized and inspired.

21
00:01:02,147 --> 00:01:05,957
For more tools, tips, and insights
to help you thrive at work, don't

22
00:01:05,957 --> 00:01:09,917
forget to subscribe to You Are Not a
Frog wherever you get your podcasts.

23
00:01:11,494 --> 00:01:13,864
And let's be honest, working
in healthcare right now can

24
00:01:13,864 --> 00:01:15,124
feel really, really impossible.

25
00:01:15,124 --> 00:01:18,394
We know that systems are under pressure,
staff are stretched, people are

26
00:01:18,394 --> 00:01:22,624
leaving, burning out, going off sick,
leaving more work for everybody else.

27
00:01:22,624 --> 00:01:25,984
Patients, the need has gone
up, demand has gone up.

28
00:01:26,284 --> 00:01:28,504
And you may well have found
yourself thinking, well, I

29
00:01:28,504 --> 00:01:29,914
just can't do this anymore.

30
00:01:29,914 --> 00:01:33,034
Nobody's listening to me,
and why should I even try?

31
00:01:33,064 --> 00:01:36,364
Now, that feeling you get when
you are really stuck where you

32
00:01:36,364 --> 00:01:38,104
are feeling a bit like a victim.

33
00:01:38,104 --> 00:01:41,552
The victim mentality, well, that is
what we call below the line thinking.

34
00:01:41,852 --> 00:01:45,916
And you can get stuck in this way
of blaming people, And even though

35
00:01:45,916 --> 00:01:48,796
it's totally understandable, it's
very difficult to move forward

36
00:01:49,120 --> 00:01:50,890
and you feel very, very stuck.

37
00:01:51,208 --> 00:01:53,578
We often believe that if
things aren't working, then

38
00:01:53,578 --> 00:01:55,108
somebody else needs to fix it.

39
00:01:55,108 --> 00:01:57,688
So the rota's wrong, management
needs to sort it out.

40
00:01:57,688 --> 00:01:58,738
The system's broken.

41
00:01:58,738 --> 00:02:03,388
And yes, that may well be true,
but unfortunately waiting for the

42
00:02:03,388 --> 00:02:07,228
system to change or even other
people to change before things can

43
00:02:07,228 --> 00:02:11,298
get better, well, that's the trap
and that's what keeps you powerless.

44
00:02:11,388 --> 00:02:16,418
Because we don't have any control over
either the system or other people.

45
00:02:16,718 --> 00:02:20,691
And if you do have some control over the
system then I bet you are working really

46
00:02:20,691 --> 00:02:22,131
hard to change that bit that you are in.

47
00:02:22,131 --> 00:02:25,191
But unfortunately, we know this,
that in the NHS all the bits of the

48
00:02:25,191 --> 00:02:26,721
system are very, very interconnected.

49
00:02:26,721 --> 00:02:29,721
So no matter how much control you
have over your bit of the system,

50
00:02:29,991 --> 00:02:33,591
there's always another bit that's
gonna come along and, and undermine

51
00:02:33,591 --> 00:02:34,851
that and make things difficult.

52
00:02:35,231 --> 00:02:39,941
So rather than feeling that for anything
to change or for things to get better,

53
00:02:40,181 --> 00:02:44,604
the system has to change, we need to
understand that you don't have to change

54
00:02:44,604 --> 00:02:49,886
the system to reclaim your power to
get unstuck and to make things better,

55
00:02:50,216 --> 00:02:54,806
you just need to change where you are
on the action stepladder, and you need

56
00:02:54,806 --> 00:02:56,486
to get the first steps right as well.

57
00:02:56,850 --> 00:02:59,820
So this is a model, and it was
originally described in a book called

58
00:02:59,820 --> 00:03:04,140
The Oz Principle, but it's been used
over and over again in leadership

59
00:03:04,140 --> 00:03:06,480
training, lots of leadership literature.

60
00:03:06,780 --> 00:03:10,080
This shows us how we move from
powerless thinking, where we talk

61
00:03:10,080 --> 00:03:14,310
about being below the line to powerful
thinking where you are above the line.

62
00:03:14,310 --> 00:03:16,830
So if you're below the line,
you're in the victim mentality,

63
00:03:17,130 --> 00:03:19,740
you might be thinking things like,
well, I can't, it's not my job.

64
00:03:19,740 --> 00:03:20,915
It's, it's their fault.

65
00:03:21,488 --> 00:03:25,443
Above the line, you are in a much
more of an activator mindset.

66
00:03:25,593 --> 00:03:29,133
Where you make things happen, you're
thinking, well, what's really going on?

67
00:03:29,433 --> 00:03:30,153
What's my part?

68
00:03:30,153 --> 00:03:30,963
What can I do?

69
00:03:30,963 --> 00:03:32,133
And let's do it.

70
00:03:32,133 --> 00:03:33,153
Let's make it happen.

71
00:03:33,576 --> 00:03:34,536
Now, here's the thing.

72
00:03:34,836 --> 00:03:39,516
We might think we are acting from power,
but if we are blaming other people,

73
00:03:39,786 --> 00:03:44,916
waiting, denying things, and just hoping
that things are gonna change, then

74
00:03:44,916 --> 00:03:47,136
we are unfortunately below the line.

75
00:03:47,523 --> 00:03:52,586
Now this doesn't mean to say that none
of the issues are true, and it doesn't

76
00:03:52,586 --> 00:03:56,876
mean that you can wave a magic wand and
everything is gonna get better, and just

77
00:03:56,876 --> 00:03:58,436
by believing you can make it happen.

78
00:03:58,436 --> 00:03:59,726
That's not what we're saying.

79
00:04:00,026 --> 00:04:04,016
But when we are below the line, we
have an external locus of control.

80
00:04:04,359 --> 00:04:08,183
We believe that the only way
anything can be different will

81
00:04:08,183 --> 00:04:10,823
be if other people do something.

82
00:04:11,123 --> 00:04:13,943
That's a very stressful place
to be because obviously we have

83
00:04:13,943 --> 00:04:15,353
no control over other people.

84
00:04:15,478 --> 00:04:19,708
Getting above the line is about
taking that control back, that locus

85
00:04:19,708 --> 00:04:21,568
of control, making it internal.

86
00:04:21,768 --> 00:04:25,848
An internal locus of control
means that you believe you always

87
00:04:25,848 --> 00:04:28,008
have a choice, however small.

88
00:04:28,008 --> 00:04:31,578
Now, often it's not the choice
that you want, but that doesn't

89
00:04:31,578 --> 00:04:32,838
mean you don't have a choice.

90
00:04:32,838 --> 00:04:36,174
It just means you would love to have
some different options, but they're

91
00:04:36,174 --> 00:04:37,554
not being presented right now.

92
00:04:37,855 --> 00:04:41,665
So if you don't shift to above the
line to having an internal locus of

93
00:04:41,665 --> 00:04:44,402
control, the system will always win.

94
00:04:44,702 --> 00:04:48,182
But you can start to navigate even
really, really difficult circumstances

95
00:04:48,182 --> 00:04:52,952
with clarity and peace if you start to
have this internal locus of control.

96
00:04:53,042 --> 00:04:55,712
So I just wanna pause here
and ask you something.

97
00:04:55,712 --> 00:04:59,822
You know, if nothing changes for you,
if you do stay below the line believing

98
00:04:59,822 --> 00:05:03,032
that nothing will change unless the
system changes and that that's down

99
00:05:03,032 --> 00:05:07,612
to other people, and if you carry on
just hoping the system will suddenly

100
00:05:07,612 --> 00:05:11,872
wake up and take care of you well,
I'm afraid things are gonna go very

101
00:05:11,872 --> 00:05:14,110
badly and you'll hit this eventually.

102
00:05:14,410 --> 00:05:16,990
So if you stay below the
line, you'll feel helpless.

103
00:05:16,990 --> 00:05:18,040
You'll blame the system.

104
00:05:18,320 --> 00:05:22,730
You'll try over-functioning to fix
what's broken, and that, as we know,

105
00:05:22,950 --> 00:05:27,740
leads to exhaustion, bitterness and
resentment, and real disconnection

106
00:05:28,040 --> 00:05:29,630
from what used to matter to you.

107
00:05:30,100 --> 00:05:34,660
Now we think that being a victim, it
means being very, very passive, but we

108
00:05:34,660 --> 00:05:39,760
can also be a victim and be very, very
busy just working our arses off, just

109
00:05:39,850 --> 00:05:42,010
'cause we think that's gonna fix stuff.

110
00:05:42,010 --> 00:05:45,160
But if we keep existing below
the line, then actually the risk

111
00:05:45,160 --> 00:05:46,690
is we leave medicine altogether.

112
00:05:46,690 --> 00:05:48,040
That's if we don't burn out.

113
00:05:48,270 --> 00:05:51,300
And not because you don't care, but
because you actually haven't got anything

114
00:05:51,300 --> 00:05:55,260
left to give and you never really learn
how to stop, get above the line, but

115
00:05:55,260 --> 00:05:56,670
you can choose something different.

116
00:05:57,110 --> 00:06:01,100
So the other choice you've got is just
to climb up the action step ladder,

117
00:06:01,310 --> 00:06:06,500
step by steps that we can get above the
line, because let's just recap below

118
00:06:06,500 --> 00:06:08,720
the line, you're feeling uncertain.

119
00:06:09,020 --> 00:06:10,130
You can't do it.

120
00:06:10,400 --> 00:06:14,330
You start to blame other
people and you are just hoping.

121
00:06:14,630 --> 00:06:18,920
If you start to climb the action
stepladder, you are able to pause and

122
00:06:18,920 --> 00:06:23,120
reflect, and you stop carrying all that
stuff that wasn't yours to carry in the

123
00:06:23,120 --> 00:06:28,070
first place, and you work out what is
yours to carry and what's not, and you

124
00:06:28,070 --> 00:06:30,980
can think about, well, how am I gonna
act from something that I want to do

125
00:06:30,980 --> 00:06:34,100
from intention, rather than just feeling
really bad and guilty about everything?

126
00:06:34,347 --> 00:06:37,319
And you'd also be able to address this
really difficult question, which is

127
00:06:37,562 --> 00:06:41,327
where do I need to set a boundary and
let the system fail so that I don't.

128
00:06:41,867 --> 00:06:44,477
And that's what starts to shift, and
that's where you really start to make a

129
00:06:44,477 --> 00:06:49,000
difference, but without sort of wearing
yourself into the ground on the way there.

130
00:06:49,247 --> 00:06:50,387
So you have a choice, really.

131
00:06:50,387 --> 00:06:56,537
You can say below the line, stuck in
blame, suffering, burnout, just waiting,

132
00:06:56,837 --> 00:06:58,517
thinking it's everybody else's faults.

133
00:06:58,817 --> 00:07:02,357
Or you can start to step up the action
step ladder towards real ownership of

134
00:07:02,357 --> 00:07:06,227
stuff, towards clarity and ultimately
peace about what you're doing.

135
00:07:06,670 --> 00:07:10,420
So even though the system's not
gonna change tomorrow, you can,

136
00:07:10,480 --> 00:07:13,480
you can shift your mindset and
that will really change everything.

137
00:07:13,807 --> 00:07:18,127
So I just want to pause for a
minute and think about why so many

138
00:07:18,127 --> 00:07:21,517
doctors just give up when they're
trying to change the system.

139
00:07:21,667 --> 00:07:25,717
What happens when you do step up,
but you're staying below the line?

140
00:07:26,017 --> 00:07:29,307
So often you see the problems
and you think, well we can't

141
00:07:29,307 --> 00:07:30,177
keep working like this.

142
00:07:30,177 --> 00:07:31,557
We've gotta change something.

143
00:07:31,557 --> 00:07:34,107
And you know, if that's
you, you are not alone.

144
00:07:34,107 --> 00:07:37,167
And lots and lots of really brilliant
doctors, they do set out to improve

145
00:07:37,167 --> 00:07:40,557
things, but somewhere on along the
line it just becomes too difficult and

146
00:07:40,557 --> 00:07:42,117
they either back off, or they give up.

147
00:07:42,447 --> 00:07:45,827
And it's not because they don't care,
but it's because they've unknowingly

148
00:07:45,827 --> 00:07:48,227
made the process really unsustainable.

149
00:07:48,287 --> 00:07:52,217
So I'm just gonna list a few of the
biggest mistakes that doctors make when

150
00:07:52,217 --> 00:07:53,867
they're trying to change their system.

151
00:07:54,081 --> 00:07:56,908
and these mistakes just leave
them completely exhausted

152
00:07:56,908 --> 00:07:57,778
and ready to walk away.

153
00:07:57,778 --> 00:07:59,758
So, number one, they're
fighting the wrong battle.

154
00:07:59,758 --> 00:08:04,903
So you might see a symptom, like a, a
rotor gap or, or poor communication.

155
00:08:05,008 --> 00:08:06,388
You try and fix it.

156
00:08:06,688 --> 00:08:09,748
But underneath there's a deeper
root cause, you know, really

157
00:08:09,748 --> 00:08:13,468
unsafe expectations or a toxic
culture or unrealistic workload.

158
00:08:13,768 --> 00:08:17,458
And then you might fix the communication,
but that root cause that starts

159
00:08:17,458 --> 00:08:20,998
coming back and you start to feel
like absolutely nothing works.

160
00:08:21,424 --> 00:08:25,801
So before diving in, you really need
to ask, what's really driving this?

161
00:08:25,801 --> 00:08:28,381
And am I just treating
the surface symptoms?

162
00:08:28,381 --> 00:08:31,891
You know, putting the sticking pasta on,
or are we really addressing the root here?

163
00:08:32,191 --> 00:08:36,211
The other issue that a lot doctors face
is they expect quick progress, and you

164
00:08:36,211 --> 00:08:40,051
think to yourself, well, if, if I'm gonna
show initiative, offer a solution and

165
00:08:40,201 --> 00:08:42,421
present the evidence, they will listen.

166
00:08:42,721 --> 00:08:45,691
And side note, when I did the Red
Well Lead Managed Thrive course, we

167
00:08:45,691 --> 00:08:49,501
used to talk a lot about doctors going
into these sort of politically charged

168
00:08:49,501 --> 00:08:53,961
situations, thinking to themselves,
but if I say that this is affecting

169
00:08:53,961 --> 00:08:57,681
patients, if I present what the right
thing is to do, then that's gonna happen.

170
00:08:57,861 --> 00:08:59,541
Then everyone will just agree with me.

171
00:08:59,841 --> 00:09:04,071
Unfortunately, when they fail to
realize that people have lots of other

172
00:09:04,071 --> 00:09:08,591
motivations, it's not always to do the
best for the patients, sadly, and if

173
00:09:08,591 --> 00:09:12,551
you're coming up against these people who
are empire building or just wanting to

174
00:09:12,731 --> 00:09:16,811
protect their little bit of the system,
even though it's affecting patients, then

175
00:09:17,111 --> 00:09:21,291
actually making just good arguments often
doesn't get you where you need to be.

176
00:09:21,533 --> 00:09:25,793
And systems are slow and people
are resistant to change, and when

177
00:09:25,793 --> 00:09:28,763
things don't change immediately,
you just feel like you've failed.

178
00:09:29,063 --> 00:09:32,683
So progress often looks like two
steps forward, one step backwards,

179
00:09:32,923 --> 00:09:35,773
one step sideways, and then maybe a
small fire or something like that.

180
00:09:36,073 --> 00:09:40,778
The other mistake we make is just to
take silence or inaction personally.

181
00:09:41,076 --> 00:09:43,986
You know, so you've raised concerns,
you've shared things, you've emailed

182
00:09:43,986 --> 00:09:47,706
people, you've had meetings and nothing,
and you, you think you're being ignored

183
00:09:47,706 --> 00:09:50,953
because of something you've done
wrong or your voice doesn't matter.

184
00:09:51,153 --> 00:09:54,334
But it just means that the system
doesn't yet know how to respond.

185
00:09:54,334 --> 00:09:59,334
So we often let this institutional
inertia become this personal shame.

186
00:09:59,334 --> 00:10:01,314
But you are not the problem.

187
00:10:01,314 --> 00:10:02,304
The system is.

188
00:10:02,704 --> 00:10:06,844
The other thing we do is we try and
fix structures without changing the

189
00:10:06,844 --> 00:10:09,034
deep culture underlying everything.

190
00:10:09,464 --> 00:10:12,170
So you might say to a new
process, have a meeting, workflow

191
00:10:12,170 --> 00:10:13,460
committee, all that sort of stuff.

192
00:10:13,460 --> 00:10:17,707
But nothing changes, because the
underlying culture of fear, blame,

193
00:10:17,707 --> 00:10:19,717
hierarchy, that's not shifted at all.

194
00:10:20,017 --> 00:10:24,097
So you cannot system fix your
way out of a culture problem.

195
00:10:24,423 --> 00:10:27,603
And sometimes the most important
work is to do with relationships,

196
00:10:27,603 --> 00:10:29,073
not just fixing procedures.

197
00:10:29,164 --> 00:10:32,554
And also because doctors are
very, very capable and they can do

198
00:10:32,554 --> 00:10:34,714
things quickly, they just think,
oh, I'll just quickly fix it.

199
00:10:34,744 --> 00:10:37,014
I'll do it myself, and they go it alone.

200
00:10:37,014 --> 00:10:39,954
But it's very difficult to change
anything without shared ownership.

201
00:10:40,154 --> 00:10:44,534
You hit resistance, you just get
exhausted, and then the idea just dies and

202
00:10:44,534 --> 00:10:46,664
you're just too exhausted to resurrect it.

203
00:10:47,000 --> 00:10:48,500
So we need to find allies.

204
00:10:48,500 --> 00:10:51,950
We need to find other people and
help them get above the line as well.

205
00:10:52,327 --> 00:10:56,650
And finally, when you're trying to fix the
system, you forget to care for yourself.

206
00:10:56,860 --> 00:10:58,540
We see this time and time again.

207
00:10:58,930 --> 00:11:02,854
You know, you just feel so focused
on helping everybody else out that

208
00:11:02,854 --> 00:11:04,084
you forget that you are human too.

209
00:11:04,084 --> 00:11:06,587
You need to rest, you need to have lunch.

210
00:11:06,587 --> 00:11:11,290
You cannot stay late all the time, but
you feel so responsible that you just do,

211
00:11:11,912 --> 00:11:15,062
and then your voice will disappear and
you've given up, not because you don't

212
00:11:15,062 --> 00:11:18,752
care, but because you've, you've burnt
out and you've run out of energy and time.

213
00:11:19,052 --> 00:11:22,682
So you can't heal the
system by harming yourself.

214
00:11:22,982 --> 00:11:26,402
So if any of these mistakes stand
familiar, you are not doing it wrong.

215
00:11:26,402 --> 00:11:28,262
You're just doing it like
lots of other doctors.

216
00:11:28,292 --> 00:11:31,172
We were never taught how to lead change.

217
00:11:31,352 --> 00:11:34,142
We were never taught really
how to work sustainably.

218
00:11:34,477 --> 00:11:36,487
The good news is you
don't have to give up.

219
00:11:36,547 --> 00:11:39,277
You just need to do this in
a way that doesn't break you.

220
00:11:39,277 --> 00:11:43,507
And the way to do that is get above
the line, because you cannot change

221
00:11:43,507 --> 00:11:45,217
the system from below the line.

222
00:11:45,217 --> 00:11:46,417
You'll end up burning out.

223
00:11:46,717 --> 00:11:48,397
And you need to do it step by step.

224
00:11:48,697 --> 00:11:50,732
So let's talk about how to do it.

225
00:11:50,932 --> 00:11:55,102
And the one problem that I see is
doctors rush into the final step at

226
00:11:55,102 --> 00:11:59,362
the top of the ladder without taking
the first steps on the first rungs.

227
00:11:59,889 --> 00:12:05,069
So the first step, the first step above
the line is simply facing reality.

228
00:12:05,369 --> 00:12:06,479
What is going on?

229
00:12:06,479 --> 00:12:07,949
Where are you on the ladder?

230
00:12:08,249 --> 00:12:09,449
Are you blaming someone?

231
00:12:09,749 --> 00:12:11,609
Are you waiting for
somebody to rescue you?

232
00:12:11,909 --> 00:12:13,529
Are you just waiting and hoping?

233
00:12:13,529 --> 00:12:14,489
Have you given up?

234
00:12:14,835 --> 00:12:19,210
So just this awareness can change the
whole thing, and facing reality is the

235
00:12:19,210 --> 00:12:21,940
first step on the action stepladder.

236
00:12:22,240 --> 00:12:25,810
Without facing reality, then any
attempt to change the system, it's

237
00:12:25,810 --> 00:12:31,540
just based on an illusion or avoidance
or hope, rather than real clarity and

238
00:12:31,540 --> 00:12:35,950
real strategy, and you probably end
up fixing the entirely wrong problem.

239
00:12:36,361 --> 00:12:40,621
So here is how this first step, the
step of facing reality, helps you

240
00:12:40,921 --> 00:12:45,282
get above the line and get meaningful
change and meaningful action.

241
00:12:45,522 --> 00:12:49,152
Well, facing reality stops
you just fighting fantasies.

242
00:12:49,452 --> 00:12:51,797
It stops you pretending
the workload is manageable.

243
00:12:51,797 --> 00:12:56,387
If you just work harder or believing
things are magically gonna improve, so it

244
00:12:56,387 --> 00:13:00,257
grounds you in what's actually happening,
not what you wish was true, so you stop

245
00:13:00,257 --> 00:13:02,987
wasting energy on stuff that doesn't work.

246
00:13:03,287 --> 00:13:08,177
And if you face reality, you find out
what the right problem to solve is.

247
00:13:08,417 --> 00:13:11,107
Because if you don't, you just
end up treating the symptoms like

248
00:13:11,107 --> 00:13:14,600
rota swaps, cover gaps, endless
meetings without understanding the

249
00:13:14,600 --> 00:13:16,700
real systemic drivers underneath.

250
00:13:17,153 --> 00:13:20,753
So if you're facing reality, you'll be
asking the sort of questions like, why

251
00:13:20,753 --> 00:13:22,313
is this happening in the first place?

252
00:13:22,613 --> 00:13:24,988
And where is the resistance really?

253
00:13:25,368 --> 00:13:28,735
And the other thing is that facing
reality just creates a bit of

254
00:13:28,735 --> 00:13:30,835
psychological safety for change.

255
00:13:31,148 --> 00:13:34,278
So starting with reality rather
than just blaming or denying

256
00:13:34,682 --> 00:13:37,628
makes it safer for other people to
come alongside and get on board.

257
00:13:37,958 --> 00:13:40,962
And you can just work out
like, what's really going on?

258
00:13:40,962 --> 00:13:43,632
We are all part of this, let's
look at it really honestly,

259
00:13:44,008 --> 00:13:45,545
without any shame attached.

260
00:13:45,948 --> 00:13:49,535
And one of the ways that you can
help yourself face reality is just

261
00:13:49,535 --> 00:13:51,365
to do our Stressors Hexagon audit.

262
00:13:51,735 --> 00:13:57,298
So click on the link in the show notes
to download our free toolkit, and

263
00:13:57,298 --> 00:14:01,708
that has a very simple audit that you
can do to help yourself face reality.

264
00:14:02,128 --> 00:14:04,263
So facing reality doesn't mean giving up.

265
00:14:04,263 --> 00:14:08,133
It just means really acknowledging
where you are so you can create

266
00:14:08,133 --> 00:14:11,392
change that actually lasts because
you'll be solving the right problem.

267
00:14:11,628 --> 00:14:15,252
Because the issue is as doctors, we
love to take action, and if you're

268
00:14:15,252 --> 00:14:19,835
facing a really broken system or a
stressful situation, your instinct is

269
00:14:19,835 --> 00:14:21,935
just to self suffer as fast as possible.

270
00:14:21,935 --> 00:14:25,169
So you wanna get right up the ladder
towards the taking action bit.

271
00:14:25,556 --> 00:14:26,396
You don't waste time.

272
00:14:26,396 --> 00:14:27,056
You don't sit around.

273
00:14:27,056 --> 00:14:28,466
You just like to get things down.

274
00:14:28,706 --> 00:14:32,036
So instead of starting at the bottom,
you just leap right up to the top.

275
00:14:32,336 --> 00:14:34,226
The bit that's called make it happen.

276
00:14:34,426 --> 00:14:38,566
And if you then skip the the first
step, which is face, what's really

277
00:14:38,566 --> 00:14:42,646
going on, you build solutions just
based on denial or wishful thinking.

278
00:14:42,952 --> 00:14:48,156
Now, the next step on the action
step ladder is owning your own part.

279
00:14:48,439 --> 00:14:51,439
And if you don't do that, then
you try and fix everything.

280
00:14:51,439 --> 00:14:55,219
You feel responsible for absolutely
everything, and you have this

281
00:14:55,339 --> 00:14:58,284
over responsibility issue.

282
00:14:58,562 --> 00:15:00,640
I talked on that in a previous
podcast, and we'll put the

283
00:15:00,640 --> 00:15:01,630
link into the show notes.

284
00:15:01,680 --> 00:15:05,220
So this is my type one control
responsibility mismatch, where we

285
00:15:05,220 --> 00:15:08,610
feel very responsible for things
that are well outside our zone

286
00:15:08,610 --> 00:15:10,050
of power outside our control.

287
00:15:10,320 --> 00:15:12,480
And this just is incredibly stressful.

288
00:15:12,780 --> 00:15:14,040
And what's more, it doesn't work.

289
00:15:14,040 --> 00:15:16,620
If you try and change stuff,
you can't control, you can't.

290
00:15:16,957 --> 00:15:17,887
It leads to stress.

291
00:15:18,127 --> 00:15:21,007
It leads to us feeling really, really
guilty and it leads to overwhelm.

292
00:15:21,307 --> 00:15:24,097
What you need to do is work
out what you are in control of

293
00:15:24,397 --> 00:15:26,647
and what part is yours to play.

294
00:15:26,977 --> 00:15:29,377
You can then work out
what you can actually do.

295
00:15:29,527 --> 00:15:33,757
So in the action step ladder you've got,
number one, face reality, number two.

296
00:15:34,057 --> 00:15:37,317
Own your part and stick to the
stuff that you can control.

297
00:15:37,467 --> 00:15:41,007
Because then you'll be able
to work out what you could do.

298
00:15:41,007 --> 00:15:45,420
You can find solutions, you can
work out what can you, what can

299
00:15:45,420 --> 00:15:47,220
your team do about this stuff?

300
00:15:47,697 --> 00:15:50,797
So once you've worked out what
solutions there possibly are, based

301
00:15:50,797 --> 00:15:54,007
on what you can control, will, then
that's the time to take action.

302
00:15:54,295 --> 00:15:57,305
Because if you leap to the top
straight into action without

303
00:15:57,305 --> 00:16:00,035
climbing those foundation steps,
well, you're gonna wobble.

304
00:16:00,035 --> 00:16:01,445
You're gonna fall off the ladder.

305
00:16:01,745 --> 00:16:03,335
You'll waste a lot of energy.

306
00:16:03,335 --> 00:16:06,295
You'll probably lose confidence too,
because rather than climbing up,

307
00:16:06,295 --> 00:16:07,885
you're just sort of scrambling around.

308
00:16:08,378 --> 00:16:12,115
Think of it a bit like managing a complex
patient without doing a proper assessment.

309
00:16:12,115 --> 00:16:15,575
So if you skip the history, the
physical examination, the, the

310
00:16:15,575 --> 00:16:17,135
test and go straight for treatment.

311
00:16:17,435 --> 00:16:18,785
Well, that's not decisive.

312
00:16:18,785 --> 00:16:20,675
It's just dangerous, isn't it?

313
00:16:20,975 --> 00:16:22,535
You would never do that with a patient.

314
00:16:22,835 --> 00:16:25,175
So the action step ladder,
it works in the same way.

315
00:16:25,475 --> 00:16:29,645
You can't get to meaningful action
without grounding, without facing

316
00:16:29,645 --> 00:16:32,885
reality, getting clarity and ownership.

317
00:16:33,235 --> 00:16:36,445
Trying to fix the system without
taking those lower steps.

318
00:16:36,475 --> 00:16:39,905
It's just like prescribing treatment
without diagnosing the cause.

319
00:16:40,075 --> 00:16:41,395
It feels like action.

320
00:16:41,695 --> 00:16:42,800
It often makes things worse.

321
00:16:43,253 --> 00:16:47,155
So if you've been living below the line,
blaming others, blaming the system,

322
00:16:47,155 --> 00:16:48,295
or feeling stuck, you're not alone.

323
00:16:48,295 --> 00:16:50,885
In fact, you've been trained to
do that because medicine, wwll

324
00:16:50,905 --> 00:16:56,085
we often reward over-functioning,
self-blame, that just leads to burnout.

325
00:16:56,175 --> 00:16:59,745
You can't control the system
and you can't fix everything.

326
00:17:00,045 --> 00:17:01,905
But you can reclaim your power.

327
00:17:02,205 --> 00:17:05,325
You can shift from below
the line to above the line.

328
00:17:05,325 --> 00:17:08,576
You shift from waiting
and hoping into choosing.

329
00:17:08,800 --> 00:17:12,790
And once you are above the line,
instead of just rushing straight

330
00:17:12,790 --> 00:17:17,350
into fixing mode, you need to ask
yourself, have I really faced reality?

331
00:17:17,350 --> 00:17:19,480
And am I really clear
about what's going on here?

332
00:17:19,826 --> 00:17:25,256
So that I can then own my part and
work out what it is that I could do.

333
00:17:25,556 --> 00:17:29,396
Stop worrying about all that stuff
that's out of my control, and get

334
00:17:29,396 --> 00:17:33,956
really clear on my role and my limits,
and make sure I have taken the first

335
00:17:33,956 --> 00:17:37,346
steps rather than just trying to leap
straight into action straight to the top.

336
00:17:37,646 --> 00:17:41,096
Real sustainable change doesn't
come from these heroic leaps.

337
00:17:41,310 --> 00:17:45,604
It just comes from climbing slowly
up the action stepladder, one

338
00:17:45,614 --> 00:17:47,741
clear conscious step at a time.