Dr Jo Egan, Ep 30
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Sharee Johnson: In this episode with Dr. Jo Egan, who's a emergency physician in Auckland, we discuss, lots of different things. Jo is, a great package for this podcast because she's a clinician. She's also been a researcher, having, her doctorate in, what helps the staff of the emergency department thrive and be well.
Sharee Johnson: So we talk quite a lot about that research, and in particular, uh, Jo describes the [00:01:00] eight themes that came through in her research, and she describes them saying that the humanity factors were the important factors, that all the things that help us remember we're human and relate to each other as humans were the things that were important to the staff of the emergency department for their own thriving.
Sharee Johnson: So we spend a lot of time on that, And one of the things that she used was Appreciative Inquiry,
Sharee Johnson: which we teach people about in our Recalibrate program. And Appreciative Inquiry comes from positive psychology. It's really about how can we look through a different lens.
Sharee Johnson: Jo, has, a lot of clinical experience. She's also a medical educator, and when she was talking about Appreciative Inquiry, she talked about asking the question of, what are we doing well here? And makes, I think, a really, uh, salient point for us to remember that, um, we might get some things wrong in health and, uh, certainly we do, and gee, there's a lot of [00:02:00] things that we get right, and remembering that, that holding our balance, holding some equilibrium by remembering all the things that we get right.
Sharee Johnson: I just enjoyed this conversation so much because of that optimism, because of that, uh, focus on thriving and wellbeing, and Jo has such a depth of understanding in this space. I say during the podcast, I wished I'd known her before I wrote my book. I have the good fortune of, of having a friendship, professional friendship with her since, writing the book.
Sharee Johnson: Jo, said that, sometimes she changes this opening question in terms of helping people tap their own capacity and their generative capacity by saying, "What is it that's giving you energy?" Or, "Can you remember a moment recently that has given you energy?" And I think that's a really powerful, useful question for us all to practice and remember.
Sharee Johnson: A number of times through the conversation, Jo reflected about how we learn when we're safe. That the pathways to learning, are very different when we're safe to when we [00:03:00] feel under threat or, or not safe. That's another thing that really resonates with me, this idea of our capacity is so much greater when we have a sense of psychological safety and, we feel safe. And that when we can remember the stories of learning and safety and connection and humanity, that these are the touchstones, the stories of wellbeing. These are the moments that help us keep going in the face of human suffering.
Sharee Johnson: She made an interesting comment, I think, at the end. She reflected on, uh, having a child who has been a doctor for 12 years, and that, that's given her another lens to understand what happens in health.
Sharee Johnson: How listening to her daughter's stories of learning and becoming a doctor, and listening for what has helped her in terms of her ability and in terms of her enjoyment in her work. I wonder if we might all go on this week after listening to the podcast, looking for, uh, how to create safety for each other [00:04:00] as colleagues, and also noticing what are the factors, what are the, the conditions that allow us to really, um, deliver it in terms of ability, capability, and to have some fun, some enjoyment while we're at work.
Sharee Johnson: Remember that good work is really good for our wellbeing and our mental health, and poor work environments, toxic work environments at the extreme end of that, are actually worse for our health than long-term unemployment. So, uh, thank you very much to, to Dr. Jo Egan for a terrific podcast episode today.
Sharee Johnson: I look forward to your feedback as always. And if you have found this podcast useful, please do hit the subscribe button, the follow button, uh, give us a like. It really does help with our podcast being shared with more healthcare people and, to our mission of trying to encourage, uh, the people in health, to share their stories and to look after each other.
Sharee Johnson: And may you be well
Sharee Johnson: Dr. Jo [00:05:00] Egan is an emergency medicine doctor at Health New Zealand, Te Whatu Ora, Waitematā, which is Auckland, for those who aren't in New Zealand.
Sharee Johnson: She is passionate about accentuating the positive that already exists in healthcare, discovering, nurturing, and valuing what really matters. She completed her doctorate in health sciences in 2018 with the thesis title Thrive: Accentuating the Positive in the Emergency Department. Jo's doctoral project combined Appreciative Inquiry and an interpretive methodology, that she's going to tell us about, to explore the thriving of healthcare workers so that it can be better understood, nurtured, valued, and fostered.
Sharee Johnson: So important. Jo has been involved in medical education for many years. She has teaching roles at the University of Auckland and Auckland University of Technology, where human factors, psychological safety, interpersonal learning, and an appreciative lens weave their [00:06:00] way through all that she does. Jo is also involved in academic and professional supervision, and she is a mum, in her own words, to two wonderful human beings who continue to teach, stretch, and fill her life with joy.
Sharee Johnson: Welcome to Recalibrating with Sharee Johnson, Jo. I'm so looking forward to this conversation with you.
Dr Jo Egan: Thank you very much. It's a real privilege to be here, Sharee, um, both to spend some time with you and, to see where our conversation goes.
Sharee Johnson: Yes. Well, I was reminiscing with you that it's a couple of years since we really had a big chunk of time together, so it's- Yeah
Sharee Johnson: so even though we've seen each other- In big crowds it's different, so how fun to have a long conversation together.
Dr Jo Egan: I reckon.
Sharee Johnson: So let's go back and start at the beginning so our audience has the opportunity to get to, know Jo Egan. Mm-hmm. Uh, can you tell us a little bit about your childhood and, and kind of how that helped walk you towards medicine?
Dr Jo Egan: Sure. That's a... Yeah, that's a good question. So [00:07:00] I was born in Wellington in New Zealand, um, to Kiwi parents, and, um, my dad was an engineer who moved around a lot, so we moved around a lot. And when I was two, we moved to the States, um, and I was there for, um, about seven years, um, enough to have a unique accent.
Dr Jo Egan: Um, and then came back to New Zealand, um, to, to finish high school. Um, we came back and forth a little bit and then ultimately I finished high school here and have stayed here all my, all of my adult life. I think in terms of, of moving towards medicine, I remember, um, in form one, which I must have been about 11, we did a project, an anatomy project actually looking at, you know, bones and what, what were the names of bones.
Dr Jo Egan: And I thought, "Man, this is really interesting." I... The, the way the body works, I was fascinated [00:08:00] by. And I thought, "I'm gonna be a doctor one day." Wow. And, um, and that- Pretty early though, isn't it? Yeah. Yeah, pretty early. Mm. Um, and that thought, um, it, it stayed, it stayed pretty much there through, um, through high school.
Dr Jo Egan: Even in, in a high school where, um, I said that to, um, one of my science teachers who suggested I have a plan B and a plan C- ... 'cause it was very unlikely that I would get into medical school. Um, which I think made me a little bit more determined rather than putting me off. Mm. Um, and, and i- i- in some ways she was right.
Dr Jo Egan: It did take me a while to get into medical school. Um, and I did, I did an honors degree in biochemistry first and, um, then eventually got into med school.
Sharee Johnson: Mm. Are you conscious, do you remember that during that first degree you still had your eye on medicine ?
Dr Jo Egan: I, I definitely did. I mean, I [00:09:00] applied, I applied several times. Um, so and then, uh, towards the end of that degree, um, I did a... My, honors was a, a research project, and I did think actually maybe I'll, you know, stick with this and, um, kind of potentially go down the academic route. Um, and, um, and I, I thought I'll try one more time and, uh, and then got in.
Sharee Johnson: Woo-hoo.
Dr Jo Egan: Um, yeah. And it definitely, it definitely felt like the right, you know, the right thing for me to do. I did keep thinking that they would You know, that they would discover that, that they made a mistake and come and, come and let me know. Some imposter syndrome before, before there was a word for imposter syndrome was definitely alive and well.
Dr Jo Egan: Mm. Um, but yeah.
Sharee Johnson: I, I, I appreciate you sharing that, Jo. I'd like to kind of underline it a bit because, you know, there's lots of kids, and I mean that with respect to all of our, um, uni students who might be listening. But there's lots of kids who are in biomed and who find their way to medicine through that route.
Sharee Johnson: Yeah. [00:10:00] And, uh, and lots of, uh, you know, pressure and challenge and, and self-doubt around whether they really can do it, whether they really want to do it, whether all the effort for those multiple applications and so on. Mm. The study, you know, all that hard work is really worth it. So I, I think it's lovely that you've, um, shared that. I hope that the people who are, are listening in that position really can take some heart.
Sharee Johnson: Did you, did that come from your family, that persistence or that determination or that, go get what it is that you want? Did those things, were they encouraged in your family?
Dr Jo Egan: Yeah, it's a really good question. And I think that, um, the, uh... In my family, definitely there was a, there was an, um... You know, we, as kids we believed, and this is probably came a lot from my mum, that, you know, that we could, we could do whatever we put our minds to. You know, that that possibility was there.
Dr Jo Egan: And growing up in the States, that is very much, uh, you know, an ethos [00:11:00] of, um, of, of the States. That, you know, anybody can, can become whoever they wanna be. Um, I was a swimmer when I was younger. And, um, and, and in the States, that, that came out as, you know, if you work really hard and swim hard, you can get to the Olympics.
Dr Jo Egan: And, and so I think that, that a lot of that came from, um, from, from those early experiences. And a, um, and, and a, and definitely an unwavering belief in me from, um, from my parents, but particularly my mum.
Sharee Johnson: Mm, mm. Do you think that cultural difference was important too? That you had that lesson from America, that, that that was also kind of endorsing the family idea that you could, if you worked hard enough, you could become whatever it was you d- you wanted?
Dr Jo Egan: Yeah, it, it certainly has, it certainly has shaped me. You know, that kind of independent belief that, that, that you can do it, which I, uh, I definitely challenge much more in my, [00:12:00] you know, as I understand the world a little bit better, but, um, but yeah, there's no doubt that it has shaped me.
Sharee Johnson: Mm. Yeah, I definitely notice that cultural difference in that, you know, I mostly coach Australian and New Zealand doctors, but I do have a handful of American and Canadian doctors that I'm talking to as well, and there's definitely that, that cultural difference. Sometimes subtle, we are affected by the water we're swimming in, aren't we?
Dr Jo Egan: Yeah, definitely. Definitely.
Sharee Johnson: And so you, you got into medicine and, uh, you had an imposter phenomenon happening some of the time. Yes. Yes. And how hard was it?
Dr Jo Egan: Undoubtedly, the hardest thing was getting in. Mm-hmm. Um, and, and I, I loved it.
Dr Jo Egan: I, I loved the learning. Yeah, I really enjoyed the learning pre-clinical and, uh, my, my undergraduate degree and honors was in biochemistry, so that kind of gave me, you know, that made that part really, you know, a, a little bit easier. So it gave me a little bit of, um, a bit more time to put into some of the other subjects that needed a little bit more [00:13:00] time.
Sharee Johnson: And did anatomy live up to the promise, or was it a disappointment?
Dr Jo Egan: No, it, it lived up to the promise. Yeah.
Sharee Johnson: 'Cause that's a long time from 11 till, you know, 21 or whatever you were when you started.
Dr Jo Egan: Yeah. Yeah, no, definitely. And, yeah, it represented the, you know, the human body is, uh, just astounding and fascinating, I thought that then and I continue to think that now.
Sharee Johnson: Yeah. How amazing. Isn't that amazing to have a career where that sense of learning and that curiosity continues on?
Dr Jo Egan: Yeah, definitely. Yeah.
Sharee Johnson: Sounds very, sounds very fulfill, fulfilling from over here. Yeah. After med school, you're thinking about your specialty or, or what's next, and was that an easy process?
Sharee Johnson: What happened then?
Dr Jo Egan: Yeah, so it was, um, there were definitely sort of some, Some interesting roads that, came up. I, um, I was really, keen on pediatrics. I [00:14:00] went as a junior doctor fairly early into, into pediatrics and, um, and loved working with kids and, and I loved the...
Dr Jo Egan: There's a lovely culture in, in pediatrics and in, in children's hospitals, that I really liked. So my first kind of inkling was maybe I could do that at that stage, I had, my daughter was three or four. And I think thinking through what I was keen to do from a medical point of view and thinking through what kind of mother I wanted to be, um, took a lot of, you know, that took up a lot of space and a lot of time, for me.
Dr Jo Egan: Actually, I had a second child at the end of my second house officer year, and then, um, I figured actually at that stage that I would be a general practitioner, that I'd do some GP. And I did a little bit of locum GP work while my son was [00:15:00] quite young. And, um, and then I thought, "Actually, I've, I've spent the last couple of years in pediatrics.
Dr Jo Egan: I need to go back to learn, remember what adult, to do with adults." And so I went to the emergency department, ... I thought I'll go there and do sort of six months there and then come back out, and I went there and never left.
Sharee Johnson: Mm-hmm. Because you discovered that you loved it, or what happened?
Dr Jo Egan: Yeah. , I discovered that I loved hospital medicine , as opposed to community medicine, that there was something about, I think something about the, the procedural aspect. And, and I think that, I think that it's, um, it's more immediately collaborative. Mm-hmm. Um, I loved being in emergency medicine, being able to see kids as well as, the full range of, of, of humanity really.
Dr Jo Egan: Um, and, and the, the teamwork and the [00:16:00] camaraderie, I really enjoyed all of it. Mm-hmm. And I think that as a specialty, um, it's, it's a specialty that, that can, um, that can easily be, be done part-time, which is what, um, I ultimately wanted to, to do For me, that was, felt like the right mix.
Dr Jo Egan: Mm-hmm. Um, and because there's not too much continuity of care issues. Mm-hmm. You see the patients that you see, and then, you know, they are either coming into hospital or sending them home. Um, that, that, you know, that seemed like it, it worked really well.
Sharee Johnson: I, I'm curious thinking about the balance between family and growing your your kids and the work in the hospital in the emergency department. And I'm curious about what that did for, uh, I guess your, um, identity and in particular the sense of imposter. 'Cause lots of people talk about that they have to work X number of days to have [00:17:00] enough confidence. That if they're- Yeah ... they're not working, for instance three shifts a week, um, then they Uh, second-guess themselves too much.
Sharee Johnson: Did you have any of that happening when you were trying to make those decisions?
Dr Jo Egan: Yeah. I, I can't remember that that was, was much of an issue. In my second year as a house officer, one of my friends was looking to do some part-time, and so we put together a proposal to, job share, and it really wasn't very common at all back in those days.
Dr Jo Egan: And we did have a little bit of a sense of kind of forging a way forward for women if, if that's what they would choose. Um, and unfortunately, it seems like it's still pretty difficult to do for all sorts of different reasons. Um, but, but we were able to. And I think that, that as part of making that proposal, um, we thought pretty hard about it in terms of what the advantages we were able to offer as p- part-timers.
Dr Jo Egan: Um, that, you know, that that gave [00:18:00] us time to, um, to continue our learning. To take what we saw, um, clinically and, and, and learn, you know, rather than trying to, you know, trying to learn while you're doing really long hours as well. We did week on, week off, and in our week off, we shared a family planning job as well.
Dr Jo Egan: So we did a couple of, um, half-day shifts in a family planning clinic, and it gave us an opportunity to, to connect and to, to do some community care as well. So I think that, that I felt like there were lots of advantages. Um, we could cover each other for sick leave or for holiday, um, some holiday leave if that was really tricky.
Dr Jo Egan: And, um, and so I, I suspect because we'd made this proposal and, you know, we were really trying to sell it, I kind of felt like, we were offering an advantage potentially. Yeah. And certainly for me, it, the, the advantage in terms of being the kind of parent that I [00:19:00] wanted to be, certainly outweighed any of those other feelings.
Dr Jo Egan: And, I knew, I knew that choosing that way would have an impact on my career and my career options. Um, and there were some specialties that, you know, this wouldn't work in that, in that sense. Mm-hmm. But emergency medicine and, a- a- in, in fact, I'm, my vocational training is in urgent care.
Dr Jo Egan: It's sort of a community-based training. Um, and although I've worked in the emergency department, all of my career, I did that training again, um, in order to have a training that fit- In with my lifestyle rather than- Mm
Dr Jo Egan: medicine primarily driving- Mm ... what was happening.
Sharee Johnson: I just really love the agency of this, that the two of you made a proposal, you built a case. Mm-hmm. And the, the sense of, you know, knowing that your wellbeing would be served [00:20:00] and that you would be better doctors. Yeah. And just for people who don't know Jo, like, we're talking about how long?
Sharee Johnson: 25 years ago or more? Yeah, I've been a doctor for 30 years this year. Yeah. And, and you're really reminding me of when we had Ashok, Ashok Bhattacharya on the, podcast in one of the early episodes, when he talked about, you know, build your life and fit your career into it, rather than the other way around.
Sharee Johnson: Yeah. I think, you know, this, um, it's, uh, giving me a bit of a thrill really, , to remember that there have always been some doctors doing this kind of stuff. It's not like it's just wellbeing landed on the planet, you know, 10 years ago. It's that there have always been examples of doctors using their agency and their network and their togetherness.
Sharee Johnson: You know, you- Yeah ... you and your colleague coming together and saying, "How can we, uh, do this?"
Sharee Johnson: D- do you feel like you had a particularly enlightened boss who accepted this proposal? Or do you feel like, no, he or she didn't need to be particularly enlightened. Uh, it was us coming together with a, a problem and working out a way to solve it, which of course emergency doctors are very good [00:21:00] at.
Dr Jo Egan: So we, we started that when we were working in pediatrics and- Mm ... and I suspect that, um, that, that pediatrics perhaps were a little bit more, more open to it. And then when I switched into emergency that, that was no issue there either. I started there job sharing- Mm
Dr Jo Egan: um, a house officer role, and then started, a, a CMO role, , that I job shared for a long time as well. Mm-hmm. Yeah.
Sharee Johnson: Lovely examples of recalibrating.
Dr Jo Egan: Yes. And, and- And in the emergency department I definitely had a great boss who, who, who had our backs and made it happen. Mm. Yeah.
Sharee Johnson: So good. So good. I've got this question here about, has medicine asked things of you that you weren't expecting, positive and negative or, or unintended consequences? You're maybe answering some of that already. Are there other things that come to mind that medicine has asked of you that you weren't expecting?[00:22:00]
Dr Jo Egan: Yes. It's hard to know what to expect, isn't it, when you're, when you're first, when you're first, um, coming through. I think that one of the things sort of in, in retrospect or recognizing along the way, um, and I guess partly this was emergency medicine as well, that the, that the shift work had an impact on, um, other things that were available.
Dr Jo Egan: Um, for a long time with young kids, you know, it, it w- it was fantastic. It, it enabled me to do, um, weekday stuff you know, I, I coached my kids' sports teams and I went on school camps and it, it gave me an incredible flexibility. Mm-hmm. Um, and then as they were getting older and I had a little bit more time to myself, realizing that it was really difficult to join a sports team or to go to a class that was a once-a-week class because my weeks, my commitments, you know, changed every week- Mm-hmm ... um, with shift [00:23:00] work. So that was, um, I guess that was something that I recognized sort of later on that, that perhaps, um, joining or being a part of a community outside of, medicine and, and my own friendship groups was, was a little bit trickier.
Sharee Johnson: Mm. Mm. Yeah, yeah. The netball team needs to have 16 people in it so that the rotating people each week can, can be accommodated.
Dr Jo Egan: Exactly. Mm-hmm. Yeah, exactly.
Sharee Johnson: Every, every job does have that, doesn't it? Can you say a little bit more about the shift work, Jo? , Even though you're available and you're able to be with the kids in the day , there's a physical toll, isn't there, in, in the shift work?
Sharee Johnson: I know, um, even with on-call, some doctors in different specialties will say no doctor should be on call after they're 50, that your body can't really recover in the same way that it can before that. Yeah. Any reflections on shift work and, and call for doctors?
Dr Jo Egan: Yeah. It's something that is always going to be there given that we need to provide a [00:24:00] 24/7 service.
Dr Jo Egan: Um, and as I mentioned before, it definitely has its advantages, um, in terms of, of creating some other time things can be more flexible in terms of doing some weekday things and, um, and I think that there does come a time where the risk and benefit, um, you know, the, the benefit in terms of the opportunities that it gives you, but also the benefits in terms of the service you're providing.
Dr Jo Egan: Um, recognizing that there are risks to, to ourselves, to our own health,, you know, as you say, the recovery time. As you get older, that you definitely notice that, takes more time to recover from. And I, I suspect it's different for everybody. There's, there's definitely some people who can last doing nights longer than, longer than others.
Dr Jo Egan: I made preparations for finding a way out of nights, um, probably in my mid-40s. [00:25:00] Actually, maybe even earlier I started thinking about it. As I mentioned, my s- my specialty or my vocational training is in urgent care, and I was involved in an urgent care practice, um, half-time and half-time in the emergency department, um, for a little while thinking maybe this is, you know, my next step.
Dr Jo Egan: It was a great experience, and it turned out not to be my next step. But that was sort of all part of that thinking, recognizing that, that nights definitely had a shelf life, or I had a shelf life doing nights. Um, and then, sort of having a bit more of a portfolio, career and creating some other opportunities, in the hope that I could, somehow opt out of those nights.
Dr Jo Egan: And I, I've been very fortunate to have found a way to do that. Mm. In 2019, I stopped doing nights.
Sharee Johnson: Fortunate and proactive
Dr Jo Egan: Y- yeah, definitely, definitely proactive Yeah.
Sharee Johnson: So, you're mentioning your portfolio [00:26:00] career, and we, we heard in the bio that, you have university appointments and we haven't really talked about it yet, but you've been involved in running some retreats with some of your colleagues.
Sharee Johnson: Um, you clinician work still. Can you tell us about the Tetris? How do you, how do you put your portfolio career together?
Dr Jo Egan: Yes. It's, um... That has, uh, I was gonna say that sort of somehow has landed in my lap, but it's, but there has been a little bit of Creating opportunities for that as well. Um, and, and it really started with, with medical education.
Dr Jo Egan: I went to an APLS, course, and I, I loved, I loved the course, I loved the learning, but I really enjoyed the way that they did the teaching. Mm-hmm.
Sharee Johnson: Tell us, APLS.
Dr Jo Egan: APLS, it's, it's, there's Australian as well, so Ad- Advanced Peadiatric Life Support.
Sharee Johnson: Thank you. Yep.
Dr Jo Egan: It's all around the world, but New Zealand and Australia do it very similarly and do it together, so. And I remember really enjoying [00:27:00] the way it was taught. There were several different teaching modalities and, and a lot, and a lot of it was hands-on and, um, simulated, patients. And I remember thinking I, I'd love to be involved in this.
Dr Jo Egan: It's something that you get invited to be an instructor rather than sort of applying or, um... And, and fortuitously I was invited, to come and do the training- Can we just- ... to be an instructor ...
Sharee Johnson: can we, can I lean into that? Sorry to keep interrupting you. That's okay. Did, did you make it known?
Sharee Johnson: Because I think this is another lesson for people about agency. Like, even though you have to be invited, did you make it known that you were interested?
Dr Jo Egan: That's a good question, and I don't know that I can remember the answer. That's okay. I may have... I'm, I'm, I suspect I probably inquired. Okay. I probably said-
Sharee Johnson: So for people listening, I really want to kinda underline this, that- Mm
Sharee Johnson: um, there are some people in the world who are very excellent at this. They make things known, and then they go, "Ooh, I was so lucky to be invited." Yeah. [00:28:00] But actually, they made it known, and, uh, there are lots of people, and I, I probably do want to say women are more likely than men, it's, I think we've got enough research to show that, um, to hesitate and to not say that out loud.
Sharee Johnson: And so- Yeah ... so just encouraging people who are listening, if there's something like you're having an experience, like Jo, where you're somewhere and you think, "Oh, I love this. I'm really interested," you know, make it known. You don't have to be, you know, nagging or insistent or making yourself a nuisance.
Sharee Johnson: Just, just make it known. Yeah. That's how we create opportunities for ourselves. Yeah. Sorry to interrupt your story. Keep going.
Dr Jo Egan: Yeah, no, uh, that's a really good point, and I would've, I would've asked. I may not have, I... A- anyway, I definitely would've inquired about it. Mm-hmm. And then , in their training there was some, um, some, some education theory as part of their training.
Dr Jo Egan: And I just was really captured by, by that. And I think one of the things that I really- That I really liked about some of the [00:29:00] education theory was, was, educators overtly create safety for learning. Mm-hmm. That's probably a broad statement that is not true for all educators. But education theory, and even, even way back then, there was an, an overt recognition that our brains work differently, in safe spaces, and that our learning and the ability to transfer our learning, is different when we're under threat compared to when we're safe.
Dr Jo Egan: Mm-hmm. And I, I really liked that idea, and liked, the idea of teaching and being involved in, that. And so that's that's probably where my portfolio stuff started. I then did a post-grad certificate in clinical education.
Dr Jo Egan: Mm-hmm. And that opened a couple of doors. Um, it was the pathway that I took was simulation heavy, [00:30:00] and, the simulation, um, service at Auckland University, which is, which is where I did the study, I got to know some of the people there, and, said I was really keen to do more, and if anything, any opportunities came up And there was a, um, an undergraduate course that was simulation-based that was just starting.
Dr Jo Egan: Mm-hmm. And, um, they were looking for somebody to, um, to convene the course. And, um, they asked if, asked if I wanted to come along and observe, and I, I came along and I... My observation didn't last very long. I kinda jumped in and They were short, they were short that day, so I kinda jumped in and was part of the team.
Sharee Johnson: Okay, but you put yourself in a, in a place of opportunity.
Dr Jo Egan: Yeah, exactly. And, um, and then, and then that... I, I got the job of being the convener for that course. And I am still involved. I'm no longer the convener. I've, passed that along. Um, and, and still, you know, very definitely in a [00:31:00] supportive role, but, but also get to just turn up rather than do so much of the organizing.
Sharee Johnson: Yeah, yeah. And so your roles at the unis, are you going to the campus? Are you running around lots of different places? Are you working from home? Like, how does that all fit together? Yeah. So for that course, it's, it's a four-day course, although I'm involved in two days of it, and so that happens seven times a year.
Dr Jo Egan: So I'm at the uni for those two days seven times a year and some other sort of support stuff. I also have been involved in, um, a trauma day, for quite a few years that is run for, urgent care registrars. And, um, some pediatric life support, run through the university. A two-day course, um, for that.
Dr Jo Egan: And every now and then I turn up and help with some of their advanced life support training, and I've helped, IV, IV training, when they're short if, if, if I can. Again, it's a a l- a little bit like emergency medicine. It's different, you know, the, it's different every week.
Dr Jo Egan: It's, it's not a , you [00:32:00] know, one day a week or two days a week I'm there. And then I did some, some study coming from that e- from that education knowledge from the theory of education and thinking about that whole idea of, of how our brains work when we create safety, and thinking how cool would that be in the emergency department, or how cool would that be in a clinical space?
Dr Jo Egan: And recognizing that clinical spaces are pretty chaotic, and there's certainly an awful lot that's not in our control. But what would it look like if we overtly created safety for our colleagues, for our patients? I, you know, I think we do try really hard to do that for our patients, but what could that look like if we were doing that for our colleagues and our juniors?
Dr Jo Egan: And, I'd been thinking for a little while that I'd, that I'd quite like to do some kind of project around that. [00:33:00] Um, the burnout rates were, were becoming louder in the news and , in the literature. And I was thinking, that I'd like to do something, do some learning, do some kind of project, um, around that, and did quite a bit of reading around burnout and around human factors
Dr Jo Egan: And in that, I came across positive psychology. And a lot of the burnout literature, made me feel pretty helpless. Mm. And I, I distinctly remember one day, I'd been doing all this thinking, and we had a, an M&M, uh, so morbidity and mortality, um, meeting, and it was sort of a pediatric-focused one.
Dr Jo Egan: And a- as I mentioned before, I, I really like pediatrics and looking after kids. And, um, and I'd hate to say that I try harder with kids than I do with adults, but you know, I... y- when you enjoy it, there's a little bit of a boost there. [00:34:00] And this was looking at how often we get our pediatric prescriptions wrong, and there was something that was wrong with our pediatric prescriptions a- almost 90% of the time. You know, s- they were often minor things, but it was still. And I remember sitting in this thing, and as I was listening, I was kind of getting smaller and smaller in my chair, and crossing my arms, and thinking, "Oh, my gosh, is it even worth coming to work tomorrow?"
Dr Jo Egan: Mm. Um, given that how often we were getting things wrong. Yeah. And I watched a video. It was Shawn Achor, um, his video on, is it Happiness at Work? I can't remember the title, but one of the TED Talks. Yeah. And I watched it, and I thought, "Oh, my gosh, this is what I need to do."
Dr Jo Egan: Because we do so much right. Yeah. You know? Yes, we get things wrong. We're always going to. We're human, and it's not to say we should ignore that. But boy, there's so much that we do well. Mm. And that we get right. And, and the thought that I could, [00:35:00] that I could put a lens on that was, was motivating, and exciting, and hopeful, and I just thought, "Boy, I need to look further into this."
Dr Jo Egan: Mm. And part of my motivation at this time was my daughter was, was getting ready to apply for medical school, she and her c- her cohort. Mm. And, um, and thinking... You know, I'd been thinking for a while- That, that I'd, , I'd like to try something. Having watched so many colleagues, particularly nursing colleagues, come into the emergency department and leave several or many years later almost a shell.
Dr Jo Egan: Mm. Um, you know, we had sucked the life out of them. Um, and, and it seemed, it seemed unjust that a career that theoretically has almost all of Aristotle's components of a good [00:36:00] life- Mm ... um, that, that we shouldn't be thriving. You know? Mm. That, that, that harm came to them, um, in a career of, of caring for others.
Dr Jo Egan: And so then with a little bit of more motivation that thinking that this is what is likely to happen to, to my daughter and her cohort as well, um, it kinda stirred me on a little bit.
Sharee Johnson: Mm. Let's keep going there, Jo, it's so interesting. I think I read about your thesis and think, "Oh my goodness, I wished I knew about you before I wrote my book," and this work that you were doing.
Sharee Johnson: And, and over the last 10 years I think we have discovered, um, probably because of COVID and, and more, more time online because we couldn't all be together, but we've all got this broader global view now, and we know that- Yeah ... there are lots of people around the world doing lots of these kinds of bits of work.
Sharee Johnson: Yeah. And finally now there are mechanisms where we know about each other's work and, and, uh, maybe we, maybe we're creating a bit more momentum as a result. I hope we are. [00:37:00] Can you tell us about your research? What, what did you find? What's been life changing or perspective changing for you out of that work?
Sharee Johnson: How have you been able to share it, those kinds of things?
Dr Jo Egan: Sure, I'd love to. , So definitely a life changing thing to do for me. I essentially spent- four years listening to good stories in the emergency department. Mm-hmm. , And in fact, people still see me and tell me their good stories.
Dr Jo Egan: Um- Good ... and so it certainly,
Sharee Johnson: You became a magnet, a magnet for the good stories.
Dr Jo Egan: A, a magnet for the good stories. And so it certainly changed my perspective of, of, of work. Mm-hmm. Um, or my, my lens on, on work. And, and my experience- Mm-hmm ... um, um, of being there. And so, and so I used a qualitative, methodology, called Appreciative Inquiry, which is based in, it's a [00:38:00] practical application of some positive psychology and philosophy.
Dr Jo Egan: Um, and in essence is exactly what it says. Y- looking for the good stuff. Mm-hmm. Um, looking for what it is that brings life or what it is that spins our wheels. And I did that in my own department. With doctors, nurses, healthcare assistants, and clerical staff as well. Yeah. And, um,
Dr Jo Egan: One of the, um, one of the basis or one of the underlying assumptions with Appreciative Inquiry, as you know, using it yourself, is that idea that change happens from the very first question that you ask. Mm. And, and I liked, I liked that idea. I liked the speed of it, um, in terms of, you know, in the emergency department, there's very little time to do anything extra.
Dr Jo Egan: Um, and so the idea that I could somehow do this and, and potentially [00:39:00] invite some change, early on. , I did some interviews and, and mostly workshops with staff, and I did them in meetings that were already happening. So there... Some teaching times with the nurses.
Dr Jo Egan: They all had a study day, so I went to all of their study days over a year. Um, and, um, healthcare assistants and the, and the ward clerks. I, I got a group of them that came to my house for dinner, and we did it there because they don't have any protected time for learning. Yeah. Um, but we kind of tried to find ways that so that it wasn't a burden on the staff as something else to do.
Sharee Johnson: Did, did you say you asked doctors as well?
Dr Jo Egan: Doctors as well, yep. Mostly in our teaching time, our departmental teaching time we did the sessions. Yeah, it was just a delightful thing to listen to, to stories and listen to them telling each other stories. And the smiles and the, and the energy. .. There's a generative energy in sharing those positive stories.
Sharee Johnson: So you, you felt that in [00:40:00] yourself, that sense of energy and motivation, but you also witnessed it in the other people?
Dr Jo Egan: Absolutely. Yeah, absolutely. And then as you mentioned, I used a, an, an interpretive sort of methodology to, um, to take some of the information a bit deeper.
Dr Jo Egan: So I did some interviews, and that in- in- information I took I took deeper in a, in a very, you know, kind of as far qualitative as you can go for a methodology. It was called hermeneutic phenomenology, which in essence is understanding, with a philosophical basis. And there's particular, phenomenological, um, uh, philosophers that, that guide the interpretation.
Dr Jo Egan: Mm-hmm. Um, and that was, that was a whole new world and new paradigm for me that took, took a lot of occasionally kicking and screaming, [00:41:00] but mostly just a lot of stretching of how I saw the world, h- how other people see the world, how many possibilities, and the, the very idea that, that, that the scientific way of seeing the world or a, positivist paradigm is, that idea of sort of cause and effect and, um, understanding things by breaking them down and, and seeing how they're made, um, that we can prove things in a certain way.
Dr Jo Egan: I just assumed that was, that was the only truth. Um, and, and being open to a different lens that said, actually, there's other truths to see and other ways of looking at the world. And that was, yeah, it was fascinating and challenging and exciting. I had the most wonderful academic supervisor who In a very human way held me through [00:42:00] this transition of paradigms as I went back and forth.
Dr Jo Egan: So it, it's the, the, the interpretation of this work was very much from, from a lens of what is it to be human in healthcare. Mm-hmm. Mm-hmm. And, and the findings were with that lens, but the findings in terms of what is it that really matters to people in the emergency department were all things about being human.
Sharee Johnson: Can you say a little more about that? What kind of things?
Dr Jo Egan: Yeah. So there were eight themes that, um, that came through. Mm-hmm. One of them was around caring for self. That was sort of multifactorial. You know, the, the idea of looking after yourself, having, having a break.
Dr Jo Egan: Um, looking after yourself, outside of, of shift work and outside of work. But it was also, there was definitely a thread that came through there in terms of knowing yourself, getting to know who you are, how you see the world, how are you triggered with [00:43:00] different patients. Um, and being able to be comfortable with who you are such that, um, you're not always thinking, "Oh my gosh, they think I'm an idiot," or, "Oh my gosh, I've..."
Dr Jo Egan: You know, they're in a bad mood because they're working with me today. You know, that kind of whole reactive thing. But actually getting to a s- a stage where You're happy and you're, you know, content in who you are and what you have to offer. And the recognition that that then gives you more cognitive space- Mm
Dr Jo Egan: to be able to look outside yourself- Mm ... to focus on the work that you're doing, on looking after your colleagues, on looking after your patients. , Yeah, so that was a, it was a, it,... Was it unexpected? I guess in some ways, it was something that I, I, I, I found really interesting that came through in that theme.
Dr Jo Egan: Mm. [00:44:00] The next theme was one around sort of knowledge or wisdom. That was around, the excitement of learning new things. Um, and also the excitement of teaching things to other people, um, and watching their aha moments. And importantly in that, in fact importantly in, in all of the themes, there was a, there was an added step with, with all of them.
Dr Jo Egan: So even with the, with the looking after yourself and this, and this knowledge, was then the step of putting that knowledge and that care of yourself into practice in terms of making a difference for, for other people. Mm-hmm. Mm-hmm. Um, the third one was around achieving or achievement. So, um, you know, nailing a really tricky technique or, or procedure. Getting a really challenging diagnosis. Um, talking down a agitated patient. Um, [00:45:00] helping somebody or, or being there with a, family and a patient who's dying and, making that as good as, as good as it can be. So that those moments of, of achieving or achievement and, um, and recognizing how they make a difference.
Dr Jo Egan: But just also that, you know, high five on the inside. Um, and occasionally, particularly in a team, high five, you know, together. That's it. Yeah. Yeah. Yeah. So that was definitely there. . Those three were sort of, kind of more focused on the self.
Dr Jo Egan: Yeah. And then there was a, there was a group that was sort of more focused on team or a sort of a broader lens. And definitely one was a connection. Connecting with colleagues, connecting with patients. And incredibly how quickly you can make a significant connection in the emergency department.
Dr Jo Egan: You know, a squeeze of a hand or a smile with an older patient or, you know, somebody bringing you a cup of tea all sorts of different things. And not only in that group, some of the stories were around [00:46:00] seeing connection of others. Seeing a, a little old lady and have her husband or her family come in, and all of a sudden, you know, they were miserable and in pain, and they just brighten up and, things change.
Dr Jo Egan: And so, so even witnessing that kind of connection was a part of that theme. Mm-hmm. The next one in that group, um, was appreciation, um, or being grateful. So being appreciated was a part of that. We don't do the work for necessarily for gratitude, but man, it makes a difference when it comes.
Dr Jo Egan: And that being, being seen or, or being appreciated either by colleagues or by patients, came through pretty strongly. And then also being grateful for things. You know, having a lens of being grateful. Um, there was one story, um, where, um, one of the nurses had had a, a, a crazy busy shift and, [00:47:00] um, and went home thinking, "I don't think I can do this anymore."
Dr Jo Egan: And frustrated with not being able to give the kind of care she wanted to give and, um, and really feeling at the end of her tether. And in the morning when she woke up, there was a post in, our team Facebook, page and one of the other, one of her colleagues who were, who was on that same afternoon said, "Hey, I, I so appreciate all of you.
Dr Jo Egan: It was a crazy shift, and I'm so glad I was on with all of you, and together we really made a difference." And that appreciation that came the next day changed the way that, that that nurse looked at that shift. And no longer was it something that, that took her to the edge of her comfort zone, but rather it was a, "Man, this is a hard job, and boy, we can do it well together."
Dr Jo Egan: Um, and, and she was ready to come back.
Sharee Johnson: Hmm. Um. It's powerful. It's really powerful.
Dr Jo Egan: So powerful. Yeah, so powerful. Um, the other [00:48:00] one in that, in that team that came through was having fun. Mm. Um, and, and I think in the emergency department, we're pretty good at having fun, and using humor, um, uh, mostly in the right place.
Dr Jo Egan: There's definitely a sweet spot for humor. Yeah. Um, but, you know, even in a, in a resuscitation, um, or in the, in the resus room, um, finding a way to bring some humor, um, bring some connection. Viktor Frankl was one of the philosophers, one of the, people that ... that his work kind of wove through some of mine.
Dr Jo Egan: And he talked about humor and about humor offering us that moment to step out from, you know, from the, from the chaos and have a moment of, of seeing it from a, a broader view and, and, and how that can just change your perspective, as well as bringing people together and, a bit of a social lubricant.
Dr Jo Egan: Um, and I th- I think in the emergency department, I think we do fun [00:49:00] well. Hmm. Um, at... Perhaps it's one of the things I love about pediatrics as well, because it, it's, it's almost expected to have some fun, you know, with some bubbles or some, um, stickers or- Puppets ... you know, you kind of have to. Puppets, yeah.
Dr Jo Egan: You, you have to do that to, to make a connection with the kids, yeah. So that was one.
Dr Jo Egan: And then there were two other themes that, that, uh, that f- felt like they were kind of more broad. So it was sort of a little bit around individual and then around team and then, and then around a broader picture of being human.
Dr Jo Egan: Um, and one of that, one of those was shared humanity. So those moments of being seen as a human rather than whatever your job label is, and equally so for, for patients. Um, somebody bringing pizza. You know, uh, basic needs seem to be a really fast way to see the humanity in another person. Somebody making you a cup of tea or getting a urinal, for [00:50:00] a patient, making sure that they can go to the toilet.
Dr Jo Egan: Those moments of seeing each other as human beings, whether they're colleagues or patients, came through really strongly in terms of, in terms of our thriving. And the final one, um, kind of wrapped them all up together, and I mentioned it before, but that, that feeling of making a difference.
Dr Jo Egan: Those stories where, where it was that making a difference was overt or that you felt that, that it made a difference. That was a, a real part of our thriving and came through in each of the others. , That when we, when we took that knowledge or that fun then made a difference in a situation, um, helped to break the ice or put somebody at ease or ease their pain. That was really strongly associated.
Sharee Johnson: What's happened since, Jo? Is there any, um, systems change as a result of the work or, [00:51:00] or are there people still in the department who are making sure that these lessons are continually lived in the department?
Dr Jo Egan: So I, I'd like to, I'd like s- I'd like to say yes.
Dr Jo Egan: And, and as with in sitting with the, with the paradigm, the complex paradigm, it's really hard to say that this, as a result of this, this has happened. And overall, um, since then, a lot of our projects in the department, apart from me, have started with what's working well here- Mm ... and how can we build on that.
Dr Jo Egan: Mm. Um, there's definitely, overt gratitude and appreciation that comes through in lots of different, lots of different ways. I think of the ways that, it is kind of iterated is, ... I, I work quite closely with our [00:52:00] Māori team, and, um, the College of Emergency Medicine has got, um, a Māori health strategy that was developed by, uh, Māori clinicians and, community.
Dr Jo Egan: Part of the strategy was a number of values, of, of values that come from te reo Māori or a Māori worldview. Mm. And when they sent the strategy back out to the community and said, "Hey, what do you think?" Um, the community said, "You know, there's some great detail in there and some, you know, some great steps to take and some great things to do.
Dr Jo Egan: And if you all lived those values, you wouldn't need the strategy." Mm-hmm. And, um, I, I, I guess I, I guess I love that. I love the, um, it is closely aligned with a lot of the, you know, a lot of the work in terms of those, themes or the values or the things that are important. If we [00:53:00] get those right, then we don't necessarily need, um, you know, a big strategy about, about well-being.
Dr Jo Egan: That if we, if we do this right, it, the result will be well-being rather than, rather than focusing necessarily on it. -- So I weave those values through in, in a lot of work that I do and, and work with, the Manaaki Mana is what it's called, the, the Maori Health Strategy.
Dr Jo Egan: I do that and support that within, within my own department. And I also do that, a little bit more broadly within Te Whatu Ora (Health NZ). Part of my strategy for getting out of nights, um, and, and thinking where could I take this, the, the doctoral work, I do have a non-clinical position with Te Whatu Ora- with a lens on organizational culture and, and wellbeing, particularly for staff.
Sharee Johnson: Mm-hmm. Um- Is that a, is that a national position? It's, it- [00:54:00] Regional?
Dr Jo Egan: I guess theoretically it has become a national position sort of by default. We've had a couple of restructures. Mm-hmm. Um, it was originally in was, it was in Waitematā. (Auckland) so I do, work in other hospitals other than my own.
Dr Jo Egan: Mm-hmm. I do Appreciative Inquiry workshops with teams. Mm. Um, I do some compassion work.
Sharee Johnson: Maybe we need to just say, we use Appreciative Inquiry in our Recalibrate program, which is in groups. I think, uh, David Cooperrider, who's the, the creator or the describer of Appreciative Inquiry initially, was, was doing that with big groups, with big cultural change.
Sharee Johnson: So I think we probably just should acknowledge that that's where it began. Absolutely. A lot, a lot of the doctors that I am working with, we are using it in small groups, but they're also using it individually. They've found it really applicable individually. .. For people who haven't heard about Appreciative Inquiry, we'll put some things in the show notes.
Sharee Johnson: But I think, um, you know, sometimes it's called the 4D model or the 5D model, and it's really starting, as Jo says, with this really central question about what's [00:55:00] working well here, and defining what the problem is that we're trying to work on. Um, which lots of models do that, that definition at the beginning.
Sharee Johnson: But then this process of saying, "Let's see what we can discover, and let's dream." And, one of the things that's really struck me in the work, um, since I've been working with doctors, is that m- many doctors individually find that very difficult, to dream. Yes. And so- Yes. So even, uh, for people who haven't heard of Appreciative Inquiry, just to encourage you to be curious about what do you want?
Sharee Johnson: What- Yeah ... what do you want, and what's working well here? And if you could dream up anything without any restrictions or obstacles or barriers or, you know, that, that deadening sentence of, "It's the system. I can't do anything." You know? Yeah. Just, it, it... Really trying to open up to, if I could dream a bit here, what would it look like?
Sharee Johnson: What would it feel like? How would people be interacting? And I think that for, in my work, it's been a really beautiful exploration of humanity that you're talking about. Helping people- [00:56:00] Yeah ... get back in touch with, what does the human in me- feel like? What does she want to experience? How does she want to experience the other humans around her?
Sharee Johnson: Yeah. It, it kind of, maybe blow up is a bit dramatic, but it kind of blows up some of the operating systems that we're defaulting into that we don't kind of have a conscious awareness anymore that we're doing it. And so- Absolutely ... even though it's a bit hard to say, "Well, what is d- going well here?" Or, "What is my dream?"
Sharee Johnson: It's a bit hard to think like that because it's, we're out of practice. Yeah. And I, I think, a- and maybe that's drawing me a bit to what you're saying about the First Nations communities too, that they have this... My experience is, I don't, I probably shouldn't be generalizing, but there's this sort of wider view of the world, this more open of what's possible or what could be possible- Yeah
Sharee Johnson: um, when humans are working together as humans. Yeah. Absolutely. That, that's all the stuff that's happening inside of me while I'm listening to you, Jill. Yeah. It's so [00:57:00] exciting to bring this alternative truth, to use a expression you used before, of, of- how else could I describe or think about the emergency department?
Sharee Johnson: Yeah. You know, how else could I describe or think about this clinical process that I'm engaged in? Um, and what happens if I even just entertain those ideas? That idea. Yeah. You know, it, it, it gives us more capacity. It, it helps us, um, remember the generative parts of us which we naturally- Yeah ... have. Yeah.
Sharee Johnson: That, that we lose. People in survival mode lose that, uh, not ... They lose the capacity, but they even lose the memory or the awareness that they- Mm ... can generate- Yeah ... idea.
Dr Jo Egan: I agree. And I think that, when you're in a system for a long time, there are limitations or boundaries that, like it or not, kind of form around you.
Dr Jo Egan: You know, you, you see things in a particular way, and it's hard to, to get outside that [00:58:00] box. ... I've done a little bit of work with a design research unit that, that does some, design for health, kind of work. And, and I always get so excited to listen to their students and to listen to some of the research that they're doing, because they come with such a different lens, and think of things that, I would never have thought of.
Dr Jo Egan: Or, um, you know, you think, "Oh, there's no way we could get budget for that," and the approach of coming in and sort of dreaming and then iterating and designing, is just such a lovely approach. And so I love that about Appreciative Inquiry, that it brings some of that design.
Dr Jo Egan: When we did the workshops and, and I continue to do, , with groups, I, I bring arts and crafts for the dreaming. Mm. Um, just to get them outside of, outside of their healthcare head.
Sharee Johnson: Yeah, yeah. Not to dwell on the Heart of Medicine, but I think we saw that in, in a different way being at the Heart of Medicine at Uluru this year.
Sharee Johnson: Yeah. We were very lucky to have you there with us, Jo. Um, [00:59:00] uh, just being in that very different environment and, being in a place that inspires awe and lets us have space and time to appreciate the nature, the natural environment around us- Yeah ... is another way that brings us to these different ideas, these different senses of what's possible.
Dr Jo Egan: Yeah. Yeah. I really like, the work of, Dacher Keltner- Yeah ... around awe. ... You know, that makes me think of that. That idea that when we have moments of awe, whether it's in nature or being together in a group where you're, You've, got the, a similar goal and you're vibing off each other.
Dr Jo Egan: You know, those, those moments of, of awe- That we know broaden our thinking, and broaden , the dots that we may not have connected before that we can now connect.
Sharee Johnson: Yeah. Totally. Let's put all of this beside the reality that Te Whatu Ora has been through lots of changes and, and lots of- Yeah disruptions during the COVID years and, and post. Uh, you have a change of government. Lots [01:00:00] of, contextual things that do ask us to be more creative and , intentional in our efforts, uh, to be connected to each other and to, stay true to what really matters in terms of your research.
Sharee Johnson: Have you got any reflections or thoughts for, people in changing health systems? You referenced the New Zealand health system for us, but, but we've all got them. It doesn't matter what country we're in, we've all got these feelings of, of barriers or frustrations, challenges- Mm ... in the health system.
Sharee Johnson: What are your reflections about what we can do, not just doctors, allied health, nurses, clerks, everybody, to maintain- Yeah ... our wellbeing and our mental health in, the reality of the system ? Yeah, in these challenging times. You've given us a lot already from your research. Anything else that you want to add?
Dr Jo Egan: Yeah. As things became more and more challenging, I pivoted, the questions that I asked. So still using Appreciative Inquiry, but rather than saying, "Tell me about a moment that you were thriving," I say, "Tell me about a moment that gave you a boost [01:01:00] of energy so that you could see the next patient."
Dr Jo Egan: And the answers are still the same. Probably what it, has done for, for me and for my work, is recognizing much more obviously just how much is out of our control. Mm-hmm. Um, you know, the pandemic that, created chaos for the whole world.
Dr Jo Egan: Um, and then even the subsequent consequences of some of that in terms of the complexity of people's lives and how that plays out in, in their health, in their thinking, in the division and aggression and, you know, all sorts of... and, and mental health.
Dr Jo Egan: All sorts of ways that that has, um, that certainly hasn't just appeared. It was there before, but it's, you know, it's just grown. And I guess that, that for me, it has brought me back to those findings, back to those values, which are all [01:02:00] based in relationship. Mm-hmm. And so particularly at times where if I think about the whole system or the whole world, I find it overwhelming in terms of changing things.
Dr Jo Egan: Whereas I think when I started my research, there was a hope that there could be some transformational change, which maybe every person who does that kind of project, you know, you're hopeful that, that you might be able to. I guess recalibrating to say actually how can this make a difference in the people where I am?
Dr Jo Egan: How can I help build relationships? What does it look like to, to build or to, to co-create with people, spaces that are safe, such that we can innovate ways to do things better, but also, um, create connection and, belonging that we can get through the challenges together.
Dr Jo Egan: Because those challenges [01:03:00] are not gonna change magically anytime soon. And how can we find touchstones or moments to bring us back to those things that are important, and to bring us back to the stories where even in the chaos and, and even in the challenge where the resource and need and the difference between them is so big, that even in that, there is still moments of compassion every second in any healthcare setting around the world.
Dr Jo Egan: Acts of kindness, moments of meaning, of connection, of excellence, of, um, of, of love, of caring, and of meaning. Um, and that is also true as well as the challenge. And, and how can we accentuate this? How can we make this a part of our narrative? Not to sweep away the other, [01:04:00] but to give us a slightly different lens.
Dr Jo Egan: A little bit, maybe a little bit more abundance or maybe even just a little bit more a sense that we're doing this together rather than trying to face it all alone.
Sharee Johnson: Do you know the word that's coming up for me listening to you is flex. Just give us- Hmm ... a little bit of room, a little bit of a sense of, you know, that we can contribute.
Sharee Johnson: Yes. That it, that it's not helpless, it's not hopeless. It's- Yeah ... might not be at the scale that we want. Mm. Um, you know, I think your, your comment about transform, I think all of, maybe not all of this, but I, that resonates with me too, that feeling of, ah, this is going to transform things. It- Yeah ... actually requires, many, many voices making many, many contributions because the system itself is vast and huge.
Sharee Johnson: Uh, the system actually is every human on the planet. Oh. Like, when we're talking about- Absolutely ... the health system, we're actually talking about all of the people looking after all of the people. Yeah.
Dr Jo Egan: Yeah. And I think that, that that's exciting and daunting [01:05:00] all at the same time. Yeah. You know, daunting 'cause how can you change such a big system?
Dr Jo Egan: And exciting because I am part of the system. Yes. And you are- And so I can do, you know, the, what I can do and what I can recognize is the, the influence that I have on others and they have on me. Mm. And how can we put some consciousness and some intention around that- Mm ... so that it's good for all of us?
Sharee Johnson: Yeah. Gosh, I think we've covered about three or four questions already.
Sharee Johnson: So, um, in order to bring our conversation to some kind of close, I wonder if you could just come back to yourself, Jo, and, and share a little bit with us about, who's, who's helped you. Have you had, coaches, mentors, teachers? Who are the ... And you can name them if you want to, but, but just more generally, who are those roles? What's been important for you in your, learning and understanding and development?
Dr Jo Egan: Yeah, definitely my family have been important, and I'll pick one of them out a little bit later. But I've definitely had, had [01:06:00] teachers, who have influenced, the way.
Dr Jo Egan: And I think also clinicians, finding clinicians along the way. Thinking that's the kind of doctor I want to be and, and picking and choosing things from different clinicians along the way. A huge influence with my academic supervisor, Liz Smythe, her, her clinical background is midwifery actually, and, and I definitely very much was, was midwifed through that, that whole process and- That's a beautiful metaphor ... my way of thinking. Um, so she did that, she did that beautifully, and we are still friends, and I still, we still have lots of great conversations.
Dr Jo Egan: Post that, I then sort of recognized the value of and was keen on, um, on supervision. And I've had, um, a couple of amazing supervisors. And inspiring people, one of them is, is Dr. Brian Broom um, who has done a huge amount of work around whole person healthcare.
Dr Jo Egan: And I feel very [01:07:00] privileged to be able to have lots of great conversations with him and some supervision. In our organization, our allied health colleagues have, professional supervision as part of their portfolios. They have to have it. And, and there's a system where peers are, are trained, um, to become peer, um, supervisors.
Dr Jo Egan: And I have been involved in that , for a number of years. And one of the lead social workers in that system, I was lucky enough to have her be one of my supervisors. And she's, she's made a big difference for me. I then went and did, a post-grad certificate in professional supervision.
Dr Jo Egan: That's , part of that non-clinical role that I have, which, has been just a delight to be involved in. Back to my family, I think, I think one of the influences, um, throughout particularly this work in healthcare has been my daughter Jess, who, um, in [01:08:00] watching her go through her junior years and see the influence that different people and different teams had on her ability and her enjoyment, and the, the environments that really, help her to thrive and, and the ones that, that really don't, and just hearing those stories.
Dr Jo Egan: I hope it's been mutually beneficial. She's had a, mom to listen to a significant proportion of her shifts, and she's now been a doctor for coming up on 12 years. Mm. Um, and so it's given me another lens in which to see the healthcare system and to see the impact of relationships of the impact that we have, on one another.
Dr Jo Egan: My other child, I have a son, he is a delightful human who is fully immersed in, in anything life has to offer, and reminds me to, to have [01:09:00] fun and to live somewhat vicariously through some of his travels and his photos and his surfing and, um-
Sharee Johnson: There's life outside of medicine.
Dr Jo Egan: Exactly. And he is outside of medicine, and so just brings this, this joy and this- Oh ... rounded perspective. Mm. So they've definitely had an influence.
Sharee Johnson: Yeah. It's really a, a reminder that nobody's doing anything on their own. We're all interdependent and interconnected. Uh, can we just pause it for a minute before we finish about this clinical supervision?
Sharee Johnson: Because, uh, it's used much more as I, as I understand it, and I only see, of course, parts of the system. But clinical supervision is much more talked about and used in New Zealand at this stage than it is in Australia. In Australia, people have coaches more than they used to.
Sharee Johnson: Clinical supervision is not talked about in the same way. In fact, doctors will say, "Well, how come allied health have clinical supervision and we don't?" Yeah. , I'm, I'm a accredited, uh, supervisor of psychologists in training, and I'm- Yeah ... recently accredited to be a supervisor of coaches.
Sharee Johnson: [01:10:00] Um, so that's all very exciting. But I've just had in the last two or three weeks inquiries about providing clinical supervision. So something's shifting or changing a little bit there in, Yeah ... in our regional dynamic. But it's a difference I've noticed for a few years between New Zealand and Australia.
Sharee Johnson: Yeah. Can you tell us a little bit about the clinical supervision environment? Yeah. In New Zealand.
Dr Jo Egan: And again, the, uh, you know, anything you do comes with a whole vocabulary, doesn't it? Mm. That, that can be- Yeah, it does ... that can be confusing. And I think that there's, there's lots of crossover in some of these things.
Dr Jo Egan: So clinical supervision is, is somebody who is in the same profession as you and, and supervising and, and, um, and, um, encouraging your clinical- Development ... um, growth and development.
Dr Jo Egan: Professional supervision, come from social work and, um, and then psychology. So the idea of, and perhaps this is kind of some of my own definition as well as, as, as well as the definition, commonly, agreed. I see it very [01:11:00] much as an ongoing education. Um, i- in a similar way to, to clinical supervision, and the education is around, kind of, uh, the, the being of human in, in the job that you're doing.
Dr Jo Egan: So bringing your, , our intent often, a- almost always I think in healthcare, is to do a good job, to make a positive difference for people. And our intention and the way things land are most certainly not the same thing a lot of the time, and that's really hard to see for yourself.
Dr Jo Egan: It's really hard to, to recognize that for yourself. And so having, um, essentially facilitated reflection and learning is what I see as professional supervision, and it can be somebody who is not in the same profession as you. Um, particularly if you've been in the profession for a little bit longer.
Dr Jo Egan: I think early on it's quite useful to be the same profession just so that you can do a little bit of both. But it's some reflective space to say, "Oh, yeah, this happened, and I wonder what happened." And I thought, [01:12:00] you know, 'cause so often some of the challenges are around relational challenges or, or even challenges with, you know, seeing a patient that reminded you of your mother, and, you know, all of a sudden you were either standoffish or, or almost tearful, you know, what, depending on the relationship you have with your mother.
Dr Jo Egan: Um, you know, and so that, that whole idea of, some transference, that we are human. That our own experience and our own, um, reactions to people and situations are going to be there. Yeah. And it can be really difficult to recognize that on your own, but to recognize that with someone who is, who is asking some really good, curious questions and providing that safety to dig down to some of your underlying assumptions.
Dr Jo Egan: And so it's often a long-term relationship, you can, you know, definitely change as you go, but it's often seen as a, as a part of your ongoing education. Mm. And I think that that realization is, is becoming more and more in New [01:13:00] Zealand. Um, for a long time the thought of professional supervision or, or coaching or needing help was...
Dr Jo Egan: felt like there was something wrong with you if you needed to do that. Um, and the recognition that actually this is proactive learning, um-
Sharee Johnson: I think we're a long way off from any proving of, you know, the cause and effect. It's far, far too complex for that. But I can't- Yeah ... help but wonder that, that these are mechanisms for reducing burnout and for, for responding to moral injury.
Sharee Johnson: And, you know, we know that these things are rife really across health. Yeah. And so I think these, these, uh, vehicles, mechanisms for us to help respond in different ways, perhaps more effective ways, which we'll learn over time - Yeah ... than to what we've been doing before. And thank you for, uh, telling us a little bit about that in, in your world.
Sharee Johnson: We need to finish sadly, are there any strings that you want to go back to and tie up or, or tend to? Anything that you are hoping to say that we, , left undone? There's a, a hundred things I think I could go back to [01:14:00] and ask.
Dr Jo Egan: Yeah. Thank you very much. It's been such a lovely conversation to have.
Dr Jo Egan: I think in, in some of the, some of the stuff that you sent me, there was something about did I have a, um- A mantra? A mantra. Yes. Um, and as I was thinking about that, it... that there is a mantra that I, um, that I do have that has come from the world of education and particularly simulation, that says in, in any given moment that we are making the best decision that we can with the resources and the information that we have in that context.
Dr Jo Egan: Mm. And, and I think that, that mantra gives me the ability to be curious rather than judgemental. And it does so not only for other people when I'm watching or observing or teaching or, in a clinical setting. Um, 'cause I believe it true of our patients and our managers and our, even, God forbid, our politicians.
Dr Jo Egan: It, it [01:15:00] helps me to remember people's humanity, including my own, and to bring some compassion and some self-compassion.
Sharee Johnson: Well, that is a very lovely place to finish. Thank you so much for your wisdom, your time. I think your ability to really draw lots of pieces of the puzzle together into some sort of coherent, understanding is, pretty phenomenal really.
Sharee Johnson: So thank you for sharing that with us today, and it's been a joy to see you.
Dr Jo Egan: It's been a real pleasure. Thank you so much, Sharee
