28 May 2020

Experiences of starting a job at the NHS from the most southerly tip of Africa

By Doranne McDonald, Improvement Advisor

It is commonly agreed amongst mental health professionals that some of life’s biggest stressors include, moving to a different country, moving to a new house, and starting a new job. Contemplating even one of these major life transitions is enough to aggravate one’s stress level significantly. Having been in the process of doing all three of the above since securing a new job as an Improvement Advisor in the Quality Improvement (QI) team at ELFT, I can safely say that my stress barometer was rising exponentially. Little did I know that having to start work remotely from Cape Town in South Africa during lockdown, would catapult my stress response to stratospheric levels, with no sign of a flattening curve on the horizon. 

A view of Table Mountain in Cape Town, South Africa from my desk at home.

Being of the generation that straddles the pre-tech and tech age, my only concept of virtual working was how virtually little I knew about Microsoft Teams, WebEx and Zoom, and remote in my mind referred to a style of parenting learnt during my psychology training, or the gadget that changed my television channels. I suspect that being the first employee to join the Quality Improvement team remotely from abroad, probably created an impending sense of apprehension, perhaps even doom, amongst the QI management team, too.

Fortunately for me, however, they had already begun to adapt to this new way of working and had preempted and tested several small changes, to smooth the path of any new virtual starter. The following three change ideas were very reassuring during this stressful time:

Regular contact with the QI management team

The thoughtfulness and kindness of the QI management team has played a major part in mentally preparing me to tackle this major life transition. Being invited to a training, a welcome meeting, and practising a MS Teams call before I had even started the job, reduced my anxiety considerably, mentally prepared me, and made me feel part the team before I had even started. It felt as if my arrival was highly anticipated. Once I eventually started remotely, the rest of the management team adopted this same attitude of care and were extremely keen on me having a good experience. I was asked to approach them with any concerns, questions or issues. Daily contact with my Line Manager in my first week, and regular one-on-one calls from both Associate Directors, have helped me adjust indelibly. I have felt virtually hugged by the whole management team from the start; a definite first for me in my career.

One-on-one virtual meetings with every member of the QI team

Meeting your new colleagues for the first time in a meeting via a computer screen can feel very surreal, and a bit intimidating at first. Robbed of the usual tools or coping skills used to connect and kick-start relationships face-to-face, the only thing that hinted at their possible personality; was the artwork on the walls behind their heads, or the colour of their curtains. At my first meeting I thought that everyone lived in magnificent industrial-size lofts, until I was casually told a few days later that that was, in fact, merely a background that one could set up on MS teams. What really helped me to slowly personalise the sea of faces, and get to know my colleagues a little better, was the encouragement from the management team that each team member book a virtual introduction during my first two weeks, to introduce themselves to me, and allow me to get to know them better. This was an invaluable experience, and perhaps an advantage of virtual working, as it escalated the process of getting to know my teammates, something that may have taken weeks or months in person. The warmth of the welcome by each person left a deep impression on me.

Assigning a ‘buddy’ to every new starter

One of the disadvantages of starting work virtually from a remote location, is not being able to turn to your team mate sitting next to you, to ask the usual 101 questions in an office environment, to orientate yourself to your new job. It can feel very isolating once a meeting has ended, sitting on your own on the other side of the world, trying to plough through all the new information, understand your role and responsibilities, as well as the expectations that people have of you, not to mention interpret some of the cultural nuances that you may not understand yet. Being assigned a ‘buddy’ whose main purpose was to welcome me to the team, answer any questions regarding work, and regularly check in with me, particularly during my first week, was extremely reassuring and containing experience. It made me feel supported and recognised during an anxious time, and set a wonderful, warm, welcoming tone that fuelled my excitement to be starting this new job.

Penguin ’buddies’ exploring their turf in Simonstown in Cape Town, South Africa.

Although crisis and adversity has forced organisations around the world to adopt new ways of working, in this stressful times, the speed at which people have adapted is awe-inspiring. This has highlighted the value and need for quality improvement work in any system, and the QI team, has successfully managed to get a new employee started 13 324,3 km’s from London, at the most southerly tip of Africa, where the Atlantic and Indian oceans meet.

My only hope now is that Blue Jeans remains something I wear, and that there is a remote chance that my teammates recognise me when I finally get to the office in London.

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