You are a junior pharmacist who has just completed work on a year-long quality improvement audit for your department. You have summarised several significant safety improvements in a report you shared with your line manager. But at your next multidisciplinary team meeting, you are shocked as your line manager presents the recommendations to senior clinical heads of departments and passes the recommendations off as their own. What do you do?
“Start with a positive approach”
There is nothing more infuriating than someone taking credit for your work.
When these situations come up in work, it is helpful to ask yourself a few questions after you have had a chance to calm down emotionally, to avoid reacting in the heat of the moment. Think about whether you should raise this with your manager, or if it is better to remain quiet. And how do you ensure you receive the recognition you deserve in future? Was this a genuine mistake?
A good idea for future work submissions to your line manager is to ensure you have copied in other senior colleagues in emails, plus actually highlighting your recommendations on how the results you have worked hard to complete are shared. You could even request in the email: “What is the best way to make sure all teamwork is recognised?” In effect, you are modelling behaviours you would like to see in your boss.
If this is recurring behaviour, it is best to start with a positive approach. Highlight your concern in a calm manner: “I just wanted to understand if you had a particular reason for not acknowledging my work?”
It would also be helpful to include that you have found other team member contributions key to completing your workstreams. Then end with a further positive.
Another useful idea is to regularly share in your team meetings or one-to-ones how you see your work developing, and agreeing with your line manager how best to share appropriately, ensuring you are acknowledged in the future. Make sure any agreements or discussions are recorded, thereby protecting your hard work.
Reema Caddies is head pharmacist for health and wellbeing provider OneMedical Group
“Speak with someone you trust about the situation”
Ideally, all audits and quality improvement projects should be registered with a departmental education and training lead, and an organisational clinical audit or clinical effectiveness lead (if your organisation has one).
In this instance, I would recommend speaking to someone you trust about the situation. It could be another senior pharmacist, or your organisation’s education and training lead. You might also like to speak alone with your line manager about the situation, saying the following: “Given the time it took me, how much I learnt and the impact on patients, I was disappointed not to be mentioned in your presentation. I would be grateful to understand why.”
Request a meeting with your line manager and/or the education and training lead to seek advice on what the next steps for your project are. In preparation for the meeting, it would be helpful for all those attending if you circulated a proposed project plan, outlining the roles and responsibilities of a project team and their individual contributions.
If you plan to publish the work, it is important to establish the status of the project with the central team, and with the support of the education and training lead and/or line manager, to ensure that a final report to the central clinical audit or clinical effectiveness team (if your organisation has one) reflects how the project was delivered.
Unfortunately, there are no universally agreed authorship guidelines for clinical audit and quality improvement projects like there are for research (see ICJME for an example), but the principles are directly applicable. Familiarise yourself with the authorship guidelines for the conferences/journals you wish to submit your work to and ensure that contributions for each part of the project team are clarified and agreed, with support from your line manager and/or the education and training lead.
Also, consider including the lessons you have learnt from this situation in a reflective account as part of your continuing professional development.
Natasha Callender is a chief pharmaceutical officer’s clinical fellow at NHS England and NHS Improvement’s Improvement Directorate
“Consider if this requires escalation”
Consider what your usual working relationship with your line manager is like. Has anything changed recently? By passing your work off as their own, your line manager has contravened several of the General Pharmaceutical Council’s standards for pharmacy professionals. By not being honest and trustworthy, they have acted in conflict with standard 6 (‘Behave in a professional manner’) and standard 2 (‘Work in partnership with others’).
If you have not already, you might like to consider speaking to them about how their actions have made you feel. It may have been an oversight on their part. They may have thought you would prefer for them to present the work to the multidisciplinary team, rather than it being an intentional act to undermine you.
A situation such as this may also require escalation — would you feel happy to discuss this with your line manager’s senior, or the chief pharmacist? If you are not comfortable doing this, you might like to have another pharmacist or education and training lead (if your organisation has one) do this on your behalf.
I am aware as a junior pharmacist you may feel uncomfortable challenging the actions of a senior team member; however, we all need to support each other and act professionally. There may be other things going on either at work or at home that could have led to this behaviour from your line manager.
It is important to seek the right support to help you get to the bottom of this, so everyone can move forward as professionals.
Jane Charsley is preregistration pharmacist facilitator at Bedfordshire NHS Foundation Trust
“Don’t be disheartened”
This is a tricky situation, particularly if you have worked hard for a long time on a quality improvement project and produced a fantastic report on your outcomes and recommendations.
Don’t be disheartened if your line manger seems to be passing your findings as their own, as there may be a reason for this. It may be the case that they are doing this because they are known to seniors and want them to be reassured that these recommendations need to be followed through.
Of course, it may also be the case that they are insinuating that the work is their own, and not giving you any credit for your work. If this is the case, then be proud that your work is being presented to a senior audience because it is of high quality. You might want to ask your line manager if you can take a lead on implementing some of your recommendations and continue to monitor outcomes. It might be an idea to suggest that the different recommendations are broken down into smaller quality improvement projects, so that your peers can do some quality improvement projects themselves, with your help.
Another thing you could do is to contact the seniors, if you feel comfortable, to get feedback from them about the work and what they see as their priorities. It is not unusual for some important projects to be taken over by seniors, as there may be wider issues and improvements that need to be made which you might not be aware of, so do bear this in mind.
The main thing is that you have produced a report that has been presented to senior managers and will, hopefully, result in significant safety improvements, which can only be a good thing.
Aamer Safdar is pharmacy education, training and workforce development team lead at Barts Health NHS Trust