Nursing Leadership in the Midlands: Evolution of Practice - Undergraduates and Beyond
The second NMBI Summer Series event was hosted at the Department of Nursing at the TUS campus in Athlone.
The event was opened by NMBI President Essene Cassidy who thanked TUS Head of Department Dr Des Cawley for his work with NMBI in co-hosting the event.
Dr Ray Healy, Director of Registration at NMBI, presented data from the MyNMBI online registration system and shared statistics on the general nursing division, as well as details on the number of nurses practising in Midlands counties.
The format for the Athlone discussion involved two panels.
The first panel discussion was Nursing Leadership in the Midlands – Undergraduate and Beyond, and it was chaired by Eileen Whelan, Group Director of Nursing Dublin Midlands Hospital Group.
Katherine Kenny Director of Nursing (DoN), Regional Hospital Mullingar, spoke about doing her bachelor’s degree in nursing science (BNS), having originally trained in the general certificate programme in St. Vincent’s Hospital. She said the BNS was a great opportunity to appreciate ‘critical thinking.’ Education, she said, provides nurses with the opportunity and the knowledge to provide safe care.
Shaini John, staff nurse at Midlands Regional Hospital Portlaoise, was asked about her nursing journey from India via Saudi Arabia to Ireland. She spoke about the pressures of a first-year student and admitted that she had cried at times. But as the months and years passed, she had “more energy inside of me”. After her training in India, she worked in Saudi Arabia for three years and found a very different culture of care and language. When she came to Naas to do her adaptation in 2007, she felt familiar with the care and compassion in the Irish healthcare system. She later became a student preceptor to undergraduate/adaptees. Nursing is changing and challenging every day, she said.
Clare O’Dea, Assistant Director of Nursing (ADoN), Midlands Regional Hospital Tullamore was asked why she changed her career towards a leadership role. Clare told of how she went into management, but it was not the pathway that she had been expecting. She said: “You learn as you go along. It is always about caring, caring for your patients, that ethos goes through the whole team.” Clare went on to say how she had great admiration for older/experienced staff who had returned to nurse education, saying there are fantastic staff members studying for a postgrad. She said nursing was challenged during Covid-19 and courses were developed quickly in response. “Some people who do not want to go to leadership are fantastic preceptors,” she added.
The panellists were asked where they thought they would end up in their careers. Lloyd McGree, Clinical Nurse Manager3 (CNM3), Midlands Regional Hospital Portlaoise, said that “you grow and develop” into roles and paraphrased John F Kennedy “the best of learning and leadership are indispensable to each other”. Lloyd said teaching didn’t come naturally to him, but his postgraduate education accelerated his journey into leadership, adding: “You can never have enough learning done.”
Katherine Kenny remarked that “education is key to where you want to go.” She said hospital management encouraged nurses to continue their education and TUS is providing short course modules which is helping them to flourish.
The panellists also discussed who inspired them. Shaini referred to the principal in her nursing college in India as a role model for her entire class, but also mentioned a CNM2 at Naas hospital she worked with during her adaptation period who had been very encouraging and was one of the reasons she stayed at the hospital for 12 years. She said she sees all her senior nurses as role models. Katherine cited Dr Mike Ryan from the World Health Organisation and his response to the pandemic and his advice that “speeds trump perfection”. She said the first months of the pandemic had been difficult as nurses, in her opinion, are not very good at self-care. She described how she had listened to Professor Michael West and how his “simple but powerful” words “go running even when you do not feel like it or go swimming” were critical for her and her “own self-awareness and self-regulation.”
During questions after the session there was a belief that there should be more support for the CNM2 role in the health service.
The second panel discussion of the evening was entitled: ‘Evolution of Advanced Practice and Specialist Nursing Roles in the Midlands’.
Those taking part include Yvonne McCague, ANP, ED, Regional Hospital Mullingar, Maree Healy, ANP Tissue Viability Midlands Regional Hospital Tullamore, Patricia Clancy, Clinical Nurse Specialist, Adult Respiratory Midlands Regional Hospital Portlaoise, Regina Healion, Clinical Nurse Specialist, Diabetes Midlands Regional Hospital Portlaoise and Dr Lisa Kerr, Lecturer in Nursing Studies, Department of Nursing and Healthcare, TUS.
Paul Gallagher Group DON for Ireland East Hospital Group chaired this discussion.
Yvonne McCague said the benefits of the ANP has been demonstrated in numerous studies. She said she is often asked by students about the differences between an ANP and a doctor and she spoke about dealing with an elderly patient and the multiple different medical issues which she could deal with or refer to a specialist colleague. She said ANPs have great communication skills and her role is to advocate for the patient.
Regina Healion spoke about her role as a CNS and how she has been given the opportunity to showcase her skillset. After two and half years she and her team have worked together to develop end-of-life guidelines for the diabetic patient, which she hopes will become national guidelines.
With Government aspiring to have 10 per cent of nurses working in advance practice, Lisa Kerr said increasing the number of courses can help make that target a reality. Evidence-based care should guide this, she said, and clinical and academic partners work together to promote research.
Panellists agreed that students should meet and talk with ANPs and CNSs as part of their studies, to show them the opportunities which exist.
Asked what they felt NMBI could do to focus on, and further enable, the role of the ANP role, Yvonne said: “NMBI has done so much with the guiding of this. We are now at a stage where we are now established and our role is evolving, we want to expand our roles in advance nurse practice. We need to be open minded and expand our roles as we do not want to be stuck in a cul-de-sac.”
NMBI CEO Sheila McClelland said ANPs are reporting back to NMBI with current challenges relating to their career pathways. She said NMBI will be evolving the register in the short-term with reference to annotation and the regulator will be delivering the competency scheme.
Carolyn Donohoe, NMBI Director of Registration, spoke on the evolution and agility of the ANP role. She said it is now possible to revise the job description under the guidance of the Director of Nursing.
Panellists came up with numerous ideas on how to further develop the ANP and CNS roles, including more funding for PhDs, more collaborative research, Board roles and the establishment joint working forums or groups. It was noted that Department of Health Policy is to support advanced practice and support all nurses and midwives to access level 10 programmes.
In her closing remarks Ms McClelland said that during the pandemic “leaders jumped out of everywhere” including among students. She thanked everyone who took part in the discussions and encouraged everyone to contribute to the NMBI Statement of Strategy 2023-25 when it goes to public consultation later this year.
The event was recorded by the TUS team and you can view it online here.