Why we must invest in our future nursing leaders

Nursing is my past, present and future. After a twelve-year career as an actor, I now follow in my registered nurse mother’s footsteps, working as an early-career public health community staff nurse with newly arrived asylum seekers, some of our society’s most disadvantaged members.

I believe we must invest in tomorrow’s nursing leaders because we are the future and beating heart of our profession, requiring courtesy and kindness yet boldness and insistence. While we welcome experienced mentorship, we can provide reverse-mentoring through partnership-working, bringing fresh perspectives to creative problem solving for the many issues faced in healthcare.

Additionally, as future leaders, we can provide peer support, learning from international best practice. As nurses, we are one of the only healthcare professions there 24 hours a day, seven days a week, 365 days a year, allowing us to intimately and holistically know those we serve on individual and population levels. Therefore, we can advocate in a way no other profession can, making us prime drivers for change. This change must be individualised, person-centred and co-produced with communities, involving empowerment, role-modelling, training projects and public health education and promotion, enabling disease prevention.

All United Nations (U.N., 2015) Member States committed to 17 Sustainable Development Goals, uniting them in global partnership to address global health issues. As future leaders, we have the capabilities, power and tools to be authentic and effective agents for social change. We can propel forwards the agendas of addressing global health injustice, eradicating global health inequalities, and achieving universal health coverage for all.

Coming from a high-income country, I am acutely aware we have much to learn from lower and middle-income countries, from the innovative and revolutionary initiatives they have implemented, as the State of the World’s Nursing Report highlights (World Health Organization (WHO), 2020). However, we are also ethically obliged to help others as a resource-rich nation (Campbell, Pleic and Connelly, 2012). Global working requires future nurse leaders to be inclusive and inclusively literate, pertinent as nursing education, fields and specialities vary significantly internationally.

Covid-19 exposed that healthcare systems, locally, nationally and globally, were unprepared. And while individual nurses require the ability to recover from difficult situations, anecdotal evidence suggests a co-opting of the terminology “resilience”. We often see the term resilience used as a weapon against individual nurses, diverting from systematic failings, causing individuals to experience internalised guilt, feelings of inadequacy, and I am confident sometimes preventing disclosure. It is victim-blaming and potentially gaslighting. If individuals cannot bounce back, there can be the perception they are not strong enough to be nurses. Attitudes must change. Because when the adrenaline of managing the pandemic wears off, systems will question individual nurse’s resilience if they struggle with potential physical, emotional and psychological fallout and trauma.

Instead, future nurse leaders need to help cultivate and develop emotionally intelligent, reflective practitioners who advocate for healthcare systems that operate likewise. Additionally, we must become more proactive and less reactive as a profession, demanding protected time for continuing professional development and restorative clinical supervision. Our future nursing leaders must fight to enhance our professional status. We need more nurse specialists, researchers and further investment in advanced nursing services. Most importantly, we need to see ourselves as leaders. If we do not, how can we expect other healthcare professionals to see us this way? We must use the lived and empirical evidence we have accrued as nurses to exhibit these leadership capabilities while working collaboratively with our interprofessional colleagues to achieve global health goals.

I hope by focussing on these suggestions, we encourage all nursing professionals to develop and flourish, addressing the four pillars of clinical practice, leadership and management, education, and research. To do so, we need to enable, empower and educate our early-career nurses and students to harness each of these. Too often, we tell these individuals only to focus on clinical practice, or they have little knowledge of the other pillars and how to develop their careers accordingly. This thinking is detrimental to our profession, as we should celebrate nursing in all its multi-faceted glory.

I believe, to achieve this goal, much has to change. We must be cognisant of “toxic positivity” because perceived “negativity” is often essential to drive change when backed by evidence. Future nursing leaders have the power to do this. They must be campaigners and lobbyists who can intelligently influence on local, national and global stages. Governments, policymakers, non-governmental organisations and national and international nursing associations need to acknowledge and invest in the benefit of these opportunities for our profession. And we do this by illustrating how these changes will improve the population health of the communities we all serve. Our leaders must be present and heard in government to effect change.

Covid-19 has illustrated how reactive the nursing profession can be, but we need to invest in our workforce and education proactively. We already know retention of new registrants within their first two years is a significant issue, and pre-pandemic, we had global staffing shortages of nine million individuals (WHO, 2020). However, I worry this pandemic will exacerbate this, prompting a mass exodus of new registrants and near-retirement nurses unless we address potential emotional and psychological burnout.

Additionally, despite nurses and midwives making up fifty per cent of the healthcare workforce, our education receives only a quarter of the expenditure on healthcare education (WHO, 2020). Therefore, we must address safe staffing legislation and better pay, terms and conditions for our profession. Without the infrastructure to secure enough staff to support students, how can we encourage and nurture them to become future leaders? We have to inspire our future nursing leaders at all stages of their careers. Again, this requires us to be campaigners and lobbyists. We reach hearts by sharing the stories of those we care for as natural empaths. Then, we back this up with evidence regarding the human and health economic cost.

Craig Davidson RN

https://twitter.com/CraigDavidson85

REFERENCES

CAMPBELL, R.M., PLEIC, M. & CONNOLLY, H., 2012. The importance of a common global health definition: How Canada’s definition influences its strategic direction in global health. Journal of Global Health [online]. 2(1), pp. 1-6. [viewed 18 April 2021]. Available from: DOI: 10.7189/jogh.02.010301

UNITED NATIONS, 2015a. Sustainable Development Goals [online]. United Nations. [viewed 18 April 2021]. Available from: https://sustainabledevelopment.un.org/sdgs

WORLD HEALTH ORGANIZATION, 2020. State of the World’s Nursing Report – 2020 [online]. World Health Organization. [viewed 18 April 2021]. Available from: https://www.who.int/publications-detail/nursing-report-2020

Men into Nursing Campaigns: Why My Opinion Has Evolved.

I was very kindly asked to write this blog post for the Royal College of Nursing’s Feminist Network.

Fact: nursing is an evidenced-based profession; as we traverse throughout our university nursing education, we learn to be a nurse whilst honing our critical thinking skills.

When I took to the stage, speaking in favour of the resolution at the Royal College of Nursing’s (RCN) Congress 2018, “That this meeting of RCN Congress asks Council to develop and promote a strategy to recruit more men into the nursing profession.”, I was a second-year university nursing student. I was in my first term as one of the Scottish representatives on the RCN Students’ Committee before taking over as committee chair in January 2019. At the time, I argued:

“Nursing is one of the most important professions in the world. At some point in their lives, everyone, whether directly or through a loved one, will come in contact with a nurse. It takes a very particular kind of person to be a nurse. They don’t do it for the fame; they certainly don’t do it for the fortune. It is something inherent within them. I was inspired to get into nursing by an extraordinary and inspirational nurse: my mum – a woman who has dedicated her entire working life to her patients and their families. I am proud to be a student nurse, and I cannot wait to be a nurse. But, I do not consider myself a male student nurse. I will not be a male nurse. However, I am passionate about getting more men into nursing, the right men who have the necessary values to be nurses. The reason: I believe the nursing workforce must be as diverse as the communities we serve in terms of gender, ethnicity and race, sexuality, gender and sexual orientation, and all other protected characteristics. At the moment, it is not. I want to promote nursing as a wonderful, rewarding career for all. And I want to encourage men into nursing who may not know it is a viable career option for them.

Eleven per cent of nurses are male; this figure has been largely unchanged since the 1980s. However, the idea of a campaign to recruit men into nursing has raised some serious debate. Undeniably, there is a serious disparity of men at senior management and professoriate level in nursing; this is an issue that must be addressed. We need to establish why this is happening. That being said, the proposed campaign to recruit men into nursing is concerned with the number of men working at grassroots, Band 5 level; the nurses who interact with patients and their families on a day-to-day basis. So, I believe it is essential we do not conflate these two issues. We won’t solve one problem by ignoring another. We need to diversify the nursing workforce, and we need to do it now.

How do we do this? Personally, I don’t believe we should be giving scholarships or grants to attract men into nursing. Women, remarkable women, have paved the way in our profession for years, which we should be immensely proud of and celebrate. It would be a disservice to these women, and all women, to positively discriminate men in this way. I think we can solve the issue of the disparity at senior levels and attract more men into nursing in the same way.

Nursing needs a serious image overhaul. We need to educate the public about what it means to be a nurse and what we do. Too often, we still hear that nursing is “women’s work” or that if you are clever, you should push yourself into a career more difficult than nursing. I am deeply offended when I hear the latter. I had the grades to be a doctor; I chose to be a nurse. Nursing is a degree educated profession with many diverse career options. We need to showcase this and celebrate nursing as a career for all. The problem, I believe, is society’s view of women and “women’s work”. How do we change that?

We should be educating children from primary school age. We have generations of societal views to change, and this is where opinions are formed. We need to have nurses and student nurses from all backgrounds and genders going into primary and secondary schools. Have them meet modern nurses. That way, we will hopefully encourage not only more young boys but more young girls into nursing”.

Whilst I still agree with some of what I originally stated; I have come to realise, as I have honed my critical thinking skills and educated myself further on women’s issues in nursing and society in general, that my views were, to put it mildly, utopian, and more strongly, damaging to women. Something I am disappointed in, as I consider myself a feminist ally, something I have discussed at length in previous blog posts and recurringly throughout my podcast with fellow registered nurse Clare Manley, “Retaining the Passion: Journeys Through Nursing.”

Reflecting on my Congress argument, I am horrified that my original statement encroached on the “vocational” nursing element, something I now vehemently argue against. Who did I think I was, Nadine Dorries? Nursing is a highly-skilled, evidence-based profession, deserving of proper remuneration with robust and strengthened terms and conditions. However, I still think that the nursing workforce needs to reflect the communities we serve, particularly at the grassroots level. Of that, my viewpoint remains unchanged.

Examples of where I believe the profession could benefit from more nurses who happen to be men include specific mental health services. Men make up three-quarters of all suicides: fact. And there is anecdotal and empirical evidence that some, not all, men prefer to be treated by nurses who are men, particularly heterosexual men who have similar lived experiences. I understand this.

I have also borne witness, working both as a student and registered nurse, to situations where a female patient is quite rightly always offered to choose whether to receive personal care or to be catheterised, for example, from a nurse who happens to be male or female. Many of whom prefer to choose a female. I do not take offence to this. And it is something I completely agree with, especially due to the increase in violence against women. But due to the lack of nurses, who happen to be men, working in patient-facing roles, this same choice is rarely given to male patients, as it is not always physically possible. There have been times when these men have told me they would prefer to be treated by a man but have been unable to be. Ultimately, should everything we do not come down to patient choice?

Another potential argument I was made aware of is that there is empirical evidence that by having more men enter the nursing workforce, we see real-time increases in pay, terms and conditions. Interestingly, when I had an educational exchange placement between my second and third year as a student in the United States, many female nurses, including senior female Professors of Nursing, who were members of the American Nurses Association, amongst other unions, were shocked that we in the UK were not proactively pushing for more men to enter the profession, as they had seen these real-time improvements Stateside. A good argument, I thought. However, again, as I have become more critical and made myself more educated, whilst this has had this effect Stateside, it has also had the detrimental effect of pushing women out of a field of work they never thought was “beneath them”. So, surely this cannot be the correct answer?

Throughout my five years of being a nursing student and now a registered nurse, I have learned that this is an incredibly nuanced argument. But I genuinely believe it is one we are addressing wrongly. Men should not be seen as an untapped workforce to plug our recruitment gaps. We are not the “white knights” who will ride in to save the profession. We are not a minority population we should be catering for, and we most definitely should not be “butching up” the profession to get more men to enter it. Those recruitment videos of manly men running around accident and emergency departments physically make me cringe. Women have never seen nursing as beneath them; men have. Society has taught men to because of society’s view and value of women’s work, and we must address that problem, which was one of my original 2018 arguments that remains unchanged.

As my opinion of men in nursing campaigns has evolved, I have gotten into many arguments on social media with fellow nurses who happen to be men, those I used to and still respect. And, subsequently, I have been unfollowed by many in their droves. Luckily, I am not that thin-skinned. But I would rather stand alongside my nursing sisters; acknowledge their issues, and fight for the nursing profession to be recognised for exactly how amazing it is. If that brings more men into the profession, then great. But it should not be our focus. And it never should have been.

Craig Davidson RN BSc (Hons)

https://twitter.com/CraigDavidson85

https://podrtp.com/episodes/

https://craigsconsiderations.com/

Sometimes it’s okay to celebrate your achievements…

Sometimes, it’s perfectly okay to be proud of your personal and professional achievements every once in a while. And for Clare Manley and my tiny seed of an idea, “Retaining the Passion: Journeys Through Nursing”, a podcast for nurses and those interested in nursing issues, hosted by newly registered nurses to be recognised by and featured in Sigma European Region’s October Newsletter really does mean the world to us.

It is a true passion project for us. And although we often struggle to find a work life balance, for us this doesn’t feel like work. There also appears to be real tangible benefits. And not only are Clare and I learning from our reflections but we appear to be helping other student, novice and more experienced nurses too.

So, thank you Sigma Nursing for the recognition. And long may PodRTP last for as long as you want us.

All our love and appreciation.

Craig and Clare.

Finding your authenticity.

Apologies for what may appear a word dump, but I just had a couple of thoughts in my head I wanted to get out there.

I have been doing a lot of self-reflection recently. Now, I want to avoid this being a navel-gazing post. No one wants or needs that. Navel-gazing is generally associated with being self-absorbed and very “me-me-me”. And I guess the point of this blog post is that this is what I want to avoid.

I do not want to be a self-promoter. And I am acutely aware that I have been guilty of this in the past, I’d be lying if I said that I hadn’t. Now, I do not blame social media, and I think it has some outstanding advantages, particularly peer-support, sharing best evidence, and providing a space to vent and reflect with our colleagues. It is also an amazing way of flattening perceived hierarchies.

But social media allows us to create a public persona, a “character”, one that may not be our true authentic self. And I am painfully aware that I’ve been guilty of this in the past. I’m trying to improve. I’m a human being, and I make mistakes.

I don’t know if being an actor from the age of twelve, hiding behind a “character” has had something to do with this. So, I often struggle with who the real me is. Who is Craig? What drives me? And ultimately, what is my authenticity? Also, my acute mental health experience in 2015, where I was admitted as an inpatient following a stress-induced psychotic episode, now makes me view myself through a microscopic lens, overanalysing every single thing I ever say or do. For those who don’t know me in person, I am actually an acutely shy, introverted person and happier in my own company with close friends than in a crowd.

Returning to social media, too often it is used to share our accolades, our successes, our triumphs. I have been guilty of this. I’m not alone in doing so, but I am conscious that I have. Don’t get me wrong, there have been achievements that I have been proud of and worked hard for; some, possibly, I may not have always deserved, however, I am grateful for them anyway. But they do not make me, and they are not my authentic self.

So, that is my new focus, finding my authenticity. I’ve had great discussions this week with three inspirational women, who I hope consider themselves friends, but who most definitely are mentors and real inspirations to me. And they have genuinely helped me with having these frank, honest and difficult conversations about finding my authenticity. I want to give them a shout out because they are amazing. They are my RCN Nurses in Management and Leadership Forum colleagues Sally Bassett and Angela Sealy, and my new mentor for the Sigma Nursing Nightingale challenge Dani Collins. Also, I would be remiss not to mention my people Clare Manley and Jess Sainsbury and my colleagues at RCN Newly Qualified Nurses, who are a constant source of support. I want to thank each and every one of them publicly.

So what is my authenticity? What drives me? I’m not sure I know entirely yet. But what I do know is I believe in a world desperately in need of health equity for all. For our patients and service users, whichever they wish to be known as, to be at the heart of every decision made regarding their care, by working in coproduction with services. For us to achieve better standards for nurses in terms of professional development, pay, terms and conditions. And for us to always strive for equality, diversity and inclusion. I don’t think that’s too much to ask for.

I do not want to discourage people from celebrating their successes because we need to celebrate nursing. But these cannot be our sole drivers. From now on in, I am going to try my best to ditch the public-facing, online persona I’ve created for myself. And to be the real me.

I am a work in progress; we all are. That is the nature of humanity and authenticity. I hope you have a fantastic weekend.

All my love Craig 

5 top tips in nursing…

I cannot quite believe the 30-day blog challenge for NHS Horizons ‘transforming the perceptions of nursing and midwifery‘ has come to an end. I have thoroughly enjoyed reflecting on my thoughts, writing them all down, and putting them out there into the ether. I cannot thank you enough for all your comments and engagement. It has been overwhelming.

As for the other wonderfully brave bloggers and vloggers who have joined in with the challenge, I have loved reading and watching your contributions each day, and feel as though I know you all a little better. When your opinions have aligned with mine, it is nice not to feel alone; and when they haven’t, it has expanded my thinking and offered me an alternative viewpoint.

This challenge has made a blogger of me, and I hope to continue for a long time; as long as people want to hear what I have to say. And maybe even when they don’t – I’m not scared to put my head above the parapet and challenge for what I believe in, backed up with evidence, of course.

So, the time has come for the last topic of this challenge: “5 top tips in nursing”. I am just at the start of my nursing journey, still in education, and have much to learn. I hope it is a long and fruitful career, and that my passion for nursing continues as I develop and progress as a nurse. Therefore, I feel a little ill-equipped to offer “top tips” to others in nursing. That is why I am choosing to offer tips for myself to follow as I progress throughout my nursing journey instead. I think they may apply to other student nurses, and perhaps even qualified nurses too.

Always remember why you chose to be a nurse:

There will be times when you are exhausted; times when you are pushed beyond what you think is possible; times when you want to break down and cry. That is okay. Hopefully, the safe staffing legislation that is getting rolled out by RCN Scotland and the Scottish Government will help, and you must always fight for this: to protect both patients and yourself. But there are times when you will question why you ever wanted to be a nurse.

I hope this doesn’t often happen, as you love what you do, and I don’t want your passion for the profession ever to be extinguished. But, when it does happen, and it will; remember why you chose to be a nurse. You wanted to make a positive difference to people’s lives; you know you can. You wanted to be that nurse that people always remembered fondly with a smile, who went the extra mile for them and their families. The nurse who cared, but who was also really good at their job; the nurse who always acted in their best interests. Be that nurse. That is who you are, and why you chose to be a nurse above anything else you could have been.

And Craig, remember that looking after your self is equally as important as looking after those you care for. Make time for yourself, your family and friends.

Use your voice to champion the nursing profession:

You know you will always do this. You have been doing it since you first started your nursing education. But remember how important your voice is: your one voice. Your one voice can make all the difference. Be that voice. Be a nursing advocate, a nursing champion.

Inspire and encourage others to use their voices. And if they feel they cannot speak up then advocate for them, remembering to channel their voices without a personal agenda. Welcome new voices into the fold; never exclude people or make them feel intimidated or unwelcome. Never become one of the people who shoot down those with different viewpoints.

Encourage discussion, debate and resolution, always with a questioning mind. Remember that you are not always right; allow yourself to be informed by those who know better, without being defensive. But, don’t be afraid to champion your cause when it is something you passionately believe in and can back up with evidence. Don’t bow down because it is the easy option or you feel scared that people won’t like you for saying something against the status quo. Just because it’s the way it’s always been done, does not mean it’s the way it always should be done.

Craig, remember that with all nursing voices together, we can create a revolution. We can make a difference: for patients, their families, and for nurses. Help lead the revolution.

The best leaders lead by example:

Being a leader does not mean being the boss or the person in charge. You are leading by example now in your advocacy and activism work while you are still in education.

When you become a staff nurse, you can lead by example by always being a critical-thinker, a problem-solver, and by following the best evidence to guide your practice. Lead by example by helping others. Try to be the nurse that others look up to. Not because you’re special – you’re not – but because you wouldn’t be happy in yourself if you weren’t pushing yourself to be the best nurse that you can be.

Craig, if you do ever enter a management role, remember that respect is earned, not given freely, and works both ways. That team cohesion and productivity is best achieved when everyone feels respected and valued. Lead by example then. Never ask someone to do something you either haven’t done or wouldn’t do yourself. Don’t breathe down people’s necks. Delegate and trust others. Offer support and guidance when needed. Know everyone’s strengths and weaknesses; celebrate their strengths, and help them develop their weaknesses. Don’t govern by fear and intimidation, be nurturing – remember what you heard at Congress: “I have your back, you’ve got my ear.”

Never stop pushing yourself to learn and develop:

You are ambitious, there is so much you want to achieve. Keep that fire burning. But, learn how to be a good staff nurse first. There is no point running before you can walk. Have goals; but, keep them manageable. And don’t feel like you’ve failed if you need to change or adapt them. That being said, never stop pushing yourself to learn and develop as a nurse.

Keep questioning; keep reading; keep going on additional training courses. Please promise me you will go back to university to push yourself academically and to develop professionally.

Craig, you can do it. Just do it. Believe in yourself. Yes, it may be hard, but it will be worth it in the end. And you can make a difference.

Inspire student nurses – they are the future:

Remember the tweet you read:

You love being a student nurse, and you have had some fantastic mentors. Take elements from all of them and add in a pinch of what is unique to you. Always, support and inspire students to be the best they can be. Find out their learning style, what works for them, and foster growth. Be proud of them.

Challenge them, but never, ever ridicule them or make them feel stupid or less than. Student nurses have given up so much in their pursuit of nursing, and we ask so much of them. Remember, nursing is not easy. University is not easy. Remember not to “eat your young” – you won’t, but you find that expression hilarious, though strangely apt for some nurses.

Lastly, Craig, remember student nurses will often have just as must to teach you as you them. They are the ones being taught the most up-to-date information. And nursing education will evolve; so, adapt with it. Things change for a reason. It’s usually for the better. Don’t look at your history with rose-tinted glasses. Look to the future of our nursing profession – our student nurses.

So that’s that. With this final post, the 30-day challenge is over. Thank you so much for reading. And I hope to be back blogging again soon. I will miss talking to you all every day.

Craig

@CraigDavidson85

My proudest moment…

I have been open and frank throughout my blog posts about the challenges I have faced in the past regards my mental health. The insight these experiences have given me, I believe, will make me a better nurse. I am more compassionate, empathetic, understanding and non-judgemental because of them. Having experienced mental health problems is a major contributing factor in my advocacy for better mental health support for nurses and nursing students. Also, why I champion the inclusion of mental health conditions and how best to support individuals who live with them in nursing education for all fields of practice.

I mention this because to understand my proudest moment; you have to know how much I have been able to turn things around in under three years – from being at my lowest point ever to where I am now. I am proud of that and grateful to those who have helped and supported me.

However, my proudest moment is the advocacy work I have undertaken on behalf of other student nurses and for the nursing profession.

As I have mentioned in previous blog posts, I am about to enter my third year studying BSc Nursing Studies (Adult) at Glasgow Caledonian University (GCU). I first completed an HNC in Care & Administrative Practice at Glasgow Clyde College, which allowed me to apply for direct entry into the second year at GCU. I gained one of 28 places on this articulation programme. Throughout my college and university education, I have always been a champion of the student’ voice and was elected class representative. Subsequently, I am now the School Officer for the Department of Nursing and Community Health at GCU, as well as Vice President of GCU’s Nursing Society. I passionately believe in advocating for students and nurses; especially around the areas of inclusivity, diversity, mental health support, and bespoke funding for nursing students.

My passion for promoting and developing an inclusive nursing recruitment drive led me to apply to be the Scottish representative on the Royal College of Nursing’s (RCN) UK Students’ Committee, which I was successfully elected to. I have voiced my concerns about making nursing more attractive to men and raised this at RCN Congress this year. Subsequently, I am now supporting lead of the student committee’s school project, which aims to promote nursing as an attractive profession to all.

I am proud of these achievements but prouder to be able to give a voice to others who may not feel as though they can. I will always be an advocate for others; it’s something I am incredibly passionate about. However, I will always aim to advocate without promoting a personal agenda. True advocates listen and relay the concerns and opinions of those they represent. They must be transparent and honest, maintaining a continuous open dialogue, which is what I do now and how I will endeavour to continue.

Craig

@CraigDavidson85