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

Why I believe the Royal College of Nursing should rejoin the International Council of Nursing.

I’ve thought long and hard about what I wanted to put in this blog post. And why I genuinely believe the Royal College of Nursing (RCN) should rejoin the International Council of Nurses (ICN).

For the RCN, I am a member of the Greater Glasgow branch. I was a Scottish representative on the RCN’s Students’ Committee from January 2018 to December 2019, becoming chair in 2019. Now, I currently am a steering committee member on the RCN Nurses in Management and Leadership Forum and an RCN Newly Qualified Nurses Twitter curator.   

Now, as with all nurses, I would consider myself a critical thinker, and I have done my research. I am not one to go with the tide. Quite often, I’m sure the opposite could be said of me. But, before I get into that, I want to explain a bit more about why I consider myself a global nurse. 

I have always been conscious of global and social justice issues. My dad’s nickname for me as a young child was actually “eco-warrior”. I consistently reminded him we needed to be turning off light switches and recycling. However, I digress. 

I first became aware of global nursing when I was chosen to be one of a group of nursing students from my university, Glasgow Caledonian University (GCU), to take part in an educational exchange trip with our international counterparts, California State University, Long Beach. I know, how awful, a summer in California. What I found so fascinating was not just the similarities we had as global nursing students, but the differences. And how much we had to learn from each other. 

Fast forward to my fourth Honours year at university. I became even more interested in global nursing when I undertook my advanced modules in public and global health. For my global nursing assessment, my report focussed on the factors increasing the HIV prevalence rate among Zimbabwean sex workers. This report discussed the nursing and healthcare strategies involved in addressing this. What I found so fascinating was that in this “low-income country”, as defined by the World Bank, nurses were not only providing but leading interventions. These are solutions we could be replicating back here in the United Kingdom. We have so much to learn from them. Due to this, when applying for my first staff nurse role, I actively sought out a position, successfully gaining a post in infectious (communicable) diseases in May 2020.

Subsequently, I am now undertaking a distance-learning, part-time Master of Public Health at GCU while working as a staff nurse. I have an active interest in global, public, and sexual health, particularly in blood-borne viruses and health protection measures. And one day, I hope to work on global and public health policy as a nurse researcher and academic. Possibly even as a governmental advisor, who knows? Furthermore, wanting to become part of a wider, global nursing network, I was invited to become a member of Sigma Theta Tau International Nursing Honour Society’s first Scotland Chapter, Omega Xi. And I am now part of their Nightingale Challenge for novice nurse leaders. 

Back to global health: “Global health” has become the popular term used when discussing health issues that transcend national boundaries. It is a field of study and practice, which seeks to understand and provide solutions to address the socio-economic, physical and behavioural factors that lead to global health inequities to achieve optimal health for all global citizens. Global health action can be either proactive or reactive, depending on the issue, and requires all nations and actors, including non-governmental organisations to share a common desire to address these using a transnational, multidisciplinary approach. We only need to look at the Covid-19 pandemic, which illustrates how much we have needed to pull together internationally. 

So, that takes me back to my original argument as to why I think the RCN should rejoin the ICN. Now, I know the fees we, the RCN, paid the ICN were in excess of £400,000 and were a significant deciding factor in our reason behind withdrawing during our Annual General Meeting (AGM) vote. The ICN requires funding from its associate members to function. However, recent evidence has come to light, highlighting that no one member association will be required to pay more than ten per cent of the ICN’s annual income. 

I genuinely believe the RCN’s withdrawal from the ICN caused them to reflect upon their governance and finance structure. That being said, I passionately believe “high” and “middle-high” income countries, as defined by the World Bank, which the UK falls under, have a moral and ethical duty and responsibility to support poorer nations. However, it goes far beyond that. It would be arrogant to assume that it’s just about what we would gain being associate members of the ICN. I think it’s more about what we can get from working with over 130 other countries with shared global nursing issues and goals. 

Now, more than ever, our nursing goals are global: recruitment and retention of nursing staff; fair pay, terms and conditions for nurses; the advancement of our profession, and ultimately, achieving the best we possibly can for the communities we look after. I believe that no one country can tackle these as an island. And we only need to look at Brexit, an entirely different debate, to see how increasingly insular the UK risks becoming. 

It is my understanding that the RCN’s November member consultation will be asking if RCN members believe the RCN should rejoin the ICN. Yet, it will also highlight the fact there are other global and European nursing associations we could be members of. However, none of these other associations has the ICN’s unique relationship with the World Health Organization (WHO). Why would we not want that? That relationship with the WHO is so special. The ICN has a seat at the World Health Assembly, the decision-making body of WHO. They were responsibly for lobbying for the WHO, both internationally and in Europe, to have a Chief Nursing Officer. And many people may not know, but they were co-authors of the WHO’s “State of the World’s Nursing Report – 2020, among many other things.

I believe that to have the most global influence; we need to be at the table. And for me, that is for us to be members of the ICN. And for us to have a seat at the World Health Assembly. So, whether this blog post encourages you to align your views with mine, I at least hope it gives you a more informed opinion and encourages you to do further research.

All the best,

Craig.

Student Nursing Times Awards 2020 #SNTA

I was utterly blown away by this year’s entrants. Many of who moved me to tears with their stories of how they got into nursing, and what they have achieved; not only as individual student nurses who have excelled in their field, but the extra work they have done for their fellow students, and the individuals they work with and care for. Each entrant’s passion and enthusiasm for nursing was inspiring. And every one of them would be a worthy winner. Sadly, this can’t be the case. But every one of them should be so proud.

I’m so looking forward to celebrating with the shortlist given the unprecedented challenges this year because wow, what a year it’s been for nursing!

When we knew 2020 would be the year of the nurse and the midwife, could we ever have expected just how amazingly our profession would have risen to every challenge thrown at it? From the final year nursing students, who actively engaged in extended placements joining the workforce to face the pandemic head-on, to those who had to for one reason or another adapt to a new theory route. Then there are the newly registered nurses, who have started at such an extraordinary time. And who have kept going. It’s not been easy. We’d be lying if we said it was. So, what a better way to celebrate than by getting together, all be it virtually to celebrate excellence in our profession.

So what’s my advice for the students watching the Student Nursing Times Awards online today that are graduating or who have stepped up to respond to the pandemic?

Well, I’d say; remember, these are challenging times, they are strange. And yes, it’s a word we’ve so often heard overused, but they genuinely are unprecedented times. Remember, though, why you got into nursing, your personal, unique reason. The one that is special to and drives you.

Always keep sight of that. These times will pass, but you don’t want to have burnt out before you’ve truly begun. Remember, ask for help when you need it. You’re never going to know everything. And no one expects you to. Be kind to yourself. And find your people, your peers who are sharing your lived experience and debrief with them. Also, reach out to more senior nurses in your team. They want to help support you. And to those students who stepped up, thank you. For those who couldn’t, you are not forgotten and are our future too.

So what did I enjoy most about judging this year? Well, I’d say what I most enjoyed was the calibre of the entrants and hearing their lived experiences. By nature, I’m a storyteller and love stories. And I left that judging day feeling so inspired by the future of our profession; because we are in very safe hands.

So, why do I think it’s essential that we continue to celebrate achievements like this even if we can’t meet in person?

Well, the whole world has changed, and we are doing so many things virtually now that we can no longer do in person. And these remarkable individuals deserve their day of celebration. Online, or in person, we will still have a fantastic time celebrating you and your outstanding achievements!

So, to those winners, congratulations. And to those shortlisted, well done to you too. Judging was the hardest thing I’ve ever had to do. And you are all winners in my eyes because you are passionate about nursing and helping others. Is there anything better than that?

All my love, Craig.

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 

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

5 words that describe a nurse…

There are a plethora of words that could be chosen to describe a nurse. In this current climate, undervalued, exhausted, overstretched and underpaid are a few that come to mind.

Nurses have faced years of hardship and have been beaten down during a period when services have been stretched to breaking point. First, there was the pay freeze, then the pitiful extended 1% pay cap. Workloads have increased, often to unsafe levels, and many nurses have left the profession, burnt out, disenchanted, and genuinely fearful for patient safety. Also, there’s been a decrease in student nursing applicants, threatening the very future of nursing. The removal of the NHS nursing bursary being the direct cause in certain parts of the UK.

This all adds up to a disaster: for our profession, for the NHS, and for the public – we all deserve better. Nurses deserve to be treated with respect and dignity, just as patients are too. Nurses deserve to be paid appropriately for the work they do. And student nurses deserve bespoke nursing funding to support them throughout their studies for what is not a conventional degree programme.

Nursing requires the essential values of compassion and empathy, amongst many others, but it is also so much more than that. It’s a degree-educated, graduate-entry profession, requiring constant critical thinking and the use of the best evidence-based practice to protect patient safety and deliver the best outcomes. Nurses are often the coordinators of care, and they’re also researchers, educators, pioneers.

However, the purpose of this 30-day blog challenge is to transform the perceptions of nursing. So, I would rather focus on the positives of nursing. I love our profession and being a student nurse, and despite all the negativity surrounding it, I cannot wait to be a nurse.

I think the 6Cs of nursing describe nursing well – care, compassion, competence, communication, courage, and commitment. However, perhaps they are a little basic. So, what can I add to these in my “5 words that describe a nurse“?

I have purposefully not chosen the word resilient. Though, I agree nurses are resilient and have to be so – for both themselves and patients. ‘Resilience’ is often used as a buzzword. I do not believe nurses or nursing students are offered enough mental health or emotional support in what is a very demanding, all-consuming profession. Nurses are expected to be able to deal with anything that is thrown at them. If they are struggling, they have to be more resilient. Do they? Is that the answer? Would it not be better and more healthy to have reflective conversations with peers or senior members of the team that could identify ways to help them cope; rather than tell them to toughen up? Resilience is, of course, important, and nurses could not be freely weeping on the wards all day. But they should be supported in this resilience, and I don’t believe resilience is a badge to be worn with pride and honour. It’s a bit ‘stiff upper lip’ for me. With regards emotional and mental health support, I am aware this is different for mental health nurses – so I speak for adult nursing, which is what I know.

In my choice of 5 words that describe a nurse, I have also not included the words kind, caring, empathetic and compassionate. Not because I do not consider these to be necessary skills or words that describe the nurse, quite the opposite. However, these words I feel are a given. All nurses should possess them. The purpose of my chosen words is to help transform public opinion of the nurse – to educate them on our role further. So, here they are.

ADVOCATE:

There is a reason nurses come out on top time and time again in polls regarding the most trusted professions. I believe advocacy is a significant reason behind this. As is laid out in the Nursing and Midwifery (NMC) Code (2015), nurses must advocate on behalf of their patients. When patients and their families are at their most vulnerable, they need someone to be championing their cause and making sure they fully understand everything that is going on with regards their diagnosis, treatment and continued care. When they do not, or if they do not have the capacity, then the nurse must act in their best interests at all times.

For nurses, advocacy goes beyond this. Or at least I believe it should. They should be advocating for their peers, for student nurses and championing the profession as a whole. Some nurses have often felt as though their voice cannot make a difference. But it can. I would always encourage nurses to make their voices heard. If they feel they can’t, then it is up to other nurses to advocate on their behalf. If we don’t make a noise and raise our concerns, then we can’t complain about our poor treatment.

COORDINATOR:

Nurses are more often than not the coordinators of care for patients. They liaise with other members of the multidisciplinary healthcare team and social care services to make sure that care runs as seamlessly as possible.

Nurses are the backbone of hospitals and care in the community; without them healthcare as we know it would cease to function, which is why the profession deserves to be respected and valued.

ADAPTABLE:

No two days are ever the same. This constant change is part of the reason I find nursing so exciting. But it is for that reason nurses must be adaptable. They have to be able to react in the moment and adapt.

Being adaptable helps protect patient safety and achieves optimal clinical outcomes. The need for constant adaptability is why I am against the “this is the way we’ve always done it” mentality and the rose-tinted nostalgia of nursing history. We can adapt because we are critical thinkers who rely on the best most up-to-date evidence to guide our practice. Another reason why it’s so essential that nursing remains a degree educated profession, fostering this level of academic thought.

NON-JUDGEMENTAL:

Nurses should treat all people equally, free from judgement, regardless of any personal views. I believe this to be such an integral quality of a nurse. In practice, when I have seen nurses and other members of the healthcare team exercise judgement, I have found it galling. There is no place for it in healthcare – or in the society, in my opinion.

REFLECTIVE:

Through reflective practice, we improve not only our practice, but we improve healthcare as a whole and the patient’s experience of their care. Of course, we will make mistakes – it is inevitable, we are human. However, it is how we reflect upon these instances and develop from them that speaks more about us as nurses and as a profession.

I look forward to your thoughts and to reading your words describing a nurse.

Craig

@CraigDavidson85

Is there nursing in my family…

I have mentioned her in my blog several times, especially in “when did I decide to become a nurse” and “which nurses inspire me”. So, if you’ve been following me or have read those posts, you will know that my mum is a nurse – Staff Nurse Carole Davidson. She had to take early medical retirement due to her fibromyalgia and misses her job terribly. She does still manage to do some nursing bank shifts; she can’t be kept away. That level of passion for nursing is one of the reasons I find her such an inspiration.

Also, not strictly my family, but my partner’s gran was a nurse. She is 90 this year and began her training aged 19 in 1947, one year before the formation of the National Health Service. I love listening to the stories of her training and time as a nurse.

However, today, I want to focus on a special member of my family, who although not a nurse, has a job every bit as essential to patient care, and helps make the nurse’s job possible – my dad, Adam Davidson, who is a Healthcare Support Worker.

My dad trained as a welder and worked in engineering for many years. However, when he was made redundant, aged 58, he chose to change career completely, becoming a Healthcare Support Worker at Erskine care home for veterans. I admire him immensely for this and am so proud. My dad has such an effervescent personality and kind heart, and I know that the veterans and their families will love him for that. And I do not doubt that he goes above and beyond for them.

Student nurses and nurses must never forget to value the vital work healthcare support workers do. They often get the opportunity to know patients much better than we can, and are the first to notice when something is wrong. I have learnt so much from them on placement, and thank all the healthcare support workers who have taken the time to help with my nursing education.

So, I am immensely proud to have a nurse for a mum and a healthcare support worker for a dad.

Craig.

@CraigDavidson85

What are my nursing pet peeves…

Well, today is the day where I am going to sound extremely critical of our profession, but it is what the question entails. And we are encouraged to be critical thinkers to improve services. However, I am aware that I am still studying and only at the very beginning of my career with lots to learn. So, I in no way think that I have all the answers. Anyway, here goes. I have addressed several of my nursing pet peeves in previous blog posts:

  • Poor patient care due to understaffing or poor communication and interpersonal skills.
  • Patient choice being neglected in favour of ease for healthcare practitioners – particularly concerning end-of-life care.
  • Insufficient understanding and delivery of palliative care.
  • Lack of emotional and psychological support for nursing students and nurses.
  • The failure of the government to secure bespoke funding for nursing students. In Scotland, the bursary is not enough. Elsewhere in the country, the student loan system, where students are getting in massive amounts of debt to become nurses, certainly isn’t working.
  • Incorrectly measured and documented observations endangering patient safety and health outcomes.
  • Lack of respect for nursing as a degree educated profession, which applies to both fellow nurses and society in general.
  • A nursing workforce that is not representative of the communities we serve.
  • Nurses being resistant to or unwilling to adapt and change.
  • The varied roles of the modern nursing not being understood.
  • Nurses who are not politically active or using their voices to affect real change and champion the profession – you can’t complain if you aren’t doing anything about it.
  • Nursing history being viewed with rose-tinted glasses. It is time to look forward.
  • The lack of education around nursing history at universities. How can we improve the future without understanding and improving upon the past

However, there are a couple of nursing pet peeves that I haven’t previously discussed.

Firstly, the reticence of certain individuals and institutions to encourage and support younger, newly qualified and student nurses in leadership roles. Sometimes the best leaders are not those with the most experience. In fact, having a fresh pair of eyes, different perspective or new vision – whatever you call it – and being on the shop floor, working directly with patients day-in-day-out, can be what makes them the best people to advocate for patients and nurses and to champion the profession.

Lastly, as a student nurse, one of my biggest pet peeves is being called “the student”. Luckily, this doesn’t happen very often, and when it does, I jokingly say: “my name is Craig”. But it is just rude. Don’t do it. Respect is a two-way street, and students are people too. We are the future of the profession after all.

Sorry about the rant – I promise that tomorrow I’ll be back to my usual chipper self. Would love to hear if you agree or disagree with my nursing pet peeves and any additional ones you have.

Craig

@CraigDavidson85

Which nurses inspire me…

Well, it goes without saying as I have mentioned her considerably throughout this 30-day challenge; my biggest nursing inspiration is my mum, Staff Nurse Carole Davidson. She inspires me, not only because she is an incredibly compassionate, dedicated nurse, who goes above and beyond for her patients and their families – you should see the gorgeous things she has crocheted for all the babies on the ward at Christmas and Easter. No, what inspires me most is that she has done all this while being the emotional, selfless lynchpin of our family; always putting others before herself.

A newly qualified Staff Nurse Davidson, aged 21, 1979.

Working in Ward 7B, Yorkhill Sick Children’s Hospital, 1983.

Princess Diana visiting Ward 7B, 1984. Can you spot mum in the background?

Other than my mum, there are some other inspiring nurses I have also discovered.

While I have nothing but respect for nursing legends like Florence Nightingale and Mary Seacole, during “Men into Nursing” debates, I often discussed the lack of nursing role models who were men. I think it could help attract men into the profession if they had someone to relate to directly and aspire to be – to show nursing is a wonderfully diverse career for all.

Professor June Girvin, who I have mentioned in a previous blog post, and Dr Elaine Maxwell kindly directed towards a plethora of hugely inspiring men. Here are my top three: two for their significant achievements in oncology, my field of interest, and one for his political activism with the RCN. If I could emulate even a small fraction of their work throughout my nursing career, I would feel immensely proud.

Cheeky, I know, and never do this for an essay, but as I am currently on holiday, I am going to copy-and-paste their biographies from Wikipedia.

Robert “Bob” Tiffany:

Robert Tiffany OBE, Fellow of the Royal College of Nursing (30 December 1942 – February 1993), was a British nurse and Fellow of the Royal College of Nursing. He was a founding member of the International Society of Nurses in Cancer Care (ISNCC) and initiated the Biannual International Cancer Nursing Conference. He was also a founding member of the European Oncology Nursing Society and first President of the Society from 1985 to 1987. An oncology nurse at the Royal Marsden Hospital in London, later promoted to Director of Nursing, Tiffany worked to identify misconceptions regarding cancer, as well as cancer prevention, early detection, and improving the lives of those stricken with the disease. The Tiffany Lectureship was founded to inform and inspire oncology nurses worldwide.

Richard J. Wells:

Malcolm William James Richard Wells, CBE FRCN (19 June 1941 – 6 January 1993), commonly known as Richard J. Wells, was a British nurse, nursing adviser and health care administrator.

Wells was born in South Africa during the Second World War. His career in nursing was largely based at the Royal Marsden Hospital, where he held various positions, including Director of the Marie Curie Rehabilitation Centre.

He served as a consultant to a host of organisations, including the World Health Organization, the International Union Against Cancer, the International Council of Nurses and the European Oncology Society.

As Oncology Nursing Adviser at the Royal College of Nursing, Wells helped shape the nursing response to HIV infection and AIDS in the UK.

Wells died in London in 1993. The Richard Wells Research Centre at West London University is named in his honour.

Trevor Clay:

Trevor Clay, CBE, FRCN (10 May 1936 in Nuneaton, Warwickshire, England – 23 April 1994 in Harefield, Middlesex, England) was a British nurse and former General Secretary of the Royal College of Nursing.

Clay began his nursing career in 1957, but it was as General Secretary of the RCN, beginning in 1982, that he became a public trade union official and negotiator. He had been Deputy Secretary since 1979 but was not a public figure.

In 1982, almost at the outset of his tenure, he began negotiations with the UK government over a labour disagreement concerning nurses’ salaries, then at yearly levels of no more than £5,833. As a result, a “Pay Review Body” characterised by autonomous operation was created; the compensation of the nurses he represented was also increased.

Clay was diagnosed with severe emphysema at the age of 37. With a membership in excess of 285,000 at the time of Clay’s pensioning off due to illness in September 1989, no labour organisation unaffiliated with the Trades Union Congress surpassed the RCN in size, and none had a greater rate of expansion. Clay’s respiratory disease claimed his life, aged 57, in 1994.

I am sure you will agree, some pretty inspirational nurses. I urge any man in nursing, who, like myself, have complained that there is a lack of male role models in nursing – do your research. Though I would like to see more nursing history taught at universities – we know Florence and Mary were great, but so were many others. And some of them even happened to be men.

For next year’s International Nurses Day, I would love to see inspirational nurses of all genders, ethnic and cultural backgrounds celebrated. That way we can showcase the wonderful inclusivity of our profession.

Craig

@CraigDavidson85

5 things I do on every shift…

As a student nurse, we are constantly on placements in different settings. And things change significantly from one setting to the next: an acute ward, an outpatients department, a community setting. So, here are five things I always do on every shift regardless of setting.

  • Introduce myself: You would think this was a given, but I have been genuinely surprised that some people do not do this. Patients deserve the common courtesy of knowing our names. We know theirs, and if we fail to introduce ourselves, it only serves to amplify the potential power imbalance in the relationship. Patients are already in a vulnerable place, why on earth would we not take the two extra seconds it takes for a proper introduction? There is no excuse. The work the late Kate Granger did in launching the #HelloMyNameIs campaign has helped address this issue on a national and global level.
  • Gain consent: I always gain consent, either written, verbal or implied, for whatever task I am about to undertake. It is essential we do this. Patients should be treated with dignity and respect, and nursing must be person-centred and focussed on patient choice. Consent must be informed, and they must be given the option to refuse treatment, as is expressly stated in the Nursing and Midwifery Council (NMC) Code (2015), which all nurses must abide by. As a nursing student who happens to be a man (note – not a “male nursing student”), I feel as though I am hyper-vigilant about gaining consent, particularly when performing intimate tasks on female patients. There was a recent debate on social media in which some nurses believed patients should not be given a choice to refuse a nurse based on gender. I vehemently disagree. Of course they should. A patient has every right to refuse care, or ask for a different nurse of the same sex. It is ludicrous that a nurse should take offence at this. I would never for a minute consider carrying out an intimate procedure – or any procedure – on a patient without first asking if they minded, and then explaining exactly what I was going to be doing. This is why I truly believe we must recruit more men into nursing so that we can offer male patients the same choice as women. With 11% of nurses being men, and often none on a shift, this is often an impossibility.
  • Ask questions: If I don’t know the answer or understand something properly, I will always ask questions; whether of my mentor or other members of the multidisciplinary team. I have never had someone shoot me down for this – and if they had then frankly, they are in the wrong job. There have been occasional times where they have not known the answer themselves, and this has then proved to be a learning opportunity for us both. It is, however, always important to ask questions at appropriate times, and this is where my trusty, surgically-attached notebook comes in handy. Asking questions encourages critical thinking, so this is something I will never lose as I progress through my studies and career.
  • Accurately measure and document observations: It is so important that observations are measured and documented accurately. An altered respiration rate is the first indication of deterioration, and universities teach that it should be counted for a full minute. A medic friend of mine suggests that there is often not the time for this; that although a full minute is ideal 30 seconds should suffice unless the patient’s breathing is erratic. But still, how many people measure for even that long? Evidence suggests that respiration rate is the most commonly overlooked observation. Likewise, a pulse oximeter will tell you the pulse rate, but it will not measure rhythm or amplitude. It cannot replace an accurate manual pulse reading. These are only a couple of examples. Others include people failing to accurately assess skin condition when carrying out positional turns, or documenting fluid balance. We shouldn’t be taking shortcuts. Yes, a lot of this is due to understaffing and an increased workload. But in the end, it will only harm patients.
  • Drink plenty of water: Dehydration not only affects us physically, but it also affects us cognitively, which is the last thing we as nurses need when administering medication and such the like. I always carry a water bottle and make sure I am keeping hydrated throughout the day. We are always prompting patients to drink plenty of fluids. So, we should practice what we preach. Also, if patients see their nurses keeping hydrated, perhaps it will encourage them to follow suit.

So that’s the five things I do on every shift, regardless of setting. None of them groundbreaking but all of them important.

Craig

@CraigDavidson85

My favourite thing about being a nurse…

I know it may seem cliché, but I am unapologetically so. My favourite thing about being a nurse is 100%, without a doubt, the patients. It is a privilege to be a nurse, to be there for someone when they are at their most vulnerable. I love getting to know people, to find out their stories. When I am able to comfort them or allay their worries, I feel as though I have done a good job. This is why I think excellent communication and interpersonal skills are essential.

We need to use these skills to develop and maintain strong therapeutic relationships built on mutual respect and trust. I genuinely enjoy doing this. Maybe it’s because I’m a chatterbox who loves a good chinwag. Maybe it’s because I was an actor for years and in companies we had to build trusting relationships quickly. Or maybe it’s because I find it fascinating to learn more about their lives, their hopes, their romantic pasts (those stories are always my favourite – I blame Disney). Whatever the reason, getting to know the patients I am looking after is my favourite part of the day.

Truly knowing our patients facilitates optimal care delivery. Because how can we properly identify deterioration if we don’t really know them? Yes, observations and algorithms may give us a medical indication, but what if they don’t? On paper things may appear fine, and if we don’t know them then we may just accept this. However, if we genuinely know “Anne”, then we know that something isn’t right. She isn’t just tired; she may be depressed, she may have hypoactive delirium. If we don’t know her and this goes unnoticed we are failing her. We are ineffective nurses who are compromising patient safety and outcomes.

It is for this very reason I am so troubled by the nursing staffing crisis in the NHS, and the failure to recruit and retain nurses. The real losers in this situation are our patients – the reason I love nursing. Nurses are so stretched that often they simply cannot spend the time they would like to getting to know their patients. And things get missed – I’ve seen it happen, as I’m sure most of you have.

As a student nurse, we are supposed to be supernumerary. However, this status often goes when wards are short staffed and we become an extra pair of hands. But, when we do get to retain it, I love the opportunity it gives me to get to know patients better. I don’t want to lose this ability when I become a staff nurse.

People have mentioned to me that they can see me progress into management or education roles in the future, which of course is extremely flattering, and a confidence boost. They certainly have more faith in me than I do. However, I worry that this would take me away from direct contact with patients. They are the reason I got into nursing and why I enjoy it so much. For this reason, I would much rather become a clinical nurse specialist or advanced nurse practitioner in time so that I still provide face-to-face patient care on a daily basis.

After all, without patients, there would be no need for nurses.

Craig

@CraigDavidson85

What’s my favourite nursing topic…

I know this is becoming somewhat of a recurring theme, but again I am finding it so hard to pick a favourite nursing topic as I genuinely enjoy them all.

At Glasgow Caledonian University, where I am currently a student nurse, our academic year is built around five modules, on top of our placements, which develop each year as we progress through our studies. These are values-based nursing practice, evidence-based practice, interprofessional practice, professional skills for practice (which includes physiology, pathophysiology and pharmacology), and our specific nursing module that relates to our field, which in my case is adult nursing.

My favourite subject this year was our adult nursing module, Anticipatory and Alternative Approaches to Adult Nursing. This module was built around case studies of patients living with the chronic conditions of COPD, heart failure and diabetes. We discussed the role of the nurse when caring for a patient throughout their illness trajectory, which included exploring strategies to support them in their homes, early interventions, and better access to safe and effective alternatives to avoid unnecessary hospital admission. We also identified appropriate responses to crises, deterioration in condition, and end-of-life care.

The reason I enjoyed this module so much was it encompassed elements of all our other modules, bringing them together in a such a way that we could utilise our critical thinking skills. It required us to fully understand the pathophysiology of each condition in addition to the pharmacology behind its treatment. We also had to identify the best, most up-to-date evidence, the role of the rest of the interprofessional team, and how we could use our values-based nursing skills to educate patients and navigate difficult conversations. I am looking forward to the next stage of our nursing module in my third year, Adult Nursing to Empower, Enhance and Enable Person Centred Care.

Palliative & End-of-Life Care

Throughout my studies, I have developed a keen interest in palliative and end-of-life care, which this year’s nursing module, alongside my experiences on placement, has only served to intensify. From my experience, not enough is known about effective palliative care, and some nurses often refer to specialists for fear of not understanding how to manage long-term conditions best. I believe it is vital that nurses can distinguish between palliative and end-of-life care, as often the two are confused. End-of-life care is an element of palliative care, but it is not all palliative care encompasses.

The Palliative Care (Scotland) Bill (2010) defines palliative care as “treatment which controls and relieves pain, discomfort or other symptoms caused by or related to a life-limiting condition with the intention of improving quality of life”. The Scottish Government (2015) adds that “palliative care is not just about care in the last days and hour of life, but about ensuring the quality of life for both the person and their family at every stage of the life-limiting disease process from diagnosis onwards”. No one should have to live in pain or symptomatic discomfort, and as nurses, we should always strive to improve or at least maintain the quality of life, which is why quality palliative care is so critical and is an area I have become interested in.

Dignified, respectful end-of-life care, which respects the wishes of the person and their loved ones is also essential. Death is an eventuality for all of us, and we should all be able to live out our last days and hours as we choose. Wherever possible we should be respecting the patient’s preferred location to receive end-of-life care and should have an anticipatory care plan put in place for when deterioration occurs.

So that’s been my favourite nursing subject this year, and my developing professional interest. I look forward to reading about your favourite nursing topics.

Craig

@CraigDavidson85

A photo of me…

Well, I love a cheeky selfie, but the photo I have chosen for today’s post is not one – although the selfie of my rainbow glitter beard from last weekend’s Pride Glasgow march I took part in with RCN Greater Glasgow Branch comes a very close second. Instead, I have chosen the below.

craig congress

This was me speaking at my first ever RCN Congress this May in Belfast. I was a first-time speaker at Congress; and although I may have been an actor for years, it is still petrifying to get up and speak as yourself, not hiding behind a character. Particularly so when it is about a subject you are passionate about, and in this case, the resolution about developing and promoting a strategy to recruit more men into nursing is one that is very dear to my heart. After all, it is one of the main reasons I put myself forward for the RCN UK Students’ Committee – I want to use my passion for this topic to affect real change. Sadly, Congress voted against the resolution, but I believe we got our voices heard and Council will take notice of what we had to say. I am already working with RCN Scotland on ways we can promote nursing as an inclusive profession for all, and I will be speaking at their event in August this year, which you can book at the link below:

Nursing, a career for men: myths, challenges and solutions

28 Aug 2018 16:00 – 18:00

Room CEE2 Centre for Executive Education, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA.

Based on me speaking at Congress, I was also asked to write a thinkpiece for Alliance Scotland:

Nursing is one of the most important professions in the world. Everyone at some point in their lives, 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 a very special and inspirational nurse: my mum, 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: men who have the necessary values to be a nurse. The reason: I believe the nursing workforce must be as diverse as the communities we serve. 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, and 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. This is something 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 level 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, what it is 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 so 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.

I sit on the Royal College of Nursing (RCN) Students’ Committee, and because of this, my picture was in the Students’ Magazine. My friend, a fellow student nurse, text me to say that her daughter had been so impressed, she had taken the magazine into show-and-tell at school – she’s seven. When my friend asked her what she had told the class, she said: “this is mummy’s friend… he’s a boy nurse because that’s fine.” Out of the mouth of babes. A campaign like this really could make a difference.

I know that I am a cisgender, white male; that with that comes privilege, and I am far from disadvantaged in society. I can’t change who I am, but I can help to diversify the nursing workforce to reflect the communities we serve. I would encourage you all to as well.

I have always been a big champion of the student’ voice and am proud of my involvement with the RCN, but attending my first ever Congress was a massive game changer for me. I left feeling empowered. The passion, commitment and activism shown by RCN students in our 50th anniversary year was inspirational. We must build on this momentum. I am certainly going to – join me.

Craig

@CraigDavidson85

Thoughts on nursing as a degree…

I wholeheartedly believe that nursing should be a degree educated, graduate-entry level profession – and I would seriously question the rationale behind anyone who opposed this view. There would be no question about doctors, psychologists, pharmacists, radiologists, physiotherapists, occupational therapists, dietitians etc., being educated to degree level; so why nurses?

As the nursing role has evolved, it is inevitable and crucial that nursing education should have too. Nurses must be critical thinkers, who can analyse evidence, enabling them to deliver the best evidence-based, patient-centred care. This ability to critique not only provides optimal patient care and outcomes, but it is also what strengthens their position as advocates and protects patient safety. If nurses are not educated in a manner that encourages and enables them to be critical thinkers, then how can they be doing this? We must always question and challenge the ‘norm’, and the ‘way things have always been done’. However, this is not always popular. There has been a long history of a hierarchical workforce in healthcare and nurses have been expected to follow orders, and do what has been asked of them without question. But, times have changed – and for the better.

The Nursing and Midwifery (NMC) Code states that nurses must: prioritise people, practise effectively, preserve safety, and promote professionalism and trust. How can nurses do this if they are not educated to degree level that teaches them the necessary skills and fosters a questioning mindset? I would also argue that to embody the 6Cs of nursing – care, compassion, courage, communication, commitment and competence – nurses must be able to challenge and be equipped with the knowledge that allows them to do so.

There is a reason that nursing education has changed; it has been a change for the better. Reverting to any form of education that takes nursing students outside of university would be an unwise decision. It would be detrimental to the profession, but most importantly to patients. We must stop looking at the past with rose-tinted glasses; we must embrace the future.

Craig

@CraigDavidson