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

Violence against and society’s treatment of women: why men need to acknowledge, address and own these issues.

I suppose it fits that this blog is coming out on Mother’s Day because I dedicate this blog post as a love letter to my mum, the woman who has played the most significant role in shaping me into the man I am today. But I dedicate it not only to my mum but to all the mothers, daughters, sisters and all the incredible women who have inspired me, taught me, and supported me. I celebrate and thank every one of you.

I do not know if it’s because I identify as a gay man, but I have always been inspired by female “bosses”, by empowered women. In fiction, from Cheetara in the Thundercats to Storm, Jean Grey and Rogue in the X-Men, from Kimberley the Pink Power Ranger to Mildred Hubble and Hermione Granger. I identified with them much more than any male characters. I am now consistently inspired by strong women, to name a few: Jacinda Ardern, Michelle Obama, Malala Yousafzai. The list is endless.

I have long considered myself a feminist. But, recently, I have been having an existential debate with myself about whether I can be. I am a white, cisgender man; with that, I realise I have been born into a life of immense societal privilege. I have never had to fight the patriarchy or society’s systemic mistreatment of women. But, I have borne witness to it. And at times, I have stayed quiet. I am ashamed of that. And I say, no longer. I will listen to every woman’s story she has to share and help her to amplify it should she wish. I will call out every mistreatment against women I see, and I implore all men to do the same thing. It is every man’s responsibility to recognise their inherent societal privilege and join the fight to dismantle the patriarchy. We must all empower and uplift women and fight for gender equality. I feel this even more profoundly working as a nurse in a profession dominated by 89% women.

However, back to whether men can call or consider themselves feminists, I guess that’s up to them. But now, I consider myself a feminist ally. And I promise I will do all I can to empower women. And I believe every man should too.

Since posting on Monday on International Women’s Day, I have been doing a lot of reflecting. I have been utterly shaken by Sarah Everard’s murder, by the outpouring of stories from the women I follow on social media, those from my female family and friends on how affected they have been and continuously are by the actions of men. I cannot begin to imagine how they feel. I am horrified and so scared that my niece, sister, mum and all my female friends live in a world where any man is potentially their stalker, their abuser, their rapist, their killer.

While it may not be all men, how do women know which man it is? There are no denying statistics: males commit 97% of sexual offences, 90% of murderers are male, and 87% of crimes committed against another person are committed by males. These facts are undeniable. So, how do we address this?

However, I am not only addressing the grave fears women have regarding sexual assault, domestic abuse and murder. But the everyday abuse and perceived societal norms women are forced to accept from men: the catcalling; the derogatory sexist comments that go unchallenged; them changing their routes home and making sure they are in well-lit areas; them texting their friends and families when they are leaving and carrying their keys in their hands for safety. The majority of men do not have to do this.

We should not be educating women on how to keep them safe. We should be instilling empathy into young men, teaching them to respect women, that they are not better and have no power over women, that brutality and violence against women are simply not acceptable or allowed, that it’s their problem. As a society, we have got it all so wrong.

I also believe a big part of the problem is nurture and role modelling. We become who we are because of how we are shaped. As a society, as well as educating young men on all of the above, we also need to nurture young men to become caring individuals who will then care for and cherish others. Cherish the women in their lives. We are products of our upbringing and social conditioning. We need to enable young men and all men to discuss their mental health struggles, not to internalise these, because in doing so, this can then potentially cause them to lash out and turn into one of these abusers and statistics.

I believe that men need to step up and join women in fighting these causes and the dismantling of the patriarchy; because only men can end violence against women, the constant threat of terror, harassment and death, and the societal norms women are forced to endure. I don’t believe women should be leading the charge on this alone because they have been doing this for centuries. Men have to join in and take positive, affirmative action because it’s men, not women, who have to change.

Love and light,

Craig www.twitter.com/CraigDavidson85

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.

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