2020 was recognised as the “International Year of the Nurse and Midwife” and the year when the Nightingale Challenge was launched to provide a range of leadership and developmental opportunities to a group of nurses and midwives across the Trust.
Our Nightingales have reflected on their experiences to capture and profile how they have developed their leadership and networking skills throughout 2020 with reference to the COVID-19 escalation and surge.
Find out more about their experiences below.
Alana McCaffrey: Deputy Ward Sister, Thompson House Hospital
When I think back to the beginning of the year myself and my partner had just returned from a lovely holiday in Iceland. However the prospect of a holiday seems so distant right now. I thoroughly enjoy travelling and at the time I had no idea that would be my last time getting off a plane for a long time. When I returned back home, I was faced with many exciting opportunities: I was due to move into my first home; there were interviews for a Band 6 Deputy Sister post within my work; and I was also due to start the South Eastern Trust Nightingale Leadership Challenge. It seemed that 2020 was going to be an exciting year, both in my personal life and professional career. The World Health Organization announced 2020 as The Year of the Nurse and Midwife and I was so privileged to have secured a place on the South Eastern Trust Nightingale Leadership Challenge. I am always keen to develop my skills in any way possible, however I knew this programme was different to the rest. It provided me with the opportunity to network with other young nurses around the world whilst learning and developing more as a leader within the nursing world. I was so honoured to be part of such a prestigious course.
From a young age I have always wanted to pursue a career that involved caring for people. Nursing is a recognized career within my family and seeing the rewarding outcome my family experienced really motivated me to pursue a career in nursing. I wanted to do something in my career that is challenging, rewarding and makes a difference in people’s lives. Throughout my time as a student nurse my interest in nursing and passion for the career became even stronger as I found I also have an aptitude for the work. The concept of helping those in need and feeling the satisfaction of knowing that was something which stood by me when applying for Nursing. I am a very caring and compassionate person and have been from a young age, therefore I always felt I fitted the role of a nurse. Never in a million years did I think I would be nursing patients during a pandemic, however I recognise how privileged I am to be in a position which I can.
I am three years qualified and I am currently in the role of a Deputy Ward Sister caring for patients with acquired brain injuries and progressive neurological disorders. I have been in this role for ten months, previous to this I was a Band 5 Staff Nurse for two and a half years within the same area. My current role is supporting my Ward Sister in her duties, therefore taking charge of my ward, and ensuring staffing levels are adequate. I have currently adapted to the position of clinical leadership role which I can confidently say would not have been possible if it were not for the Nightingale Challenge. My perspective on many things both personally and professionally has been enhanced by taking part in this programme and this can be exemplified in a number of ways. Firstly, it allowed me to step out of my comfort zone. I think back to the first module of the Nightingale Challenge, it was called “All About Me” and the way Karen Hunter made us think about ourselves: how we act; how we talk; and how we behave and perceive things. By the end of the module, we all realised that we are quite tough on ourselves and automatically deride ourselves without any thought. She made every young woman in that room realise that they are strong, hardworking and confident leaders. It was only then that I even considered applying for the Band 6 post within my job and I could not recommend this course highly enough as it prepared me for taking on the leadership roles within the Deputy Sister post. Secondly, my confidence has been greatly enhanced and my ability to make decisions and delegate duties to others has came to the fore. This would have been an aspect I struggled with previously and definitely an area of weakness which required improving, therefore I am confident that I am developing as a leader within my nursing career. Lastly, I am reassured with the support I have received from all of the young women involved in the Nightingale 2020 Challenge. From networking with such amazing young women and developing friendships is something I will be forever grateful for.
The disappointment was felt by all of the Nightingales when it was evident that lockdown would have a devastating impact on our ability to attend the events in line with the Nightingale Challenge. It felt as though all of these opportunities being provided to us were stolen. However, I think many people can confidently say that technology kept the unity of the nation and in this situation it allowed us Nightingales to continue to network. We were fortunate enough to continue the modules and attend numerous conferences. For instance, I attended the NICON 20 conference via zoom in October and to listen to these incredible leaders was truly inspiring.
I love many aspects of being a nurse, however the main reason for me is being able to care for those who are sick and vulnerable. Knowing that you are making a positive impact on a person during their most difficult time is a sense of satisfaction and pride I cannot put into words. I thrive on the rewarding feeling you receive and I am so privileged to be in a position where I can make a difference to people’s lives, providing patient’s families with a sense of security and relief that their loved ones are receiving the best care possible. I can confidently say that the friendships you develop with other nurses is a friendship like no other.
I was keen to undertake this programme in order to improve myself in various areas. As previously mentioned, I was aware that I needed to improve on my leadership skills in order to develop my confidence. I had found myself in many situations taking on too much in the fear to not delegating appropriately or effectively. As well as this, my Ward Sister also encouraged me to undertake this programme as she saw the potential in me to progress in my career. I felt the timing was perfect, what better way to prepare for a promotion than to embark on a renowned leadership programme. Never in a million years was I prepared to take on this promotion ahead of the world’s largest pandemic.
As I put on that dark blue uniform, it was only a week later that COVID-19 was declared a pandemic. It was evident that 2020 was going to be a challenging year with many tests along the way. I eventually stopped watching the news as it became clear this virus was spiralling out of control and I was extremely apprehensive of what was ahead of me. As days went on workload was at its highest, staffing was at its lowest and I could not keep up with policy after policy. My leadership skills were put to the test and it was in times like these I reflected back to what I learned in the Nightingale Challenge. I felt more of a responsibility to ensure all our staff and patients were protected, this involved arranging fit testing for different masks, ordering of PPE, and communicating with relatives with regards to the stopping of visits. It was extremely difficult to adapt and communicate these changes. I would certainly say many staff were in operation mode as there was little time process to adapt to these changes. As we have a unit dedicated to tracheostomy patients, we were aware that these patients were extremely vulnerable, and it was up to us to ensure their safety. As a whole, it certainly enhanced teamwork and communication as the team really came together and we got through the worst of these challenging times. It definitely helped us prepare for other challenging situations which may occur.
We were fortunate enough to have many staff redeployed to us during these challenging times and I knew I played a vital role in ensuring they were supported and inducted to this new environment. The team we gained during the pandemic were truly remarkable and adapted quickly to the changes that were thrown to them. It was times like these that everyone from senior staff to newly qualified nurses stepped up to the mark and displayed true leadership qualities to support each other in ensuring the safety of ourselves and particularly our vulnerable patients. I gained so many skills and knowledge during this time and feel I have developed into a better nurse and leader. The COVID-19 pandemic created such a sense of unity, passion, and drive within our team and although pressures were high, I have never been more proud to be part of such a tremendous team.
In relation to my personal life it was extremely difficult. What I thought was an exciting step in my life turned out to be the loneliest. I had moved into my first ever home, therefore when lockdown was announced I was no longer able to see my family. We are an extremely close family and when I have my bad days they are the first people I turn to. To not have that close contact or even a hug from my mum was emotionally tough. My aunt was also very unwell at the time, therefore not being able to care for her any more or support my mum during this difficult time was heartbreaking. It was sad to know that everyone had experienced a personal impact due to COVID-19; therefore the sense of unity that we were all in this together was something that kept me going.
Seeing the emotional impact of patients not being able to see families was devastating, particularly in our younger patients. It had an impact on their motivation towards rehabilitation and was another difficult factor we faced throughout this.
There have been many leadership styles I have observed throughout my time as a nurse. However, leadership was greatly highlighted during the management on the ward during the pandemic. I have worked under my Ward Sister for three years and I have always respected her ability to be a great leader. More so, seeing how she stepped up and lead her team through such a difficult time was inspiring and her incredible leadership and bravery is something I aim to replicate within myself. Her compassion, motivation and support provided was paramount to ensuring both patients and staff were always kept safe. She adapted her leadership style to the situation which, I am sure is not as easy thing to do.
My personal ambition is to be a transformational leader, a leader who seeks the best ways to achieve a goal, a motivator to staff and a role model who is always approachable. I hope to empower others to become great leaders and be accountable whilst taking pride in their roles which they enjoy doing. I also admire aspects of a democratic leader as I think it is good to let your team know they are involved and to be receptive to their ideas. By taking their ideas and values on board it develops good two-way communication, therefore allows for a more valued team and comfortable approach to their leader.
I have come out the better side of all of this. I have learned from all of my experiences in the COVID-19 pandemic; I have become a nurse who can adapt to changes effectively, a team player who knows to check in on people and a leader who can influence others. A famous quote I learned from Karen Hunter is “every time you influence another person, you are leading”. I found I could lead even when out of my comfort zone as I helped other redeployed staff and other colleagues feel supported in such unknown times.
It has become evident that nurses are experienced in adapting to change and seek alternative ways to work. It has been incredible that we have been able to continue the South Eastern Trust Nightingale Leadership Challenge through technology as it allows us to connect with nurses, midwives and leaders from all around the world.
To conclude, it has been an eye-opener to reflect on such a challenging and rewarding journey. I have learned how to work under serious pressure and prioritize effectively. I now recognize the importance of knowing how to ‘switch off’ and not to take things for granted. I know the importance of looking after your mental health to be the best version of yourself when in the workplace. I am incredibly proud to call myself a nurse and a Nightingale and I am excited for my future and the potential opportunities which may come my way.
Christine Gordon: Clinical Sister, Medical Assessment Unit, Lagan Valley Hospital
Since I was very young, the only career I ever wanted to follow was nursing; no other career ever crossed my mind. Sometimes I wonder was I influenced by my God Mother and Great Aunt who were also nurses. I listened to their many inspirational stories and looked at photos of them in their white nursing dresses and hats from I was very little.
Very recently I have been appointed to my current role as a permanent Clinical Sister (Band 6), from a temporary post. This is such an achievement for me especially during 2020 ‘The Year of the Nurse and Midwife’. I thoroughly enjoy my career in nursing as I believe it is a ‘calling’ in life to give back something to the world. I am more so enjoying the Clinical Sister role, as I can gain more experience, skills and qualities in a leadership and management role which entails not only caring for my patients, but also the team, and being able to make changes to ensure high standards of care are provided, to make each patient’s hospital journey patient centered and effective.
In 2020 ‘The Year of the Nurse and Midwife’ this excellent South Eastern Health Social Care Trust Nightingale Challenge Leadership Programme commenced. I was delighted when a Sister in the hospital nominated me to participate. The timing was perfect, as I was temporary in my role as a Clinical Sister at the time. I took this challenge as a way of developing and exploring my collective leadership skills and qualities to be able to develop and better myself for this role.
Since the Nightingale Challenge programme commenced, the COVID-19 pandemic has also been having a huge impact on our role as leaders. Challenges I have faced are dealing with quick changes in the way we deliver care to our patients and our ways of working, for example more wearing of PPE, infection control changes, team members having to work within other teams and other wards. Other challenges we have faced are, dealing with the unknown, every day can be different, protocols changing frequently and keeping myself and the team informed about these changes. My leadership goals and objectives I set at the start of this program, throughout this pandemic have been challenged greatly, but it has also been an excellent time to develop these skills and qualities. Listening to the team and patients has been of great importance, to see how people are feeling and managing, to learn what changes are working and what needs to be improved on. This goes hand-in-hand with giving the team feedback: what has been working well and what has not? I have also been challenged with difficult situations and decision making, which now has been the time to get myself involved in these and not to shy away, in order to build on my confidence as a leader. Displaying positivity has played a huge part as a leader during these challenging times, to ensure good team morale so that patients and their family have confidence in our delivery of care.
The Nightingale Challenge programme provided us with many opportunities to help fulfil my leadership goals and qualities, such as the NIPEC (Northern Ireland Practice and Education Council) Conference and SQE (Safety, Quality and Experience) Final Event. The COVID-19 pandemic set challenges along the way and some of these events had to be cancelled and the Nightingale Challenge programme was delivered via zoom. One of the excellent opportunities that did go to plan was hearing a speech from Chief Executive Seamus McGoran on his experience of leadership in the South Eastern Health & Social Care Trust. Another great opportunity was hearing the nursing challenges and opportunities in the greater UK by Executive Director of Nursing, Midwifery and Allied Health Professionals, Public Health Agency, Rodney Morton. Also a great presentation from Eunice Strahan on the challenges and differences to nursing in the greater world: Zambia and Uganda. I have been able to meet up with other Sisters in the hospital to share and learn from their experiences as leaders, so that I too can bring some of their ideas to my ward.
Through hearing and gaining all this leadership experience through the Nightingale Challenge programme, I have come to the conclusion that I am a transformational leader. I work well with the team, together identify needed change, create a vision and inspire and motivate others to change.
COVID-19 has impacted greatly on me both personally and professionally this year. Many new challenges sprung on us within the work place, trying to keep the team together and trying to create a positive morale in uncertain times. I have learned to understand that as senior leader within the team, others will look to you for answers, support and reassurance, which I believe has been a perfect year to build my confidence and professionalism to provide this. Juggling my profession and the personal impact of COVID-19 on my family life, by being unable to spend quality time with family and friends which I think highly of as my ‘down time’ from work, has been particularly difficult . Instead I have discovered some technical, safer ways of doing this via WhatsApp and video calling. I was also faced with a further challenge by trying to organise my wedding for a second time this year due to the first one being cancelled during lockdown in June, and having to be reorganised for a later date, with the unknown to whether it would go ahead. Thankfully the second date went ahead with some restrictions. What I have taken away from these challenges, is that the things we take for granted in life, may not happen as planned, but with a little tweaking, changing, setting goals and positivity, everything is possible!
In conclusion, the Nightingale Challenge programme has given me the opportunity to explore my leadership, find out what type of leader I am and gain experiences from other leaders. I will be able to bring all of this experience and learning to my current role as a Clinical Sister and be able to transfer these in my professional and personal life.
Caoimhe Hayes: Deputy Sister, FERA Centre, Downe Hospital
“love that within nursing there are so many different pathways and opportunities”
What made me follow a career into nursing was my biggest inspiration in life – my Nanny Hayes. I have said for many years as a child that I was going to be a nurse like my Nanny and to be honest I never imagined doing anything else as I had my mind made up a long time ago. My Nanny had actually tried to talk me out of nursing when it came to applying to university but as I said I had my mind made up and was going to nursing no matter what. Still now after working as a nurse for four years I cannot imagine doing anything else. Every day I try to make her proud and do my best as I know she is watching over me.
I am a Deputy Ward Sister in a Frail Elderly Assessment Centre (FERA). I have been working here almost two years. I had worked for a year in the FERA Centre and then applied for a temporary uplift to a Band 6 in February. Within the FERA Centre we are an eight bedded assessment centre for people over 65 years of age. We receive referrals from Emergency Departments, G.P.s, Specialist Nurses, in-house Consultants, and Enhanced Care at Home (ECAH). The underpinning focuses of care for this dedicated population are to enhance service delivery at the same time minimise potential overnight hospital admission. Before this I worked for three years in a medical ward in the Ulster Hospital. The experience I received in the Ulster Hospital was fantastic but since moving to the Downe Hospital, I have been provided with a number of further opportunities to enhance my career.
I love that every single day is different, no two days are the same in work and every day is a learning day! You receive so much job satisfaction within nursing. There are some days that work is stressful and you have a bad day but overall it is very rewarding. I also love that within nursing there are so many different pathways and opportunities. I have been so lucky that I have had the opportunity of a temporary uplift to a Band 6 position, I have attended the South Eastern Health and Social Care Trust Nightingale Challenge Leadership Programme and I am currently undertaking Specialist Practice in Care of the Older Person at Queens University. Within nursing you meet so many inspirational people with so many different backgrounds and circumstances. You create so many friendships and within your working team you feel as if you are a small family. When you do have a bad day or are not feeling yourself, you are guaranteed by the end of your shift your colleagues will lift your mood and make you feel better.
This programme inspired me as it provides an opportunity for personal development and to learn about leadership. It had been advertised as an innovative programme which offered many exciting opportunities for young nurses and midwifery leadership development. This programme opportunity had become available just before I applied for my temporary uplift to a Band 6, I thought this would be the perfect course to attend in order to help me become a leader.
The COVID-19 Pandemic had actually been a great way to develop my personal goals and objectives. I commenced my temporary uplift in February and the COVID-19 pandemic began shortly thereafter. Whilst this seemed like an absolute nightmare at the time, it has actually provided numerous benefits. Who would have ever thought that the COVID-19 pandemic would have positives? It felt like being thrown into the deep end but it was the best way to learn and develop as a leader. My Ward Manager had been off work for a short while, therefore I had no other option but to be a leader as I had to manage the ward in the absence of my Ward Manager. We also had staff redeployed to work with us during the pandemic which felt like a challenge at first. Leading through unprecedented times and undertaking many changes was a fantastic learning curve. We all joined as one team and worked extremely well. The redeployed staff members have really enjoyed working with us as part of a team and have actually come back to cover some bank shifts as they still feel part of our team (as they are) which feels rewarding.
Originally the Nightingale Challenge had hoped for us to attend numerous events and conferences but unfortunately a number of these had been cancelled due to the COVID-19 Pandemic. Nonetheless, we still had been provided with a number of amazing guest speakers within our modules virtually. Also by attending the Nightingale Challenge face-to-face before the COVID-19 Pandemic provided great opportunities to meet new people from different backgrounds and different job roles. Everyone had been so friendly and also glad to meet others from different roles.
Within nursing there are many different leadership styles. Everyone has their own specific and preferred leadership style. My biggest influence within the FERA Centre is my manager, Ward Sister Emma Cullen. She is a fantastic leader and she influences us to be best that we can be. Emma is very approachable and enthusiastic as a leader. This was reinforced in Karen Hunter’s Nightingale Challenge modules: ‘If leaders create positive, supportive environments for staff, those staff then create caring, supportive environments for patients, delivering higher quality care.’ I hope within my role as a leader being a Deputy Ward Sister that I aspire to lead this way as the outcome we always aim to achieve is high quality care. Like my Ward Manager Emma, I hope to always be approachable and supportive to other staff members. I am true believer in teamwork as I witness every day in nursing the effectiveness of working as part of a team creates positive outcomes.
COVID-19 has taught us all so many things in life. Within nursing we always seem to do over and beyond. We work full time and then we work extra to ensure that our work colleagues are not working short staffed and we often forget to take care of ourselves. Whilst this is only sustainable for a while, burnout tends to catch up. During this pandemic it has highlighted the importance of self-care and not to feel guilty on your days off.
Again, within the modules Karen included the importance of a resilient team to be:
- Better equipped to deal with the challenges of work (and life)
- More able to do the right things – for themselves, their colleagues, service users, family and friends
- More inspirational and effective people to have around – role models for each other
- Well – physically & psychologically
- Able to sustain higher levels of performance
This is definitely the case for coping during this pandemic.
I have felt so privileged to have been able to take part in the Nightingale Challenge. Karen Hunter Principal Consultant, HSC Leadership Centre, delivered the programme and is an absolute inspiration. I could listen to her every day. She is so enthusiastic about her role as a leader. Karen inspires you so much to become an effective leader. Within the module Power-Points, she included so many positive quotes which I love as it creates so much positivity. The Nightingale Challenge has encouraged me to become an effective leader within my job role. Rather than thinking that I am too young or not experienced enough to be an effective leader my work every day shows that I can be a leader. In the words of Karen, ‘Every time you influence another person you are leading’. This is what I hope to do within my role as a Deputy Sister; I hope to influence my colleagues. I believe that everyone should see and reach their potential. Karen has taught the importance of positivity and since attending the Nightingale Challenge programme, I have created a positivity board within our staff room with inspirational quotes as I definitely felt it would be something nice to look at whilst on break and give us an opportunity to reflect on something other than coronavirus.
Emma Savage: Ward 27, Ulster Hospital (Mental Health Inpatients Unit)
When asked to reflect on what made me follow a career in nursing, I initially found it difficult as like many 18-year-olds I was unsure of what my future career might be at that age. I always had an interest in mental health and how it so indiscriminately affects people of all walks of life. This is perhaps what led me to study Mental Health Nursing. On reflection, I now realise I was in fact exposed to health care and the nursing profession through close family illness at a young age. I recall watching in awe and admiration as those family members received excellent care and treatment provided by the NHS. It was this that perhaps shaped my desire to help people and improve their wellbeing. In my current role I can assess and treat patients with various mental health illnesses, as a team we empower and enable patients to return to a community setting and enhance their quality of life.
Having graduated from Queens University Belfast as a qualified Mental Health Nurse in 2015, I first took up post in the Dementia Assessment Unit in the Downe Hospital and later moved to my current position at Ward 27 in the Ulster Hospital (Mental Health Inpatient) in 2017. I have been fortunate to work in two compassionate, motivated and patient focused multi-disciplinary teams during my career. The managers that I have worked under have inspired me with their confidence, fairness and approachability. They have shown how cultivating and developing an effective team can enhance patient care and patient safety. This has driven me to pursue a career in leadership within nursing and in February 2020 I was delighted to be promoted to Deputy Sister within my ward.
When the World Health Organisation designated 2020 ‘The International Year of the Nurse and the Midwife’ in honour of the 200th anniversary of the birth of Florence Nightingale, it was expected to be year of celebration and of recognition of the vital services that nurses and midwives pay to the global community. Nurses and midwives have so often been considered the most ‘trusted’ of professionals, due to the diligent care they provide the public from birth to death. However, never did we imagine the global pandemic that was about to occur, nor the new light that all healthcare and key workers would be viewed in as a result. 2020 (and now into 2021) has indeed been a year of challenge for many, but also an opportunity to develop, grow and lead.
I was delighted to be nominated for a place on the ‘Nightingale Challenge Northern Ireland Global Leadership Development Programme 2020/21’. I recall meeting with young nursing and midwifery leaders from across Northern Ireland in early January 2020 at the Northern Ireland launch of ‘The International Year of the Nurse and the Midwife’. Industrial action in support of improved conditions for nurses had just finished and it was the newly appointed Health Minister, Robin Swann’s first public event. I felt at that moment slightly overwhelmed yet privileged to be part of this global momentum to upskill young nurses and midwives in leadership, policy-making, quality improvement, global health and making global connections to enhance our knowledge and improve health and healthcare (both globally and locally).
Throughout the Nightingale Challenge Global Leadership Development Programme I have been honoured to hear from speakers with vast experience in healthcare leadership such as Charlotte McArdle (Chief Nursing Officer for Northern Ireland), Mary Frances McManus, (Director of Nursing Public Health, DoH), Rodney Morton (Director of Nursing, Midwifery & Allied Health Professions PHA), Howard Catton (CEO, International Council of Nurses) and Andrea Sutcliffe (Chief Executive of Nursing and Midwifery Council) and many more. These speakers have spoken with such passion and enthusiasm about the future of nursing; it has instilled in me a desire to develop as a leader so as to improve the conditions in which nurses work in and the way in which patients are cared for. Through the programme I had been provided with an opportunity to attend a World Congress on Psychiatric and Mental Health Nursing in Vancouver. With COVID-19 this was unfortunately cancelled however the opportunity to make global connections did not cease as we have been provided the opportunity to link in with 30 young nurses from across the globe via zoom. These ‘Global Associates’ have shared our struggles and challenges in fighting COVID-19 and displayed a commitment to enhance patient care and global health as a whole.
At a local level, we first felt the impact of COVID-19 on our ward in March 2020, at this time I was newly established in my position as Deputy Sister and had to develop skills rapidly to meet the expectations of my new role. With staff re-deployed in and out of our ward, our team was ever developing and changing, as were the procedures surrounding the virus and infection control. In a time that was both mentally and physically draining I assumed a leadership position and with the support of all of the staff around me and those leading the Nightingale Challenge Global Leadership Programme I developed new skills and ways of working, including an understanding of quality improvement. I have learnt something new every day and have relished the challenges that this virus and my new role has brought, most of all, that every leader must be resilient, dynamic and able to adapt.
I hope that I am an effective and approachable leader, one that leads from within the team and acts as a support to those above and below me. I have recognised leadership qualities within myself that I must strengthen and at times perhaps challenge. Through the Northern Ireland Global Leadership Programme, I have also had the opportunity to avail of a professional mentor within the Department of Health. This will enhance my knowledge of leadership and provide me with opportunities to continue to develop. I am thankful for the insight and confidence that the Nightingale Challenge Global Leadership Development Programme has given me, and I look forward to continued learning and development.
Charis Kelly: Wards Sister, Ward 13, Ulster Hospital
My name is Charis Kelly, I currently work as a Registered Nurse caring for older adults. I have a specialist practice degree and am working towards Advanced Nurse Practitioner. I began my career working for 2 years in a nursing home for ‘Four Seasons Health Care’ quite close to my home – I really enjoyed working there and loved how it felt like the residents’ own home. I am now on secondment as a Ward Sister, having been a Deputy Sister for almost 4 years.
I joined the Ulster Hospital 10 years ago as a Registered Nurse, during which time I got married and had my 2 children. After 5 years I progressed to a Deputy Sister post and started my ‘specialist practice’ degree. At the time I swore I’d never go back to university, but here I am ready to start all over again. I have attended many training courses along the way and acquired numerous skills and assessor roles.
Although I thoroughly enjoyed working as a Deputy Sister, an opportunity arose for me to apply for a Ward Sister post. It was a challenging time; we experienced high levels of ‘winter pressures’ and a strike by nurses over pay and conditions. I had my first management student – an MSc student, new junior staff to help transition into their new roles as Registered Nurses and then bang… a global pandemic! We switched to managing COVID-19 patients overnight. It felt surreal, our way of nursing had completely changed, and my leadership style had to adapt very quickly to the changes too.
During the pandemic I have led my team through unprecedented times and have undertaken many changes so that we could maintain delivery of the best of quality care, whilst preserving the safety of patients and staff during this time. I had honestly found the move to the Ward Sister role daunting enough at the time, but little did I know that part would be easy and the most daunting and challenging time in anyone’s nursing career lay ahead.
2020 was designated as the ‘International Year of the Nurse and the Midwife’ by the World Health Organisation. It was planned to be a year of celebration for nurses and midwives all around the world, but instead we have been faced with tackling a global pandemic. In December 2019 I was nominated to be a participant on the ‘Nightingale Challenge Northern Ireland Global Leadership Development Programme’ which is led by Dr Catherine Hannaway. Dr Hannaway has been a huge support and has shown great enthusiasm for nursing and improving health globally, and networking all over the world. I have gained knowledge into different leadership skills, undertaken Institute of Healthcare Improvement modules on Quality Improvement (QI) and have a QI Project underway. I have gained new insight into global health, in particular I have completed the United Nation’s Certificate on the Sustainable Development Goals. I have built up professional relationships through networking with other young nursing and midwifery leaders from all around the world (known as our Global Associates) and had opportunity to meet inspirational leaders such as Professor Charlotte McArdle (CNO, Northern Ireland), Elizabeth Iro (CNO, WHO), Howard Catton (CEO, ICN), Professor Brian Dolan, and Northern Ireland’s Health Minister, Robin Swann. I would never have had these opportunities if it wasn’t for this Programme which was instigated and funded by the Department of Health in Northern Ireland – it has been a real privilege to be part of it.
Since taking up my role as Ward Sister and being involved with more senior management, as well as having the opportunity of participating on the Nightingale Challenge Global Leadership Programme, it allowed me to gain more knowledge, observe different leadership styles and find my own way of being a leader to my team. I have recently undertaken the NHS Leadership 360 Assessment and other leadership development tools such as Belbin Team Roles and understanding Learning Styles. What I have found especially important during the pandemic is a need to focus on staff, being visible to them, approachable, thinking about their wellbeing, building their resilience, trying to keep the motivation going and importantly, praising them. As a nurse sometimes someone just saying thank you and well done makes all the difference.
We have all had to adapt during these unfamiliar times and have experienced a range of emotions, anxiety, stress, the unknown, whilst caring for our own families, our patients, and of course importantly ourselves. NHS staff have been redeployed to different areas to help look after patients in areas that they have not had previous experience and they deserve huge thanks and recognition for their hard work. I do not feel like a hero, I honestly feel I am just doing my job, a job that we trained for and faced with professionalism, integrity and we have done it well. I feel very proud of the team I work in and all those who have supported the work that has gone on through the pandemic, in every sort of role from healthcare providers to shop workers and many others, all around the world.
As the Government ‘lock-downs’ continued, we have run weekly Zoom quiz nights for the team – this has certainly boosted morale and provided some fun for staff outside of work. As more of our services are reopening and redeployed staff are returning to their usual roles, we will work on our building back, building better plan, reuniting and strengthening the team again. Our own Trust has provided some great on-line resources to help staff through the difficult period too.
The team I work in have been inspirational, professional and courageous, at times even keeping our patients dancing and singing through all of this. They have dealt with everything thrown at them and I believe it has made us stronger as individuals and a team – and I am proud to have led them this far, but I couldn’t have done it without them. Our Lead Nurse, Richard Donovan, has supported us though all the changes and has guided me through different leadership styles as I’ve needed to adapt.
Through all of this, I have seen that nurses really are highly skilled, dedicated and courageous, they have the ability to brighten up someone’s day, and bring a holistic approach to care, through listening, building relationships and being advocates when there is a need. I really do consider being a nurse is a tremendous privilege and I am proud to say I believe we have all given our very best through such challenging times.
Madelaine Carey: Acting Band 6 Sister, Enhanced Care at Home
When I first I decided I wanted to be a nurse I was fifteen. I remember being drawn to the endless possibilities and exciting opportunities that nursing could offer, as well as it being a very compassionate and caring career. I knew I wanted to travel and I thought nursing would be a great way to meet a variety of people and learn new skills, and I have been fortunate enough to have worked in London and Australia during my career. However, I think the main reason I chose nursing was because I recognised the impact that a nurse can have on a person, and their journey, and I knew I wanted to be a person who had a positive and supportive impact on others.
I have been a registered nurse for nearly ten years and I have had the opportunity to work in a range of different setting both at home and abroad. I am currently working in Enhanced Care at Home (ECAH); a community team that aims to prevent hospital admissions and supports hospital discharges. The main aim of ECAH is to provide monitoring, support and interventions to patients that enabled them to remain in their home and receive care that may have previously required hospital admission. For the past year I have been seconded to a Band 6 position within ECAH and this new role has enabled me to learn and develop my skills in leadership and management. As a Band 6 you are required to manage and allocate caseloads, support and manage staff as well as review and discuss patient care with the multidisciplinary team. As part of my role I also carry out health assessments on patients to further support care management and planning.
Nursing comes with many ups and down down but what I love is the feeling of making a difference to patients and colleagues. This difference may be something big, like supporting a family during a time of crisis, or something small, like making a cup of tea for a colleague, but these acts can often lead to a bigger sense of feeling supported and appreciated. The same reasons I came to nursing are why I love it. I strive to create a positive and supportive environment in the hopes that I can impact a person’s journey for the better.
When I decided to return home to Belfast, after working in London and Australia, I remember reflecting on the knowledge and experience I had gained so far in my career. I reflected on those who had helped to shape and guide me as a nurse, and I realised the main theme among those colleagues that helped me was their ability to provide strong and effective leadership, even in stressful or difficult situations. It was then I realised that I wanted to represent this kind of leadership with my colleagues and from then I took an interest in leadership styles. This was what inspired me to undertake the Nightingale Challenge Northern Ireland Leadership Development Programme 2020 as I hoped to further develop and grow in my leadership abilities.
At the start of the Nightingale Programme I had recently been seconded into the Band 6 post and had commenced a post-registration module in Queens University. I was focused on these new challenges and was hoping to succeed, learn and develop in all aspects. I hoped the Nightingale Programme would provide me with skills and knowledge that would help me to develop in my new role as a Band 6 and build upon my leadership techniques. I was also excited to meet other new young leaders that have similar interests in development and effective leadership and to learn from their experiences. When the impact of COVID-19 became a reality in our lives, my focus changed and I had to adapt quickly. The Queens University course was postponed, and my team and my new role were my main focus. As I was new to this post I was still learning and found myself thrown in at the deep end, especially as this was unknown territory for many of my colleagues. However the Nightingale Programme could not have come at a better time as the skills I developed in the first modules had been invaluable to me in supporting my colleagues during the first response of the COVID- 19 pandemic. I have since been able to complete the Queens University module and continue to develop and learn in the Band 6 post. COVID-19 changed my focus for a short time but my overall I feel I was able to address some of the goals and objectives that I had set in the beginning of this programme.
The Nightingale Programme created a great environment to have open and honest conversations with the other Nightingales about our experiences and developed a network in which we could connect and discuss ideas. With COVID-19 I was disappointed that I was not able to meet up with the other Nightingales in person but we kept in contact with small gestures of support through texts which kept us feeling connected. The Nightingale Programme encouraged me to reach out to the other leaders and senior management in my area to have discussions surrounding ideas and development of our service. This engagement has lead to me undertaking a quality improvement project with the aim to further develop our role within nursing and residential homes.
I was also invited to participate with Nursing and Midwifery Frontline Forum which gave me an opportunity to engage with other members of the Trust from a range of different backgrounds. These sessions also gave me an insight into the exciting and innovative ideas other leaders were undertaking.
The Nightingale Programme discussed collective leadership. This is a strategy that states that everyone can take responsibility for the organisations success, not just management, and not just in the area you work. This strategy encourages leadership techniques such as team-working, power sharing and staff empowerment. These are just a few of the techniques I have observed throughout my career that I feel leads to effective leadership. A leadership style I would like to further develop in my practice involves encouraging staff empowerment. I feel that development and empowerment of staff in the work place creates innovation, motivation and helps staff to engage in the success of an organisation, and by prompting staff empowerment I feel there would be an overall improvement to patient and staff experience.
One of our team’s main roles during the first COVID-19 response was to support nursing and residential homes. The team carried out assessments and monitoring of un-well patients, as well as support for the staff in these homes that were often very worried and scared. During this time I recognised I had to step-up my leadership role providing guidance and support, or sometimes just a reassuring ear. This time was difficult and stressful for everyone and I used reflection as a strategy for coping. By reflecting on the positive aspects and constructively learning from any negative elements I was able to destress and learn from situations that I found difficult. I discussed these elements with my colleagues through debriefing and as a team we were able to support each other. I have always been a very resilient person and I use goal setting as another coping strategy. Prior to COVID-19 I had been training for a half marathon, unfortunately this was cancelled, but I continued with training and setting myself goals which helped me to feel positive when I achieved my target.
I feel the Nightingale Programme developed my confidence in a leadership role. It has shown me the value of connecting with other leaders to gain knowledge of their experiences, which may better my own leadership in the future. I will continue to make these connections and engage with other leaders. My focus over the next few months will be to, not only provide support and care to my colleagues and patients but I will be undertaking a quality improvement project. This project’s aim will be to help further support staff in nursing and residential homes to recognise and escalate signs of deterioration to my team, and hopefully prevent unnecessary hospital admissions. I hope to use the leadership skills and knowledge that I have gained over the past year to help implement this project. Personally this programme has given me renewed sense of enthusiasm towards leadership and development and the skill I gained through this course will remain with me for the rest of my career.
Pauline Allen: Deputy Sister, Ward 14, Lagan Valley Hospital
I have always wanted to be a nurse from a very young age. I enjoy helping others and always feel like I have achieved something good when I help others.
I started my nursing career in 2009 in Ward 14 Lagan Valley Hospital and worked as a Band 5 for seven years and then had the wonderful opportunity to progress to a Band 6 Deputy Sister, the role in which I work today.
I love being a nurse as you get be involved in a patient’s journey at an uncertain time to provide reassurance, care and compassion. To see patients improve and get home is a very rewarding aspect of being a nurse.
I was inspired to undertake the Nightingale Challenge Northern Ireland Leadership Development Programme 2020 to gain future knowledge and skills within leadership; make relationships; and learn from nurses and midwifes from a variety of backgrounds.
COVID 19 has impacted greatly on the goals we had set out at the start of the Nightingale programme due to not being able to meet face to face makes learning from each other more difficult.
Although throughout the COVID 19 pandemic I have used many of the different types of leadership skills to fit different situations and peoples personalities. I feel as a leader throughout this pandemic I have had to put aside my own fears to keep my team’s morale and outlook positive.
COVID 19 has made me appreciate the team which I work in as everyone looked out for each other and relationships were made stronger. On a personal level it was difficult to manage home life and work life but by using skills learnt within the Nightingale programme and also the importance of self-care I feel made the whole experience easier.
The Nightingale programme has given me coping mechanisms which are transferable to a wide variety of situations. The Nightingale programme has taught me that looking after yourself is very important and essential to ensure you are in the best place to provide high quality of care to patients and support colleagues.
Lauren Curran: Health Visitor, Ballynahinch
I am a participant on the Nightingale Challenge Northern Ireland Global Leadership Development Programme (NCNI GLDP). I was extremely privileged to be selected as one of 30 aspiring nursing and midwifery leaders from across Northern Ireland to undertake this course hosted in the South Eastern Health and Social Care Trust (SEHSCT).
I currently work as a Health Visitor within a Multi-Disciplinary Team (MDT) in the Ballynahinch area. Prior to this I was a Midwife in the Down Maternity Department, but progressed to completing my Post Graduate Diploma in Specialist Community Public Health Nursing in 2018/19. I felt Health Visiting would allow me to further develop the aspects of my midwifery role I loved, building partnerships with women and families and providing support and parent education to support the development of babies and children. Initially it felt that I was leaving midwifery, but in fact I have found that I use my midwifery practice and knowledge everyday as a Health Visitor, and feel having that background has supported me immensely in my current role.
I have been in this post for just over a year, and my passion for the role continues to grow daily. As a Health Visitor I am there to provide care and support to children and families for their health and development, from before the birth of a baby, normally to the child’s 5th birthday. I carry a caseload of families and I am responsible for providing them with the Healthy Child Healthy Future framework of contacts. Often our involvement with families is much more than the essential visits, as we respond dependant on the identified need of a family and create personalised care plans, in partnership with the family or individual. I really love the variety my job offers, in one day I could be completing antenatal contacts with a first-time mother, attending a child protection review, providing support and advice on behaviour or supporting a mother to breastfeed. No two days are the same and it makes my work interesting and challenging. As a MDT Health Visitor, we have reduced caseloads, to enable us to provide targeted, personalised early intervention to issues such as maternal mental health, feeding support and parent education. This has enabled me to full embody the Department of Health policy ethos of co-production with all clients I work with. Co-production is a strong, real partnership approach which actively involves clients in their care and encourages them to share their knowledge and experience, which leads to empowered individuals, and great job satisfaction.
Even though I am relatively new to health visiting, something that stood out to me from the start of my training post to now, is the strong leadership and focus on personal and professional development within health visiting in the SEHSCT. I have already been supported by inspirational leaders at varying bands within the organisation. From my practice teacher Elaine, to the Lead Nurse for Public Health Nursing, Helen Leigh, who encouraged me to step out of my comfort zone and actively involved me in service development within the MDT and supported me in engaging with external stakeholders in meetings. I knew that when the email came out about a place available on the Nightingale Challenge NI GLDP that this would be an amazing opportunity to develop. I approached my manager and as always Cathy was so supportive of my development and encouraged me to apply. A short time later I heard that I was selected for the course and was so happy and excited to get started.
The Programme began with a two-day workshop in the Stormont Hotel, Belfast, with a focus on personal and professional reflection and also the setting of objectives for the year ahead to challenge us on our individual leadership journeys. Over these two days we had the privilege of hearing from numerous established leaders including Professor Charlotte McArdle, Chief Nursing Officer (CNO) for Northern Ireland, Robin Swann, Minister for Health in Northern Ireland and Rodney Morton, Director of Nursing, Midwifery and Allied Health Professionals in the Public Health Agency. There was a real buzz among participants as we left on the second day, we had set our goals and were heading out with a new perspective, back to our roles to achieve our goals.
The year had started with many on the Nightingale Challenge NI GLDP having plans to complete learning visits across the globe but unfortunately COVID-19 put a stop to this for many. Luckily for me and three other Nightingale Challenge NI GLDP participants, our learning visit was in March 2020 to London and we were able to attend and return home safely just days before lockdown was implemented. We travelled to London on the 5th March with our CNO Professor Charlotte McArdle, meeting Dr Catherine Hannaway, Global Health Consultant on arrival. We were privileged to be joined by three other young global nurses Dr Billy Rosa from New York, Winnie Nakamanya from Uganda and Abdul Wadij from Pakistan who were with us for the whole trip. The purpose of this learning visit was to learn about nursing and midwifery in government in the UK and also our role as global nurses and midwives.
We made our way to Westminster and the Houses of Parliament to meet with Lord Nigel Crisp, Co-Chair of the Global Nursing Now campaign and Chair of the All-Party Parliamentary Group on Global Health. We had a guided tour by Lord Crisp and got to sit in and observe live sessions in both the House of Lords and House of Commons. We then received a short masterclass from Lord Crisp on how to integrate nursing and midwifery practice with government policy. My takeaway message was that nurses and midwives need to be actively involved in government. To be effective in influencing government policy we need to be able to relate proposed care/service change in a way which demonstrates how it meets or contributes to government objectives. We also benefitted from having CNO Professor Charlotte McArdle and the global nurses with us as we received insight into how this happens in Northern Ireland and how current levels of nursing involvement in government differ globally.
We all attended the Commonwealth Nurses and Midwives Federation (CNMF) Conference for two days in central London. The over-arching theme of the conference was a focus on how as global nurses and midwives, we can break down barriers to help achieve Universal Health Coverage (UHC). Around 300 nurses and midwives from over 34 countries globally were in attendance. Spirits were high for a multitude of reasons, especially so as it was the year of the Nurse and the Midwife. There was an excitement and feeling of togetherness from the moment we arrived, possibly heightened because we knew we were about to face the growing COVID-19 pandemic, with a shared sense of caution and worry, it brought great camaraderie that we were facing the coming months together, as one global family.
We had learnt a lot about networking in our first sessions in Belfast, many of us thinking ‘I don’t know how to do that’, but this learning visit developed our networking skills so much. On reflection it was the moments between sessions where we got to speak to other global nurses and midwives and gain their perspective on things that our real understanding of being a global nurse or midwife developed. Within leadership as a global nurse or midwife, professional networking is a vital component to develop and nourish mutually beneficial relationships. I recall over lunch one of the days being in the main room I had started a conversation with a gentleman about the session that had just finished, he asked about my role and I informed him who I was. This gentleman then informed me that he was a CEO of a large healthcare company in Canada with a nursing background, and then spent the next while discussing nursing publications and how I can develop in this field to get work published. I took away so much from this short conversation and it just highlighted to me the importance of networking, if I didn’t say that simple ‘Hello’ I would never have gained that insight and knowledge.
One of the stand-out take home messages for me on the Nightingale Challenge NI GLDP after our first two days was Dr Catherine Hannaway encouraging us to be ‘Glo-cal’ in our approach, ‘Think Global to act Local’. Initially I didn’t truly understand the meaning of this but after attending my first global conference, I developed a greater understanding of the meaning behind these words and how they are imperative to effective healthcare leadership. Deva Marie Beck, International Co-Director of the Nightingale Initiative for Global Health closed the conference reminding us that ‘we are global citizens, living in a global village’. We all had the realisation that work we are influencing and leading here in Northern Ireland can and is having an impact to other individuals and communities globally through shared learning and development.
Coming away from the conference, a great emphasis throughout was about the importance of reflection as an aid to achieving Universal Health Coverage. Dr Billy Rosa concluded it perfectly encouraging us to “look at ourselves again and again and strategically take the steps that are needed to become the change-makers, leaders and policy shapers we were meant to be”. This resonated especially so with us as Nightingale Challenge NI GLDP participants as we are emerging leaders in our field.
Something that the NCNI GLDP participants who were also on the Learning Visit to London (Michelle, Caroline, Sinead and I) benefited from immensely on this trip, was having several days in a small group with Professor Charlotte McArdle and Dr Catherine Hannaway, I don’t think I can convey in words how immensely privileged we felt to get this. Learning to use those times we had in taxis, our ‘windows of opportunity’, allowed us to discuss career pathways and our individual plans with Professor Charlotte McArdle and she was clearly genuinely interested in our career development, personally, encouraging me to progress with completing a masters’ degree. Knowing that we have that personal support from the highest level of nursing and midwifery in Northern Ireland is so motivating. Being able to discuss our learning with both Professor Charlotte McArdle and Dr Catherine Hannaway, and getting their perspective on things was so beneficial.
One example which I think demonstrates the profound positive impact this course has had so far is this. I recall sitting on the evening of the first day and discussing with other participants how inspirational and motivating it had already been, but not yet seeing how we in our roles as Band 5/6 could be true leaders as we didn’t have the ‘management title’. Now, ten months down the line, those same people, including myself are leading daily, and every time we meet talking about how we are active leaders and ways in which we have utilised this platform. Even with all the challenges we have faced, and still continue to face within healthcare due to COVID-19, it is so good to see my peers and myself develop as leaders in our own fields, and use every opportunity to utilise our leadership skills.
I personally cannot thank enough our CNO Professor Charlotte McArdle and Nursing and Midwifery Officers Mary-Frances McManus, Heather Finlay, Dale Spence and Caroline Lee, for having this course commissioned and developed with Dr Catherine Hannaway. Your passion for investing in and developing the nursing and midwifery workforce in Northern Ireland is clear and I am thankful for this opportunity. The support we have also received within the SEHSCT has also been exceptional and it is great to have so many opportunities afforded to us. Here is to 2021 and beyond, where all Nightingale Challenge NI GLDP participants will continue to flourish and develop as future nursing and midwifery leaders in Northern Ireland.
Katie Niblock: Ward Sister, Mental Health Services for Older People
I began my career as a Nursing Assistant in the South Eastern Health and Social Care Trust (SEHSCT). Working with such inspiring and influential nurses encouraged me to follow a career in nursing and with support from my managers over the years this was made possible. I was seconded from the Trust and studied with the Open University. I have always had a passion for older people and knew I wanted to work with this client group. Mental Health has always interested me, so working within Mental Health Services for Older People was an obvious choice for me.
I am now a Ward Sister and I have been in this role for two years. I am working on the same ward as I started on as a Nursing Assistant. I have worked here for 16 years in various roles, including Student Nurse, Staff Nurse, Deputy Ward Sister and now Ward Sister. I feel this ward has helped to support and guide me on my journey and my managers could not have been any more inspiring and supportive.
What I love about nursing is having the ability to care for people and to promote their quality of life; to help improve the lives of others and to be there for people when their families cannot; to act as an advocate for patients and to strive for the best outcomes possible.
Having not long begun my role as a Ward Sister I wanted to gain further knowledge and skills to be an effective leader and this inspired me to undertake the ‘Nightingale Challenge Northern Ireland, Global Leadership Development Programme’. I wanted to learn from others, especially nurses and midwives from all around the world. I feel this opportunity is very unique and that we have a lot to gain from others. All the inspirational speakers we have had the privilege to meet and listen to on the programme has also helped me strive for better outcomes. It has given me an insight into global health issues and how we can help make a difference. I have recently completed the United Nations Certificate on the ‘Sustainable Development Goals’.
As part of the Programme, I have also completed Institute of Healthcare Improvement (IHI) modules on Quality Improvement and am undertaking a quality improvement project which I have worked hard to continue progressing throughout the pandemic. I am doing this alongside a Safety, Quality and Experience (SQE) project, with support from Mentors within my Trust. They have been invaluable in maintaining momentum with the project(s). Not being able to meet with the other Nightingale programme participants over the year face-to-face has been a disappointment, but unavoidable at this time. To continue to build our Nightingale Challenge network in Northern Ireland and beyond, we have used Zoom, email, WhatsApp, Twitter and private Facebook Groups. We work alongside a group of 28 ‘Global Associates’ who are young nursing and midwifery leaders from all around the world. The opportunity has been invaluable for learning first-hand about global health issues. I have a project team which has enable me to work alongside Quality Improvement (QI) experts. I have also enjoyed the various talks from speakers on the Workshops (some face-to-face, others by zoom) led by Dr Catherine Hannaway, Global Health Consultant. Catherine has provided an amazing amount of expertise, support and guidance to the group.
The SEHSCT have provided additional modules to Nightingale Challenge participants. I have found all these very interesting and worthwhile.
I think in my workplace and throughout the NCNI GLD programme I have seen a combination of each of the leadership styles. I would like to try more of a coaching style with staff (when its appropriate) and have sought further training on this.
As Ward Sister I have found the pandemic both challenging and rewarding. Having to keep up with the ever evolving changes is difficult and also trying to disseminate these changes to all the staff has proved challenging. But to see how well our ward staff have coped under the pressures has been very rewarding. How easily the staff have adapted to changes and adhered to strict Infection Control/social distancing measures has been inspiring.
I think personally I have learned to appreciate the important things in life, family, friends and outdoor space. A session on ‘Resilience’ at one of the NCNI GLDP workshops by Ed, Sipler, SEHSCT with accompanying tools was really useful. On my days-off I enjoy walking with my dog. I feel this really helps to clear my head from work. In July of last year I started stricter exercise regimes and have lost 2.5 stones since then. I feel so much healthier now. This has given me a focus over the past few months.
Professionally I have learned how to be much more flexible and to adapt to changes; how to lead staff through difficult and uncertain times; and how to lead by example, to show support and appreciation to all the staff. Trying to keep morale high on the ward has been very important. I feel that the opportunity to be part of the Nightingale Challenge Northern Ireland Global Leadership Development Programme has really helped me achieve this.
Nicola Herdman: Nurse, Ward 1A, Lagan Valley Hospital
The World Health Organisation named 2020 as the “Year of the Nurse and Midwife”, marking 200 years since the birth of Florence Nightingale.
I was thrilled to be nominated to participate in the South Eastern Trust Nightingale Challenge Northern Ireland Global Leadership Development Programme 2020. The aim of the Nightingale Challenge is to enable nurses to develop their leadership skills, increase self-confidence and build a network of friendship with other young nurses and midwives throughout the South Eastern Trust. It has been lovely to meet so many nurses and midwives from different working environments and stages in their career. It is a chance for us all to learn from each other. We have been able to enjoy face to face gatherings and more recently our virtual meetings. At times it has been quite emotional, the group has a feeling of warmth and unity. As a ‘Nightingale’ I have had the privilege of meeting and listening to many influential leaders including Interim Chief Executive Mr Seamus McGoran.
Nursing is a vocation, it is both challenging and rewarding. How humbling is it to make a difference to people’s lives every day. It is this that drives me to come onto my ward and always give my best. Since qualifying in 2018, I have been so blessed to commence my nursing journey on a very supportive and positive ward, which promotes an environment of learning. I have been constantly encouraged and given many opportunities. I am based within 1A, a General Medical Ward, in Lagan Valley Hospital. At the beginning of the COVID-19 pandemic we were transformed into a ward treating COVID positive patients. Working within a time of such uncertainty made me feel incredibly anxious, however, being part of such a unified and adaptable team made me so proud. During this transition on our ward, the motivation and support from both the 1A staff and the wider multidisciplinary team was amazing. We rose to the challenge and provided impeccable person centred care at a time when everything we knew and valued as a team was changing. Being a Nightingale has also enabled me to share in the COVID-19 experiences of other nurses and midwives within the South Eastern Trust.
Every member of a team has the ability to be a leader, it is vital to be supportative and approachable. Everytime we influence someone, we are leading. My personal leadership style is transformational and I feel it is important to encourage others and be a good role model. I enjoy motivating others and promoting self-awareness.
I used to fear change, now however after receiving guidance and support from my ward manager, our team and Nightingale programme, I embrace it and will continue to develop and adapt throughout my career. 2020 is certainly “Year of the Nurse and Midwife”; we have proven that together we can face anything.
Julie McGrattan: Critical Care Outreach Nurse
2020 – ‘The year of the Nurse and Midwife’ – Well what a year this has turned out to be, who would have foreseen that nursing would play such a pivotal role globally? For me ‘The Year of the Nurse and Midwife’ meant undertaking the Nightingale Challenge, it was to be an exciting opportunity to meet other likeminded nurses and midwives and learn about leadership within healthcare whilst developing as a leader myself. There were travel opportunities to network with colleagues worldwide, conferences to attend and interactions with senior leaders within the trusts, local, national and international organisations. I felt excited and eager to embark on this journey, but, like so many parts of our lives affected this year COVID-19 had other plans and everyone’s 2020 became something no one had ever imagined.
When I began the Nightingale Challenge in January 2020 I was keen to discover what leadership meant within Critical Care. I had been a Critical Care Outreach nurse since May 2019 and having spent six years in Intensive Care prior to this I wanted to develop my leadership skills and abilities as this new role provided new challenges, responsibilities and opportunities. I was introduced to peers who shared the same worries, concerns and anticipation I had regarding leadership, this provided us with a great sense of camaraderie and community. As the year progressed traditional leadership styles within Critical Care were turned on their head, Intensive Care nursing as we knew it had changed, the red tape was thrown out, changes occurred quicker than any of us had seen before and it was fantastic to witness teams collaborating well together with a shared objective-patient care.
Becoming a nurse was not something I had always dreamed of but I had envisioned a role in healthcare, and nursing fitted into this vision, I had no preconceptions of what it would be and like most of the public, I never really understood the role of the nurse. On reflection I know I made the right choice, nursing can be anything you want it to be; there are limitless opportunities from travel, promotion and a wide range of positions and locations. My career began in Acute Medicine I spent three years in Medical Admissions before moving on to Intensive Care nursing. This amalgamation of fast paced and Critical Care nursing proved the perfect marriage for Critical Care Outreach, I can draw on my acute medical and critical care skills to develop my role. Lone working, decision making and rapid response were all part of my new role, I had goals to achieve and leadership was a huge part of this, the Nightingale Challenge has been immensely rewarding in achieving this goal. My line manager encouraged me to undertake the Nightingale Challenge, knowing that someone supports your goals and helps you achieve them in practice in important. I have been given all time required throughout the year to dedicate to the Nightingales, I am grateful for this support.
As COVID-19 was declared a pandemic, I was as you would imagine redeployed to the Intensive Care Unit (ICU), this was a familiar stomping ground however this time it felt different and my role felt different. The first few weeks of my redeployment were spent with the other redeployed staff; I was not one of them they looked to me for advice and reassurance. It was my responsibility to orientate them to the unit and demonstrate what was expected of them as registered nurses within the critical care environment. This was a leadership role, I had to step up and act as a role model and make myself available and approachable to answer any questions they had. I enjoyed this opportunity; this was my chance to make a difference to their experience. Understandably many were apprehensive and a few were terrified. Having completed the primary module in the Nightingale Challenge I was more attune to what staff may be feeling and thankfully developed my skills to alleviate some of their tension. I was acutely aware that morale and emotion are visible and can be inherited by others, I was mindful of my attitude, I was encouraging and upbeat. I encouraged the redeployed staff to think of this as an opportunity to make a difference, we were all in it together, and I wanted them to feel welcome and important. I highlighted the need for transferrable skills. Acknowledging that, no, not everyone was a critical care nurse, we were all nurses and never have nurses been so vital. I tried to be jovial whilst under my friendly manner I felt apprehensive myself, following the media and news of increasing numbers of positive cases I knew it was only a matter of time before ICU would be overwhelmed. I tried to be prepared, but it is difficult to prepare for something not witnessed before. The thought of being the ICU nurse caring for six ventilated patients with junior and redeployed staff as assistance was more than a little concerning but if I had to do it then I would manage, thankfully it didn’t come to that…yet.
Through my time in ICU the Nightingale Challenge was at the forefront of my mind, we had been set a challenge to think of things we appreciate daily, in the middle of a global pandemic I remembered that I am thankful for a strong team and appreciated everyone’s contribution to providing excellent patient care and encouraging one another to keep going. A goal I had set myself at the onset of this challenge was to interact more with senior colleagues and learn leadership qualities from them. I feel COVID-19 has enabled me to achieve this goal, there were positives within this chaos, barriers had been broken down, the middle man had been removed. I found the traditional hierarchical structures were not as important as they once were and I believe this encouraged change and allowed everyone’s voice to be heard, leadership could come from any level. The pandemic allowed individual strengths to shine through, some had better logistical abilities, some were the idea people and some just got the work done. I am honoured to have been involved in such a dynamic innovative team. Everyone was prepared to go the extra mile. From being an eight bedded ICU to being prepared to escalate beds dramatically is to be commended. Although this was a stressful time for us all there was a sense of accomplishment within ICU and I felt immensely proud to be a nurse and to be on the frontline during a global pandemic.
As the weeks progressed and things got busier, spirits were still high, the adrenaline was keeping us going. It was a strange feeling to have public support the ‘Thursday night clap’ was somewhat emotional in the beginning. In the midst of lockdown for me going to work was actually a social outlet a place to have intellectual conversation and enjoy light hearted banter. They say only those with a dark sense of humour can become a nurse, I guess this is true to an extent. There were times when we all needed a laugh and looked forward to our breaks as things were tough. There were emotional days and particularly difficult days, I tried to remember to be a role model and did what I could to boost morale. The personal protective equipment (PPE) was a struggle-the heat, the sore noses and ears, the headaches but we had to keep going, our patients needed us and we would do whatever it took to be there by their bedside, especially as their families were not, the art of nursing has not been lost during this pandemic, we video-called with families, arranged religious visits and simply spent time with our patients, held their hand, talked with them, and answered their questions. Every person within that unit had an important role to play, I encouraged staff to be involved, I taught them things, demonstrated tasks then observed them carrying out said task. I empowered the redeployed staff to involve themselves as much as possible and encouraged them to see this as an opportunity. I reminded them that they were making a difference and their role was as important as the next persons, we were a team. During these times a decisive leader was required; someone to make the decisions when others were unable to. There were daily meetings within the directorate to disseminate information and communicate needs of the department, I was lucky to attend some of these meetings and it allowed me a better understanding of the roles of management. It afforded me the opportunity to network with leaders within my directorate and I engage with senior colleagues. I observed mostly decisive management styles through these briefs.
I had the opportunity to observe many leadership styles this year some better than others and some who I hope to emulate throughout my career. “The mark of an outstanding leader is their ability to encourage leadership in others” is a quote used by Karen Hunter (Leadership Centre) within the Nightingale Challenge. This is paramount to the future of nursing and something I challenge to replicate myself. Every member of staff regardless of role was a leader and stepped out of their comfort zone to confront this pandemic, each of us had the ability to challenge the status quo and we all advocated for our patients and our colleagues. The qualities I admired in remarkable leaders were their ability to motivate, boost morale, support and improve their teams’ performance. I have learned to be flexible and to adapt to change, I have been willing to embark on new challenges and can be a leader, I plan to continue to develop these attributes as I progress. Flexibility and change was evident through the use of IT, I even attended the Northern Ireland Practice and Education Council (NIPEC) two day conference via zoom, which in itself is a historical event. So much became virtual and remote, staff quickly adapted to the idea of virtual learning and meeting.
Teaching is a fundamental part of the Critical Care Outreach Nurse’s role, it is a transferrable skill that has been valuable to my redeployment, I was able to confidently engage with all members of the team and encourage learning. Situations I once found daunting aren’t an issue, I found myself teaching senior colleagues and managers throughout the trust about the ICU environment including the theory and practice behind tasks such as application of PPE, proning patients, infusion pumps etc. I feel this ability humanised these senior managers and showed their willingness to be involved in the team and to work together with shared goals. It highlighted to me that a leader must be willing to learn and continuing professional development is always important.
Professional networks are important to any leader and I have developed many new professional networks throughout the course of the Nightingale Challenge. As a Critical Care Outreach Nurse I work throughout the Ulster Hospital, the key to my role is liaising with multi-professionals. We collaborate with the Physiotherapy Leads within the trust to deliver teaching and work closely with them professionally to deliver patient centred care. As the link between the wards and ICU I have developed my ability to advocate for my patient, I recognise their needs and problem solve to meet those needs including referring to appropriate professionals (ENT, SALT, dietetics, respiratory). I frequently discuss patients’ needs with their Medical Team and refer any concerns to their Consultant. I liaise with my ICU colleagues if there is a critical care requirement. As an Outreach Nurse my leadership role can be practical, we regularly deal with deteriorating patients and are often first on the scene therefore adopt the role of team lead ensuring anyone who the patient needs access to have been contacted. I have often contacted Senior Medical Staff, liaised with Patient Flow, Radiology and Ward Management to ensure safe transfer of critically unwell patients.
During our time together as Nightingales we discussed resilience and the importance of it as nurses. COVID-19 definitely strengthened my character and has made me a more resilient person. With the help and support of inspirational leaders ICU became a resilient team and we were able to support each other, personally I believe this pandemic has changed many nurses and as a workforce as a whole we are more resilient together. Having faced this challenge and worked through two surges now I feel there isn’t much nurses can’t do, we are strong as individuals and stronger together.
On reflection, 2020 will be a year that goes down in history and I will be proud to look back and say “I was a nurse in ICU during that time.” The Nightingale Challenge equipped me with the tools to express myself as a leader something I will continue to reflect upon as I continue my nursing career. I look forward to a time I return to my usual role and feel enthused to develop as a Critical Care Outreach Nurse. I hope to always be approachable and knowledgeable and display the marks of a good leader.
Andrew Tumilson: Deputy Charge Nurse, Ulster Hospital
I was delighted and honoured to be nominated in late 2019 to join a cohort of 30 leaders from across Northern Ireland to participate in the Nightingale Challenge Northern Ireland Global Leadership Development Programme (NCNI GLDP) launched in January 2020 alongside the 2020 International Year of the Nurse and the Midwife. Due to the covid-19 pandemic it will now run until the end of June 2021.
I was a little apprehensive but equally excited to be part of the programme which really is a once in a lifetime opportunity to meet, and learn from, colleagues from across the globe as well as collaborate with nurses and midwives within Northern Ireland.
I am passionate about my own continuing professional development and that of my colleagues, so was particularly excited to have the opportunity to receive evidenced-based leadership knowledge and skills learning from top speakers that I could utilise in my everyday role alongside advancing the nursing profession through leading by example.
I qualified as a Registered Nurse from Belfast University in 2009. I gained my core nursing experience from working in acute medicine which provided me with the opportunity to work in a range of sub-specialities, including Gastroenterology, Cardiology, Haematology and Oncology. I also worked as a Community Nurse for over a year early in my career. As a qualified nurse I have been fortunate to work across three acute hospitals in Northern Ireland. This enabled me to see care delivered in a range of wards, specialities and care settings, and enhanced my learning as well as my overall skills.
Since initially qualifying as a nurse through to my current role as a Deputy Charge Nurse, I have developed a passion for raising standards in providing high-quality person-centred care with a particular focus and interest in palliative and end-of-life care. I recognise the importance of building relationships with patients for whom there is advanced disease(s) and their families. I am committed to supporting patients and families making decisions about where they wish to spend their final days and months of life and assist them to achieve that aim. My ambition is to ensure all patients’ needs are met by focussing on ‘what matters to them’ not ‘what is a matter with them’. Against this background I have collaborated with nurses and Nurse Practitioners in British Columbia, the Royal College of Nursing, and colleagues across NHS Scotland to build a body of evidence for change as my quality improvement project to be completed as part of the NCNI GLDP.
I was delighted that we were given the opportunity on the NCNI GLDP to undertake a quality improvement project. My project is in relation to anticipatory prescribing and holistic assessment utilised at End-of-Life Care, with the aim of maximising symptom management and respecting patient’s wishes – if their wishes are to die naturally at home. The project will need to be completed in 3 phases. The principle aims include:
- ensuring there is seamless communication around the 24-hour clock amongst the healthcare team
- transparency in respect of services available in both acute and community settings
- maximising symptom control in the community and preventing avoidable hospital admissions for patients in the final hours of life.
I hope my Quality Improvement project will help build the evidence to contribute to closing the gap in Northern Ireland in respect of anticipatory medications and improve the communication and standardisation of anticipatory care across a range of healthcare settings.
In March 2020 the World Health Organisation declared the Covid-19 global pandemic. During all of this, in January 2020 we had commenced the NCNI GLDP aimed particularly at improving leadership skills, policymaking, advocacy and the understanding of global health of young nursing and midwifery leaders. We were really fortunate to have two face-to-face workshops (in January and March 2020) before we were forced to link virtually via technology, using emails, WhatsApp, Facebook Groups and Zoom. I managed to complete 4 of the Institute of Healthcare Improvements (IHI, USA) Quality Improvement modules online and the United Nations Primer on the Sustainable Development Goals. I undertook some modules internally within the South Eastern Health and Social Care Trust in partnership with the Leadership Centre, BSO. I was proud to be able to participate as a speaker in the webinar “Nursing in a Global Pandemic” with Dr Catherine Hannaway (NCNI GLDP Programme Director) in partnership with the Royal College of Nursing. I also attended the NICON conference in Northern Ireland which was interesting and beneficial. There were some opportunities to undertake personal development exercises, including the NHS Leadership 360 Appraisal, Belbin Team Roles Assessment, Honey and Mumford Learning Styles and development resources provided by Clive Hook (Leadership Development Consultant) and QI resources and support from Maggie Morgan Cooke. – all have been hugely beneficial in understanding my own personal strengths alongside areas for growth and development.
Facing the challenges of Covid-19 as a nurse leader seemed less daunting because of the learning I gained and the networking opportunities. The NCNI GLDP gave me the confidence to act as a role model for others who needed to change the way they worked to respond to the Covid-19 pandemic. In respect of enhancing resilience and my personal well-being I was able to access a range of support resources available within the SEHSCT including Dr Ed Sipler’s resources that were profiled as part of the NCNI GLDP. I found these all really useful.
As a Deputy Charge Nurse, I needed to facilitate my team to change working arrangements as a response to managing an increasing workload in the ward environment. The situation would change several times daily, so it was important for me to ‘think on my feet’ and act decisively in the interests of patients and staff. I was also required to provide leadership and tutorials to support staff that had been redeployed to a new clinical area where some of the procedures were unfamiliar. In addition, the patients required more support and reassurance as some were dealing with the fear of their cancer diagnosis and acquiring the Covid-19 virus during periods when they were receiving treatment and would be immunosuppressed. The immunity of the patients was altered due to both the disease processes they were living with and treatments to help manage the disease, such as chemotherapy or immunotherapy. The families were unable to be present due to the Covid-19 restrictions, so this was a very important role for nurses to fulfil, including myself.
The NCNI GLDP programme continued on-line with Zoom workshops and personal support. We began to network with other inspiring young nurses and midwives from all across the globe (known as our Global Associates) and had opportunity to hear from and discuss issues with very senior leaders from Northern Ireland and more widely, which really was an amazing opportunity. These senior leaders included Professor Charlotte McArdle CNO, NI, the team from the Department of Health and the CEC, as well as global leaders such as Elizabeth Iro (CNO, WHO), Howard Catton (CEO, ICN), Lord Nigel Crisp, Dr Catherine Hannaway, Professor Brian Dolan and many others. The presentation by Professor McArdle on policy-making and advocacy was an excellent presentation which changed the landscape in what I thought I knew about policy-making and inspired me to further develop my advocacy skills and opportunities in a number of areas important to me.
I was very proud to be able to lead and maintain behaviours of wider health and wellbeing of staff during the pandemic and influence senior decision-making. I was humbled by being able to be an advocate for the niche of patients within my clinical area who were approaching the end of life and who wanted to be at home in their final days of life. I ensured they had holistic assessments undertaken and reviewed and ensured they had adequate anticipatory medications prescribed, to not only manage symptoms but to prevent avoidable hospital readmission.
I believe I am now more confident and competent as a young nurse leader. Going forward I want to share the knowledge and skills that I have gained through further opportunities to contribute to a range of learning and sharing activities. A particular aim is to contribute to ‘Dying Matters’ week commencing 10th May 2021.
On reflection, the NCNI GLDP has exposed the elements of both personal and professional growth that I and my colleagues need to nourish and further develop to enable us all to reach the platforms and positions of the many great leaders we have met through the programme, who have shared both knowledge and wisdom of how they have grown into the people and leaders that they are today. I am hugely grateful for the many resources, presentations and diverse range of learning styles within the NCNI GLDP to augment the diversity of how we can engage with others along this journey and have learned a new and important term – GLOCAL – ‘thinking Globally, acting Locally’.
Louise English: Staff Nurse, Treatment Room
What made you decide to follow a career into nursing/midwifery?
From an early age I cared for family members, later I went on to undertake voluntary work in a nursing home while still studying. I worked in community care prior to starting my Nursing. I felt such an achievement from the small difference I could make in the day to day lives of people.
What is your job role and how long have you been in this role?
I have worked in the treatment room for two years after a decision to change from hospital setting where I worked for seven years. My current role involves delivering care within the treatment room such as dressings, injections, bloods.
What do you love about being a nurse/midwife?
How rewarding my job can be while helping and caring for others. I also love that in Nursing you can continually learn and it has many different paths you can take.
What inspired you to undertake this programme?
My Treatment Room Lead had been on a similar programme and had expressed how it had benefited her in her career in nursing.
At the start of the Nightingale Challenge Programme you developed objectives as well as professional and personal goals for your leadership development. How has the COVID-19 pandemic impacted on you meeting these goals and objectives?
Part of my personal goal was to complete a gratitude dairy daily. This was difficult to continue during challenging times but also highlighted how important it was to do so. Professional goals were to encourage team work and recognise those who may need a little extra support with a positive working environment. This was achieved during COVID-19 as everyone worked together in challenging times to support each other and provide a safe environment for staff and patients.
What professional networks have you developed and how have you engaged and connected with other leaders and professionals as part of this programme?
I have found that I have gained some important support networks from the team of Nightingales that I met on the South Eastern Health and Social Care Trust Nightingale Challenge Leadership Programme and ability to contact others in similar situations to express day to day challenges and what others have done to overcome these.
What type of leadership styles have you observed and as a result would like to develop in your own practice?
I have observed the team being supported, guided and updated on continual changes due to COVID-19. I have also recognised that the full Nursing team need to be involved in continual changes and updated in order to reduce staff anxiety. This is something that will I continue to implement throughout my career.
Describe the impact COVID-19 has had on you both personally and professionally and how you have developed your own coping strategies and resilience during this time?
COVID-19 has been a struggle, as I am normally very sociable and this could not happen. I had to find other ways to cope and distract me from the stresses of the world, work was one of these. I love my job and am lucky enough to have a fantastic team around me. Work became a main part of my focus and this helped keep me active and my brain focused.
As a result of the Nightingale Challenge Programme what changes have you made professionally and personally?
I have learnt how to take a moment and approach and analyse things rather than jumping in and adding unnecessary stress. I have learnt that it is important to look after myself and I have recognised how to maintain a positive mental attitude in day to day life both personally and professionally and how this can make an overall difference and prevent burnout.
Ellis Magill: Enhanced Care at Home
1. What made you decide to follow a career into nursing/midwifery?Nursing is something I had wanted to do from a young age. I have always had a caring personality and that grew stronger as I got older. The idea of helping people has always been something that I have felt strongly about.
2. What is your job role and how long have you been in this role?
I am a band 6 Sister in ECAH and have been in this role since December 2019.
3. What do you love about being a nurse/midwife?
I love being able to care for people. I love meeting new people and get great job satisfaction from knowing that I have done my best in order to help my patients and their relatives. My team delivers care at home and I am proud to be part of a service that can keep a person safely in their own surroundings.
4. What inspired you to undertake this programme?
I undertook the South Eastern Health and Social Care Trust Nightingale Challenge Leadership Development Programme to build on my skills, knowledge and confidence to ensure I could demonstrate the appropriate leadership skills to work within my own team and the multidisciplinary team in order to deliver safe and effective care.
5. At the start of the Nightingale Challenge Programme you developed objectives as well as professional and personal goals for your leadership development. How has the COVID-19 pandemic impacted on you meeting these goals and objectives?
The COVID-19 pandemic has created a more stressful work environment, made worse by the fact that we were unable to prepare for this .I feel that I have worked harder to meet my goals, individually and with my team. It has encouraged me to be more aware of the importance of each team working together.
6. What professional networks have you developed and how have you engaged and connected with other leaders and professionals as part of this programme?
Throughout the pandemic my role has been interchanging and this has meant that I have developed new relationships with teams that I may not have been involved with before. This programme has given me the opportunity to interact with other professionals in all areas of Nursing for advice and support.
7. What type of leadership styles have you observed and as a result would like to develop in your own practice?
This programme has helped me to recognise different leadership styles, including Transformational Leadership. I would like to develop this in my own practice, to encourage myself and my team to make decisions independently, encouraging them to also be positive leaders.
8. Describe the impact COVID-19 has had on you both personally and professionally and how you have developed your own coping strategies and resilience during this time?
COVID-19 has been very challenging both personally and professionally. It has been tough physically and mentally and I have had to learn new coping strategies as this has been a situation that we are not used to. I have learnt the importance of self-care, looking after myself in order to perform the best to support my team.
9. As a result of the Nightingale Challenge Programme what changes have you made professionally and personally?
The Nightingale Challenge has made me more aware of my reaction to change. It has encouraged me to reflect both personally and professionally on events in order to make appropriate decisions beneficial to my patients, my team and myself.
Ellen Hunter: Staff Midwife, Ulster Hospital Maternity Unit
My name is Ellen Hunter, I am a Staff Midwife at the Ulster Hospital Maternity Unit in Northern Ireland. I qualified as a nurse in 2012 and initially re-located to Kingston-upon-Thames where I secured a permanent staff nurse role within a busy midwifery unit. I had always been fascinated by babies even as a young child. The chance to work in a maternity unit seemed like a golden opportunity as I could gain a deep insight into the midwifery role whilst caring for and supporting new mums and their babies, which I was rewarded with tremendous job satisfaction.
I missed my family in Northern Ireland, so I successfully applied for a nursing role in an emergency department back in Northern Ireland. On my return, I continued to reflect on the wonderful experience I had working within a maternity unit. It was after talking to a family friend who was a trained midwife that my mind was made up. She encouraged me to complete my nursing degree as a pathway to becoming a midwife myself. I am so glad I took this advice as I have loved every aspect of my professional journey, from being an undergraduate nursing student straight from school to working as a staff nurse, to then training to be a midwife, which is definitely my dream career. I qualified as a midwife three years ago and am currently working as a midwife in the Ulster Maternity Unit.
I have a strong passion for caring for woman with complex needs both physical and social, in pregnancy. I am committed to women having and making informed choices around their pregnancy and birth. I am proud to work as part of an integrated team with a model of care that has the pregnant woman and wellbeing of the baby at the centre of all we do. Against this background I wanted to contribute to the International Day of the Midwife in 2021 particularly given the theme of ‘Follow the Data, Invest in Midwives’. Data is vital to underpinning evidence-based midwifery practice. Data also allows us as a profession or team to demonstrate sound decision-making that is well informed and timely. It reduces unnecessary and ineffective interventions and helps mitigate any risks.
There is a growing body of evidence that demonstrates how midwives make a valuable contribution both at birth and in early years. Midwives have a public health ethos that includes a commitment to positive parenting as well as sustaining the emotional wellbeing of the mother [rcm.org.uk, High Quality Midwifery Care 2017]. The World Health Organisation [WHO] also play a key role in strengthening midwifery across the globe. In Northern Ireland, Health Minister Robin Swann announced on the 27 April 2021 that there will be 1,300 pre-registration places for nursing and midwifery which is another record high at the same level as last year. We look forward to the launch of the 2021 ‘State of the World’s Midwifery’ report on the ‘International Day of the Midwife’ too. The more data we can gather, the stronger the case for improving maternity services through investment and new ways of working worldwide.
As a midwife, I am committed to my personal continuing professional development. When I was informed that I had been nominated to be part of the Nightingale Challenge Northern Ireland Global Leadership Development Programme [NCNI GLDP] I was both honoured and excited. The programme’s aim is to develop young nurses and midwives’ leadership, policymaking, quality improvement and partnership working skills; building a cadre of strong, politically astute young nursing and midwifery leaders well positioned to play a part in strengthening nursing and midwifery in Northern Ireland. Led by Global Health Consultant, Dr Catherine Hannaway, the passionate steering group including Chief Nursing Officer, Professor Charlotte McArdle, Dr Dale Spence, Lead Midwife at the Department of Health, Northern Ireland and Mary Frances McManus, Lead Nurse for Public Health.
At our first workshop in January 2020, I was delighted to have the opportunity to meet Professor Frances McConville, WHO and we heard from Howard Catton, CEO International Council of Nurses [ICN] and even met the brand-new Health Minister for Northern Ireland, Robin Swann. Howard Catton talked about global health, nursing and youth. Howard used the word “Glo-cal”, this means thinking globally and acting Locally. This has been especially important when thinking of the Covid-19 pandemic and how we have reflected and continue to use research and evidence from all over the world but acting locally to implement guidance to safeguard our communities. Despite the Covid-19 pandemic we have been able to network virtually with young professionals, [our Global Associates] from all over the world – from the USA to Uganda and Pakistan to name a few. This has given me an insight into some of the difficulties faced in different parts of the world. The enthusiasm, passion and drive from the Nightingale Challenge Global Associates really is infectious.
As well as completing the United Nations e-learning ‘Primer Certificate on the SDGs’, the NCNI GLDP also provided me with an opportunity to undertake 4 evidence-based Quality Improvement Science Modules, led by the Institute of Healthcare Improvement [IHI, USA]. Armed with this knowledge I have applied this learning to an improvement project, which is another requirement of the programme. I am fortunate to work in a forward-thinking unit that uses quality improvement regularly to continuously improve quality of care and outcomes for women and babies. The aim of my improvement project is ‘To develop, pilot and evaluate a model of peer support for newly qualified midwives to coincide with the current preceptorship programme, to enhance midwives experience when transitioning from student to registrant.’ I am currently in the first phase of my project which is the planning phase. Using the Plan-Do-Study-Act part of the IHI Model for Improvement Methodology. I am currently reviewing the evidence available to help build a case for change. I believe we need to create a culture and environment that values midwives and continues to invest in their continuing professional development and wellbeing. In order to provide high quality continuity of care it is important to retain staff and develop them so they feel valued and empowered to be the best they can be. I believe by investing in midwives from the outset by providing protected time to newly qualified midwives, encouraging peer support through peer education and supervised reflective practice will create a supportive environment to allow midwives to communicate with and support one another in a climate of openness and transparency for learning and sharing.
A huge challenge whilst I have been undertaking the NCNI GLDP has been the impact of the Covid-19 pandemic, both personally and within maternity services, even though most of our services have continued to offer full services as babies don’t wait. However, as midwives it was necessary to adapt the way we worked as a team. This included using alternative means to communicate with women such as telephone consultation for initial antenatal appointments and use of zoom for staff education. Good communication in midwifery is key. Effective communication can help you avoid conflict, build a trusting relationship, solve problems and create better outcomes and experiences for the women and babies we care for. The introduction of Personal Protective Equipment [PPE] meant the physical barriers make effective communication very difficult. Midwives have to use the full range of non-verbal cues as well as verbal explanations to reassure women and their partners.
From a personal viewpoint, a close relative of mine gave birth during ‘lockdown’, so I know first-hand the challenges of undergoing a pregnancy and subsequent birth during a pandemic. Having to stay at home during most of the pregnancy and then the family restrictions at the time of the birth added to stresses within the family. The midwife and wider team had a key role in ensuring the experience was positive with good communication at the centre of all care to ensure the woman’s needs were met.
In terms of building my own personal resilience, I sought out resources from the NCNI GLDP and from my Trust [SEHSCT]. A session led by Dr Ed Sipler provided useful strategies for building resilience that were so well-timed as we moved into the latest lockdown. Ed shared many techniques with us such as mindfulness, breathing exercises and self-compassion. What I found most helpful was a document Ed shared, ‘Bend don’t break’, that I utilise daily and has changed my thinking. This sounds complicated but it takes only seconds: Catch it – recognise unhelpful thought; Pause it – stop, create time to think; Challenge it – reality test [is it true] look for an explanation [can I do anything], and perspective [will this affect me tomorrow]: Change it – balanced perspective.
The Nightingale Challenge Northern Ireland Global Leadership Development Programme has challenged me to examine and reflect on my personal and professional leadership style and journey. At the start of the programme, I thought that you needed to be a Manager to be a leader. However, I now understand that leading is essential in every healthcare setting at every level, so investing in the development of midwives from the very start of their career’s is essential. As a midwife, leadership means empowering women to be the lead in their care, facilitate change ensuring robust, women-centred, evidence-based care and influencing others working towards a shared vision. I am motivated and inspired to continue to learn more about leadership and to motivate others to be strong leaders in midwifery.
Happy International Day of the Midwife 2021!
Jayne Robinson: Deputy Sister, Craig Ward
As a small child in primary school I remember watching a programme on TV about the Children’s Hospital in Belfast, I loved this programme! I remember being fascinated by what goes on in hospitals and I knew that when I grew up I wanted to be a children’s nurse so I could help people like the nurses on the TV. There is no other job I can ever imagine doing! I have spent part of my career working in paediatric intensive care and for the last year and a half I have been Deputy Sister in Craig Ward in the Ulster hospital.
Children’s Nursing is so special because not only do we care for our patients but we also look after their whole family. On a daily basis our ward is filled with fun and laughter, magic cream and clown doctors. It is one of the best feelings when you see a sick child getting better and finally getting to go home with their worried and anxious parents.
I am so thankful to have been offered to participate in the Nightingale Challenge Northern Ireland Leadership Development Programme 2020 as I am continually looking at how I can improve my care and leadership, not just for my patients but also for the staff team that I now help to manage.
The Nightingale Challenge has presented me with the opportunity to pause and reflect on my own emotional intelligence and to discover ways in which I can improve my practice and leadership style. I have found it interesting to hear and learn from the other Nightingale nurses in the programme and to make connections and network across the Trust. I have particularly enjoyed having the opportunity to hear about the experiences from many nurses across the world and how they have raised the profile of nursing within their country. It has motivated me to consider ways in which we can improve services for the children in Northern Ireland as they are the future of our healthcare system and by investing in their needs now we can help ease the pressures of the future.
The COVID -19 pandemic brought lots of challenges to the world of paediatrics however, thankfully children have not been as affected by COVID-19 as adults. At the beginning of the pandemic elective surgery was cancelled and the paediatric wards had to adjust their ways of working and there was the possibility of redeployment. Both the children and their families were apprehensive about being in hospital and the changes that were being brought in. Although this was an anxious time it also provided a great opportunity for learning and for staff to upskill in areas they would not normally get the opportunity to. Staff became creative in order to make sure that the ward remained a child friendly and welcoming place, despite the PPE and enhanced infection control measures. In my role I found it essential to maintain a positive attitude and to not get overwhelmed by my own anxieties and the frustrations and worries of others. I have used several of the techniques that were taught in the Nightingale Challenge in order to achieve this. For example, I aim to take five minutes on my walk into work to think through the day ahead and to try to leave any worries about home at the door. Likewise as I leave work I reflect on the day and think of a few things that have gone well that I am thankful for. I find that this practice has now become a habit and has allowed me to give the best of myself to my colleagues.
I firmly believe that in a world where there is so much negativity that we need to encourage one another and build each other up so that we can be the best team possible for our patients. This is something that I have been very conscious of throughout the pandemic and I have strived to be open and honest with staff, patients and parents at all times, including admitting that sometimes I don’t have all the answers. While it seems that everything in the world is now different and chaotic, one thing that is steadfast is the care and compassion that we as nurses show to our patients.
I am so thankful to have worked with some brilliant nurses and healthcare professionals throughout my career who have helped shape me into the nurse that I am today. I hope that through my practice I will have been able to inspire a child or young person to go into nursing, just like the nurses on TV did for me. As I look forward to 2021 I hope that nurses and midwives continue to be recognised, appreciated and celebrated for all the work, care and compassion they give to the community.
Jacqueline Magee: Staff Nurse
Having a close family member with Severe Learning Disability was my motivation to follow a career into nursing. To care for someone who is in need of support be it for an illness or a disability is an honor.
I completed my nursing at Queens University in 2007, since then I have attended mandatory training, stand-alone courses and various other study days to help develop and keep my skills and knowledge up to date. When I read about the Nightingale Challenge Northern Ireland Leadership Development Programme 2020 I knew that it would be different to anything I had experienced before and put my name forward immediately.
I was so delighted to have successfully received a place on the Nightingale Challenge. At first I wasn’t sure exactly what to expect but I could not wait to learn more about leadership, develop myself and my skills and network with other nurses within the South Eastern Health and Social Care Trust and around the world.
Prior to the Nightingale Challenge I would have seen leadership as a hierarchy, those in positions above me were the leaders however Modules 1 and 2 have been a complete eye opener for me. Listening to Karen Hunter, Principal Consultant, HSC Leadership Centre speak during our sessions has been inspirational and hearing my fellow Nightingales tell of their experiences both good and not so good has contributed to a completely new way of looking at both myself personally and professionally.
The first module “All About Me” was fantastic, understanding how much control I have over how I can choose to react to different events and others around me to help strengthen my own character and therefore be in a better position to help my colleagues develop their strengths. I left these sessions feeling excited with the prospect of attending various events and meeting other professionals from all areas of health care……then our world changed.
As lockdown was initiated and cases of COVID-19 increased, I was told that I was to be redeployed to the Thompson House Hospital to work within the nursing team caring for patients with neurology conditions and brain injuries. This was a major step for me as prior to this I had never worked within a general setting, having spent my last 11 years in the same role within a community setting delivering care to adults with learning disabilities. However, I looked at this as a positive learning experience and stepped up to the challenge as I really wanted to learn more, step out of my comfort zone, and challenge myself.
During the lock down I also faced challenges at home, having two young boys under the age of five and my parents who were also my only child care both receiving their letters to direct them to shield. Not being allowed to be with my parents and having to witness my children talk to them over a screen or through a window was a very upsetting time, but I realised that everyone had experienced a personal impact due to COVID-19 and now more than ever we needed to support each other, be it family, friends or colleagues.
The disappointment felt by us all was very evident when we realized that lockdown would also have an impact on our plans to attend events in line with the Nightingale Challenge. Although it has been an unusual and sometimes frustrating experience, technology and the use of Zoom has been a life-line to many both at home and to help ensure professionally we could keep in contact and up to date with training needs. I was fortunate to join the NICON20 conference via Zoom in October and our Module 2 was able to go ahead which although we were not meeting face to face both events were extremely beneficial. In some ways COVID-19 has made us sit up and look at how we can use technology to our advantage within the healthcare setting.
With the new knowledge gained from the Nightingale Challenge modules I feel I am better equipped now to recognize many different leadership styles, and identify how my reaction to these can make such a difference to both myself and others within the workplace. More importantly however, the unfortunate effects of COVID-19 made it clearer to me that every member of staff, no matter their banding or job title, had a vital role to play to ensure that we all provided the best holistic care to our patients and their family members and that we all can be great leaders within the workplace when the situation calls for it.
I found I could lead even when out of my comfort zone as I continued to mentor student nurses within my new setting, providing support, encouragement and hope in such an uncertain challenging time for us all. If I were to pin-point one learning outcome from the last six months of events it would be this……we do not need to become experts in one leadership style but know how to change certain aspects of how we lead to ensure we get the best possible outcome from ourselves and our colleagues. The skills and knowledge I have gained and the experience of working within a team of nurses has boosted my confidence and given me a new love for nursing. This along with the Nightingale Challenge has given me the confidence and enthusiasm to progress my career further and strive to be a good leader no matter what role I am in at the time.
Leslie Anne Armstrong: Community Staff nurse, District Nursing
My name is Leslie Anne Armstrong I am a Community Staff Nurse working as part of the District Nursing team in Dunmurrry within the South Eastern Trust.
I have been qualified for just over 3 years and have recently completed my first revalidation. I have worked as a Community Nurse for 1 year, prior to this I worked as a staff nurse in the Royal Victoria Hospital Emergency Department (ED).
Transitioning from the acute to the community setting was extremely challenging but I feel I have adapted well. In ED I worked as part of a large, well supported team in a fast paced environment delivering emergency care to patients. In the community I work as part of a small District Nursing team and am a lone-worker for the majority of the time visiting patients with complex needs at home and avoiding hospital admissions.
As a Community Nurse I work in a variety of environments from health centres to residential accommodation and patients own homes. I meet the needs of elderly, disabled and vulnerable patients who are unable to visit their GP/ treatment room. It is a particularly rewarding job as we are helping those being cared for at home to maintain their independence and freedom whilst being able to access great nursing care.
I feel the skills of a good Community Nurse are to be well organised, confident and able to cope in potentially challenging situations. Leadership and management skills are also important as you will supervise junior members of the team, Health Care Assistants and Student Nurses.
A vital role of the Community Nurse is to communicate with other allied health professionals such as GPs, Social Workers, Specialist Nurses (Palliative, Tissue Viability, and Diabetes), Occupational Therapists and Physiotherapists to ensure a high standard of person-centred care is given to all patients.
I thoroughly enjoy being a nurse especially working in the community engaging with a variety of different patients with different complex needs whilst building my skill set. I feel I make a positive impact in my patient’s lives.
I decided to follow a career in nursing after working briefly as a Community Care Assistant. During this time I discovered that I had a genuine passion in caring for others and wanted to better myself both personally and professionally. During my first shift as a student nurse I knew that I had made the right decision to pursue my career as a nurse.
I was absolutely thrilled to be offered a place of the South Eastern Health and Social Care Trust Nightingale Challenge Leadership Development Programme. The World Health Organisation had announced 2020 was the year of the Nurse and Midwife I thought this was the perfect time to develop my leadership skills.
The Nightingale Challenge is an invaluable course for young nurses. It gave an opportunity to meet with a group of young nurses from all different backgrounds and share our experiences and to gain confidence and leadership skills.
I attended the “All about me” workshop lead by Karen Hunter, Principal Consultant, HSC Leadership Centre, and remember coming away from the workshop feeling uplifted and ready to take on the world. Karen challenged us to explore our attitudes and thoughts about ourselves and encouraged us to see ourselves in a more positive light.
We were given a leadership challenge to make a few changes in our place of work in order to raise staff morale and bring the “feel-good factor” into work. One of the ideas that I implemented in my team was to do a “feel-good Friday”, this meant that every week on a Friday we would take time out and have a lunch together as a team. This incentive worked really well in my team.
As the news came of the COVID-19 pandemic, I knew that 2020 “the year of the nurse” was going to be literally the “Year of the Nurse” but not in the context that I had imagined. The idea of nursing during a pandemic was frightening and overwhelming. Although I faced many challenges professionally and personally I felt prouder than ever to be a nurse. I found extremely rewarding to drive home from a hard shift and to see the NHS rainbows being displayed on people’s windows.
Throughout COVID-19 community nursing has faced huge challenges. The number of patients being admitted to hospital has been reduced; this has resulted in community nurses nursing sicker and more vulnerable patients at home. Due to COVID-19 medical professionals have been more reluctant to come out to visit patients in their homes; this has led to the role of the Community Nurse being expanded. During the pandemic other members of the multi-disciplinary teams (Occupational Therapists, Physiotherapists, Dieticians) that we work alongside have been redeployed therefore our patients have less access to services than ever before.
Throughout COVID-19 I felt a sense of unity amongst the Community Nursing Teams. I recognised different leadership styles within the team and felt incredibly proud to be working alongside such a strong group of nurses.
On reflection through all my experiences during COVID-19 I have learned that I can adapt well during uncertain times in order to ensure my patients receive high quality care. I have also learned that my positive attitude has impacted on my patient’s and colleagues during such a difficult time.
Catherine Crymble: Head and Neck Cancer Clinical Nurse Specialist
What made you decide to follow a career into nursing/midwifery?
At school I was extremely quiet and tried my best to not stand out. I wasn’t a natural academic or sport’s person; however I always knew that I wanted to work in healthcare caring for people. I was unsure of what exact path and the prospect of a nursing career was only decided in my senior year of school.
Within my first year of nursing I felt it was the first thing in my life I was naturally good at. It is a career that used natural qualities/values that have been instilled in me through my family and experiences growing up. Throughout my three years in university I was able to adapt these and utilise them into skills which I still use to this day.
Throughout my six year career I have learnt about myself as a practitioner and as a person. I have a passion for people and their well-being. I have been able to see that nurses are not just to be seen as ‘hand holders’ they are independent practitioners in their own right with a cascade of skills and roles.
I started my career in Scotland however moved home in 2018 to be closer to family. The Ulster Hospital has been a very welcoming environment with great opportunities. I will always be grateful to the team in Maxillofacial and Plastic Surgery for supporting me to achieve my current role.
What is your job role and how long have you been in this role?
My role is a Macmillan Head and Neck Cancer Clinical Nurse Specialist (CNS) within the Ulster Hospital. I am extremely privileged to care for those diagnosed with head and neck cancer.
I meet patients at diagnosis and support them through their cancer journey. This can include aiding them in decision-making regarding treatment, carrying out physical examinations or signposting to vital support services such as Macmillan.
I work between two specialities Maxillofacial and Plastic surgery. On a daily basis I work between a number of clinical settings including wards and outpatients. There is never two days the same!
I have been in this role for approximately a year and a half. I never anticipated that I would be in this position at this stage of my career. It has always been my dream to specialise in Oncology and support those with a diagnosis of Cancer.
What do you love about being a nurse/midwife?
I love nursing because we have the power to make a difference. We witness people in their most joyous and difficult moments in life. We are privileged not only to be asked but to be welcomed to be part of these.
What inspired you to undertake this programme?
I do not manage a ward or staff, but I manage a service alongside my colleague Dr. Cherith Semple. We work alongside Consultant Surgeons, Anaesthetists, Ward and Nursing Staff to facilitate a service that supports those diagnosed with Head and Neck Cancer.
I feel my ward experience has prepared me for the clinical aspect of my role, however I feel I was lacking in managerial experience.
I was thrilled to be selected for this opportunity. I have felt great benefit from the South Eastern Health and Social Care Trust Nightingale Challenge Leadership Development Programme 2020 thus far. It has enabled us to look at ourselves as individuals, practitioners and as leaders. Promote our natural strengths and reflect on areas to adapt.
From the initial onset the course which is facilitated by Karen Hunter, Principal Consultant, HSC Leadership Centre, has been a huge inspiration not only in my professional but personal life. The first module ‘’All about me’’ looked at how our mind-set shapes our behaviour and ultimately the outcomes we wish to achieve. This struck a chord with me as I realised my timid approach to things although beneficial at times is most likely affecting how others perceive me. Karen has given us tips and tools of how to look at strategies to optimise on qualities such as these when appropriate but also promote a more confident communication style when necessary.
Recently in Module 3 we have had the exciting opportunity to learn about Nursing and Midwifery in different regions of the world. We have had talks from Dr Catherine Hannaway, DProf, RN, RM (ret.), RHV, Global Health Consultant and Programme Director, and Rodney Morton, Executive Director of Nursing, Midwifery and Allied Health Professions, Public Health Agency. It has been so beneficial to hear from professionals such as these and discuss matters with them. We have also had the opportunity to hear from Sobia Idress, Global Associate and Voice for Nursing in Pakistan who was extremely inspiring.
At the start of the Nightingale Challenge Programme you developed objectives as well as professional and personal goals for your leadership development. How has the COVID-19 pandemic impacted on you meeting these goals and objectives?
The COVID-19 pandemic has been a unique situation that has impacted everyone on a personal and professional level.
At the earlier part of this year I put huge pressure on myself to get my own house. As a 28 year old woman who still lives with their parents I think sometimes despite my career achievements I felt that I should have reached other personal milestones in my life. I found it difficult not to compare myself to friends and colleagues.
I began to work full time with the addition of shifts at the weekend to help on wards to save for a deposit. I found myself becoming increasingly tired throughout the week and felt like I spend my days off sleeping and not getting to appreciate my free time.
I think this past year I have actually taken this pressure off myself. My focus has changed and I have been able to gain insight into a different pace of life and realise what is ultimately important. I have an amazing family, group of friends and my health. I have been able to also realise just how far I have come within my nursing career from being a Band 5 Staff Nurse to now working as a Band 7 Clinical Nurse Specialist.
Prior to the COVID-19 pandemic my aim within my professional life was learn about my speciality, gain confidence and ultimately feel more competent within my role. I was extremely thrilled to be selected to be part of the Nightingale Programme especially with 2020 being the Year of the Nurse.
The past 11 months although it has been difficult for us all, it has shown me how adaptable we are as health care professionals. Despite having families, commitments I have been inspired to see so many people go over and beyond for the care of patients. It proves that working for the NHS is so much more than a vocation.
I was initially redeployed at the beginning of the pandemic to help on the wards. I think initially naturally I was concerned about the provision of our service, however was able to see the ultimate aim and gladly provided support to colleagues and patients.
Throughout this time the team has been providing support to wards, however has also been able to adapt our service in a number of ways: we have set up virtual clinics; started up new clinics; and provided teaching sessions for staff members to educate them on the care for those with head and neck cancer.
We continue to work towards a number of service improvement initiatives which I feel despite adversity and working under extreme pressure shows the resilience we have as a team. We have taken this opportunity to look at our current ways of working and hopefully make changes to benefit our patients.
What professional networks have you developed and how have you engaged and connected with other leaders and professionals as part of this programme?
I have so enjoyed meeting the other members of the SET Nightingale Team. We all come from varied clinical and personal backgrounds however there is so much shared learning/experiences to discuss. Just listening to their experiences has been an inspiration to me.
When we first initially met and were able to see each other face-to-face however due to restrictions we have been meeting virtually via zoom. We have learned so much from the speakers but I think also our connection to each other through the pandemic has been extremely beneficial. We have that common link of working within leadership roles and to hear how everyone has stepped up for those around them makes me feel so proud to be part of the programme.
What type of leadership styles have you observed and as a result would like to develop in your own practice?
I feel over the past year due to the COVID-19 pandemic leadership has never been so important within healthcare. I have witnessed leadership not only on managerial level but also within teams on ward level.
My Clinical Managers MaryJo Thompson, Caroline Lynas and Robert McCormac have constantly been checking in with the Cancer Services team by holding regular zoom meetings to update us on any recent developments and check our general well-being. Again I think that despite us not being able to meet as a team face-to-face it has kept us connected.
A quote that has resonated with me during the pandemic is ‘Have Courage and be Kind’. We as a health service have been asked to put aside fear and step up to a task which has been asked of us all. Fear can sometimes have an impact on our ability to work together and therefore it is vital that we remain kind to others. Simple acts of kindness hold so much power. Within the Oral Surgery Department the Consultants, Nursing staff and Secretarial staff have constantly kept me going on my most difficult days by a quick ‘’check-in’’ or reminding me to go for my break. These are acts that are maybe not necessarily conventionally deemed as leadership tasks however they have made so much difference and should be recognised.