As some of us break up for the festive holidays, I wanted to wish readers of this blog a happy time. I do appreciate that some of you will be working though. In our university we have a December graduation and it is always with pride and pleasure that I sit on the stage with my colleagues as we watch our students cross the same stage and be awarded their degree. The three or four years that the students have been on our courses seems to fly by for us - not sure if it is always the same for the students - and we can see the changes in them over that time. We have 'graduation stories' here, and it's interesting to hear about the challenges that some of the students deal with as they work their way through the course. I am amazed and humbled by their ability to juggle the challenges of the course with the personal circumstances that must take so much time in their lives. My PhD showed that some students manage these challenges and successfully complete (first year), while others find that they need to make the decision to leave. Amongst my conclusions was that (rather obviously) those who were highly motivated towards the profession were much more likely to stay than those who were ambivalent about nursing as a career. This issue is of real interest to me as I work with colleagues on a NES-funded project on selection processes for student nurses and midwives. Back to the graduation, and it is always a high point to end the year for those who have graduated and us as their lecturers.
Happy Christmas all!

An inspirational lecture by Professor Brendan McCormack of the University of Ulster ('Human flourishing through nursing research and development: seeing, appreciating, and making use of what is right in front of us) has set me thinking. The focus of his research is on the person at the centre of the care experience, and his lecture uses a number of examples of patient/carer voices that really bring home to the listener what it means to be on the receiving end of care. For me, it is this kind of research that makes a massive impact on the educational experience of student nurses. A couple of personal examples illustrate what I mean by this:

Gwen is a newly-qualified nurse who had a challenging educational pathway for a number of reasons. One of these reasons is that she developed breast cancer as a third year student. She is one of the most inspirational people I have met - genuinely. She quietly got on with her treatment, and then came back to our university and successfully completed her course. As well as this, she has developed a 'lecture' where she talks to our students about what it meant to her to be on the receiving end of care - what made it a 'good' experience and what made things harder for her. Gwen and I have written an article about her work with our students, and the ripple effect (as she calls it) of her shared reflective patient journey - the impact that her experience has had on the people that she has spoken to, the ones they have spoken to...... and so on. The article is in press and I will make sure I let readers of this blog know about it when it is published - Gwen is an eloquent writer.

A second example relates to my own experiences as a relative of someone who is on the receiving end of care on a fairly regular basis. My daughter has epilepsy and, although she has been fit-free for around 3 months now (touch wood!!), she has had a difficult few years. We have received amazing care from her specialist nurse and her consultant. And we had reasonable care when she was admitted this year in status. When she was taken into A&E with a smashed face following a fit in the High Street, care was ok. But what makes the difference is not the technical care (can't fault it), rather the artistry of care - the demonstration of care through the use of language, touch, a look. When that is missing, it makes one feel invisible and not important.

My aim is to help our students to understand how we can ensure that patients, relatives and their carers feel visible and important.

Always Events

The Picker Institute’s website provides a refreshing view of patient care. Discussing ‘Always Events’ they focus (rather obviously) on the things that one should always do when working with patients. The aim is to optimize patient care through events that are significant (i.e. fundamental to patient care), evidence-based, measurable and affordable (i.e. things that the organization can do without major resource implications). The focus on patient safety is absolutely crucial in the effort to improve patient care, but a renewed effort to meaningfully engage with patients and others to determine what should always be in place is energizing. Unsurprisingly, the key areas in which patients ask for Always Events include: respect; coordination and integration of care; information, communication and education; physical comfort. I am sure we would all say that we espouse these values and approaches to care, and in our relationships with students. For me, the Picker Institute’s work is a timely reminder as I work with my colleagues to develop the pre-registration nursing curriculum – with the person (patient, student) – at the centre of the experience.

Telehealth and nursing education

The RCN has commented on the Audit Scotland report A Review of telehealth in Scotland. The RCN's comment relates to the benefits to patient care that telehealth can bring. It also highlights the need for education and training of staff. What about student nurses? It is a key imperative in a technologically-enhanced healthcare context and one which educators of nursing will need to address within their curricula. One example of the way in which telehealth impacts on care is the Scottish telestroke programme. It highlights the aspirations that the Scottish Government has in achieving effective and sustainable 24/7 acute telestroke services. These kinds of developments will impact on our students while they are undertaking their courses and as they progress as qualified nurses. Telehealth champions have been identified in practice and in HEIs in Scotland and working together to take the agenda forward.

Leadership in nursing education

There is a great deal written about nursing leadership - in the research literature, policy (think clinical leadership) and in the national media. Leadership certainly seems to be at the heart of quality nursing practice. But what about leadership in nursing education? Leadership at all levels is vital to the development of innovative, creative, quality education. Leaders take measured risks; they experiment with a view to developing practice; they support others to be creative and to do things that are out of the ordinary. What we also need to do is to make sure that as we work differently in these evolving education and healthcare contexts, is to ensure that we find ways to build the evidence-base. I recognise that this is a challenge - funding is not always forthcoming for research in education, but there are real opportunities to understand the impact of changing educational provision on patient care and health outcomes. 

As part of my Florence Nightingale Leadership scholarship, I am obviously looking at my own leadership development with the aim of improving myself both personally and professionally. But one of the fantastic aspects of the scholarship is the opportunity that I have had to 'shadow' others - senior nurses, senior academics, senior police officers and others. As I think of the challenges of leadership in nursing education, evidence building and creativity in practice, I am pleased to have had the chance to see others' leadership in action.

Quality assuring nursing education

As I sit in the midst of my institution’s NMC Annual Monitoring visit, I am reflecting on the ways in which organisations work to ensure that the quality of their courses is of the highest standard. While the Monitoring Visits, and the other organisational quality assurance processes, are of absolute importance, I would suggest that quality assurance is an embedded feature of our everyday working lives. As an educator - whether in the university, in practice or both – we will all work towards the enhancement of the delivery of an educational experience for students that aims to prepare them as effective practitioners. I’m currently delivering a Clinical Leadership Masters module – an online module – and have worked very hard to provide creative learning materials and activities that will inspire the students to engage actively in the learning experience. Quality assurance for this comes through peer review, technological support, and external validation. Most importantly for me, the students’ responses to the activities and their ongoing feedback keeps my feet firmly on the ground, and my mind firmly focused on quality assurance and enhancement.

My own view is that the monitoring of quality is a learning opportunity – as well as an opportunity to celebrate what others tell us we are doing well. I personally experience this in my work life every day.

Welcome to new bloggers! And thinking about pre-registration nursing education

I have had a number of queries from people about this blog – how to sign up. All you have to do is click on the ‘sign in’ on the top right of the blog page. If you don’t have a Google account, you will be asked to sign up but you can use your work or home email – no need to create a new email! I hope that works but email me outside of the blog if anyone is still having problems.

For those of you who are not used to the world of blogging I am pleased to be engaged in this new venture with you! If you’re familiar with blogging, I’ll look forward to sharing discussion and debate with you. If you are interested in having a ‘guest’ blog – just let me know. The greater the debate around the issues that affect nursing education, the better from my perspective.

As we embark on a new academic session, it is always pleasing to see the new students (keen and enthusiastic, finding their way), and the students who are entering into a new academic year. In my institution, we are currently developing the pre-registration programme for the implementation of the new NMC standards. We have been engaging with students, clinical staff, service users, and academic staff with the aim of having early conversations so that we can take on board views, evidence, feedback in a meaningful way. This aspect of the development work links directly to the focus for my Seattle visit (mentioned in an earlier blog) in which I aimed to come to a stronger understanding of how approaches to partnership, collaborative working relationships can blur the boundaries between the groups of people who are working towards a common goal (in this case the development of a curriculum that is fit for purpose and which ‘produces’ graduates who can take on the evolving demands of working in the future healthcare environment). What I learnt in Seattle was this (amongst other things): we need to find ways to celebrate the good that we do, the progress that we make, the leadership that we see across organisations, and the ideas that we have. Partnership working is such a complex area – one which is dependent on so many variables – that making them work is sometimes a challenge. I am pleased to be working in an environment where we can have open conversations with the relevant people, and where we are all working towards a common vision – of the development of practitioners who make a positive impact on practice.