Nurses make a huge difference to the lives of patients and their families. Bearing in mind the compassion and dedication of our nursing teams, it is no surprise that the nursing profession seems to have a special place in British esteem; frequently polled as the most trusted profession and, largely, admired and respected by the public.
Several nurses have played a key role in shaping and revolutionising our healthcare services and their legacies continue to live on today. Known as the founder of modern nursing, British nurse Florence Nightingale is often thought of as the pioneer for infection control, raising standards of care for patients. Referred to as the ‘Lady with the Lamp’ as she made her rounds of injured soldiers at night. However, behind this tender image was a knowledgeable and determined nurse, whose actions significantly reduced mortality rates. She is rightfully celebrated as one of nursing’s most respected figures. Likewise, Mary Seacole was a British-Jamaican nurse and savvy businesswoman, celebrated for her bravery in nursing soldiers back to health during the Crimean War. The NHS Leadership Academy have recognised her leadership contribution by naming one of their prestigious leadership programmes after her. Many other nurses have made history too, with their compassionate practice, their breakthroughs and discoveries, as well as their devoted activism.
It ought to follow then, with such a positive public perception and the inspiring nurse role models that exist throughout history and in the present day, that nurses would naturally recognise their potential as clinical leaders and trailblazers. As it turns out, many of us rarely spend enough time considering the possibility of meaningful leadership, beyond the natural progression of climbing through our hierarchical banding system.
The NHS Regional Clinical Leadership Fellow Scheme provided an avenue and an opportunity for us, as three front-line nurses from varied nursing backgrounds, to actively learn and develop as clinical leaders, alongside colleagues from several different professional backgrounds. The part-time nature of the scheme meant that we were able to engage in leadership endeavours whilst remaining in touch with the (increasingly pressured) realities of life on the shopfloor.
The scope and breadth of work streams we were supported to engage with across the regions were wide-ranging and challenged each of us in different ways. These workstreams included shaping the community nurse workforce priorities, implementing the Professional Nurse Advocate role, along with exploring the recruitment and retention needs of Health Care Support Workers. Some of our project work stretched us well beyond our comfort zones, such as entering the complex space of refugee health and wellbeing, which became increasingly pressing as a result of escalating global events. Additionally, the Omicron response and short-lived NHS vaccine mandate meant that we had to assimilate at pace and adapt to a constantly changing environment. These ever-changing leadership priorities, along with the current state of transformation of the NHS, meant that our year as regional clinical leadership fellows working for the NHS England regional teams was never going to be smooth sailing. However, the volatility and uncertainty of many of our evolving workstreams has strengthened our resilience and reminded us of how adaptable we have the potential to be. It also highlighted to us the importance of taking time to pause, reflect and regroup – to manage our energy instead of our time, and to connect meaningfully with one another as we navigate these complex challenges together.
The scheme has been a real journey of discovery – both for us as nurse leaders, and in terms of having a better understanding of the national and regional landscape of the NHS. It has also enabled us to realise a renewed sense of our nursing identities, with the help of some truly inspirational leaders we have met along the way. We have found both our individual and collective leadership voice; reminding ourselves that it is as valid as any other, despite some of the intrinsic hierarchies that seem to exist within healthcare. In that respect, an important lesson for all of us is the importance of ensuring visible and vocal nursing leadership remains present at all levels within the healthcare system.
We each feel enriched and re-invigorated by our time spent as clinical leadership fellows, as we adapted to expecting the unexpected and embracing a positive culture of learning when things did not quite go to plan. As we return to our clinical posts, with new insights, skills and experiences, we each see this as the beginning of a new chapter of our professional careers. We are excited for what the future holds, as some of us consider nurse consultancy posts, academic possibilities or courageously applying for roles that we never thought we would apply for.
We clearly have a proud history of strong nursing practice, and we are truly standing on the shoulders of giants. The most appropriate way to show gratitude for the work of those before us, and to prepare those who follow in our footsteps, is to carry the torch of nursing leadership and encourage more nurses to enter the leadership arena. By empowering ourselves, enabling our colleagues and inspiring our students to flourish as leaders, we advance not only our profession, but the delivery and quality of care for the communities we serve.
Rosie Royce qualified as a nurse in 2003 and worked in critical care as a staff nurse until 2010. She moved out of the secondary care setting to community care as a community nurse from 2010 to 2017 and more recently has enjoyed her role as a Macmillan palliative clinical nurse specialist. This is a varied role that includes managing a clinical caseload, developing palliative education and leading palliative care strategically within the wider system. Rosie is a Queens nurse and Florence Nightingale Scholar. Throughout her community career she has been involved in improvement projects including proactive management of frail older adults in care homes and using frailty scales to identify palliative patients. More recently Rosie has been the clinical lead on a project to implement a single point for access for palliative patients. Rosie has currently completed the regional clinical leadership fellowship and is looking forward to heading back to her trust to implement her new skill set and lead transformation in the future.
Ryan is a registered mental health nurse, currently working as a ward manager on an older adult inpatient ward, having worked on a range of inpatient mental health units throughout his career. Having been involved in a number of quality improvement projects, he saw the clinical fellowship scheme as an opportunity to apply those skills in a wider setting; during his year he conducted systems review for refugee healthcare and supported international recruitment of allied health professionals. Ryan is passionate about improving parity of esteem between mental and physical health, tackling cultural stigma towards mental illness, and addressing health inequalities in mental health settings.
Sally has been a Critical Care Nurse for 25 years, working in a variety of settings in the UK and in Africa. She is passionate about providing high quality care to patients and excellent education and training to staff. During the challenge of the fellowship, she has been able the develop the Professional Nurse Advocate course and thoroughly enjoyed exploring recruitment and retention initiatives. Balancing this with frontline clinical work has been challenging but inspirational. Having returned to her substantive role with this new insight and experience, she is beginning to shape new projects and initiatives within her organisation to continue to improve patient care. Twitter: @SallyRudge6