In this week’s blog, Rhona Martin who is a Chest, Heart and Stroke Nurse in NHS Fife in Scotland reflects on how the Queens Nursing Institute Scotland Leadership programme has contributed to her personal and professional development as a community nurse.
The Queens Nursing Institute Scotland (QNIS) Leadership Programme “supports, develops, and inspires Scotland’s community nurses and midwives to become agents for health improvement and catalysts for social change to build a healthier fairer Scotland” (The Queens Nursing Institute Scotland 2023). I know that “journey” has come a bit of a cliché when describing something new or different that is happening in your life, but I cannot think of a better way to describe this unique and transformational programme that I have immersed myself in.
On hearing that I had been nominated by my line manager to apply for the QNIS Leadership Programme cohort 2023, I felt honoured and privileged to be given this opportunity. However, it is fair to say that the application process was both daunting and exhilarating in equal measures. For this year’s cohort The Burdett Trust for Nursing provided funding for 4 applicants to take forward a Cardiovascular Project with a focus on primary prevention of cardiovascular disease, which became the basis of my application.
How my vision will be achieved is an evolving process but the fundamentals remain the same:
To be proactive in our approach in the prevention of future strokes and cardiovascular events through improved detection of AF and Hypertension and instilling interventions aimed at reducing the risk of stroke in people who have not yet had a stroke. There has to be equity in health and an important factor in my proposal is to ensure that the people living in our more deprived areas have access to this support and attain their full potential for health and wellbeing as unfortunately cardiovascular disease is one of the conditions most strongly related to health inequalities, deprivation, and low health literacy.
There were 3,836 stroke related deaths in Scotland in 2021 and whilst there has been a decrease in stroke deaths in the last 10 years it remains the leading cause of death and adult disability in Scotland. The number of people dying after a stroke in the most deprived areas of Scotland was 43% higher than in the least deprived areas in 2021 which is consistent with the previous 5 years. There are of course, non-modifiable risk factors for stroke such as age, sex, and co-morbidities but identifying modifiable risk factors in individuals and supporting people to make lifestyle changes could potentially reduce the prevalence of stroke in a significant way (Public Health Scotland 2023).
The Scottish Government’s commitment to stroke care led to the development and publication of Scotland’s new Progressive Stroke Pathway in March 2022. As Stroke Clinicians, this pathway provides the recommendations in practice that we should be striving to achieve. One significant recommendation is that there should be improved detection, diagnosis and management of AF and hypertension through quality improvement within community settings (Scottish Government 2022).
I am often asked how the QNIS programme will assist me in achieving my vision towards this and this is a very difficult question to answer and therefore difficult to put into words. For my vision to reach fruition I need to bring others with me on this journey, to share my ambition and to inspire them to commit to what will be a long-term process. The QNIS is at its core a Leadership Programme “inspiring others with tenacity and resilience” (The Queens Nursing Institute 2023). The programme blends a range of opportunities and learning approaches including two residential stays and one virtual workshop, monthly coaching, peer support and online gatherings with person centred care at the forefront. As an experienced nursing professional, I thought that I had person centred care covered, which for the people I care for I probably did. What I didn’t consider was myself and my team being central to this principal and how we as clinicians have to be healthy in mind and body to be able to foster healthy, respectful, and empathetic relationships with our service users and be a champion and advocate for high quality community nursing and equality for all in healthcare (McCormack et al 2021).
I now lead by incorporating this principal by ensuring that I support my team to embrace self-care, reflect, and to share constructive feedback. I have incorporated the “Mini Kitbag” resource into our team meetings to not only open conversation but to encourage listening without judgement and if appropriate for us to offer advice and support. What is exciting is that my team are now using aspects from this kitbag in conversations out with these meetings to reflect, express their thoughts and feelings and ask for support (International Futures Forum 2023).
I was, and continue to be, challenged at times on this programme with critical personal dialogue on past, present, and future experiences, exploring my values and beliefs through the eyes of others as I try to make sense of this journey of self-discovery. It continues to be a work in progress, but I have made significant changes physically and mentally in both my work and personal life since starting this programme and interestingly in both aspects people have said “ I can’t put my finger on it but there is something different about you”. This may bring about different challenges as both myself and others adapt to these changes but I will continue to embrace this opportunity to become the best person I can be not only for myself but for my team and the people that I support in my role as a Chest Heart & Stroke Scotland Lead Community Stroke Nurse.
For anyone who may be interested in or given this opportunity, I would say be brave and bold and just enjoy the journey!
Rhona works in NHS Fife (@NHSFife) as a Chest, Heart and Stroke Scotland Community Nurse (@CHSScotland). More information on the Burdett Trust for Nursing and Queens Nursing Institute Scotland can also be found on Twitter (@BurdettTrust and @QNI_Scotland).
International Futures Forum (2023) IFF Kitbag Available at https://www.iffkitbag.com
McCormack, Brendan, McCance Tanya, Bulley Cathy, Brown Donna, McMillan Ailsa, Martin Suzanne 2021, Person-Centred Healthcare Practice, Wiley Blackwell, Chichester
Public Health Scotland (2023) Scottish Stroke Statistics Available at https://publichealthscotland.scot
Scottish Government (2022) Strokes: progressive stroke pathway Available at https://www.gov.scot
The Queens Nursing Institute Scotland (2023) About QNIS Available at https://qnis.org.uk
Burdett Trust for Nursing – https://www.btfn.org.uk
Queens Nursing Institute Scotland – https://www.qnis.org.uk/