Clinician, teacher, leader, academic: the four-way route to nursing success
Jo says that the death of mother and grandmother, both before she was a teenager, meant she hit adulthood well acquainted with loss. She didn’t take a conventional route into nursing; following a degree in physiology and pharmacology, Jo completed the fast track programme for NHS leaders. Whilst enjoying this role, Jo also came to realise that she wanted to put her leadership and management skills to good use in the clinical arena.
One of her early postings while training at St George’s in London was on the infectious diseases and HIV ward.
“I became acquainted with care for people with significant life changing illnesses, as well as with issues around equality and diversity.” Time on an oncology ward convinced Jo that she was felt “at ease around sorrow” and that she had the skills to deal with it.
After spells as a registered nurse, working in a hospice and in surgery, as well as taking time away from work to have two children, Jo went back to work on a head and neck surgery unit and then progressed to be junior sister and practice educator on a chemotherapy and oncology ward. “There were a lot of patients with life-limiting illnesses and I was content with the complexity and found that my pharmacology background was really useful.”
After being unsuccessful in applying for a job as a palliative care clinical nurse specialist, Jo decided to enrol on a palliative care degree. Since 2006 she has fulfilled the role of palliative care team leader and then consultant nurse.
Jo is unclear whether she found palliative care, or if it found her. “It wasn’t that I thought I initially had a great vision for palliative care, I just really enjoyed patient-centred care. I loved looking at the rules and when a person’s goals for their own lives didn’t fit with the healthcare system, thinking about how we could break the rules or move the system in order to help them achieve what they wanted to achieve.”
The greatest impact Jo has had is as lead author of Care After Death: Guidance for staff responsible for care after death. This essential guide was inspired by Jo’s realisation that there was huge variation in care after death practices which was having a direct impact on the experience of the grieving family and the memories they were left with. First published in 2015 and updated regularly since, the guide was intended to help ensure that a person who has died is cared for and that there is well co-ordinated support which respects the wishes of the deceased and their families. Care After Death covers many different aspects of care after death for adults including ensuring timely verification of death, as well as other related issues such as respecting people’s cultural and religious wishes, preparing the deceased for viewing and facilitating people’s wishes for organ donation.
Jo has continued to show huge personal commitment to this work over the years. At the heart of her drive is the need to ensure those who are caring for the dying and the deceased feel confident and competent so they can ensure grieving, distressed, and frightened families are supported at such pivotal times. She is grateful to co-authors and for the support of Hospice UK.
As well as being nurse consultant at the Royal Free Hospital in London, Jo is also a core member of the National Nurse Consultant Group for Palliative Care. This is a UK wide network for all practising nurse consultant working in any care setting providing palliative care.
What drives you to make a difference?
From her very first days as a student nurse, Jo was committed to delivering on the wishes of the people she was caring for.
“I always had a longing to improve the patient experience, and I have always enjoyed working with their families, managing differences of opinion, and training doctors and nurses to work with this. Because in palliative care we’re taking a holistic approach, we can see opportunities sometimes to make things better, to help a whole family function and cope. That is a skill that I have been honing the whole way through my career.”
Jo sees no sign of this drive diminishing, nor the need for supporting individuals and their families at this most sensitive time.
“When I think about nursing in the future I reflect on how people are living longer and with co-morbidities, whilst supporting children and sometimes parents, within a very ethnically diverse society. We must strive to improve our ability to work with families and make systems work so people can live the best life they can.”
Perhaps, unsurprisingly, with someone as driven as Jo, she also won’t let a gap in her understanding or skills stand in the way of progress for long.
“I have a tendency if I don’t have the knowledge, to lean into it and get it. I don’t run away from it.”
How do we see the art and science of nursing expressed?
Jo has her own formula for managing the daily pressures of clinical work with the desire to take a wider and more long-term view of patient and family care.
“One of the ways I cope is to try to and deal with that which is in front of me. My work on a daily basis gives me a real blend of clinical and strategic leadership as I seek to take forward the things I can influence, like promoting the Care after death Guidelines.
Jo believes that the nurse consultant role has the potential to marry the art and science of nursing.
“I think the answer lies in the nurse consultant role. If you are a nurse in practice and you are clinically nursing a patient, and have written the national guidelines, you are testing out what works. If you are a nurse in practice and leading, you are working out how patient care can be orientated in a system. If you are a nurse in practice and you are leading education, then you are training the nurses of the future.
My worry is that nursing leadership roles that do not contain a clinical element are reliant on other’s narrative to effect change. I think we (leaders) should stay in clinical practice.”
It’s through facing the daily communication challenges of clinical work that Jo can then continue to learn and share the best strategies for practice development
How can nurses strengthen their leadership and impact?
Jo takes her responsibility to nurture her team very seriously and places huge weight in career development and her role as a manager in building that.
“In terms of how you grow nurses, I think role modelling is really important. I have been lucky enough to have been inspired by nurses and I want to learn from nurses. As a leader it’s important to make sure every nurse has a significant education opportunity every year. I want them all to have a project every year because they should all be growing. I am constantly looking for those opportunities to develop nurses.”
Being sure to communicate to nurses when they’re doing a good job is another important factor in ensuring nurses have the greatest positive impact, according to Jo.
“I want them to have praise too. I nominated someone for an award last year. She didn’t get it but it made me aware that I hadn’t done that (nominating staff) enough and so I am doing that more now because people’s skills need to be facilitated to shine to the wider nursing and palliative care communities.”
“I’m always looking to make system better for patients without stretching the staff beyond that which they can cope with change wise. You must became increasingly aware of your strengths and weaknesses. You have to listen, listen, listen and pay attention to the detail.”
London United Kingdom