‘The Deteriorating Patient’.

I would like to thank the Florence Nightingale Foundation, and Professor Liz Robb especially, for giving me the chance to undertake this programme and seeing in me, even in a challenging interview process, something that she and Mr Bryan Sanderson recognised would benefit from investment.

I would also like to express my gratitude to my sponsor, The Burdett Trust for Nursing.

Christina Edwards, my mentor, has been an inspiration – she has challenged me to consider my responsibilities as a senior clinician and a nurse, and has guided me throughout the scholarship. I feel very privileged to have spent this time with her

The team back at base, both my current and previous Directors of Nursing, have provided me with the support to complete the programme and the courage to apply in the first place. The Deputy Director of Nursing has been a true ally throughout, and a whole group of colleagues across emergency care and the wider senior organizational team have tolerated my ‘scholarship’ probing and absence.

I would personally like to thank the Between the Flags & Sepsis teams at the Clinical Excellence Commission in Sydney, especially Malcolm Green and Lisa Coombs for their generosity towards me during my time with them. They gave me their time, shared their projects and even drove me on site visits.

I would also like to acknowledge all the other scholars in the group. We have created some great friendships, been through lots together, and continue to support one another through challenges and much change. I hope we will continue to be in touch as our careers progress well into the future.

Finally, I would like to acknowledge my partner Craig, who has had to put up with many discussions and been left ‘home alone’ many times whilst I go off on my trips around the country and world in the name of leadership development.

Receiving a scholarship to concentrate on my personal and professional development came at a critical point in my career, having been in a nurse consultant post for almost 7 years, and needing some challenge about my future options.

The opportunities the year has provided are beyond anything I could have expected, having been welcomed by a state-wide project team in Australia, read about the Afghanistan/Pakistan political situation, listened to Atul Guwande give a lecture about compassion, and been presented with personalized ‘Lovehearts’.

One of the main reasons for applying for the scholarship was to take the opportunity to explore my personal impact. The assessments completed for both the initial coaching with Sue Machell and for the Ashridge Leadership Process programme provided a wealth of information on the impact I have, whether personally or within the wider organisational team. The programmes undertaken at RADA and at Ashridge were, at times, very difficult as they made me confront areas of conflict, but have given me a wealth of knowledge and skills to draw upon in the future.

Historically, my development has often been driven by a desire to work with inspirational individuals or teams. The scholarship has renewed those aspirations and I have met and subsequently made contact with some really amazing figures in the profession with which to explore future work. It has also reignited my desire to examine options for doctoratal study but, more importantly, has made me focus on how and where I feel I can best contribute to the future of nursing. Over the last few months, I feel as if I am growing in confidence to make strategic plans for meetings or services, to negotiate with challenging partners and to meet with, or speak to, executive or national project leads. Undoubtedly this is due to the skills and knowledge generated through the year.

The project I have worked on throughout the scholarship – Deteriorating Patient – is a workstream within our quality improvement strategy. The residential week undertaking Leading Change and Organisational Renewal (LCOR) with Dr Peter Finklestein provided me the opportunity early in the scholarship to explore the project and identify a clear plan for progression. The overseas visit to the Deteriorating Patient project in New South Wales gave me inspiration and the opportunity to discuss many of the issues with the team responsible for delivery across a whole state, and who are some years into it’s development. The project will extend well after the scholarship but we have made some significant development, including implementation of education and new observation protocols across the Trust. This is thanks to the focus and contacts enabled by the scholarship, but also the confidence to explore something different.

The opportunities taken are included as a appendix to the paper but include, as well as those identified above,

• Co-consulting – a comprehensive coaching tool
• the Westminster Experience – an amazing insight into leadership in a political environment
• the annual Institute of Health Improvement conference in Florida five days of improvement science and inspiration
• site visits and lots of reading.

The experiences over the last year have been unforgettable and will forever impact on my nursing career. My responsibility now is to use this experience and to pass it on what I have learnt; to the next scholars, to our colleagues, to the profession and most importantly to our patients.