ANNP to Service Line Clinical Director – The power of a Florence Nightingale Foundation Leadership Scholarship.

My clinical journey in nursing has led me on to an advanced practice trajectory. Therefore as an ANNP, I am undertaking what was historically a doctor’s clinical role. This is the result of two developments within the NHS service, that is, centralised neonatal intensive care and implementation of the European Working Time Directive (EWTD), the latter resulting in a reduction in junior doctor’s working hours thus leaving a gap in the service provision. This gap is increasingly being filled by specialist and advancing practice nurses and the role change, for me, resulted in me losing my nursing identity, one which I am very proud. Added to that and despite taking on increased clinical responsibility as an ANNP, there is yet no facility on the Nursing and Midwifery Council (NMC) register for such sub-specialities which causes me concern.

Therefore, my application in 2012 to the Florence Nightingale Foundation for a leadership scholarship was driven by my need to re-focus on my nursing identity and to raise the profile of advancing nursing practice in the UK. From the outset, including my interview, I grasped every opportunity to experience, reflect, assess, develop and influence which was liberating and empowering. I am a very different nurse leader having embarked on the leadership scholarship experience and I am currently undertaking a leadership role within my organisation, one which I would never have even considered applying for pre scholarship

The scholarship was divided into three aims:

  • Personal Leadership development
  • Career leadership objectives
  • The patient care improvement project

Initial leadership assessments including MBTI, 360 degree appraisal, political and emotional intelligence and influencing styles identified my specific learning objectives:

  • Development of my personal impact
  • Development of networking nationally to influence advancing practice nursing
  • Development of political and strategic influencing skills

Learning, experiential activities and achievements included:

  • Leading Change through Organisational Renewal (LCOR) module (five day residential course)
  • ANNP conference, London
  • Attendance at the Florence Nightingale Foundation Annual Conference, London
  • The Westminster Experience led by Baroness Julia Cumberlege
  • Co-Consulting groups: focused on personal effectiveness and questioning techniques
  • Personal Mentorship with Liz Morgan, Chief Nurse & Director of Education, Great Ormond Street Hospital
  • Visit to Cornell Hospital, New York and meeting ANNP and educator to discuss advancing practice strategies in USA including registration and governance
  • Presented audit of ANNP numbers and practices in the UK at international neonatal conference – ReASoN 2013
  • Part of working party with RCN, London, identifying career, education and competence framework for neonatal nursing in the UK
  • Invited to sit on BAPM working group ‘Report of BAPM Working Group on the optimal arrangements for NICUs in the UK including guidance on their medical staffing’ published July 2014
  • King’s Fund, Personal Impact & Influence (five day program plus follow up progress day)
  • RADA  2 day ‘Communication Skills for Leadership’ course including Thomas-Kilmann Conflict Mode
  • Promoted to Service Line Clinical Director for Neonatal Services in my Hospital Trust
  • Invited to sit on executive committee for Neonatal Nurses Association (NNA)
  • Visit to two hospitals in the South Island New Zealand to review the neonatal services and ANNP registration and practice
  • Published editorial in neonatal journal – ‘INFANT Grapvine’
  • Developed and ran leadership program for NICU SLT including senior nurses and consultants
  • Mentoring sessions with Greg Dix, Director of Nursing, Plymouth Hospital’s NHS Trust
  • Invited to sit on the South West Neonatal Operational Delivery Network (ODN) Board
  • Passed the ‘lamp’ to the Dean at the 2014 Florence Nightingale Commemoration Service

Despite having ANNPs in practice in the UK since 1992 and now integral in the neonatal service, there has never been any national senior nursing agreement or strategy for succession and standardised development and education for advancing practice nursing. This failure is impacting on both training and recruitment of ANNPs in the UK and consequently on patient care for the neonatal population.

I used my FNF leadership scholarship to investigate and compare advancing practice and registration in the USA and New Zealand to the UK by visiting and meeting educators and senior nurses there. I also worked with the RCN, BAPM, NNA, RCPCH and BLISS to raise the profile of advancing neonatal nursing practice in the UK. The RCN supported the development of a document to identify career, education and competence framework for neonatal nursing including advancing practice in the UK  published September 2014.

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