I was privileged to have been given the opportunity to be one of the Emerging Leaders scholars for 2016 sponsored by the London Network for Nurses and Midwives (LNNM) through the Florence Nightingale Foundation. This reports outlines an overview of my learning and development during the scholarship programme.
I am relatively new to management role and maybe a little naive to the politics and
influences around my service, the ins and outs of service commissioning and the NHS politics in general. I applied for the Florence Nightingale Foundation Emerging leaders scholarship program as I wanted to become an effective leader and not just a manager. I worked for the health services for the elderly since arriving in the United Kingdom from the Philippines in 2002 and has not changed speciality since then.
The well-structured scholarship programme provided me with the training opportunities in a safe learning environment. I submitted and committed myself to every learning sets afforded to me during the programme. The sessions around personality analysis and leadership traits gave me an invaluable insight of what type of leader I would like to become. It became apparent that while, I have inherent leadership traits and potentials, some of my skills and my understanding and practices of leadership were out of date and required fine tuning – I was maybe a good manager but not necessarily an effective leader. It was an emotional journey that has taken me out of my comfort zones and has exposed my vulnerabilities. Understanding and capitalizing on my strengths and working to improve on my weaknesses enabled me increased confidence in my own personal experiences and authority as a nurse in the elderly care speciality. I now intend to use this new-found confidence to be able to influence the approach to care of older people and put emphasis on dementia care and to effectively challenge fundamental assumptions about practice delivery and future care provisions.
I placed focused on improving my negotiation skills as part of my personal leadership development. Attending a course in negotiation for increase effectiveness in Harvard University in Cambridge, Massachusetts has improved my negotiating skills significantly and increased my confidence as I engage in the negotiation process for service development and improvement. The course has a lot of practical tips and examples that can help one become an effective negotiator and a creative problem solver. As a lead nurse, I spend a good part of my working day negotiating with staff, service commissioners and many other members of the multi-disciplinary team and these are good experiences for me. However, to have presence and influence in shaping health services and delivery locally and nationally, I require excellent and strong skills in negotiations.
Dementia is a growing global challenge and has become one of the most important health and care issue facing the world (Prime Minister Challenge on Dementia 2020). An estimated 44 million people are living with dementia in the world today and this figure is set to double by 2030 (World Alzheimer’s Report 2014). In the UK, there are 850,000 people living with dementia (Dementia 2014: Opportunity for change, Alzheimer’s Society 2014, ) and about one- third of these lived in residential/nursing home (Dementia UK update, Alzheimer’s Society, 2014).
To experienced what best dementia care can look like, I initiated visits to 3 facilities locally and abroad – a private nursing home in Ipswich, the dementia village in Amsterdam and a memory assisted living facility in Westwood Massachusetts. The nursing home in Ipswich, invested in training programmes to develop their staff in the implementation of researched based care for their residents with dementia. The home has a memory lane facility that reflected lifestyles of the current residents. In the dementia village in Amsterdam, residents with severe dementia are given the opportunities to live as close to normal as possible. Residents in a group of 7 or 8, grouped accordingly by commonalities of their lifestyles and interests, live in their own house and are allowed to participate in the day to day household chores. The environment supports persons with dementia to understand where he is. The care is funded by the state. I also visited a memory assisted living facility in Westwood, Massachusetts, a facility for residents with Alzheimer’s disease, dementia and any other form of memory loss. This provided another perspective of what best dementia care can look like. All 70 residents privately paid for their own care. The care model is activity driven – making sure that residents are mentally stimulated and are physically active.
A common observation from the visits to the different facilities was one that ensured residents with dementia were treated with respect and dignity, maintained well-being, valued as a person, allowed to live with normality and therefore had meaning to life.
In June 2016, six months through the scholarship, I presented my personal progress and development as emerging leader to the London Network for Nurses and Midwives in London during the network’s celebration of their two decades of supporting nurses and midwives. To say the least that I was nervous at the time was an under statement. I have since presented to the Patient Experience and Engagement forum (PEEF) and the falls safety committee of my Trust. The same opportunity was accorded during the monthly ward sisters’ meetings when we have to highlight the importance of getting care right for patients with dementia admitted to the acute wards, in the community and in the nursing home settings. I have developed an in house training and sharing sessions for the staff of my service – a conscious drive to provide staff with appropriate trainings and be involved, so a shift in the care mentality can flourish. The biggest opportunity to share my journey, came when I delivered a masterclass on dementia care during the Florence Nightingale Foundation annual conference on 3 February 2017. Surrounded by nurses all passionate about improving dementia care, I was humbled by the experience. Am also looking forward to attend dementia awareness symposium in Davao del Sur, Philippines in June 2017. I may will use this opportunity to persuade provincial health officials to include dementia in the health care discussions and priorities for my province.
Reflecting on the whole scholarship journey, to deliver best care for dementia is a tough task to accomplish but not impossible. Modern challenges to our current health care industry including policy changes and reforms and budgetary cuts that significantly affects staff availability may have negative effects on service delivery. Effective nurse leadership is important as they do have direct influence over staff performance and patients’ care outcomes. Nurse leadership to improve quality and align resources in health care exist as evidenced in the care settings and places I have visited. The type and quality of leadership directly influence the quality of care being provided by the rest of the staff group and can only relate to a positive patient care experience and increased patient satisfaction. From now on, I need to be an effective nurse leader and will take this role actively to drive service development, align resources and implement change in my unit level.
Finally, I am an FNF scholar and will forever be thankful for this opportunity. The change in me as a nurse, as a person, because of the scholarship programme is positively overwhelming. I have developed the habit of collecting and keeping “good people” as my professional network expanded. I am a new leader – inspired, transformed and ready to face the challenges of making sure that the health services for the elderly is appropriate and spot on.