Looking back on the American Academy

HULL, United Kingdom—Ten days and 11 flights after leaving the U.K., I returned, accompanied by a virus that floored me for four days. I hope I contracted it in the United States and not China, where airport posters warn of the dangers of some local strains of Avian flu.

The first sign I was ill showed up in Boston; I nearly fainted during a five-mile run along the Charles River. Previous runs in Washington, D.C., had gone well; this was a struggle. But for a welcome lamppost, I would have hit the ground. My flight home from Boston’s Logan Airport is a blur, and I hope that what I attributed at the time to jet lag and exhaustion has not infected too many other passengers. That was the low point of my recent round-the-world trip.

The high point was attending the 40th Annual Meeting of the American Academy of Nursing and seeing colleagues being inducted into the academy. The following pictures, all featuring Yours Truly, celebrate the event.

Joyce Pulcini, PhD, RN, FAAN, of George Washington University (left)
and Yours Truly with Sally Wai-Chi Chan, PhD, RN, director of Alice Lee Centre
for Nursing Studies in Singapore, who was recently inducted into the American
Academy of Nursing. Chan was sponsored for membership in the academy by Pulcini and Elaine Amella, PhD, RN, FAAN, of Medical University of South Carolina. Amella, one of my own sponsors in 2007, was unable to attend.

Chan (center) and Yours Truly (far right) with Courtney Lyder, ND, FAAN, dean, UCLA School of Nursing, Los Angeles (second from right); Rob Fast, director of operations at UCLA School of Nursing and Lyder's personal assistant (far left); and Mark Hayter, PhD, RN, also newly inducted into the American Academy of Nursing. Hayter is a colleague of mine at the University of Hull and one of the editor's of Journal of Advanced Nursing.

Rita Pickler, PhD, RN, PNP-BC, FAAN, also an editor of Journal of
Advanced Nursing, with Hayter and Yours Truly.

I always consider my fellowship in the American Academy of Nursing as one my greatest honours. I was among the first three non-U.S. citizens to be inducted in 2007, the first from the U.K. and Europe. While international fellows have been unable—until now—to sponsor our own fellows, I have been instrumental, most years, in successfully organising sponsors for colleagues, including David Thompson of the Australian Catholic University and Seamus Cowman of the Royal College of Surgeons in Ireland.

Recently, however, the academy has decided to make its growing band of international fellows full members, charging us appropriately, but also affording us the right to sponsor our own fellows. There was some resistance to our initial entry, thus the two-tier membership for the past five years. Likewise, there was some resistance to this latest move. While lamenting the full fee—I’m Scottish—I publicly welcomed the move to full membership. I think it will increase the number and importance of the academy’s non-U.S. fellows. My previous hope—and efforts—to establish a forum for international fellows in the American Academy of Nursing may now be realized.

I see that dates for next year’s academy meeting clash with an invitation to Australia I have already accepted. I love Washington, D.C., now the permanent home of the academy’s annual meetings, and I will miss my 2014 visit. Anyone who doubts what America has achieved since independence only need visit Washington. The view of the capitol building from the National Mall—and vice versa—is one of the most impressive in the free world. I usually take in the White House and nod to the occupants, walk round the National World War II Memorial with gratitude for our allegiance, hold back tears at the Vietnam Veterans Memorial, and “have a dream” as I ascend the steps to the Lincoln Memorial. I guess all this will still be there the year after next.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

UK to USA via China

JINAN CITY, Shandong Province, China—If anything exemplifies the Chinese character, it is their behaviour in elevators. Most Westerners walk to an elevator, select a floor, and wait for things to happen. Not the Chinese. They run into elevators, select their floor, and immediately press the “> <“ button to close the door. Beware; in China, these buttons actually work! In the UK, they are buttons with no obvious purpose; most of us suspect they are not connected.

So, entering an elevator with a Chinese person in it requires rapid reactions and split-second timing. If you are some distance from the elevator, do you run, or do you wait? Getting that wrong could mean bruised elbows as the doors slam shut (another feature of Chinese elevators) and little sympathy from the occupant. If you get close to the elevator before the door slams shut, you may have the opportunity to press the call button and retain the elevator, incurring the wrath of the occupant or occupants.

The Chinese seem very impatient in their daily lives; everything happens at breakneck speed: driving, walking, speaking, eating, and thinking. To some Westerners—this one included—it can be exhausting. Retiring to your hotel room at night is like heaven.

But I love the Chinese people. They fascinate and frustrate in equal measure, something I discuss regularly with my Chinese colleagues. As the old cliché puts it, China is a country of contradictions, and these contradictions are everywhere.

On the one hand, it’s a nonindividualist, collective culture where, on the other hand, people drive with little regard for other road users. On the one hand, it’s a health-obsessed culture where taking exercise is highly regarded and each food is considered healthy for one spurious reason or another, this juxtaposed, on the other hand, against astonishing levels of tobacco use and alcohol abuse (amongst men). At a more prosaic level, Chinese adherence to modesty in dress and sexual mores is puzzling. When using the washroom in the school, I stood at a male urinal while the students I had been teaching (predominantly female) stood next to me and washed their hands, as if a more-than-middle-aged gent did not have enough problems.

Since my last entry, I have been back to the United Kingdom to teach, supervise, and hold meetings. I am ultimately heading for the annual meeting of the American Academy of Nursing in Washington, D.C., but I took the opportunity to return to the Far East to make one of many visits to Shandong University School of Nursing. These visits are intended to promote the Journal of Advanced Nursing, but I was asked to do some teaching and delivered a session on statistics to Master of Nursing students.

Yours Truly, Florence, and friends.

I am always surprised to see the large bust of Florence Nightingale in the foyer to the school; another contradiction. What place this Western epitome of class, privilege, and Christian values has in atheist, communist China is hard to fathom. And nobody here can explain. China remains a communist country; students of all subjects at the university have to study Marxism. Official dinners, such as my welcoming banquet, are attended by the director of the School of Nursing, who is a Communist Party official. Every school has one. On the other hand, China has a free-enterprise economy, one of the strongest in the world, although its success is viewed here as an outcome of communism. Outside my hotel, I saw an old man rummaging through a garbage bin. Chinese communism/capitalism—whatever it’s called—has been successful, for some people.

The pollution here is very bad. Even my host admitted that Jinan is one of the most polluted cities in China. I arrived on a warm day with the usual blue haze in the sky. After a three-mile run near my hotel, the taste in my mouth was terrible, my eyes were stinging, and my throat hurt. The following morning, the rain came, and the clouds concentrated the pollution at a very low level. The fumes literally choked me, and I got an idea of what some of the industrial cities of England must have been like before the Clean Air Act. We have largely lost our heavy industry, as European manufacturing has moved on a large scale to China, the rest of the Far East, and Southeast Asia—and they are paying the price. The rain did, however, clear the pollution for a day, and I faced a beautiful clear morning on my third day. It felt like winter—perfect for running—but the effect in my respiratory system was the same. 

Before the rain.

After the rain.

While working out a round running route through my part of the city, I had the added pleasure of finding that, for motorcycle users—going at, yes, breakneck speed—the distinction between the road and the pavement intended for motorcycles is flexible. This uncertainty was compounded by pavements suddenly giving way to unguarded storm drains and then ending at busy junctions, with no obvious sign of a safe crossing. Next time, I may eschew running altogether but, at least, I got mainland China on my Garmin GPS webpage, and I intend to get the USA on the same page with runs in Washington. D.C. and Boston over the weekend.

Great news to end this entry! I just received an email from Rob Fast, the PA to my good friend Dean Courtney Lyder of UCLA School of Nursing, inviting me to dinner at 701 Pennsylvania Avenue on Friday night. Last year, this topped the best restaurants Washington. I feel like an A-list celebrity.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Heat, humidity, and innovation

HONG KONG—The ability of Hong Kong residents to fall asleep instantly on a train and awaken at their station amazes me. This week, I am living in Sha Tin, in the New Territories of Hong Kong, and commuting to Hung Hom to work at The Hong Kong Polytechnic University (HKPU). The 20-minute train journey, which begins at Lo Wu, on the border with mainland China, is packed in the mornings. Those who get a seat simply close their eyes and sleep. Most of those standing stare at the screen of their mobile phone. I simply cannot imagine the Far East and Southeast Asia before the mobile phone. It is the same wherever I go in this part of the world. Whether in Japan, Singapore, Hong Kong or Taiwan, the people’s dedication to mobile technology puts even my own technology-addicted children to shame.

Hong Kong Polytechnic University is a lively place. Recruitment days, graduations, celebrations—there is always something happening in its concourses. In a decade of visiting this campus, I cannot recall a time when there was not a new building being erected. To the present, these have always been in neat red brick. However, the most recent addition is Innovation Tower, which is drawing attention in the design world.

Innovation is a key word here, and it is also demonstrated in the exclusive Hotel ICON, built by HKPU to train students of hotel management in the environment of a five-star luxury hotel. The basement Asian buffet is great for lunch and, over dinner, the views from the high-level Above & Beyond are fabulous. HKPU has recently entered the Twittersphere and has been tweeting about our visit and our seminars.

The schedule at HKPU is heavy. I am here with my University of Hull colleague Mark Hayter, PhD, RN, to teach in a preregistration master’s nursing programme. But teaching here is not the same as back home. In the Far East and Southeast Asia, it is rare for students to ask questions in class; they would never dream of interrupting you. Instead, they queue up after the lecture and ask questions, individually. Generating audience participation is virtually impossible, and the most direct question is usually met with silence. This difference in culture is one adjustment you have to make to your teaching here; everything is very formal.

Alex Molasiotis

Students enrolled in the programme are all graduates and employees of the prestigious Hong Kong Sanatorium & Hospital. Luckily, the hospital has requested that some of the teaching be provided by international scholars, so, for several years, we have visited twice annually. The students are bright and challenging, with varied academic backgrounds. They are a pleasure to teach and have no difficulty asking questions, but always after the lecture. I was pleased to hear from Alex Molasiotis, PhD, RN, head of the school of nursing, that the contract has been renewed for a few years.

Mark Hayter focuses on qualitative methods and I on quantitative methods. Therefore, my sessions cover the concepts of measurement, study designs, and statistics. I also give a presentation to new intakes of master’s and undergraduate students on a systematic approach to studying anatomy and physiology. This is something I want to work up into a more concise presentation and then publish something to accompany it.

I have published several books on anatomy and physiology, but I have a passion to convey the logic of anatomy and the relationship between structure, function, and control. As I write for my “Four things about ...” blog, which is about a simple approach to anatomy and physiology, I am encouraged by the number of hits (87,335). There was a public holiday during our visit, and I used the time to revise one of my online lectures on homeostasis, which is linked to the blog. We were both invited to give seminars; Mark delivers one on sexual health, and mine is on activities of daily living.

The weather is unusually warm for this time of year, and the humidity is high. Local colleagues assure us that it is getting cooler, but running for several miles means you end up drenched in sweat and severely dehydrated, with a core temperature above the physiological norm. Even after a cold shower, it takes an hour to cool down. If you arrive at a social event within that hour, you look as if you have been swimming—fully clothed.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.