Finland to United Kingdom to Bahrain

MANAMA, Bahrain—There could be no greater contrast than between the lush greenness and clean air of Finland and the scorched, dehydrated, and dusty landscape of Bahrain. That contrast is even more striking when you have only 24 hours between the two places with a very short visit home. The visit home was even shorter than planned, due to being stranded in Helsinki by one airline, having to transfer to another airline and another city in the UK, and finding my way home after public transport was closed. Such are the joys of international travelling, which some look upon in envy. As ever, I thoroughly enjoy what I do around the world, but the process of getting there can be tedious.

Finland

I was in Turku, as I was last year at this time, to give sessions on writing for publication to postgraduate research students at the University of Turku. This time, it was a Journal of Advanced Nursing (JAN) show, as I was with fellow editor and Hull colleague Mark Hayter, PhD, FAAN, professor of sexual and reproductive health at the University of Hull. The sessions were enjoyable, and the students interacted well.

The weather was fantastic, the food excellent, and it is always good to catch up with international colleagues. If there is a link between Turku and Bahrain, it is the open-access journal I edit, Nursing Open. One of the editors, Riitta Suhonen, PhD, RN, works in Turku, and, here in Bahrain, I am with Seamus Cowman, PhD, FAAN, who is now head of nursing at RCSI Bahrain, affiliated with the Royal College of Surgeons in Ireland (RCSI). Cowman is another editor of Nursing Open and, incidentally, the first Irish nurse to be elected a fellow of the American Academy of Nursing.

Bahrain

Bahrain continues to develop since my previous visit and, despite the desiccated landscape and dusty Middle Eastern backdrop, it has paradisiacal elements as land is reclaimed along the coast and small, exclusive communities emerge. I should be used to living in hotels—not all of which are five-star, believe me—but the luxury of the Gulf Hotel, Bahrain, and the tranquility and service of its Platinum Club provide an insight into a lifestyle that, but for generous hosts, I will never be able to afford. The dilemma is: Do you eschew it for fear of getting used to it and missing it; or do you indulge, knowing it will rarely be on offer again? As I stare out over the night lights of Bahrain from the top floor of the hotel and the waitress pours me another (free) drink, I think you see how I solved the dilemma. I’m going to miss this one day!

The purpose of my visit to Bahrain is to work as an external examiner on the master’s in nursing programme at the RCSI. I examine the same programme in Dublin, and part of the job is to ensure that the same standards are applied in both locations, on behalf of the RCSI and on behalf of the National University of Ireland, which is the degree-awarding body.

The Nursing Open theme continues, as one of the editorial board members, Catherine McCabe, PhD, RN, assistant professor, Trinity College, Dublin, Ireland, arrives today in her capacity as external examiner for the undergraduate nursing programme. I am very pleased that my contract has been extended for another year and that I will also be starting as an examiner next month at Sultan Qaboos University, Oman. By sheer coincidence, my fellow examiner is none other than Cowman from RCSI. The Honor Society of Nursing, Sigma Theta Tau International (STTI), is represented here by the relatively newly formed Rufaida Honor Nursing Society, which is seeking to become a full chapter of STTI. Catherine O'Neill, senior lecturer, RCSI Bahrain, played a major role in establishing it, along with local colleagues.

Running, climbing, and football

My efforts to get out on the rocks are being thwarted by an inordinate amount of travel, both in and out of the United Kingdom. This is probably the busiest year of my life. However, I continue to train indoors, and combine rock climbing with running. Finland was a joy to run in, but my 0530 run today in 30 degrees Celsius (86 degrees Fahrenheit) to avoid the sun, had me almost at my physiological limits. I don’t understand why this should make your legs feel as if they had lead weights attached. In addition, the expatriate workers waiting for their transport to work shared incredulous looks as I panted past. To make a living, they are forced to work in this heat. I could be in bed in an air-conditioned room.

Finally, the UK football (soccer) season has ended, and the highlight of the English season, the Football Association (FA) Cup included, for the first time in the club’s 110-year history “The Tigers,” my local Hull City team. The match was played at Wembley, the 90,000-seat national football stadium in North London. The opposition was the mighty Arsenal, a North London club, and 25,000 of us made the journey south to watch the game, including the three Watsons pictured.

We lost, but only after taking a 2-0 lead and taking them into a period of extra time. Nobody expected that, and I think we were happier than the Arsenal fans. We stayed to see Prince William award the FA Cup runners-up medals and departed, elated. My voice took a week to recover, and I look back on what was, surely, a once-in-a-lifetime experience.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

Another quick visit to Rome

I was in Rome again this week to attend a conference. I missed by one day the 4 million visitors who were here for the double papal canonisation (Pope John XXIII and Pope John Paul II) on 23 April in St. Peter's Square. To non-Catholics, these events are unfathomable, and the ordinary “Catholic in the street” would have difficulty explaining the criteria, the significance, and the effect, if any, on their lives. As one of them, I won’t try to enlighten you.

The weather in Rome was a pleasant change from the U.K., where we are still having subzero Centigrade nights and the garden (the “yard”) is still a place to be endured rather than enjoyed. The conference, held in the Italian Ministero della Saluta (Ministry of Health), was run under the auspices of IPASVI (Nursing Board of Rome) and showcased the work of the Centre of Excellence for the Development of Nursing Research.

The research theme focused on the importance of nurses in feeding patients and contributing to health, and Gennaro Rocco, president of IPASVI, outlined the work of the centre. Since 2010, they have produced an impressive 82 publications from 48 funded projects, a great many in top journals and most in collaboration with other disciplines. Italian colleagues bemoan the poor state of academic nursing in Italy. I know everything is not perfect, but something seems to be working, and this is largely due to President Rocco.

The location of my accommodation was not ideal for running, but I managed to piece together two 3-mile runs early in the morning. Following my first half-marathon (see previous entry), I realised I was not as fit as I thought I was. So, I’ve been studying Run Fast: How to Beat Your Best Time—Every Time, by Hal Higden, and learning the difference between repeats and intervals—not the same thing—and what “fartlek” training is. If you sniggered at fartlek, go to the back of the class. It’s a real word; Google it.

Another review of UK nursing

I tried, without success, to take some days off at Easter, but, at least, I was mainly able to work at home. Once again, just when I thought it safe to read the newspapers without risk of stroke or heart attack, I see another review of nursing education has been commissioned by the U.K. government. The review will be led by Lord Willis, who led a commission on behalf of the Royal College of Nursing a few years ago. That commission looked at preregistration nursing education and came to the conclusion that there is no evidence that being an educated nurse means you are an uncaring nurse. It seems that this new commission will review all aspects of nursing education with a view to recruiting into nursing older candidates with the “right attitude.”

This strays into the territory of the Lancet Commission I will be leading, which I do not mind, but this newly commissioned review begins with the premise that there is a problem—that nurses are not caring enough and that they have little regard for patient dignity. These things may be true, but I am determined that the Lancet Commission is distinguished by the fact that it is not out to solve problems. It does not start from the premise that there is a problem—we don't deny there may be one. Instead, we want to see—whatever the current state of nursing—how best we can prepare nurses from registration throughout their careers to meet the challenges of the next 20 to 30 years.

Bad news

I mentioned in a previous entry that I was revising a research grant application for the Alzheimer’s Society. The proposal was duly revised, resubmitted, and rejected. I have never expressed irritation to a grant-awarding body in the past, but I did this time on the basis that I considered they had wasted my time. Everyone feels angry and let down when a research proposal representing months of works and investment of time and hope is rejected, but the task I was given was huge and the space in which it could be accomplished a challenge, and I failed—apparently. Back to the proverbial drawing board.

On the bright side, I have had several papers published, the most recent being one where, along with my co-authors David R Thompson, PhD, FAAN, Wenru Wang, PhD, RN, and Rob R. Meijer, PhD, we looked at issues affecting measurement of a property called invariant item ordering in the Mental Health Inventory. It was published in Personality and Individual Differences. Reviewer comments were extensive and very helpful, and, in the process of revision, we were asked to consider something that was new to me—person-item fit (PIF).

I contacted my Mokken scaling colleague Rob Meijer in the Netherlands, who has written about this. It just happened that he was developing software to analyse the kind of data I was looking at. In fact, he ran it for me and joined in authorship of the paper. Since then, his colleague Jorge Tendeiro, PhD, provided me with a link to the software and the syntax to run it. 

They also provided me with a draft article (“Practical Guide to Check the Consistency of Item Response Patterns in Clinical Research through Person-Fit Statistics: Examples and a Computer Program”) they wrote for people like me who may not, unlike them, have the programming and statistical knowledge to do these things without a lot of help. In fact, the paper quoted what I said to Meijer when I read one of his papers on PIF: “I have read the 2001 paper; frankly, most of this is beyond me and Google is not much help.” My ignorance has spurred a paper, and I was glad to be of service.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those promoting products or services will not be posted.