03 December 2015

Sandstorms and traffic in Riyadh

RIYADH, Saudi Arabia—Arriving at King Khalid International Airport in Riyadh in the early hours of last Sunday impressed on me just how different this place is from anywhere else I go. The streams of young ladies in various queues are stopped past immigration and have their passports confiscated. This violation of human rights means they are the indentured maids of Saudi families. Misbehaviour of any kind ends in corporal punishment, or worse.

Yours Truly with Assistant Professor of
Nursing Joel Gonzales Patalagsa, RN,
of King Saud University.
The other side of Saudi Arabia becomes visible when my Indian driver shakes my hand, this followed by a charming young man in full Arab dress who also welcomes me to Riyadh. The latter is Fayez, the unfortunate member of the teaching staff at King Saud University who has been tasked to meet me. It is 3 a.m. before I arrive at my hotel. Fayez is clearly getting the rest of the day off; I am not. Three and a half hours later, I am up and off to meet the dean of nursing. I had my revenge on poor Fayez, however. My driver had no idea where to take me—nobody gave us instructions. We took in a great deal of Riyadh before I phoned Fayez, waking him up to get directions.

The dean is Associate Professor Ahmad Aboshaiqah, PhD, RN, whom I met earlier this year on a previous visit to Riyadh. Aboshaiqah, who lived in the United States for 10 years and whose doctorate was supervised by a mutual colleague, Marilyn Oermann, PhD, RN, FAAN, commiserates on the loss of my good friend here, Professor James Ware, FRCS, who died a few weeks back. I knew Ware in Hong
Professor James Ware,
8 July 1941 – 9 October 2015
Kong, his death was sudden and, as everyone here confirms, a great loss. He led the team responsible for medical examinations at the Saudi Commission for Health Specialties and also established the Journal of Health Specialties. I wrote his obituary for the journal, and that will be published soon.

Where are the women?
I am on my first visit to King Saud University to advise staff members on writing for publication. Everything is done twice, as there is strict separation of male and female students and, therefore, male and female staff members between the main campus and the “girls’” campus. Apart from the Arab dress and Arab manners—ultimate politeness to visitors and brusque orders to junior staff—everything is quite normal with the men.

To enter the girls’ campus is to enter another world. There is not a glimpse of an undergraduate student and no view of the actual campus, which is behind high walls and large double doors at the end of long corridors. I am in an outer sanctum where men may wander freely and only staff members and masters’ students may venture. Most women—staff and students—are in the hijab, with only eyes visible, which makes it very hard to know who is speaking.

There are few non-verbal clues to indicate what they are thinking. I also keep introducing myself to people—without a handshake—who tell me that I had already introduced myself. There is continual and distracting adjustment of the abaya, the yashmak, and the headdress and, as Arab women do not project their voices, I am both confused and exhausted by the end of two days. However, in two-to-one consultations—no female meets you alone—I was able to advise on research projects and manuscripts and answer questions about master’s and doctoral study at my university.

There is virtually nothing to do in Riyadh. Where alcohol might take the edge off a long evening for me elsewhere, it is not available here. To pass the time, you work your way through a series of tooth-rotting and waist-expanding sickly sweet fruit drinks and mountainous plates of food. Walking is virtually impossible. Pavements—where they exist—are badly kept and where there is construction, piles of bricks, tiles and sand block your way. Magnificent buildings tower into the night sky, but getting to them on foot is impossible and an incipient sandstorm makes being outdoors unpleasant. Crossing the road to get to something that looks interesting is life threatening, as indicated in this podcast clip. There was a gym at the hotel, so I managed to burn a few calories in the evening.

I will be in Saudi at least three times this next year, with one of those visits to King Saud University. I visit Oman in January and Qatar in February, so it seems that the Far East is becoming less of a venue for me as the Middle East becomes more prominent. With the world the way it is now, I am frequently asked about my personal safety. People unfamiliar with the region cannot distinguish between Arab and terrorist, between Moslem and Islamic extremist. The religion may seem incomprehensible and aspects of the culture repellant, but every person who declines contact isolates the region further. As for personal safety, if I change my schedule or the places I visit, I hand a minor victory to the merchants of death.

Good news and bad news
As the joke goes, do you want the good news or the bad news first? The UK government has decided to do two things with nursing education that make perfect sense to me, one of which I have long advocated. Nursing students are paid bursaries by the National Health Service (NHS) to study nursing, and this will end. Despite progress made in moving nursing to universities and the move to all-graduate entry to the profession, we have never completely broken the link to the idea of the hospital apprenticeship model of training. Most other students have to fund themselves or take out loans, which are repaid when they enter employment. The UK is unique. In the United States and Australia, nursing students have to finance their studies at university like any other student. There is evidence—admittedly anecdotal—that some students come into nursing only to be paid the bursary, with a low commitment to the profession. These reports come from fellow students. It has always seemed wrong to me that, in a situation where we are heavily oversubscribed to nursing programmes, that we may be turning away people with a genuine commitment in favour of people doing it for the bursary.

The other thing that will change, mainly as a result of this change in funding, is that the cap on nursing places in universities will be lifted, as it has been lifted for other subjects. Universities can now take as many nursing students as they can manage. These moves are proposed as a response to nursing shortages and the high levels of non-UK nurses working in the NHS. These proposals were raised in a report titled "Supplying the demand for nurses" by Edmund Stubbs, whose credentials include four years working as a health care assistant. When I downloaded my copy, I opened it with relish. Thus ends the “good news.”

Expecting to find a good read, I was horrified to find language that was highly insensitive toward non-UK nurses, inappropriate nationalism, and complete misunderstanding of how nursing education is organised. The insensitive langauge came in the form of negative stereotyping of non-UK nurses who work in the NHS. Stubbs describes how many go home after working for a few years, as if they were to blame for being recruited, many leaving the poverty of their country to earn money elsewhere and support their families. This seems like a very acceptable form of foreign aid to me. 

The nationalism was apparent in the suggestion that, while those who choose to work in the NHS should have their loans repaid, those who work abroad should not. There is no logic to the NHS repaying the loans. I fail to see how this represents a cost-saving (which is at the heart of the report), and it continues to set nursing students aside from other students. Bribing nurses to remain in the NHS by creating a financial differential is just wrong. If we want to encourage nurses to work in the NHS, we must make it a better place to work, and if we want to stop nurses from working overseas, then what about our contribution to global nursing and how do we ensure that nurses gain international experience that they can bring back to the UK?

Finally, the report suggests that increasing the number of nursing students will be beneficial to the NHS as cheap labour. This is ludicrous and, in any case, nursing students have been “supernumerary” for nearly 20 years and are not included as part of the nursing workforce. The author makes no mention of this or about how nursing students will receive adequate supervision in clinical practice. I assume he is unaware of the issues. I wish I could end on a higher note, but, but except for this blog and podcast, where I describe fully what I think of this and some recent research on non-UK nurses working in the NHS, I find myself—finally—lost for words.

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.

12 November 2015

St. Martin's summer in Genoa

GENOA, Italy—Following my return from Australia, October was spent mainly in the UK. Early November finds me back in Genoa, Italy for my final visit of 2015. My visits for next year are planned already. The weather is exceptionally good, and I’m assured this is St. Martin’s summer—a warm spell in early November during the feast of St. Martin before the weather turns cold. I made the best of it with several early-morning runs along the coast.

Mary Seacole Leadership Awards
Soon after returning from Australia, I was in London for the  Royal College of Nursing Mary Seacole Leadership Awards. The event was held at the Royal College of Obstetricians and Gynaecologists (RCOG) in London’s Regent’s Park, and it was a bit like revisiting the scene of an accident. The 2008 UK Research Assessment Exercise Nursing and Midwifery subpanel meetings oscillated between the Royal College of Surgeons and the RCOG, both in Regent’s Park, and while I enjoyed my time on that panel, the work was hard and prolonged.

Parveen Ali describes her project
at the Mary Seacole Leadership
Awards ceremony in London.
I was invited to the awards ceremony by my very good friend and colleague Parveen Ali, PhD, RN, senior lecturer, University of Sheffield, one of the recipients in 2014. In addition to receiving her award at this event, she also presented her excellent project on the use of multilingual nursing staff as translators in UK hospitals. Her interest in the subject arose when she was working for a telephone triage service—since discontinued—called NHS Direct. A native of Pakistan, she is a fluent Urdu speaker, but when an Urdu speaker called, she was required to transfer them to a translator. Listening to the translators, who were not nurses, she often heard them misunderstand callers. These services cost a great deal, and she wondered why the National Health Service did not utilize the services of bilingual nurses, both for telephone services and in clinical practice. For her project, she reviewed the policies of many NHS Trusts and found much the same policy—with some anomalies—across England. Her study raises some very interesting points.

Genoa
Links between my own University of Hull and the University of Genoa are strengthening. Our previous dean made a visit with me last year, and colleagues from Hull are working, albeit at a distance, with Genovese colleagues on translation and validation of a questionnaire designed to help in health promotion related to melanoma. Mark Hayter, PhD, FAAN, my colleague of many sojourns to the Far East and a Journal of Advanced Nursing editor, visited two weeks before me and, like me, has a programme of visits planned for 2016 and has also established collaborative projects.

My week here has been spent working with colleagues on a range of research and writing projects and teaching research students about writing for publication. The next visit, which will bring Hayter and me here at the same time, is in February 2016.

Pain
My running continues, but climbing of all sorts and gym work have ceased, because of a deltoid muscle-rotator cuff injury. I can’t pour water out of a kettle, shake hands, use a mouse and keyboard, turn over in bed, or scratch my head without extreme pain. Although I am having physiotherapy and taking some very powerful antiinflammatory medication, I’m still in pain.

Next week, I will be Aberdeen, on the north coast of Scotland, the city of my birth, to take part in a review of the nursing and midwifery education provision at Robert Gordon University. I’m hoping that will be the final flight of 2016, but it looks like I may need to go to Saudi Arabia in late November or early December. Next week, I also celebrate my 60th birthday with family and friends at home in Hull, and then I look forward to a long break at Christmas before traveling to Oman the first week of January.

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.

17 October 2015

Waltzing Matilda

SYDNEY AIRPORT, Australia—Sydney’s Qantas First Class Lounge is my favourite airport lounge in the world. Not only is it the untrammelled luxury, it is also the view. From where I’m sitting, I can see the classic outline of the Sydney skyline across a superb view of the airport with planes constantly on the move.

I have been in Australia as a guest of the School of Nursing and Midwifery, University of Newcastle, New South Wales. My good friend and colleague, Sally Chan, PhD, RN, FAAN, invited me for the week as an international visiting research scholar. I also hold a conjoint professorship at the University.

Double happiness
The occasion for my visit is the 25th anniversary of the School of Nursing and Midwifery, which coincides with the 50th anniversary of the university. Professor Chan describes it a “double happiness,” reflecting her Chinese heritage and referring to a very common and much loved Chinese symbol.

The week also coincided with the 2nd Australian Nursing and Midwifery Conference. Held in Newcastle, it attracts delegates from across Australia, the Far East, Southeast Asia, and Sri Lanka. My job for the week was to entertain the staff for three days with seminars on the publication process and open-access publishing. I also gave a lecture on my favourite analytical method, Mokken scaling, captured for posterity on my podcast page.

At the conference, I provided a workshop on writing for publication, which I broadcast on Periscope TV. Twenty people joined us, but I forgot to set my iPhone to save, so that was lost to posterity. I won’t repeat that mistake. Finally, at the 25th anniversary celebration, I gave the keynote address, titled “Nursing education: attitudes and evidence.” This was an important occasion for the school as the Honorable Jillian Skinner, MP, New South Wales Minister for Health, was present, along with the vice chancellor (president) of the university and the pro-vice chancellor for health.

My keynote focused on the need to maintain university level education for nurses in the face of pressure in the UK to return to the “good old days.” I was very pleased that Skinner—daughter of a nurse—made it clear that, while there is such pressure in Australia, such a return will not happen during her term of office. Before my address, we were entertained with some highly original a cappella singing, including a rendition by the university Echology choir of “Waltzing Matilda,” Australia’s unofficial national anthem.

Otherwise
It was not all work. On my first day in Newcastle, we visited Hunter Valley, famous for its vineyards. I tasted some of the best wines I have ever had. Apparently, you sip a little and pour the rest out, which seems like a waste to me. I slightly regretted my cabin-luggage-only policy, as I could not take any back with me. Some of my Australian family came to visit, and I ran a total of 22 miles along the waterfront this week. This was my first time in Newcastle. It will not be my last.

Yours Truly with Professor Sally
Chan in the Hunter Valley vineyards.


The smile on my face speaks volumes.


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

18 September 2015

Packing 'em out in Finland

KOUPIO, Finland—A family wedding (our son Thomas), two visits to Ireland, and one to Finland have taken place since my last entry. The wedding photographs are well aired on family Facebook pages, but I thought it would do no harm to share one here. My talented sister-in-law made the wedding dress.

From left to right: Charles, Joseph, William, Yours Truly, Thomas,
Sally, Deborah, Hannah, Lucia, Amelia, and Rebecca—all Watsons!

Ireland
The visits to Ireland, made in close succession, were for the purpose of participating on an interview panel for a senior academic position at University College Cork (UCC) and to attend an examinations board at the Royal College of Surgeons in Ireland (RCSI).

I worked in Ireland for six months—from 1998 to 1999—but when the “Celtic Tiger,” the rapid economic expansion that took place in Ireland between 1995 and 2000, inflated house prices and kept my family stuck in Scotland, I had to retreat back to the United Kingdom. Nevertheless, I have maintained regular contact with the Republic and make several visits annually.

Cork is a beautiful place, and I was very grateful to the UCC for two nights—my second stay—in the five-star, family-run Hayfield Manor. In Dublin, I have said goodbye several times to the RCSI at examination boards, but I keep being asked back and have no complaints. It was a pleasure to introduce a good colleague, Parveen Ali, PhD, RN, lecturer in nursing at the University of Sheffield, to Dublin and to have dinner with Catherine McCabe, PhD RN, assistant professor in nursing at Trinity College Dublin, with whom I have worked in Bahrain.

Finland
After a weekend at home, I flew to Helsinki and on to Koupio to spend a few days at the University of Eastern Finland. My host here has been Mari Kangasniemi, PhD, RN, with whom I had breakfast in Rome a few years ago at a conference. I am always pleasantly surprised how these unplanned encounters lead to future collaboration.

I gave two classes here, one to assembled masses of doctoral and master’s students in health on how to attract a reader’s attention in a manuscript. (To listen to this lecture as a podcast, click here.) I am rarely able to say that I packed out a lecture theatre, but I did this time. People were sitting on the floor and out in the corridor, and I was asked some excellent and challenging questions at the end.

The point I made about attracting readers’ attention in manuscripts is to realise who the initial readership is—first, the editor-in-chief and then the other editors and reviewers. If you do not take these people into account, your ultimate intended readership will never see your work. My second class, which was more sedate, was a dialogue with the doctoral students in nursing.

Future plans
After I return to the UK, I have no further travel planned for this month. Next month, I go to Australia and possibly Hong Kong and, if plans work out, Saudi Arabia in November. I look forward to teaching my online module in quantitative methods at the end of this month and getting reviews back on the manuscripts I’ve submitted in recent months.

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.

09 August 2015

Humidity and humility in New York

HULL, United Kingdom—Unusually, I’m at home in the UK. My holiday with Mrs. Watson (Debbie) in New York was one of the highlights of my life. Debbie, an experienced New York visitor, impressed me with her understanding of how the avenues describe latitude on Manhattan and the streets longitude, with Broadway doing its own thing at an obtuse angle. I loved everything we saw and did. I will spare you most of the details, but running in Central Park was a particular highlight that also provides the title for this entry.

On the way to New York, I said yes to everything that British Airways had to offer in first class, most of which came with champagne. Suffice to say I had no problem sleeping the first night. I woke at 6 a.m. and ran to Central Park, ran around it and then ran back to the hotel, a total of nine miles. I would not recommend this as a training regime, but it seemed to work.

Two days later, I tried to repeat this heroic feat—without the champagne—and had to stop after five miles. The humidity and temperature had spiked, and I discovered I was not Superman. It was a long walk back to the hotel followed by a long talk from Debbie, a much more experienced runner than me, about overdoing things. I’m glad to say I rallied for our last morning, got up at 5 a.m., walked to Central Park and completed the six-mile run without incident. I really felt like I was in a movie and expected to see Woody Allen or the cast from Home Alone at any point.

Our holiday started and finished in the Concorde Lounge at London Heathrow Airport, so it was fitting that we paid Concorde a visit in New York at the Intrepid Sea, Air &  Space Museum. Mrs. Watson in foreground.

Journal matters
I am glad to say that authors submitting to Journal of Advanced Nursing (JAN) and Nursing Open were not all on holiday, nor were my editors and associate editors. More than 50 manuscripts, at the various stages I engaged with them, awaited my attention, so I did not have to wonder what to do first. One of the proofs awaiting correction for JAN was an article by Snowden et al. (2015) on which I am second author. When I am the author of a JAN manuscript, I have no editorial involvement with the manuscript until it is accepted and at the proofing stage. This article reports on a study of the latent structure of emotional intelligence and the discovery of a novel dimension, evident using two entirely different analytical methods.

There was more good news for JAN. I listen to “Today,” the BBC flagship news programme, every morning from 6 a.m. (in bed for at least the first 30 minutes) and was startled at 6:45 a.m. (still in bed) by a mention of “the Journal of Advanced Nursing.” What followed was a report on an excellent article by Weldon et al. (2015) reporting on the effect that music played in operating theatres has on communication between members of the surgical team. The piece was also featured in the subsequent news bulletin. The study shows that music can be detrimental to communication. If you want to hear the coverage, I made it available with a short commentary in a podcast.

Also, I had to resume arbitrating between some authors who dispute ownership of a dataset from which an article was recently published in JAN. I find these disputes often take months to resolve, and I feel sorry for the doctoral student in the middle of this who hasn’t done anything wrong. Clearly, the dispute is at a higher level, but its resolution may well have an impact on the doctoral project.

Life goes on
Along with my wife and two of my sons, we spent a weekend in Scotland clearing my mother’s house. My mother recently moved to a nursing home in Hull and her house is for sale. There were plenty of laughs as we found things long forgotten in the house and reminisced. Some harsh decisions had to be taken about what was being removed and what was going to a local charity shop. However, the hardest thing for me was locking my father’s workshop and studio for the last time ever. The click of the padlock simply choked me and moved me to tears as I recalled the boats built, wood turned, watercolours painted and framed for sale.

My sons took a selection of items but we had to leave many of his beloved tools behind, some of which I recall watching him working with when I was a child; we have no room for them. We managed to find around 50 of his watercolours, and we have stored them. He died five years ago, and we all miss him tremendously. But life, as the cliché goes, goes on, and next week my daughter, who lives in Germany and who I rarely see, returns for two weeks for my son’s wedding. I have no travelling planned until September and look forward to this precious time with them and the rest of my children and grandchildren.

Reference
Snowden, A., Watson, R., Stenhouse, R., & Hale, C. (2015). Emotional intelligence and nurse recruitment: Rasch and confirmatory factor analysis of the trait emotional intelligence questionnaire short form. Journal of Advanced Nursing. doi: 10.1111/jan.12746

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.

10 July 2015

Between Sydney and Hong Kong

CATHAY PACIFIC FLIGHT 162—Another two-week visit to Australia is over, and I am bouncing back over Typhoon Linfa on the way to Hong Kong. Turbulence on my last few long-haul flights has been bad, and this one is no exception. Like all seasoned flyers, I try not to look worried.

I have been fulfilling my adjunct professor role at the University of Western Sydney (UWS) and visiting my family in Brisbane. The UWS occupies several campuses and, for the first time in many years of visiting, I was in Parramatta, a suburb of Sydney, the first week. Situated on the site of a former asylum—a “lunatic” asylum, as it would have been called—the Parramatta campus takes in many of the elegant buildings associated with the place’s former purpose, and the older buildings are complemented by many fine, modern buildings.

Yours Truly with Associate Professor Michelle
Cleary, who organized my visit.
Numerous mental health hospitals in Australia are located on the banks of navigable rivers, as lunatics were not permitted to walk on the Queen’s highway—these institutions were built during the reign of Queen Victoria—and had to travel by boat. A steep set of steps leads from the river to the campus, and I imagine this is how many people were led up to their new and permanent home. I met one of the senior managers of UWS last year and only just managed to stop myself from cracking the old “the lunatics are now running the asylum” joke. He had probably heard it many times before.

With apologies to the occupants of Parramatta, this is not the most salubrious suburb of Sydney, and one of the missions of UWS is to serve these communities. My hotel website boasted “access to a state-of-the-art gym.” There was access, but the gym was a mile into town, a walk I made each evening past less than desirable housing and youth that appeared intimidating. Some of my colleagues were astonished that I had ventured out of my hotel. I reckoned that the sight of an elderly man in shorts and T-shirt in temperatures just above freezing was enough to keep me safe. It was very cold, the coldest winter in Sydney in 17 years.

Family time
The weekend I spent in Brisbane was warmer. I feel blessed to have such a great family, who make me welcome. Apart from Christmas, it is one of the few times of the year I leave work behind, literally in luggage left at the Sydney airport, and spend time with family. I always come away grateful, a few pounds heavier, and with an increased knowledge of Australian wines and beers. (Someone has to do it).

But my time in Australia was not all fun. Back at UWS, I gave a day and a half of writing-for-publication workshops and two video-conference sessions, one on social media and the other on marking theses and dissertations. Otherwise, I held staff consultations about publication plans and kept up to date with editing and supervising—from a distance—my PhD, master’s and final-year students. Two of my PhD students, one from Taiwan and one from mainland China, have completed their theses, and I am arranging for their examinations, which, in the UK, is done by viva voce, otherwise known as the “viva”). The viva is a terrifying prospect for most students, so I expect anxiety levels to be high when I get back to my desk at the University of Hull.

Two busy weeks
I have two weeks of intense activity coming up. It has to be two weeks because, although I have many July deadlines, it is only two weeks before I go on holiday and take the long-suffering and mostly tolerant Mrs. Watson—it’s OK, she never reads my blog—to New York. For the record, this is the first time in 31 years we have been away together on holiday without at least one of our children. We have gone on work-related trips to the Far East and Southeast Asia, but, as I am frequently reminded, those “don’t count.” 

So, before that happens, I have a PhD thesis and a pile of scripts from the Royal College of Surgeons in Ireland to examine, a handover of my acting associate dean role to the incumbent who is now back in the role, Journal of Advanced Nursing author guidelines to revise, and lots of research data to analyse. I see the seat belt sign is on again, and I am trying not to look worried.

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.

22 June 2015

Hong Kong and Seoul

HONG KONG, SAR, China—I’m posting this from the Cathay Pacific First Class Pier Lounge at the Hong Kong International Airport. The Cathay Pacific flight from Manchester to Hong Kong (CX 358) was restored toward the end of last year, and this was the first time I had taken it with the intention of staying in Hong Kong. My previous use of the route was for an onward flight to China. The flight arrived at 6:30 a.m., and, to fight off jet-lag and avoid falling asleep, that made for a very long first day in Hong Kong. I tried going for a walk, which, in 75 percent humidity, lasted five minutes. Eventually, I surrendered at 6:30 p.m. and slept until 6 a.m. the next—my longest sleep in Hong Kong and my longest sleep for years.

I was back in Hong Kong for a second set of meetings with the University Grants Committee Research Grants Council. Most of the work of the committee is done in the four months before we arrive, and these are the meetings where final decisions are made. We also make an academic visit to one of Hong Kong’s higher-education institutes, and this year we visited, in a purely advisory capacity, the City University of Hong Kong. Otherwise, I caught up with old friends and colleagues.

Thomas Wong, PhD, RN, former vice president of Hong Kong Polytechnic University and an entrepreneur with his own consultancy business (GINGER Knowledge Transfer and Consultancy Ltd.) and health provider spin-off (Seamless Care), is the best value for money in Hong Kong and my oldest friend there. Little happens in nursing in Hong Kong and mainland China that Wong either does not know about or has not been instrumental in developing.

I also met Eric Lu Shek Chan, MSc, RN, GAPFON member and former deputy chief nurse at the Hong Kong Health Authority, now dean at Caritas Institute of Higher Education. Chan had planned to meet me in Seoul, South Korea, at the 2015 conference of the International Council of Nurses (ICN), but the Hong Kong government prohibited any health-related personnel from travelling to South Korea due to the MERS (Middle Eastern Respiratory Syndrome) crisis. The risks of becoming infected with MERS must rate similarly to the chances of winning the United Kingdom National Lottery. Made of stern stuff and with the proverbial British stiff upper lip, I decided to take my chances and head to Seoul.

ICN International Conference
This was my second visit to Seoul, my first several years ago in prohibitively cold, subzero temperatures. This visit was warmer but at a much more civilised temperature than Hong Kong. Conditions for running were ideal, and I recorded Seoul, Gangnam District, on my Garmin webpage.

I have attended ICN conferences before—in Taiwan and Japan—and this one bore the same overriding feature: It was huge. There were thousands of people there, the venue was enormous, and it was by luck much more than management that I ran into colleagues from the United Kingdom, United States, Italy, China, and Australia. I could see from Facebook, Twitter, and LinkedIn that many other people I knew were also there, but, despite trying, we never met. I was especially pleased to meet for coffee with GAPFON colleagues Hester C. Klopper, PhD, MBA, RN, RM, FANSA; Cathy Catrambone, PhD, RN, FAAN; Pat Thompson, EdD, RN, FAAN; and Cynthia Vlasich, MBA, BSN, RN. I also had lunch with Sally Wai-Chi Chan, PhD, RN, FAAN, featured in many entries passim from Singapore and China.

Pam Mitchell, PhD, RN, FAAN, University of
Washington; Sue Turale, DEd, RN, FACN, Ewha Women's University, South Korea; and Yours Truly struggling with that last course.















Sadly, my impression of Korean food, honed during my first subzero temperature visit, did not improve as a result of this visit. I simply cannot get the theme, appreciate the tastes, marvel at the presentation—and I’m British! However, it was not for want of trying, and I did enjoy one excellent dinner—mainly the beer and the company—hosted by my publisher, Wiley, through its Asia-Pacific office.

Leaving the best till last
Amidst all this fun and frivolity, something wonderful happened last week, and that was publication of the 
Thomson Reuters impact factors for 2014. My journal, Journal of Advanced Nursing, has increased its impact factor (1.741), its citations (12,024), and its ranking (10th place). Therefore, we can once again claim to be a top-10 journal. I would like to thank our authors, readers (especially those who cite us), our incredible team of editors, and the staff at Wiley.

The best news I've had in years!

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.

10 June 2015

First time in Valencia

HULL, United Kingdom—Most of the time, travel goes well. Sometimes, it goes spectacularly wrong, and Monday, 8 June, was looking as if it would fall into the “spectacularly wrong” category.

I arrived at London Heathrow’s Terminal 5 early in the morning after an overnight stay in one of the airport hotels only to be told that I had no seat booked on the flight—or any flight. Apparently, all the air miles and frequent-flyer status in the world will not get you on a flight it you have no ticket. The travel agent used by my hosts in Spain had issued several itineraries but had not actually booked and paid for a ticket. I found this out after several phone calls to Spain that, in order to sort things out, required the travel agent to open the office early. Had I been in Valencia, I would gladly have turfed the agent out of bed myself.

Like most Spanish cities, Valencia is magnificent.
Amedved/iStock/Thinkstock
Eventually, I caught a later flight for the same connection from Madrid to Valencia, meaning I had to do what I have done many times in the past: sprint through the terminal in Madrid to my connection. I made it. After recounting this to a colleague that evening on Skype, she described me as “the Daniel Craig of nursing.” With my accent, I had always been satisfied with being the Sean Connery of nursing, but I probably needed upgrading to a newer model.

Return to Spain
The international component of my nursing career began in Spain 25 years ago when I took part in a staff exchange programme between the University of Edinburgh and the University of Navarra in Pamplona. Thus began a love affair with Spain and the first of many professional and family visits to Pamplona. My oldest daughter, who studied nursing at the University of Hull and did an elective in critical care in Pamplona, has since worked exclusively in critical care and is well on the way to being a critical care advanced nurse practitioner.

This trip, however, was my first visit to Spain in nine years and my first ever to Valencia, located on the Mediterranean. Hosted by Universidad Europea Valencia, I was there to attend a public event at which a former PhD student of mine was making her case for promotion to associate professor. The former student—Silvia Corchón Arreche, PhD, MSc, RN—was one of the best I’ve supervised, and she sailed through the event. I was one of a panel of three external assessors. Colleagues and family members of the candidate were present, as was the rector (equivalent to president or vice-chancellor in the United States and United Kingdom, respectively). Before you ask if I can speak Spanish, the answer is no, but it is easy to read scientific Spanish, and I could follow the PowerPoint slides. When it came to questions, I was allowed to ask and be replied to in English.

I was accommodated in the historic quarter of the city, which houses many churches, markets, and a cathedral. Like most Spanish cities, it is magnificent. The temperature dropped from 49 C (120.2 F) to a cool 34 C (93.2 F) while I was there. Running was possible in the very early morning. A superb feature of the city, and surrounding the historic quarter, is the bed of a long-ago diverted river, complete with bridges, and it is ideal for running.

The return journey was uneventful, and I leave for Hong Kong and South Korea in three days. Dire warnings are being issued by the Hong Kong government about travel to South Korea due to the MERS (Middle Eastern Respiratory Syndrome) crisis, so I am hoping it does not lead to any restrictions.

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.

02 June 2015

Farewell to Bahrain

MANAMA, Kingdom of Bahrain—My four years as an external examiner at the Royal College of Surgeons of Ireland-Medical University of Bahrain (RCSI-MUB) are over. I may have said something similar last year, after three years as an examiner. However, I was invited to sit for a further year, and the absolute maximum is four. I am sorry to leave and will miss my visits to the island, but other opportunities are opening for me in the Middle East, to be reported in due course.

In addition to examining, I gave a workshop on scientific writing, after which I presented certificates to newly inducted members of the Rufaida Honor Nursing Society. Officers of the society recently met Hester C. Klopper, PhD, MBA, RN, RM, FANSA, president of the Honor Society of Nursing, Sigma Theta Tau International (STTI), when she was visiting the Middle East, and the local society is making progress in its bid for STTI membership.

New inductees of the Rufaida Honor Nursing Society.

Uncool running
I rose almost early enough on two mornings to avoid the sun but failed to escape it completely. At 5:30 a.m., it is in the low 30s Celsius (86 Fahrenheit), but during the day it has been as high as 40 degrees Celsius (104 Fahrenheit), and when the sun is up, it is impossible to walk, let alone run. Foolishly, I went running at 6 p.m. one evening before it had cooled down, and the ambient temperature was body temperature (37 Celsius/98.6 Fahrenheit). The rest of the story is nearly heat-stroke history.

It was hot in Bahrain!
When I ran recently in a more civilised temperature back home in England, I completed a 10 kilometres race in 46 minutes and 5 seconds, three seconds above my personal best. The 46-minute target continues to elude me. For the rest of the running year, I’m going to focus on breaking 21 minutes for 5 kilometres, something I want to achieve before I am 60 years old.

The next few weeks
Back home at the University of Hull, I am handing back the job of associate dean for research and enterprise in stages to the incumbent, who will resume the position in July. The role has not prevented me from travelling or missing the most important meetings that go with it. Essentially, there is barely a job that cannot be done remotely these days, and nearly all of the administrative aspects of the role were done online. Our faculty of health and social care is now under the leadership of Julie Jomeen, PhD, RN, RM, and I look forward to discussing the next few years—the final ones of my career—with her soon.

Over the rest of June, I visit Spain, Hong Kong, Korea, and Australia. I will report in detail from each of these places, but I am pleased to note that my link with the Hong Kong Polytechnic will continue. I had reported its end in a previous entry, but today I was invited to become a visiting professor again, but in a different role. The university has launched a massive open online course (MOOC) in anatomy, to which I will contribute. “Human Anatomy” is offered under the auspices of EdX, which involves prestigious partner universities such as Harvard and MIT in the United States.

The world needed another Watson
Two weeks ago, Alex Watson, my sixth grandchild—no granddaughters yet—was born to the delight of his parents and grandparents but consternation of his big brother Connor who seems to be tolerating this 100 percent increase in number of his siblings and 50 percent decrease in amount of attention he gets. Yours Truly also has to fight for attention. I can almost predict the welcome tomorrow: “Oh, you’re back. When are you away again?”

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

12 May 2015

Jasmine in Genoa

GENOA AIRPORT, Genoa, Italy—The scent of jasmine hung in the heavy, humid coastal air of Genoa. It was especially pleasant in the morning, when the flowers were opening, and was still in evidence as the sun went down. However, not everyone enjoys this. Many locals are allergic to the pollen. During my time here, the offices around me at the University of Genoa echoed to the sounds of repeated sneezing and Italian cursing.

This was my second visit here this year, and the weather was superb. Lemons were growing within reach of my window, and I was very tempted to slice one up for a gin and tonic. My 10k training finished at the sea front on the famous Corsa Italia, and I am now resting my 59-year-old legs before a race this weekend. Climbing, including indoors, has been neglected lately due to running.

The view from my window in Genoa.
My work at the University of Genoa with colleagues in the school of nursing continues to focus on the doctoral students with whom I am working on a rapid evidence assessment. These are not full-time students. Few live locally, and they meet only a few times yearly. Working hard at a distance, they retrieved and filtered some useful literature down to a few items that will form the basis of an excellent review paper, the topic of which will be revealed nearer to the time of submission. I averted a collective crisis of confidence, as they had convinced themselves that they needed to scrap what they were doing and start again. They are now back on track, and my visit, in this regard, was useful. Otherwise, I advised colleagues on their publication plans and research projects.

A new honor society?
I was asked about membership in the Honor Society of Nursing, Sigma Theta Tau International (STTI) by one of the faculty who believes this would be a good thing for Italian nurses. I agreed, given that there is no Italian chapter and no Italian members that I know of. They were astounded when, within minutes, I put them in contact by Twitter with STTI President Hester C. Klopper, PhD, MBA, RN, RM, FANSA, —who replied—and by email with Elizabeth Rosser, DPhil, president of Phi Mu Chapter in England. I see from my email trail that they already have advice from Rosser on how to join and set up a society here. As the saying goes, “Watch this space.”

Rejection
News arrived from a journal editor that a major manuscript, which I have been leading and which has already graced the editorial desks—briefly—of three other journals, has been rejected again. I had to heed my own advice about not corresponding with editors over rejections and simply to take any good advice on board and submit elsewhere.

Yours Truly tames the Ducati Monster in Genoa.
My co-authors, both much younger than me, kept me on track, but we were all astonished at a comment from one reviewer that defied all logic with regard to the method we were using and the principles we were addressing. Still, the experience was useful as, when I was taking a class with the master’s students in Genoa on scientific writing, I was able to say that I had just been rejected and was in the process of applying my fourth rule of writing: treat a rejection as the start of the next submission.

I don’t leave the UK until the end of the month, when I visit Bahrain and the fledgling Rufaida Honor Society at the RCSI-Medical University of Bahrain. Before then, I will be participating in an online series of lectures for International Nurses Day and presenting on “Global issues facing nursing” before travelling to London to take part in a forum at the headquarters of the Royal College of Nursing of the United Kingdom. The following week is spent mostly in Edinburgh, Scotland, where I will examine a PhD at the University of Edinburgh, give a presentation on research assessment at Edinburgh Napier University, and meet a research collaborator at Heriot Watt University. Between those sessions, I will catch up with as many colleagues as possible.

I mentioned in my last entry that my daughter was taking part in an international street dancing competition in Florida. Her team won, as did the junior team from her dance club, so that was a memorable visit to the United States. I’m also glad to report that the long-suffering Mrs. Watson and her itinerant husband will be taking a holiday in New York City in July. I have never visited NYC, although my wife has, and this will be her turn to show me around a foreign city.

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.

17 April 2015

Another side of Saudi Arabia

JEDDAH, Kingdom of Saudi Arabia (KSA)—At 2 a.m. the morning after my arrival, Saudi Arabia’s health minister, Abdullah al-Rabeeah, was removed from office by King Abdullah for claiming he did not know why the number of people with MERS (Middle Eastern Respiratory Syndrome) was increasing, thereby admitting he had been unable to address the problem. 

The unfortunate turn of events for al-Rabeeah meant I was one of the first people to meet his interim replacement, His Excellence Acting Minister for Health Adel Faqih, Saudi Arabia’s labor minister, who now serves in both roles. Faqih presented me, later that morning, with my “hadyyah” (gift) for presenting at The Second International Health Specialties Conference in Riyadh, KSA, sponsored by the Saudi Commission for Health Specialties.

Apparently some folk
think I'm OK! 
(Click photo to read text.)
According to colleagues here, the sacked minister, an engineer by background, was popular and had made a good impression on my nursing colleagues, some of whom met him. However, politics is politics the world over, and, frankly, honesty does not pay if you wish to keep your job.

International conference
My paper at the conference was on the difference ethics can make to health care, but I also gave a preconference workshop to 150 nurses and physicians on getting papers published. Among the attendees was my former PhD student, Mansout Alyami, who works at the Ministry for Health. The workshop was the most popular of the two sessions, with an additional 150 people being turned away.

This was especially surprising as I was competing for participants with such luminaries as Geoff Norman, PhD, of McMaster University who, I now realise, is one of the world’s foremost experts on medical education. I was very pleased to get to know Norman over the course of the conference, and his presentation on myths in medical education reinforced many of the things I had long held doubts about, such as learning styles, self-assessment, high-fidelity simulation (essentially a waste of money), and the predictive value of multiple-choice tests (turns out they’re pretty good). Norman, who backs all this up with evidence, has already sent me his portfolio of research papers and reviews on these issues.

Jeddah
After three days in the oppressive heat, oppressive atmosphere (especially for women), and dry dust of Riyadh, I flew to Jeddah on the coast to participate in a scientific forum at Fakeeh College of Nursing & Medical Sciences, where I presented three papers over two days. Another former PhD student, Wafaa Aljohani, who is a faculty member at the school, facilitated my visit. I also met former PhD student Samira Alsenany, who works at King AbdulAziz University, the oldest university in KSA.

A preserved building in the old town of Jeddah,
included in UNESCO’s World Heritage List.
 
Compared with Riyadh, Jeddah is a coastal paradise. In addition to the weather being cooler, it is less dusty and less oppressive in many ways than Riyadh. The population is cosmopolitan, and, because the city is close to the holy cities of Mecca and Medina, it is a tourist destination. This was my first sight of the Red Sea where, as the Old Testament describes, Moses parted the water and crossed from Egypt to the Promised Land. I can imagine that, all those thousands of years ago, this place did not look very promising.

International family
The Watson family is scattered across the globe. Another contingent is in Florida, where Mrs. Watson and our youngest daughter arrived this week. Our daughter is taking part in a street-dancing competition at Daytona Beach, and Mrs. Watson will continue training for the London Marathon.

My ambitions are modest by comparison. I am training for a 10-kilometre race, and managed to run 13 miles over four days along the seafront in Jeddah. My next visit to the Middle East is in May, when I go to Bahrain, but a visit to Genoa, Italy comes before that.

Podcasting continues, if you want to listen to my daily reflections on Jeddah. With my new Veho MUVI Mini Cam, claimed to be the smallest video camera in the world, I posted on YouTube a compilation of video segments, all in one 48-minute clip, that range from Hull to Riyadh. Persevere—or fast-forward—to take a cultural tour of Riyadh and hear the call to prayer going out.

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.