A good week for nursing

HULL, United Kingdom—I have just returned from a week in Genoa (Genova to the locals) in the Ligurian region of Italy, on the country’s northwest coast. Once again, I taught research students at the University of Genova and liaised with collaborators about various research and writing projects. My colleagues there have translated the Edinburgh Feeding Evaluation in Dementia scale into Italian, and I was helping them test its psychometric properties. This provides me with another database on which to run my own beloved method of Mokken scaling. The sample size is small, but the results are promising and point, as does most psychometric work, to the need for a larger sample. We should get a preliminary publication out of this work.

The most important nursing paper in Europe

Linda Aiken

I said it was a good week for nursing, and I was referring to the publication last week of a paper by Aiken et al. titled “Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study.” (Linda H. Aiken, PhD, RN, FAAN, FRCN, Claire M. Fagin Leadership Professor in Nursing, professor of sociology, and director of the Center for Health Outcomes and Policy Research, University of Pennsylvania, USA, is on the Lancet Commission on UK Nursing, which I will chair, as is another co-author of the paper, Anne Marie Rafferty, PhD, CBE, PhD, FRCN, chair of nursing policy, King’s College London, UK.) The paper, published in The Lancet, is one outcome of the RN4CAST study and, in addition to showing the effect of inadequate staffing levels on failure to rescue patients, shows—clearly—the benefit of degree-level education for nurses.

Alvisa Palese, MNS, BMS, RN, associate professor, Udine University, Italy, and I were among referees of the Aiken et al. paper, and we published a comment in The Lancet alongside it. I am pleased to have played a small part in such a seminal paper, a document many of us hope will have a profound influence on European nursing education and practice. Watch for further correspondence in the pages of The Lancet. My Italian colleagues have already submitted a letter and some “heavyweights” in Canadian, U.K., and Australian nursing are “limbering up.” (They emailed me the morning before I left Genoa.)

It has also been a good week for nursing in Italy. I’m a bit late with this news, but the first six nursing academics have just been given licences for employment as full professors. (I was able to confirm the numbers just this week.) Until now, nursing academics have been promoted only to the level of associate professor. It especially pleases me that Alvisa Palese, my good friend, colleague, and—ironically—research student, is one of the six.

The Italian process for appointing senior academics is national and very rigorous. A committee—the Abilitazione Scientifica Nazionale (ASN)—makes annual judgments on the basis of individual applications. Although I am one of an international panel of assessors for the ASN, I was not involved in this last round. The primary “unit of currency” for promotion is publications, and these must be in refereed journals with an international reputation. Those with impact factors are at the top of the hierarchy.

There is worrying news that the ASN is going to make future recommendations on the basis of an individual’s h-index, and there is a rumour that an h-index of 23 will be the requirement. I have been consulted by Italian nursing academics and organisations about this, because the h-index is something about which I have written. My view on the use of h-indices per se is that caution should be exercised. Moreover, I think an h-index requirement of 23 is ludicrous. Few academics attain that level, and it is especially the case that few nurses have attained it, or will. I’m glad to say I have, but only after a 16-year professorial career.

Next ports of call

Next week, I will be in Belfast to sit on the validation panel of a nursing programme at the University of Ulster, and I have dinner booked with Hugh McKenna, CBE, PhD, FRCN, FAAN, pro vice-chancellor, University of Ulster, UK. Later this month, I go to Basel for a long weekend to discuss issues that face nursing globally with Hester Klopper, PhD, MBA, RN, RM, FANSA, president of the Honor Society of Nursing, Sigma Theta Tau International, and a select group of colleagues. We’ll be meeting under the umbrella of GAPFON (Global Advisory Panel on the Future of Nursing).

I put more than 20 Genovese miles on my Garmin GPS watch, and I plan to add Northern Ireland and Switzerland for the first time this year. My 19-year-old son just broke 20 minutes for the first time in our local 5-kilometre parkrun race. Pressure to perform in my family is terrific, but what I like most is that none of my children—most of whom are runners and climbers—expect me to do any worse than they do. For your information, my fastest 5 kilometres is 21 minutes 38 seconds, and that was last year when I was a young man of 57. I am now 58 and have not broken 22 minutes this year, but I’m working on it.

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.

Anybody NOT in Hong Kong?

Hong Kong SAR, China—My first 2014 visit to Hong Kong was busy, mainly because so many other UK nursing academics were here. The list included: Hugh McKenna, CBE, PhD, FRCN, FAAN, pro-vice-chancellor (research and innovation), University of Ulster, UK; Dame Jill Macleod Clark, DBE, PhD, FRCN, professor of nursing, University of Southampton, UK; and Dawn Freshwater, PhD, RN, pro-vice-chancellor, University of Leeds, UK (soon to become deputy vice-chancellor, University of Western Australia). McKenna chairs the Research Excellence Framework’s subpanel for dentistry, allied health professions, nursing, and pharmacy, on which Macleod Clark, Freshwater, and I sit, and McKenna and Macleod Clark will serve on The Lancet Commission on UK Nursing, which I will chair. It’s a very small world.

Laifuyu/iStock/Thinkstock

Of course, we had to have dinner, and we were joined at Felix, one of Hong Kong’s most exclusive “high-level” restaurants (located at the tower atop world-famous Peninsula Hotel), by Kay Jones, MBA, chief operating officer, School of Health Sciences, City University London, UK, and Philip Esterhuizen, PhD, RN, lecturer in adult nursing, University of Leeds. The view over the harbour to Hong Kong island is eye-watering, the food to die for (I don’t think I have ever used that expression before), and the service unobtrusive and immaculate. The washrooms are a triumph, with surprises for both genders (best Googled rather than explained).

Amidst all this luxury dining and fun, this impromptu type of meeting, which involves colleagues who are as busy or more busy than me, is crucial. We have to take these opportunities, as nobody else provides them. Held without agenda, aims, or objectives, they are the most productive. Untrammelled by organisational issues, hierarchy, or the need to list tangible, bean-counting outcomes, such as how does this benefit my university, these gatherings are the time to discuss the state of nursing, the future of nursing, and who we need to cultivate. Of course, the Chatham House Rule applies, and what is said by whom at these tables stays at these tables.

Once again, I was in Hong Kong with Mark Hayter, PhD, FRSA, FAAN, my colleague from Hull and fellow editor of Journal of Advanced Nursing. Although we were teaching and consulting at Hong Kong Polytechnic University, our time here allows us to set up lunches and dinners with key people in the SAR (Special Administrative Region) and to extend the influence of our own work with the Journal of Advanced Nursing and the University of Hull. We also took time while in Hong Kong to meet Linda Sim, manager of the Marco Polo Club, the frequent-flyer privileges club associated with Cathay Pacific Airways. We dined at Hutong, another high level Chinese restaurant overlooking Hong Kong harbour, and were joined by Graeme Smith, PhD, RN, professor of nursing at Edinburgh Napier University, UK, and editor of Journal of Clinical Nursing, based in Hong Kong.

Recognition at last

This month, Alzheimer’s Disease International published a report, Nutrition and Dementia, in which my work on the development of the Edinburgh Feeding Evaluation in Dementia (EdFED) scale is cited. I was very pleased to see this, as it may increase the use of the EdFED and stimulate further research. It also reminded me how grateful I am for long-standing collaborations in the development and application of the EdFED, especially with Ian Deary, PhD, FRSE, FBA, professor, The University of Edinburgh, UK, and Li-Chan Lin, PhD, RN, professor, National Yang-Ming University, Taipei, Taiwan.

While in Hong Kong, I resided out in the New Territories, to the North of Hong Kong, where I found a running route along the reservoir in Sha Tin. It was cold this time of year and humid—not ideal for running, but still a great way to start the day and to register another 20 miles over five days in my wife-imposed half-marathon training program me.

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.