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.

En route to London from Italy

BRITISH AIRWAYS FLIGHT 2869—I ran out of two things these past two weeks: energy and enthusiasm. As I write this, I am on the journey home from Genoa in northern Italy to London’s Gatwick Airport in the United Kingdom, having spent a week in Italy teaching and consulting with colleagues at the University of Genoa. After posting my previous blog entry about my time in Taiwan, I spent a week in Hong Kong, two nights at Heathrow Airport, and then this week in Genoa.

My energy has been at low ebb for most of this three-week journey. It took most of my two weeks in the Far East to overcome jet lag and then, after returning to Europe, I underwent another bout, from which I am only now recovering. I am not looking for sympathy—most of my international work is self-imposed—but I am a lot older now than when I started these years of intensive international work.

I completed the week in Hong Kong with colleague Mark Hayter, PhD, RN, FAAN, and, after fitting in a variety of dinners and breakfasts with old friends and colleagues, Mark and I flew home. Formal links with Hong Kong Polytechnic University are now concluded, but I return to Hong Kong in June to work with the University Grants Committee, and I will continue to advise the university’s Research Assessment Exercise.

Regaining inspiration

As usual, I ran the Corsa Italia several times in Genoa, mostly in darkness, as the days were quite short. The PhD students here are an inspiration to work with. For my past two visits, they have been working on a rapid review, applying the principles of rapid evidence assessment. They work as a group, with my support, and they are in the process of producing for publication a very good review on the influence of the clinical learning environment on nursing students’ competence with regard to patient safety.

Members of my PhD class at the University of Genoa
working hard on a rapid evidence assessment review.

Next week, the RN4CAST@IT will be launched at the University of Genoa, and Walter Sermeus, PhD, is coming from the University of Leuven in Belgium to help with the launch. RN4CAST, which was inspired by and involves the work of Linda Aiken, PhD, RN, FRCN, FAAN, has been very effective across Europe in providing evidence for the effectiveness of nursing care and the value of graduate nurses. I played a small part in the project by putting my Genovese colleagues in contact with Sermeus and Aiken.

Summing up, after 17 podcasts, 10 lectures, keynotes and plenaries, and a rejection of a major paper on the effect of sampling on Mokken scaling (to be continued), in addition to keeping up with all my work as acting associate dean for research at Hull, I am returning to my family with the prospect of five weeks at home, which will be a joy. My travel responsibilities during those weeks will be limited to obtaining visas for forthcoming visits to China and Saudi Arabia and preparing lectures for those visits. Life is busy and never dull.

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.

At 'Oxbridge' and other seats of learning

GENOA, Italy—Despite the location of this entry, I have been mainly in the United Kingdom since my last post, which was from Australia. I made one brief visit to Dublin, Ireland, but otherwise have been in Cambridge and Oxford—two major seats of learning known collectively as “Oxbridge”—and Birmingham, the UK’s second-largest city and, arguably, also a major seat of learning. If you are not familiar with the very British TV comedy “Blackadder,” this YouTube clip will provide a sample and explain, at the expense of my own University of Hull, where Oxbridge is positioned in the UK educational hierarchy.

My visit to Cambridge was to attend part of the NET2014 conference and to present with Karen Holland, editor of Nurse Education in Practice, a workshop on writing for publication. The NET conference, formerly named the Nurse Education Tomorrow conference, evolved out of the journal Nurse Education Today. The conference was the idea of Jean Walker, a former colleague of mine from the University of Edinburgh, and one of its earliest proponents was Elisabeth ‘Liz’ Clarke, PhD, formerly of the Royal College of Nursing of the United Kingdom and now of the Open University. In her keynote address, Clarke, who is not a nurse but a psychologist by background, reflected on the conference’s 25 years and challenged nurse educationists with these questions:

• What are the greatest achievements in health care education of the past 25 years?
• What are the big issues we must tackle?
• What do we need to do to demonstrate our positive contribution to health care services, higher education, and society as a whole?
• What are the priorities for our future scholarship agenda?

The conference was held in Churchill College, named after our great Second World War prime minister, whose papers are lodged there in a special archive. The college is relatively modern, built in the 1960s, and accommodations seem to have changed little since those days. I must be getting old and soft, but an unsprung student bed with a thin mattress is not what I am used to.

The purpose of my visit to Oxford was to meet with fellow Journal of Advanced Nursing (JAN) editors and the management team from Wiley headquarters. This time, I can report excellent accommodation in a large hotel that incorporates a former Knights Templar hospital. I concluded these knights were not very tall, as I bumped my head several times on massive ceiling beams upon entering—and usually when leaving—the bathroom.

The JAN management-team meetings are one of the most enjoyable events of the year for me. Wiley looks after us very well, and the JAN editors are the best team in the world to work with. During two intensive days, every aspect of the journal is analysed, and our performance in terms of impact factor, downloads, and international outreach is scrutinised. Change always follows these meetings, but this is always positive and agreed to by the whole team. Our vision for the journal is ambitious, and we hope that this becomes obvious in the year ahead. Amongst other things, we hope to increase traffic to our blog, which has been renamed JAN interactive.

Birmingham was the venue for the penultimate meeting of the 2014 Research Excellence Framework (REF) subpanel for dentistry, allied health professions, nursing, and pharmacy, to which I have referred previously. I love working with this team, too, but I don’t think many of us will miss these events, as membership on these panels involves very hard work. The eyes of the UK academic community are on the REF panels and subpanels with the outcome—scores awarded to UK universities for excellence in research—eagerly awaited. The world is also watching and waiting, because this exercise was the first to include research impact. There will be international scrutiny to see how we did it and what we found, and it is my expectation that research impact will form part of research assessment in several of the countries I visit regularly.

I’m in Genoa—also known as Genova—for the usual reasons (blog passim): to meet research students at the University of Genoa and to collaborate with colleagues here. In the middle of the week, my dean, Steven Ersser, PhD, RN, makes a visit. I had better be on my best behavior.

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.

Sunshine and sea

GENOA, Italy—The vagaries of air travel mean I arrive here on Monday, 16 September, at 10 p.m. instead of 2 p.m. After an unexpected night in the Radisson at Manchester Airport and an unplanned visit to Rome, I miss my first meeting. I meet my good friend and translator, Guiseppe Aleo, professor at the University of Genoa (Università degli Studi di Genova), in the lobby of the hotel to catch up on what I have missed and to plan the week ahead. I am an honorary docenti (teacher) at the university.

Genova—for some reason we call it Genoa—is on the Ligurian coast of Italy, where the food and wine are superb. This was the home of Christopher Columbus—remind me again, what country did he discover?— and Marco Polo. I have been coming here for several years to work with colleagues in nursing at the university, in particular Loredana Sasso and Annamaria Bagnasco. I teach postgraduate nursing students and advise colleagues on research and publishing in English-language academic nursing journals.

Tuesday, 17 September

My first full day here is spent with colleagues at the university, reviewing several research projects underway. The range of what is being studied here is impressive and clinically oriented. Academic nursing is relatively young in Italy, but there are some active centres where research into nursing issues is making great progress. Today’s meetings progress slowly, however, as I have to work through my translator.

The weather is superb. One of the main local news items is the righting of the liner “Costa Concordia,” which sank nearby last year. Over dinner, a colleague with vast knowledge of the safety systems on these ships explains how difficult it is to sink one of these vessels.

Dinner is in a formaggio (cheese) restaurant outside Genova. The Ligurian coast has a backdrop of mountains, and most of the towns here seem, in a clichéd but literal way, to “hang” off the mountains. Most remarkable is the network of high bridges and tunnels that run parallel to the coast. Moving along the coast, you either are looking down—vertiginously—from one of these bridges on the regular series of roads with hairpin bends that run below to the coastal towns, or up from those same roads. Italian driving means that the transition between the bridges and the roads is seamless.

Wednesday, 18 September

I spend the day with University of Genoa postgraduate research students. I meet these students twice a year. In the past, they have listened to me lecture, from morning until night, on a range of topics. Apart from the fact that I am on the verge of repeating myself—some of these students have been in the group since I started visiting here—I feel it is time to catch up with their projects, to give me the opportunity to question them and for them to question each other.

I work without my translator, because the rules state that the projects are to be presented in English. They all do very well, helping each other—and me—with the language. The projects range from educational to clinical work. I have always been impressed by the students’ ability to think clearly, apply best research practice to their projects, and deal with hard questions. I am especially heartened that they interrogate each other. Using this format, the students are able to learn and understand what the others are doing. I would like to see this approach adopted with my own research students and others at the University of Hull. Several of the students are on Twitter. Gianluca Catania and Milko Zanini are two who are worth following.

At dinner this evening, we discuss the Francis Report (blog passim), and it becomes evident that criticism of nursing in the U.K. has a negative effect in countries such as Italy, where our system of nursing education is held up as a good example of what can happen if you educate nurses at university level. Politicians and policymakers in other countries, opposed to raising educational standards in nursing, are quick to cite problems in U.K. nursing.

This evening, I am taken on an unexpected tour of the historical heart of Genoa. Superlatives are hard to find, but this is one of the biggest surprises of my life. Rows of palaces with relatively modest and mysterious exteriors hide courtyards, architecture, and elaborately painted ceilings, glimpsed only through doorways and gaps in curtains. All of these buildings are now businesses, mainly banks. The tour ends in the historical port where the galleon “Neptune” from Polanski’s 1986 film “Pirates” is berthed. Many people do not recognise it and assume it to be an historical ship, to the amusement of the Genoese.

The "Neptune," built to full scale for filming of Roman Polanski's
"Pirates," is a popular tourist attraction in Genoa's harbor.

Thursday, 19 September

This is my final morning with the research students, and I hear about two new projects. The remainder of the day is spent looking at research projects with colleagues and advising on the analysis. I am one of the few people who regularly use Mokken scaling, a form of item response theory. Some of the datasets being established here are suitable for analysis. I am especially pleased that a large dataset of older people with dementia is being gathered, including the Edinburgh Feeding Evaluation in Dementia (EdFED) scale—translated into Italian—which will soon be ready for analysis, at which point I will have my first co-authored paper with Italian colleagues.

Friday, 20 September

My final day is spent with colleagues, reviewing projects and planning potential publications. Already, I have several short visits planned for next year, which should give me a view of Genoa in all seasons. Combined with a planned visit to Rome, I feel that Italy has become a firm fixture in my professional life.

I have run here every day, building up from three to six miles over the course of three evenings. The Corso Italiana, a tiled promenade approximately two miles long, is ideal for this. There are many runners, walkers, and others taking various forms of exercise, and the view of the Ligurian Sea, especially as the sun goes down, is worth the effort. It is a great segue between the end of a working day and the start of an excellent Italian dinner. According to my Garmin webpage—where my runs are recorded from my GPS watch—I have burned 2,500 kilocalories in the past three days, a drop in the ocean compared to my calorie intake over the same period.

Saturday, 21 September

On this last morning, a last run, coffee by the coast, and a midmorning beer in the sweltering heat before going to the airport. I reflect on the title of this blog—a climbing term—and think how little outdoor climbing I have done this year. Back home, the season is almost over, but I still enjoy indoor climbing two or three times weekly with my children. As a form of exercise and mental rest, it is unbeatable. I have a fairly busy week ahead at my own university, then back to the airport on Saturday for a visit to Hong Kong. 

A significant piece of news is that The Lancet, one of the leading medical journals in the world, has invited me to lead a commission into U.K. nursing. I have accepted the invitation and am in the process of appointing commissioners. Although the commission will focus on U.K. nursing, it will not be completely composed of U.K. nurses. That’s all I can say for the moment, but I will keep you up to date on progress over the next two years.

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