Hong Kong: The same but different

HONG KONG, SAR, China—Five days ago, less than a week after transferring through Hong Kong International Airport, I was back, jet-lagged. Although I have been through the airport 10 times since my last visit, this was the first time I had stepped out of the airport in 12 months.

I am back in Hong Kong to sit on the University Grants Council (UGC) Humanities and Social Sciences Sub-Panel. Under excellent chairing by Cindy Fan, PhD, vice provost for international studies and global engagement, UCLA Department of Geography, we disbursed approximately HK$ 50 million for research to eight universities in the Special Administrative Region. I am halfway through a six-year term (maximum), which guarantees me three more annual visits to Hong Kong.

We also made a UGC advisory visit to the University of Hong Kong. My assignment was to meet with the dean and colleagues in the Faculty of Medicine, which includes the School of Nursing. The University of Hong Kong is the oldest in Hong Kong and, for 50 years, its only university. Currently, the president and vice-chancellor is Peter Mathieson, a nephrologist from the United Kingdom. En route to a meeting, he introduced himself to me in the elevator, and I was able to tell him I was from the University of Hull. The University Grants Council, under which the Research Grants Council (RGC) sits, hosted an excellent banquet on the final working day.

Friends, old and very new

Graeme and Maggie Smith with Nathaniel

Outside of meetings, I had dinners with a series of old friends and colleagues, including Eric Chan, MBA, RN, dean of Caritas Institute of Higher Education and member of GAPFON. I extended my stay to attend a 100 Days celebration for Nathaniel Smith, 100-day old son of my good friends Graeme Smith, PhD, RN, of Edinburgh Napier University (UK) and his wife Maggie. I attended their wedding here six years ago. This was my first meeting with Nathaniel, and I think I made quite an impression.

The weather is always a topic of conversation in Hong Kong, something I think the locals inherited from the days of British colonisation. It’s been wet, humid, and increasingly hot over the course of the past week. That’s the same as usual, but during my 12-month absence a new high-rise building has risen on the Kowloon side of the harbour. Also, Louis’s Steakhouse, Hong Kong’s oldest and one of my favourite places to eat, has closed, priced out of business by rising rents in the Wan Chai district. I am lucky this year, because I will be back in Hong Kong in early July en route to Australia. I am taking my son Joseph, and we are meeting my daughter Lucy. Some of that will feature in my next entry.

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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.

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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!

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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.

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A week in Taipei

Hong Kong SAR, China—How many keynoters with the surname Watson can you have at one international conference? Apparently, the answer is two. The 700 participants at the 18th East Asian Forum of Nursing Scholars (EAFONS) at National Taiwan University Hospital in Taipei were greatly amused that both keynote speakers had the same surname.

I was sharing the platform with Jean Watson, PhD, RN, AHN-BC, FAAN, distinguished professor and dean emerita, University of Colorado Denver, College of Nursing; Living Legend, American Academy of Nursing (2013); and founder/director, Watson Caring Science Institute. More than 20 years had passed since I first met Watson, when she gave a lecture at the University of Edinburgh. Since then, our contact has been by correspondence. She was one of my reviewers during my time as editor-in-chief of Journal of Clinical Nursing, and she oversaw my contributions to both editions of her book Assessing and Measuring Caring in Nursing and Health Science. I neither pretend to understand nor agree with everything Watson says about nursing and caring, but she is a captivating public speaker and fantastic company.

She shared my consternation that we had to endure a three-hour gala conference dinner without a glass of wine, but we had an excellent dinner the next evening—with Taiwan beer—at the world-famous Ding Tai Fung restaurant, at the base of Taipei 101. This was my second Ding Tai Fung experience, as my PhD student Yeh Tzu-Pei and Ting-Ting, another PhD student from National Taipei University, took me to the original Ding Tai Fung restaurant upon my arrival in Taipei.

Overexposure

During my five days in Taiwan, I gave four presentations: a keynote and plenary at EAFONS, a lecture to research students at National Taiwan University Hospital, and a speech to the annual general meeting of STTI’s Lambda Beta Chapter-at-Large, at the invitation of Pei-Shan Tsai, PhD, professor and associate dean of Taipei Medical University College of Nursing. I attended EAFONS at the invitation of Lian Hua-Huang, PhD, professor and former dean of nursing at National Taiwan University, and she was a generous and attentive host.

Never give this man a microphone. Yours Truly at the
plenary session with Taiwanese colleagues.

 I must have had hundreds of photographs taken. This is the habit in the Far East and South East Asia, to get your picture taken with a “celebrity,” and, apparently, I’m a celebrity! I have picked up dozens more followers on my Facebook page, and the photographic evidence is there to see.

Running

Yours Truly surrounded by fans.
That's orange juice I'm drinking.

Apart from the rain, the weather in Taipei was perfect for running, and I managed a total of 12 miles round the campus of National Taiwan University, where I was staying for the week. On Sunday, after a morning visit to Holy Family Church and lunch at Cha for Tea, I went to the airport to meet two old friends from Hualien who work at the nursing college and university run by the Tzu-Chi Buddhist Foundation. Upon boarding the plane for Hong Kong, I reflected on the terrible air crash that had occurred in the city that week. Not every flight ends with an arrival at the destination.

Podcasting continues, and people seem to be listening to them. Mrs. Watson prefers the shorter ones, she tells me.

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Tense days in Hong Kong

HONG KONG INTERNATIONAL AIRPORT—It cannot have escaped any reader’s notice that Hong Kong has been volatile lately. My introduction to the “Umbrella Movement” was pictures of tear gas and riot police on BBC news reports. I instantly recognised Hong Kong’s administrative district, known as Central, thus the #OccupyCentral hashtag on Twitter.

Having been in Hong Kong for a week, I made sure I visited the site of the protesters, now relocated slightly to the district of Admiralty. It was a moving occasion. I was moved because I was here with my wife in 2003 when protesters first took to the streets—peacefully—and a million people marched through Admiralty and Central. I was impressed by the fact that the protesters made room for the bus we were on. We were traveling in the opposite direction, and they simply parted and let us through.

Protesters occupy Admiralty district of Hong Kong.

Umbrella Movement banner at the university.

Night view above Umbrella Movement protesters.

This time round, things have been brought to a standstill. Pictures that accompany this entry show some of the scenes I photographed. My government has been quiet about all this, except to express that Mainland China—to whom sovereignty was transferred in 1997—is showing restraint. Ironically, citizens of Hong Kong now have more democracy—albeit limited—then under British colonial rule. We did not allow them to vote at all.

Why we are here

As usual for this time of year, I have been teaching, together with Mark Hayter, PhD, RN, FAAN, my University of Hull colleague, at Hong Kong Polytechnic University (HKPU). It was a delight to be accompanied by Theofanis Fotis, PhD, senior lecturer, School of Health Sciences, from the University of Brighton. I first met Theo in Singapore (blog passim), and it was good fun to show him our version of Hong Kong.

Mark and I taught first-year students in HKPU’s Master of Nursing programme, dividing qualitative methods (Mark) and quantitative methods (me) between us. We also consulted with second-year students about their research projects.

I made a point of asking each group about the Umbrella Movement, and the reactions and responses were interesting. In typical Hong Kong fashion—modest, quiet, and unobtrusive, especially with “seniors”—they were reluctant to talk, but when I said I had visited the protesters, they opened up. Most had joined in at some point. Uncertain about the future, they were hopeful that nothing violent would take place. It is not my “fight,” but I am not hopeful. I cannot envisage China bending at all, and I worry, if it continues, how it will end.

Frequent flyers

Mark and I entertained Linda Sim, the head of Cathay Pacific’s frequent flyer Marco Polo Club—to dinner. We make this a regular feature of our visits to Hong Kong, to thank her and her team for excellent individualised service and to raise any concerns and questions we have. Frequent flying is serious business. We went to another of Hong Kong’s high-rise restaurants, Wooloomooloo Prime in Tsim Tsa Tsui. The view was stunning.

Buildings in Hong Kong are, for the most part, confusing to navigate—even after many years. Mark and I both had the experience of leaving our offices to attend a meeting, with a destination office number written on a slip of paper, only to realise after wandering about for a while that the meetings were being held in our own offices. If I told you Mark knocked on his own door, you would not believe me, but he did.

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.

Middle East to UK to Far East

HONG KONG, SAR, China—I am always happy to visit a new country, and, last week, I was in Oman for the first time. I was examining at the College of Nursing at Sultan Qaboos University in Muscat. Muscat, located on the northeast coast of Oman, faces the Gulf of Oman, which separates the Persian Gulf to the north from the Arabian Sea to the south.

I have to stoop to superlatives to describe the weather. The temperature was over 50 degrees Celsius (122 Fahrenheit), with humidity that exceeded anything I have experienced in the Far East and Southeast Asia. Leaving any air-conditioned building was like being hit in the face with a wet, warm sponge. One evening, at an outdoor cocktail party, I decided to check my phone for messages, and the phone, which had been in my air-conditioned room for hours, simply started dripping with water. I survived and even managed to run, at 0530, but my GPS watch was a victim of the humidity and stopped working—permanently.

The view from my hotel in Oman.

Sultan Qaboos

Sultan Qaboos University is enormous and located on the same campus as Sultan Qaboos University Hospital (SQUH). Together, they serve as a major centre of medical and nursing education for the region. My own University of Hull has a long-standing relationship with both the College of Nursing and the hospital. One of my colleagues at Hull was a recent examiner at SQUH; colleagues from SQUH visit Hull and our local hospitals—my daughter has looked after them on the local cardiothoracic intensive care unit; and, over the next few years, we plan to take several cohorts of staff members into our post-registration, undergraduate degree program me.

In Oman, I met members of a recent delegation to Hull, who enthused about the personal and detailed care they received while at Hull. Although they visited many centres in the UK, they chose us because of our hospitality—crucial in Arab culture—and we have my colleague, Jeremy Jolley, PhD, RN, international coordinator, to thank for this. Jeremy preceded me as examiner at the Sultan Qaboos University College of Nursing, and his legendary sense of humour and easy way with international colleagues meant I had a lot to live up to. I don’t yet know if I passed the test, but will conclude I did if I am invited back.

New friends

I was not examining alone; I was reunited with my colleague from Bahrain, Seamus Cowman, PhD, RN, FAAN, head of nursing at the Royal College of Surgeons in Ireland–Medical University of Bahrain. Also, I was delighted to meet, for the first time, Marilyn Lotas, PhD, RN, FAAN, associate professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA, and Shadia Yousuf, PhD, RN, assistant professor, King Abdulaziz University Faculty of Nursing, Jeddah, Saudi Arabia, who gave me news about two of my previous PhD students, now working in Jeddah.

We examined the students in the clinical areas, presenting patient cases and interacting with patients, and following up with a series of very demanding oral examinations. We do nothing like this in the United Kingdom and, while I questioned the value and sustainability of some of the examination procedures (suitable for small numbers but probably unworkable for large numbers), I also wondered if we were not a bit “soft” on our own students.

Professor Cowman and I with male nursing students in Oman.

Hong Kong … again

I returned to the UK for a day to remind my wife and family what I look like and then left for Hong Kong. This week, I am working for the University Grants Committee of the Hong Kong Special Administrative Region (SAR). Specifically, I am serving on the humanities and social sciences committee, reviewing research grant proposals related to health.

The view from my hotel in Hong Kong.

I know Hong Kong well and have many friends and colleagues to see. Last night, I went to one of the best places here to get a haircut, the YMCA Salisbury Hotel. If your image of the YMCA is one of old sports halls with table tennis, pool, and a song by Village People, think again. The YMCA has two very good hotels here, and I often use them. In a few weeks, on the way back from Australia, I will be staying at one of them with my 15-year-old daughter.

The haircut at the YMCA reminds me of one of my funniest moments in Hong Kong. The first time I decided to have my hair cut there, I went in and an older Hong Kong lady was sweeping the hair from the floor. Nobody else was there. I asked about a haircut and, with no English, she pointed to me to sit down and proceeded to cut my hair—very well. I asked about the cost, and she said “one hundred dolla’,” meaning HK$100, which I gave her. She put the note in her pocket, and I thought no more about it until my next visit a few weeks later. The lady was still sweeping the floor, but there was also a young man there, who proceeded to cut my hair. At the end, I took out a HK$100 note and handed it to him. “No,” he said. ‘You must pay at the shop,” and handed me a bill for HK$110. I stole a glance at the hair-sweeping lady on the way out. I think I saw her smiling!

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.

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.

The importance of chance encounters

UNIVERSITY OF HULL, UK—As a young academic at the University of Edinburgh in the early 1990s, I attended the Royal College of Nursing of the United Kingdom Research Society Conference in Birmingham, UK. An argument with a taxi driver over the fare meant that I walked to my accommodation under a very dark cloud.

Walking in the opposite direction to me was a man, clearly of Chinese origin, who looked as if he wanted to speak—the last thing I wanted to do. However, he introduced himself as the PhD student of a colleague and good friend of mine in Glasgow, which brightened my mood a little, and we spoke for a few minutes.

More than 10 years later, I found myself sitting opposite him, unaware of who he was, at lunch in Hong Kong, and he recalled that we had met. His name was Thomas Wong. One of the most influential figures in nursing in Hong Kong, he was professor and head of nursing at Hong Kong Polytechnic University. He has, variously, chaired the Nursing Council, been dean of his faculty of health care and a vice president of the university. Currently, he is president of Tung Wah College in Hong Kong.

I have just returned from one of many visits to Hong Kong, my previous visit being the subject of an earlier blog. I was undertaking visiting-professor duties at Hong Kong Polytechnic University, where nursing is now led by another friend and colleague, Professor Alex Molasiotis. Clearly of Greek origin, Alex is a leading expert in cancer and palliative care nursing, with an outstanding CV and previous working experience in Hong Kong and mainland China. We met unexpectedly in Singapore and found a common interest in the Far East and Southeast Asia, and also my hometown of Hull, UK, where Alex studied for his master’s degree and still has family links.

Courtesy of the Cathay Pacific long-haul flight to the United Kingdom from Hong Kong, I was reflecting on the past decade, during which I have made more than 50 visits to Hong Kong. I thought about the important place that this unique and extraordinary Special Administrative Region of China (and former British colony) has had on my personal and professional life.

Personally, it is a place that is now familiar to my wife and several of my children; where I feel almost as “at home” as I do at home. Professionally, the influence Hong Kong has had on my career is obvious. It has been for me, literally, the gateway to the Far East, Southeast Asia and Australasia since, at the invitation of Professor David Thompson, then of The Chinese University of Hong Kong, I found myself in Hong Kong for the first time.

Since then, I have collaborated on research grant applications and publications with colleagues across the Far East and Southeast Asia. I am now a part-time professor in Australia and a visiting professor in Singapore. People like Thomas Wong—who I very nearly ignored the first time I met him—and Alex Molasiotis, together with countless others who took the time to get to know me—thankfully, I reciprocated—have kept me constantly engaged in activities that are amongst the most rewarding of my professional life.

If this blog entry has a moral, it is this: Never underestimate the next person you meet, never ignore people at conferences, and set no limits on where your next conversation may lead you, professionally and geographically.

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

'You have to have an assessment!'

HONG KONG—I am easily irritated by what I take to be stupid comments or questions, especially ones that convey a bureaucracy with which I don’t agree.

“You have to have an assessment” was the response in Hong Kong when I tried to use an indoor climbing wall.

“But I’ve been climbing for nearly 30 years,” I replied.

“You have to have an assessment!” was the firm response with that “the-issue-is-now-closed” look that the charming but invariably inflexible person behind a desk in Hong Kong conveys so well.

“Can I have an assessment?” I asked, conceding that safety is an important issue and that they had no proof I could climb safely.

“You have to make an appointment” was the reply, at which point I turned and walked out, deciding that my training regime would have to be suspended during this trip to the Far East.

The incident reminded me of a friend who graduated as a nurse in the United Kingdom and, after moving to Hong Kong, was required to pass a local exam prior to practicing. As she had graduated from my own alma mater (Edinburgh) and from the school where I first taught, this offended me ... until!

We do exactly the same in the United Kingdom to all incoming nurses; we even ask native English-speaking nurses (North Americans and Australians) to take an English language test (IELTS or TOEFL) to quite a high standard before they can register. They also have to have a period of induction prior to practice. The Australians have reciprocated by insisting that incoming nurses also take an English test, including native UK nurses.

I have mixed feelings about the need for all this assessment and for the resulting assessment industry that has grown up around it (a view I won’t be expounding on too much at the reception I’ve been invited to attend by the Commission on Graduates of Foreign Nursing Schools during the upcoming meeting and annual conference of the American Academy of Nursing in Washington, D.C.). I can see that safety is paramount, and guaranteeing the competence and educational level of everyone arriving from a foreign country with a nursing registration is crucial and, probably, impossible without a formal approach. However, when I arrive in Washington, DC, as I could do here in Hong Kong, I can produce my driving licence and hire a car with the likelihood of killing a great many more people than if I turned up to work as nurse. This is only an analogy. Nursing is infinitely more complex than driving, but the principle applies, and I see no efforts in any country to streamline and accelerate the processes.

I have no solution to the problems encountered by nurses who wish to migrate or just gain experience outside their own country. In fact, I can acknowledge that there is a need for some “barriers” to free movement of registered nurses. I know very well how a rash of scandals involving non-native nurses in the United Kingdom leads to calls for tighter regulations. In addition to protecting patients, these regulations protect the nurses from beyond our borders who are practicing safely and making a major contribution to our National Health Service. All this is notwithstanding the fact that registered nurses from anywhere within the European Community can work in the United Kingdom without let or hindrance, including an English language test.

So, I did not manage to do any climbing in Hong Kong. But if you have read this entry to my blog, I hope you will think I have made reasonably good use of the time that was freed up.

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