If it's Wednesday, I must be in Spain!

RIYADH, Kingdom of Saudi Arabia—I’ve been mostly confined to Europe recently, but that’s not a complaint. In fact, it has been pleasant to take short flights for a change, and those flights—and two rail journeys—have taken me to Edinburgh, Belfast, Manchester, Madrid, and Genoa. This has given me a respite from the medium to long hauls that started with Qatar and Saudi Arabia (reported here), followed in quick succession with trips to China, Hong Kong, and Australia, all with return flights to the UK.

Edinburgh

I take every chance I can to visit Edinburgh. My recent trip was to address a conference of doctoral students and staff members on using social media to promote research (click here for podcast). In doing so, I mentioned this blog. In fact, on my travels I meet a great many people who read “Hanging smart.”

The conference was held at Edinburgh Napier University, and I used the opportunity to meet my oldest school friend—of 55 years standing—for dinner. On the way to meet him, a colleague from Pamplona, Spain contacted me to ask what I knew of Nan Shepherd. My friend in Spain is interested in all things Celtic, and he knew I came from the same area of Scotland as Shepherd: Royal Deeside. That morning Shepherd, a writer of novels and poems, was featured in the news as only the second woman—the first being Florence Nightingale—to have her image on a UK bank note and the first woman featured on a Scottish bank note. (Scottish banks have always had their own bank notes.)

“Where’s this going?” I hear you ask. My host and old school friend is the “honorary” grandson of Nan Shepherd, his mother having been brought up by her, and his brother Erlend Clouston (former journalist and hotelier extraordinaire) is Nan Shepherd’s literary executor. Later, on this European journey, I had dinner with my Celtic colleague in Pamplona and was able to recount this extraordinary coincidence.

Belfast and Manchester

My visit to Belfast was to examine the thesis of a doctoral student at Queen’s University Belfast. I felt very sorry for the student as my flight was delayed two hours, and I doubted I would make it. I took the flight, conducted the examination with both eyes on my watch, and was back at Belfast City Airport approximately 90 minutes after arriving, only to suffer another delay of nearly one hour.

In the meantime, I was speaking on my phone at every opportunity to the Saudi Health Office in London about my visa for the next visit, and they were doubtful if they could get it to me within a week. The problem was, I needed my passport within the week for a visit to Spain. At the last minute, and at great inconvenience to my contact there, the visa was obtained. Sometimes, I wonder if the stress is worth it. The day after my return from Belfast, I was in Manchester to address the Saudi Association in the UK on “Writing your thesis: Chapter by chapter” and “The four rules of writing your thesis” (both available as podcasts).

Spain

About to address nursing alumni
at the University of Navarra.

I was pleased to complete, before leaving the UK again for a few days in Spain, one major piece of work for our associate dean for learning and teaching and also to make significant progress with a research grant proposal. I flew to Madrid to address alumni of the University of Navarra School of Nursing, Pamplona campus, on “'Keeping the science in nursing,” and then I was off by train to Pamplona in the north of Spain, made famous by Ernest Hemingway for its running of the bulls. Although I had been in Spain recently, many years had passed since visiting either Madrid or Pamplona.

With former doctoral students Christina Oroviocoicoechea,
Silvia Corchon, and Ana Carvajal at the University of Navarra.

Madrid and the University of Navarra, which was established by the Roman Catholic organisation Opus Dei, hold a special place in my academic career. It was there, in 1991 when I was at the University of Edinburgh, that we had an exchange programme for staff and my international career began. It was there that I first lectured through translators, occupied a desk in a university outside the UK, spent prolonged periods (other than military service) away from my family, and began to see the potential of international work.

I have had great success with four doctoral students from Pamplona who studied with me in the UK, three of whom are now good colleagues (one decreased, sadly), and I have established strong professional and family links. My oldest daughter Hannah came here with me when she was 8 years old. She made two other family-exchange visits and then returned in the final year of her nursing diploma to work in critical care for a month, which led to her securing a job in critical care in the UK. Hannah has remained in critical care and is on the verge of qualifying as an advanced nurse practitioner.

We also have additional family ties here in that another of my colleagues and his wife are godparents to my son Joseph. My visit to Pamplona was to address colleagues on writing and publishing in impact-factor English nursing journals (podcast), in addition to attending a doctoral student examination and holding other meetings with faculty members in the School of Nursing.

Italy

I returned to the University of Genova in Genoa on the Ligurian coast of Italy. One of the hazards here is that, whereas Spanish women greet you with two kisses, right cheek first, in Italy they greet you with two kisses, left cheek first. Get it wrong, and a nasty head butt or a clash of spectacles can easily take place. This visit was to make further progress on some research work, establish a new project, and continue working on publications with doctoral students. I also managed a 10-mile run on my final morning.

Middle East

Passing through the UK, I transferred from London Gatwick to London Heathrow at the weekend and proceeded to Doha in Qatar for lunch with Richard Gray, PhD, RN, of Hamad Medical Corporation before flying on to Riyadh to deliver on Monday two papers at the nursing stream of the Saudi Health 2016 Conference. Tomorrow, I meet with colleagues at King Saud University and then fly home via Doha.

Running

Between trips to Spain and Italy, I spent one day at home and took part in the Beverley 10k race. It was not my best effort and, for the UK, it was hot (20 Celcius, 68 Fahrenheit). I have had difficulty finding the time and the right places to do the sort of fast training you need for races. However, with my youngest son injured at the moment, at least I was the fastest Watson at 51:05. My ambition to beat 45 minutes will have to wait for another race.

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.

Italy, Qatar, and back to the UK

EN ROUTE TO MANCHESTER—After a 4 a.m. start, I’m having breakfast in the luxurious Al Mourjan Business Lounge in Hamad International Airport in Doha, Qatar. I’m also reflecting on yet another month spent largely away from home as I watch my diary fill up with travel well beyond the middle of the year.

My flight to Doha was aboard the fabulous Boeing Dreamliner plane, and the picture shown below, which I took en route from Manchester, England to Doha, shows its unique wing shape against an extraordinarily blue sky. As I write this, I am about to return to Manchester from Doha, aboard Qatar Airways Flight QR46. 

Italy

Wing tip of the
Boeing Dreamliner

Earlier this month, I spent a week in Genoa, Italy at the University of Genoa, which I visit regularly. The weather in Italy was beginning to warm up, which was a change from a cold and dull UK. On this occasion, Mark Hayter, PhD, RN, FAAN, my Hull colleague, was there, making his second visit. Since we both edit the Journal of Advanced Nursing, we often share our experience of writing for publication with colleagues and students. It’s a good double act, as we complement each other methodologically across the quantitative-qualitative spectrum.

One of my tasks on this visit was to inaugurate a series of international lectures for final-year nursing students, and I was asked to talk about writing for publication. I am really not sure how relevant this is to all of them, but I emphasised the bad things we academics get up to by way of cheating with regard to publications: plagiarism, duplication, fabrication, falsification, creation of bogus webpages and publications, and subversion of the peer-review system. Frankly, they loved it.

Qatar

Spotted on Professor
Gray's noticeboard

My return to the UK today follows a few days of visiting the Hamad Medical Corporation (HMC) in Doha. This visit was built around several lectures, workshops, and tutorials on writing for publication, and I was there at the invitation of Richard Gray, PHD, RN. Gray is an editor of the Journal of Psychiatric and Mental Health Nursing, also from the Wiley stable. 

Hamad Medical Corporation is, primarily, a private company that provides medical care on an impressive scale to the population of Qatar. It is not an educational or research institution but has a very active education department led by Annie Topping, PhD, RN, one of my long-time friends in nursing. I may have mentioned this in a previous entry, but I was a student nurse on the ward that Topping managed at St. James Hospital in London when I did my ward management assessment. We go back a long way.

In addition to the work, which starts at 7 a.m. in Qatar, I visited The Pearl, a housing complex mainly occupied by expatriates. The HMC owns two blocks there for its employees. Over a barbecue and speaking with friends, I gained more insight into expatriate lifestyle in Qatar, which, I imagine, is similar across the Middle East.

In a country that is nomadic in origin but now extremely urbanised, the expatriates are the nomads. Few spend a long time here, but most have spent a long time away from their native countries in expatriate communities. Similar communities can be found in Hong Kong and Singapore. Although expatriate life offers great rewards, it also requires great sacrifices, and I am not sure if it is a life I would have liked to lead. On the final day, I gave a lecture titled “Tips on successful publishing,” which you can listen to in this podcast.

Next month, the Middle East beckons again. I note that my 50-page passport has only one page left. and it is only four years old. My priority on returning to the UK is to obtain a new passport, or I will not be going anywhere.

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.

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.

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.

A quick visit to Rome

ROME—Frequent visits to Italy make me appreciate my proximity to continental Europe. Running along the banks of the Tiber at 6:30 a.m., with Rome waking up around me and the sun already burning the top of my head—much less protected by hair than it used to be—is one of the most memorable things I have done this year. Rome is beautiful. It certainly represents no hardship to visit these visually stunning and deeply historic places, so easily accessible from the United Kingdom.

I am here at the invitation of Gennaro Rocco, president of Ipasvi (Nursing Board of Rome) to deliver a paper, “The ethics of publication,” at the Ministero della Salute (Italian Ministry of Health). Rocco is the epitome of Italian style, manners, and leadership. He has been elected to his presidency for more than a decade, and his vision and drive have helped Ipasvi establish a Centre of Excellence for Nursing Culture and Research.

My role at the Centre of Excellence, along with other international advisers, has been to provide advice on academic publishing with a view to helping Ipasvi develop the first Italian academic nursing journal. Once again, I have been reflecting on why I am here and why I should be so lucky to visit the capitals of the world, to work with the cream of international nursing, and to do so at no expense to me or my university. Another chance encounter, the subject of a recent post, played a part.

In 2004, I co-organised a symposium on quantitative methods in nursing research at the annual International Research Conference of the Royal College of Nursing of the United Kingdom. The symposium was well attended and very well evaluated. However, the most important outcome for me was my first meeting with Alvisa Palese. Flamboyant, immaculate, and affectionate—in a word, Italian—she enthused about the session, and I have been in contact with her ever since. She is now my PhD student at Hull. This contact led to a regular series of workshops delivered to Italian postgraduate nursing students in Trieste and Genoa. These students are pioneers, especially the doctoral students, as doctoral-level education for nurses is a fairly recent development in Italy.

This has been a very short visit, but one worth reporting on, as I think that the Centre of Excellence for Nursing Culture and Research is going to become a major force for nursing change in Italy. There is such a centre in Spain, which is similar to, though slightly ahead of, Italy in development of nursing education, but I know of no other centres like this anywhere in the world.

What struck my U.K. colleagues and me most was the integration and common purpose amongst nurses engaged in professional regulation, clinical practice and education. I have also witnessed this in the United States and Australia. Sadly, in the United Kingdom, there is a void between clinical practice and academia, and our regulatory body is not especially proactive in developing the profession. We were there to advise, based on our experience, but we would give a great deal to have a Gennaro Rocco in our midst, and I envisage a day, not too far away, when senior Italian nurses are advising us in the United Kingdom. Moreover, I welcome that day.

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