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.

Gender problems

MUNICH, Bavaria, Germany—“Don’t you have a gender problem?” I was asked as I sat down to dinner in a Munich restaurant last night. I thanked the questioner—a distinguished Austrian physician—for his concern, prodded myself in all the appropriate places, and assured him that all was well in the gender department. The Germans and Austrians do have a sense of humour!

What my colleague was referring to was nursing. In German, there is no word to denote a man in nursing. The German word for nurse—“krankenschwester”— is a feminine noun. Spain and Italy simply had to change “enfermería” and “infermiera,” respectively, to “-o” endings to indicate masculinity, but this is not an option in German. Gendered nouns mostly fell into disuse in English centuries ago so, while we tend to associate nursing with women, the word itself is neutral.

Bernd Reuschenbach

I was in Munich to address the 47th Kongress für Allgemeinmedizin (general practice) und Familienmedizin (family medicine) this morning. The theme of the conference was “Komplexität in der Allgemeinmedizin-Herausforderungen und Chancen,” essentially “complexity in care.” I am here at the invitation of Bernd Reuschenbach, a lecturer in psychology at Katholische Stiftungsfachhochschule München (the Catholic Foundation University of Munich) and Antonius Schneider, chair of general practice at Technische Universität München. Reuschenbach is engaged here in nursing education, and Schneider was one of the main conference organisers.

Antonius Schneider

The title of my presentation was “Nurses and doctors can and should work together.” Addressing the issues of complexity and interprofessionalism, I tried to illustrate the advanced and specialist roles that nurses play in some parts of Europe and the United States. Such developments are only starting in Germany, and the question-and-answer session was challenging, to say the least. I learned that I should stop referring to “the UK and Europe.” as if the UK is not part of Europe. I was asked, if nursing took over a range of advanced roles, what would be left for doctors to do, and could nurses replace general practitioners (family doctors).

“Of course not,” I replied. In answer to what was left for doctors to do, I answered, “Diagnosis, that’s what you’re trained for.”

I thought I had gotten away with it, but someone approached me afterward to say she was “astonished” (not in a good way) about the things happening around interprofessional learning in the UK that I had seemingly ignored. It was maybe a lesson to be more thorough in the future, but I also warned her that what many people say they are doing is not, necessarily, what they are actually doing.

On a lighter note, I was linked up to a mobile tie-clip microphone. When I visited the washroom, the microphone was still turned on, and you can guess the rest. Further demonstration that the Germans have a sense of humour.

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

Up in the air

SOMEWHERE over Australia—Cathay Pacific Flight CX100 left Sydney, New South Wales (NSW), Australia at 2 p.m. After dinner, a film, and a sleep, we are still over Australia, nearly six hours later. This is a vast land with miles and miles of nothing below us most of the time. I have a great fondness for most of the countries I visit regularly. Australia, however, has a special place in my heart.

My family has been associated with this country for more 50 years following the emigration of some of my family, including my grandmother, after the Second World War. Three of my children have been here. It is hard not to like the place. As the early morning flight to Sydney from Brisbane circled the lagoon, clear blue water reflecting a perfect sky made me want to stay a while.

The Sydney skyline.

Meanwhile, back in the real world, I am on the way to Hong Kong. After that, it’s on to the U.K. and home to family and work. I have visited four countries in three weeks and have reported on my visits to Ireland and Taiwan. My annual visits to Australia are due to my part-time professorship at the University of Western Sydney, an eponymous university that lies to the west of Sydney. It is spread over several campuses —some of it is a long way from Sydney—and I feel lucky to be based on the Campbelltown, NSW campus, which is relatively rural but within a short train journey of the centre of Sydney.

June to August is the winter season in Australia, and the early mornings were ideal for running. There was frost on the ground and, as the sun rose revealing a cloudless sky, I was able to explore some new parts of town. My academic activities included teaching senior honours undergraduate students about turning their assignments into published articles. I also presented to colleagues on other campuses about increasing their online profile—this blog was referred to—and about ethical issues in academic publishing.

I especially enjoyed giving a lecture to clinical nurse consultants and other clinical colleagues at the Nepean Hospital in Penrith, NSW, on presenting a conference paper. Online lectures are used a lot here, on several campuses, to teach nurses and midwives, and I make a contribution to this by providing links to my online lectures at my own University of Hull. I used my nights alone in the hotel to make one, especially for students here, on writing for quantitative research. You can listen to it and hear what I sound like; don’t be too harsh.

I mentioned my family earlier. My final weekend in Australia was spent in Brisbane, Queensland, where most of my cousins live. This is definitely the best time of year to visit Brisbane, as it is only hot at the moment, as opposed to unbearable. I paid a visit to a Royal Australian Air Force (RAAF) base near Brisbane and had some fun in the cockpit of an RAAF Airbus refuelling plane. It was still on the ground, I emphasise. I then watched the All Blacks (New Zealand) destroy the Wallabies (Australia) at rugby union on television. For North American readers, rugby is American football without the helmets.

Second Officer Watson pretends he knows what he's doing.

Soon, I will be home to spend the rest of October in the U.K. In September, I have several European trips planned. Otherwise, if the weather holds, I will be climbing rocks.

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

From one heat wave to another

TAIPEI, Taiwan—Wherever I go, weather records are broken. This week, the weather in Taiwan has been the hottest on record for 100 years. Depending on what you read or to whom you speak, the temperature in Taipei yesterday was either 37.5 or 39 C (99.5 or 102.2 F). Either way, the air temperature exceeds body temperature and, according to this morning’s Taipei Times, the government is considering calling public holidays if these temperatures return. There are hotter places but, as one who visits here regularly, I’m finding the crushing humidity exhausting. When there’s no precipitation which, when it comes, is in the form of torrential rain, the relative humidity has varied between 70 and 90 percent.

A few years ago, colleagues and I were caught in Typhoon Morakot, a low-grade typhoon against which it was almost impossible to walk. (Our hotel shook.) I would not like to see a typhoon that registers at the top end of the scale. Last year, at dinner in Chaiyi City, the room suddenly moved a few inches in one direction and then, after a few wobbles, settled back to its original position. Earthquakes, some literally tearing large parts of Taiwan apart, are a regular feature here. I have been here for a week, at Tzu Chi Buddhist College of Technology (TCCN), which is in Hualien, on the Pacific coast of Taiwan. (I’m hoping my university insurance company agents are not reading this entry.)

With me are my colleagues from the Wiley stable, Mark Hayter, PhD, RN, FRSA, and Graeme Smith, PhD, RN, editors, respectively, of Journal of Advanced Nursing and Journal of Clinical Nursing. We have been providing writing-for-publication seminars, workshops and consultancy sessions to colleagues in the nursing school at TCCN. Our link with the college spans eight years, over which time the school has significantly increased its publication output, and not only in our journals. All three of us have also held research grants with colleagues here and have co-authored articles with them.

At TCCN, Yours Truly seated at center, flanked on my
right by Mark Hayter and on my left my Graeme Smith.

We prefer the long train journey between Taipei and Hualien to the short plane journey. It is demonstrably safer (Google “Hualien airport crash”) and takes in a large section of the beautiful and lush Pacific coast. A free day on these journeys is rare, but today is relatively free, and we will re-visit our “old friend” the 101, previously the tallest building in the world. This Gothic-art deco tower never ceases to inspire awe in terms of its symmetry and elegance. The view from the top, accessible via an ear-popping elevator, the fastest in the world, is truly leg wobbling, even for a rock climber.

From Taiwan, I head to Hong Kong for one night before flying on to Sydney. In my last entry, I stated that no visit to Taiwan is without incident and that I would be surprised if none occurred on this trip. My problem? Which one to tell you about. 

We have a favourite restaurant where we requested to eat. On the way from our hotel, we screamed directions to our driver, who willfully ignored our instructions and drove us to one of the best local hotels. It was a soulless place with a large deserted dining room and mediocre food. Our host, completely aware of our request to eat elsewhere, thought it better for us to eat here. The Taiwanese are a polite, caring, and attentive people, but cultural differences run deep, and what you receive is rarely what you ask for.

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

Inane matters

CORK, Ireland—A short break from this blog has given me time to do the first full entry on the brand-new Journal of Advanced Nursing blog, which has had more than 400 views since June. I also publish our newsletter for the Faculty of Health and Social Care at Hull as a blog, and my own blogs have been updated. I was pleased to see that my “Four things about ... (a simple approach to anatomy and physiology)” has had more than 84,000 views. Forgive the blatant plug!

Since my last entry, I have been: 1) enjoying some extreme weather in the United Kingdom (30 degrees Celsius, or 86 degrees Fahrenheit, is considered extreme in the U.K.), 2) working hard on a research-grant proposal, 3) rock climbing, and 4) running—poorly—in a set of league races. My work as editor-in-chief continues, and it has brought me to Cork, Ireland for the annual meeting of the International Academy of Nursing Editors, a group that suffers from the acronym INANE.

This is my first time at INANE, and I was asked to chair an early morning “Town Hall” meeting on hot topics in editing. We covered several topics, including open-access publishing, succession planning for editorial positions, and the training that those new to editing might require. INANE is a truly international organisation, and this meeting, hosted by the Department of Nursing and Midwifery at University College Cork, attracted more than 100 people—mostly, but not exclusively, editors from 16 countries.

This is the first of three weeks of travel. After returning to the U.K. from Ireland, I will spend a week in Taiwan and the following week in Australia, which is where my first contribution to Reflections on Nursing Leadership magazine, the progenitor to my “Hanging smart” blog, was written. Naturally, I intend to send my reflections on these visits.

I rarely visit Taiwan without some hilarious incident, usually at my expense. For example, a few years ago I sent some clothes to the local laundry, which phoned my Taiwanese colleague, whose cell phone is always on speaker, to enquire if I wanted my underpants (“shorts” in the United States) pressed. The secretaries in the open-plan office were unable, despite considerable effort, to suppress their laughter. When the exchange was translated to me, I laughed, too—eventually. I will be surprised if there is nothing to report next week.

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

A week in the life of an editor-in-chief

HULL, UK, Sunday, 16 June—I leave my family celebrating Father’s Day—my Father’s Day (third Sunday in June)—at lunchtime to travel to Oxford for a few days. You may have gathered I like to travel, but I don’t like travelling on a Sunday. In the United Kingdom, Sunday means slow and indirect trains with several changes, reduced service on the train (no free wine in first-class, for example), and when you have left your family sitting outside in a sunny garden, it feels so much worse.

The purpose of my visit is the annual two-day management-team meeting for the Journal of Advanced Nursing (JAN). Therefore, my mood lifts as I reach Oxford—location of the Wiley-Blackwell offices—and check in to my hotel. The most interesting and enjoyable part of my work, amongst many interesting things I do, is my role as editor-in-chief of JAN. I get the opportunity to work with some superb people at Wiley-Blackwell. Some have been my colleagues here for years, and I have a top team of editors to work with. A pint of Guinness with fish and chips at the Head of the River pub on the Thames also helps lift my spirits.

Fish and chips lift my spirits.

Monday

The first day of the meeting is concerned with reviewing the year: what has worked and what needs to change. We consider the journal impact factor (JIF). Despite its manifest imperfections, and a recent call for it to be ignored, many authors decide where to send manuscripts by JIF, and we simply do not have the luxury of ignoring it. Our consideration of the impact factor is given added poignancy by the fact that announcement of the 2012 rankings is imminent. Let me introduce the team:

The publishers

At Wiley-Blackwell, my immediate contact and journal manager is Rosie Hutchinson, who has been with Wiley-Blackwell since 2009. My longest-standing contact and contemporary is Associate Director Griselda Campbell, whom I have known for more than 20 years, since she visited me as an early-career academic at the University of Edinburgh, when she worked for another publishing company. Then, there is what I refer to as the “engine house” of the Journal of Advanced Nursing: Senior Editorial Assistant Gareth Watkins and Managing Editor Di Sinclair. Nothing seems to be too much trouble for Gareth and Di, and the extent of their knowledge of the online system we use to manage submissions and reviewing is immense.

The editors

I don’t hesitate to say that I work with the best possible team of editors. They are all experienced and capable, and a cursory glance at their profiles reveals the calibre of person who edits JAN. New to the team, but joining us from the Journal of Clinical Nursing (which I used to edit) is Mark Hayter, PhD, RN, FRSA. He was featured in my previous blog, due to his forthcoming induction as a fellow of the American Academy of Nursing. Jane Noyes, DPhil, MSc, RN, works in Wales. She, along with Lin Perry, PhD, MSc, RN, and Brenda Roe, PhD, RN, FRSH—another colleague of more than 20 years standing—preceded my appointment. They are an incredible repository of knowledge about the Journal of Advanced Nursing and also bring very specific expertise to their roles as editors. The newest member of the team is Rita Pickler, PhD, RN, FAAN, who joins us from the United States.

Dinner is in Oxford at Malmaison; excellent food, wine, and good company. I learn about the Travel John from Di, whose annual visit to the Glastonbury Festival is imminent. The Rolling Stones are headlining.

Tuesday

Sleepless night—no JIF announcement yet! In a previous blog, I explained that my success as editor-in-chief is partly judged on the basis of JIF.

Our second day at the management-team meeting always focuses on planning, and this is where the real discussion and debate take place. Many ideas—mostly mine—are “shot down in flames,” and we often end up back where we started with some change proposed to the way we do things. Our main concerns are maintaining a reputation for quality, good service to authors, and good management of copy flow. We realise that we often make adjustments to the systems at our peril and need to be absolutely sure that what is decided is both necessary and likely to work.

The team disperses at the end of the day; back to their own countries, day jobs, and professional duties. I remain in Oxford for a final night on my own, with time to catch up on Skype calls, FaceTime, emails, and editing.

Wednesday

After my third early-morning run of the week along the River Thames, I “hot-desk” at the Wiley offices to catch up with work: write a European Community-funded research proposal with a colleague from the United States; lunch with the publishing team to discuss the use of Journal of Advanced Nursing Linkedin pages, and prepare my first entry for our new blog.

I travel from Oxford to the south coast of England to address the inaugural conference of Phi Mu Chapter of the Honor Society of Nursing, Sigma Theta Tau International (STTI), launched in 2011 at the U.S. Embassy in London. Dinner is with Dame Betty Kershaw, DBE, OStJ, FRCN, Elizabeth Rosser, DPhil, MN, DipRM, Dip NEd, RN, RM, and Eileen Richardson, MA Ed, RGN, SCM, Cert Nursing Studies (Education). Kershaw was the driving force behind establishing this all-England chapter of STTI, which is hosted by Bournemouth University. Rosser has now taken over as president, and Richardson has supported this work throughout. I stay in Hotel Miramar, where a plaque on the wall indicates that J.R.R. Tolkien, author of The Lord of the Rings, was a frequent visitor.

J.R.R. Tolkien stayed here!

No announcement of JIF yet, but an SMS message from Ian Norman, PhD, RN, CQSW, editor-in-chief of International Journal of Nursing Studies, informs me that we have both slipped down the rankings (unsmiley face).

Thursday

Excellent news! The JIF of Journal of Advanced Nursing has improved, despite slippage in rankings. Congratulations to Nursing Outlook, in the top five; commiserations to Nursing Science Quarterly, which, along with another 65 journals, has still not reappeared on the Thomson Reuters list. My email to the team is more upbeat than the one I had been planning overnight.

It is a great honour to present the opening keynote at the Honour Society. My theme is “Putting nursing back at the heart of people care,” and the session is attended by the vice-chancellor (equivalent to president) of Bournemouth University. Dinner is like a reunion of old friends and colleagues and is attended by a trio of nursing dames: Dame Kershaw, referred to above; Dame June Clark, DBE, PhD, RN, FRCN, FAAN, recently inducted as a fellow of the American Academy of Nursing, an avid reader of this blog, and the person responsible for bringing the Honour Society to the United Kingdom for the first time in Wales; and Dame Yvonne Moores, DBE, FRSH, CIMgt, former chief nurse of England, following her roles as chief nurse in Wales and Scotland. For an explanation of the title “Dame,” you need to understand the U.K. Honours system, and few of us actually do!

Friday

Six hours and three trains later, I am back in Hull with my family. Tomorrow starts with a 5-kilometre Park Run. On Sunday, I fly to Dublin for one night. No more travelling until the end of July, and no more entries to the blog until then, either.

Gotta run! Photo from Park Run, different time of year.

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

Examining in the Kingdom of Bahrain

MANAMA, Kingdom of Bahrain—The last time I visited Bahrain, I arrived on a Sunday night and took a taxi to the nearest Catholic church to attend Mass. This proved to be a mistake. The “five minutes” from the hotel, as estimated by the hotel receptionist, turned into a considerable taxi ride, miles from the Diplomatic Area (DA) where I was staying. The class of housing dropped and the width of the streets steadily reduced and, eventually, I found myself downtown, where the walls had slogans in English and Arabic. This was immediately following the Arab Spring risings, which had reached the Kingdom and the television screens. My hosts, my employers and my wife would have had a collective fainting fit if they had seen me.

I attended Mass, the only westerner, and then tried to hail a taxi. Plenty went past, but none would stop. As a mild sense of anxiety set in about my predicament—lost, dark, miles from my hotel, and in an area of obvious unrest—I was rescued by a diminutive Indian gentleman, clearly amused at my attempts to hail a taxi in that area. He promised, and duly fulfilled his promise, to lead me to safety. My escape took me through a series of back alleys and past some dubious looking local characters to an area where taxis were available. I hailed one, and my saviour disappeared down one of the alleys from which we had emerged, hardly stopping for thanks.

This is my second visit to the Middle East this year (blog passim) and my second time here as an external examiner at the Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI-MUB). I have not ventured beyond the DA and, apart from a five-kilometre run that I worked out for the early mornings (30 degrees Celsius; 86 degrees Fahrenheit) before the temperature rises to a searing 40 degrees C (104 F), I have only been to the college and restaurants. The RCSI-MUB was established in 2005 and represents one aspect of the work of the RCSI in Dublin to expand and find business in this region. As such, the RCSI is both innovative and entrepreneurial and has established a very good name for itself in Bahrain and Saudi Arabia.

The RCSI-MUB runs a School of Nursing and Midwifery here that provides undergraduate programmes, including a bridging programme for local diploma-educated nurses and a master’s programme. I examine the bridging programme and the master’s programme and, as my reports to the college have indicated, have been impressed with the standard of work and, in particular, by some of the master’s students, who have to present their work to members of the school in my presence. I predict that the School of Nursing and Midwifery here will become a powerhouse for academic and clinical nursing in the region.

In my previous entry from Finland, I promised to let you know if any of my colleagues have been invited to become fellows of the American Academy of Nursing (FAAN). I am happy to report that Sally Chan, the subject of a previous post, has been selected; also Mark Hayter, my Hull colleague and fellow editor of Journal of Advanced Nursing. The contingent of FAAN international fellows is growing, and I am very happy to be part of that group. I always look forward to my visits to Washington, D.C., but I predict that this year is going to be more fun than usual. If you see me there in October, please say hello.

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

From the land of the midnight sun

TURKU, Finland—The flight from Helsinki to Turku barely gets in the air before it lands in Turku. This very short flight takes you from the capital of Finland to the mouth of the river Aura on the nation’s southwest coast. Turku boasts a fine university, the University of Turku, which houses the Department of Nursing Science and an array of nursing scholars of truly stellar reputation in Europe and beyond, including Helena Leino-Kilpi, PhD, RN, Sanna Salanterä, PhD, RN, and Riitta Suhonen, PhD, RN. It is remarkable to find such talent in so small a department.

I, together with Ian Norman, PhD, RN, FEANS, my rival in editing and friend in research and scholarship, have been teaching writing-for-publication classes to Finnish postgraduate students—not all from Turku and not all in nursing. Norman is professor and associate dean of the Florence Nightingale School of Nursing and Midwifery at King’s College, London, and editor-in-chief of the International Journal of Nursing Studies. Over the years, I have researched, written, and published with him and have learned a great deal about acquiring research funding and managing research projects. The classes were challenging. These are some of the best research students in Scandinavia, and they questioned nearly every point we made. As usual, I came away realising that my ideas and my PowerPoints need further revision.

Compared with England and Ireland—I visited Ireland on the way here—the weather in Turku is superb. The British Isles are mostly shrouded in mist and still experiencing very cold weather despite the time of year, but Turku was 25 degrees Celsius (77 degrees Fahrenheit) with bright sunshine that only receded for about three hours after midnight. This is, almost, the “land of the midnight sun.” I managed two runs along the Aura River, still navigable well into the town of Turku, where some splendid tall ships and lots of boats moored along the banks are used as bars and restaurants. Wednesday night in Turku is Harley-Davidson night, and I think that nearly 1,000 of them were parked along the river last night, with their riders—average age easily more than 60—admiring each other’s bikes.

Work continues wherever I am. When classes ended this morning, I spent the rest of the day in my hotel room in close contact via Skype and email with Parveen Ali, PhD, PG Cert (HE) RN, RM, my good colleague at Hull. She and I, together with our expert in orthopaedic nursing, Julie Santy-Tomlinson, MSc, RGN, RNT, were awarded a small amount of money by the Royal College of Nursing (of the United Kingdom) Society of Orthopaedic and Trauma Nursing to conduct a systematic review of acute lower limb compartment syndrome (ALCS). The work will inform a consensus conference of the society convened to produce nursing guidelines for detection and management of ALCS. The report is due to be submitted by 5 p.m. today. I think we made it.

The rest of the year is shaping up. I will be in Bahrain before the end of the month. Then, after a relatively quiet two months, August will find me in Taiwan and Australia. In October, I head, in quick succession, to Hong Kong and mainland China, returning to the United Kingdom between those trips to teach at my university. The China visit leads directly—after the longest Cathay Pacific flight of 18 hours—to Washington, D.C. for the annual meeting of the American Academy of Nursing. Next month, we should hear who the new fellows are, and I am hoping the list contains at least two international fellows who are well known to me. You will be the first to know.

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

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.

Return to Riyadh

RIYADH, Kingdom of Saudi Arabia—Listening to “Brothers in Arms”—loud—on the Emirates Airline entertainment system as the Boeing 777 descended into King Khalid International Airport (KKIA), Riyadh, Saudi Arabia, I brushed away several tears. During the First Gulf War, I used to listen to this haunting and emotional song on headphones to drown out the overhead roar of American B-52 bombers, accompanied by massive refuelling planes, as they took off from the military airport in Riyadh to rain down fire and death on forward lines of Iraqi troops.

The bombers were so laden with weaponry that they took off underfuelled. After takeoff, and before proceeding to the Kuwaiti border to lighten their loads, the bombers’ fuel tanks were topped off nearby, in midair, enabling them to proceed to their target and create “fields of destruction,” a phrase from Dire Straits’ song, “Brothers in Arms.” These takeoffs were always followed by the release of a Scud missile in our direction, to which we replied with a Patriot missile from the front gate of our compound. The sickening shockwave, as it broke the sound barrier at ground level, used to make my chest reverberate.

My first visit to Saudi Arabia was courtesy of Her Majesty’s Armed Forces in which I played a small role as a nursing officer in the Royal Army Medical Corps. This time, upon exiting the plane at the airport terminal, I recognised the underground car park where, a couple decades earlier, we had established a 1,000-bed military hospital and set up our evacuation ward. And on my journey home, I walked through shops and lounges where, more than 20 years before, we set up operating theatres and general wards in what was then a newly built, but deserted, building.

This visit was entirely peaceful. I was in Riyadh at the invitation of the General Directorate of Nursing Affairs at the Saudi Ministry of Health to address the Saudi International Conference of Excellence in Patient Care  (SIEPC 2013) on the topic of writing for publication. The conference was attended by “local” nurses from the Gulf states and Jordan, as well as Europeans, Australians, and Americans. The theme of the conference, ostensibly, was about hospitals in the region achieving Magnet status, but it was an opportunity to learn about nursing and, especially, nursing education in Saudi Arabia and Jordan. If the words “Europe” or “United Kingdom” had replaced “Saudi Arabia” or “Jordan” on the program, the discussion would have been much the same.

We share many of the same problems, such as shortages of nurses and nursing faculty, and the employment of immigrant nurses, with the Philippines being a major provider. One difference in Jordan from the rest of the world is the higher proportion of men in nursing, a remarkable 60 percent. It’s actually an issue they would like to address, as it is a symptom of very high unemployment among Jordanian men. There is a deliberate strategy in Saudi Arabia toward “Saudi-ization”—the education, training, and employment of Saudi nationals in a range of professions—including nursing. The initiative is still, however, in its early days.

Meantime, many Saudi nurses visit the United Kingdom and North America to pursue master’s degrees and doctoral education. I have personally benefitted from this. I was met at the airport by Mansour Al-Yami, in full Arab dress, whose studies I supervised at the University of Sheffield. Worth following on Twitter, Al-Yami is involved in his role at the Ministry of Health in recruiting nurses to Saudi’s workforce. Soon, he defends his doctoral thesis in Sheffield.

Yours Truly with Mansour Al-Yami, former student of
mine who is now at the Saudi Ministry of Health.

At the fabulous Four Seasons Hotel, I had dinner with Professor James Ware, director, Medical Education and Postgraduate Studies, the Saudi Commission for Health Specialties, along with Wafaa Al-Johani, who works in nursing education in Jeddah. Al-Johani is one of my former doctoral students, and she made the journey especially to see me.

Wafaa Al-Johani, one of my former doctoral students.

My time in Saudi has been informative, enjoyable and, as I alluded to above, moving. I have three children and a future son-in-law in the military. One daughter returns from Afghanistan soon; she was preceded by her fiancé. Her older sister, a nursing officer in Queen Alexandra’s Royal Army Nursing Corps, leaves for Afghanistan next week. My daughters complete four generations of Watsons who have gone to war.

I often end these entries on a light note, related to my current location or next flight (Rome in May, as it happens), but I must end this one with a rhetorical question: Will the madness of war ever end?

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