Another side of Saudi Arabia

JEDDAH, Kingdom of Saudi Arabia (KSA)—At 2 a.m. the morning after my arrival, Saudi Arabia’s health minister, Abdullah al-Rabeeah, was removed from office by King Abdullah for claiming he did not know why the number of people with MERS (Middle Eastern Respiratory Syndrome) was increasing, thereby admitting he had been unable to address the problem. 

The unfortunate turn of events for al-Rabeeah meant I was one of the first people to meet his interim replacement, His Excellence Acting Minister for Health Adel Faqih, Saudi Arabia’s labor minister, who now serves in both roles. Faqih presented me, later that morning, with my “hadyyah” (gift) for presenting at The Second International Health Specialties Conference in Riyadh, KSA, sponsored by the Saudi Commission for Health Specialties.

Apparently some folk
think I'm OK! 
(Click photo to read text.)

According to colleagues here, the sacked minister, an engineer by background, was popular and had made a good impression on my nursing colleagues, some of whom met him. However, politics is politics the world over, and, frankly, honesty does not pay if you wish to keep your job.

International conference

My paper at the conference was on the difference ethics can make to health care, but I also gave a preconference workshop to 150 nurses and physicians on getting papers published. Among the attendees was my former PhD student, Mansout Alyami, who works at the Ministry for Health. The workshop was the most popular of the two sessions, with an additional 150 people being turned away.

This was especially surprising as I was competing for participants with such luminaries as Geoff Norman, PhD, of McMaster University who, I now realise, is one of the world’s foremost experts on medical education. I was very pleased to get to know Norman over the course of the conference, and his presentation on myths in medical education reinforced many of the things I had long held doubts about, such as learning styles, self-assessment, high-fidelity simulation (essentially a waste of money), and the predictive value of multiple-choice tests (turns out they’re pretty good). Norman, who backs all this up with evidence, has already sent me his portfolio of research papers and reviews on these issues.

Jeddah

After three days in the oppressive heat, oppressive atmosphere (especially for women), and dry dust of Riyadh, I flew to Jeddah on the coast to participate in a scientific forum at Fakeeh College of Nursing & Medical Sciences, where I presented three papers over two days. Another former PhD student, Wafaa Aljohani, who is a faculty member at the school, facilitated my visit. I also met former PhD student Samira Alsenany, who works at King AbdulAziz University, the oldest university in KSA.

A preserved building in the old town of Jeddah,
included in UNESCO’s World Heritage List. 

Compared with Riyadh, Jeddah is a coastal paradise. In addition to the weather being cooler, it is less dusty and less oppressive in many ways than Riyadh. The population is cosmopolitan, and, because the city is close to the holy cities of Mecca and Medina, it is a tourist destination. This was my first sight of the Red Sea where, as the Old Testament describes, Moses parted the water and crossed from Egypt to the Promised Land. I can imagine that, all those thousands of years ago, this place did not look very promising.

International family

The Watson family is scattered across the globe. Another contingent is in Florida, where Mrs. Watson and our youngest daughter arrived this week. Our daughter is taking part in a street-dancing competition at Daytona Beach, and Mrs. Watson will continue training for the London Marathon.

My ambitions are modest by comparison. I am training for a 10-kilometre race, and managed to run 13 miles over four days along the seafront in Jeddah. My next visit to the Middle East is in May, when I go to Bahrain, but a visit to Genoa, Italy comes before that.

Podcasting continues, if you want to listen to my daily reflections on Jeddah. With my new Veho MUVI Mini Cam, claimed to be the smallest video camera in the world, I posted on YouTube a compilation of video segments, all in one 48-minute clip, that range from Hull to Riyadh. Persevere—or fast-forward—to take a cultural tour of Riyadh and hear the call to prayer going out.

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.

Facing up to demographic change in China

LUZHOU, Sichuan Province, China—Luzhou City has the same population as my native Scotland: 5 million people. The UK could be dropped into Sichuan Province, and it would take a major expedition to find it. The size and scale of everything in China is impressive, but its growing population is presenting problems.

The one-child policy was misguided. It failed to curb population growth and led to asymmetric growth whereby China has a surplus of men. The policy also led to another demographic change. By 2050, if the trend continues, the proportion of the population that is younger and economically active will be outweighed by the older and more dependent proportion. This change in the dependency ratio means that an increasingly older population will require care when fewer people are available to look after them.

While in Luzhou, I participated in a conference at Affiliated Hospital of Luzhou Medical University on elder health promotion and nursing care. The session I presented was titled “Preparing nurses to work with older people.” This was my second visit, and they honoured me with a three-year visiting professorship and signed a memorandum of understanding with my university.

Reunion

It was good to see old friends. Not the least was my translator, Daniel Kuwei Liu, an extraordinary young man fluent in English and French. Formerly located in Luzhou, he now works in Beijing. When the opportunity arose to translate for me, he made himself available. Much frustrates me about working in China, but the sincere loyalty of many Chinese people to old friends is salutary. 

With Daniel Kuwei Liu and conference delegates.

Another loyal friend who has featured in blogs passim, Sally Chan, PhD, RN, FAAN, now head of nursing and midwifery at The University of Newcastle, New South Wales, Australia, also addressed the conference. Chan made a previous appearance in this blog when she was head of nursing at National University of Singapore. In addition to addressing the conference, Chan and I met with senior staff members of the hospital affiliated with the university, and we also gave short speeches to nursing students. We were asked many questions about ourselves and how nursing could be developed.

Sally Chan and Yours Truly.

Nursing is considered a relatively low-status occupation in China, and the image of the profession is poor. I hope the opportunity that the students had to hear from a global nursing academic like Chan and the editor-in-chief of a major nursing journal lifted their vision. Men are particularly lacking in nursing here, and the few men present were interested to see someone who had spent his career in the profession. However, above all else, everyone was astonished to hear I had eight children and only one wife.

The mighty Yangtze

Luzhou is situated on the banks of the Yangtze River, which runs from the Himalayas to Shanghai. On my previous visit, pollution was such that I could not see the river. This time, I managed two three-mile runs along the riverbanks in the early morning. Air quality was good, and the temperature and humidity were bearable. On the first day, I shared the banks with assorted joggers, dancers, martial artists, and fishers. On the second day, it was raining, and the few people I saw looked at me as if I was crazy.

Sichuan Province is famous for the pandas near the capital city, Chengdu, and also for the cuisine which is—famously—spicy. I was rendered speechless at least twice when I swallowed a chili. There is a particular seed here that makes your mouth go numb. For a few minutes, you speak as if you have just left a dental surgery. This passes, though, and my best advice is not to speak until the effect wears off.

“Hot pot” cooking is also very common, although not unique to Sichuan Province. This is a process of cooking your own food in a steaming pot into which a rich variety of ingredients can be added. Frankly, it is not my favourite way to eat, as it is hard work. That and the constant way of toasting, common in Sichuan, whereby everyone leaves their place and goes round the table offering thanks and clinking glasses. You barely consume one uninterrupted mouthful and are exhausted by the end of the evening.

I go home for Easter Sunday and a few days of leisure but will address the PhD Experience Conference at the University of Hull, slated for 7-8 April. At the end of the week, I go to the Middle East, to Saudi Arabia. I fly to Riyadh, which I have visited before, but will also visit Jeddah for the first time. This will be another reunion with old friends and former PhD students. It’s not all hard work!

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.

'I'm only a nurse'

HULL, United Kingdom—I was teaching a group of students last week who were finishing the return-to-practice course we offer at the University of Hull. All of the students in the class are registered nurses who have taken a career break and, as a result, not met the prescribed number of hours of practice as specified by the United Kingdom’s Nursing and Midwifery Council. My task was to tell them about recent developments, including various commissions and commission reports—such as the Francis Report—that have made recommendations relevant to nursing.

The class session could not have been better timed, as publication of the Shape of Caring report had just been announced. I had not seen the report, but I was aware, based on advance information and discussions with colleagues close to Lord Willis, chair of the Shape of Caring review, what was likely to be recommended.

I knew, for example, there would be proposals for widening access to the nursing register by making it easier for health care assistants to enter nursing education by receiving credit for previous experience and undertaking a shortened programme. I questioned the wisdom of this proposal, as I have discussed previously in “Nursing education,” another blog I write. Repeating what we often hear, one of the students in the class observed that the proposal to broaden access addresses the problem of prohibiting good, caring people who wish to look after patients from doing so. 

Time to drop the apologetic "I'm only a nurse."

Michael Jung/iStock/Thinkstock

I replied that—assuming they are given the right assignments—such people should not be excluded from working with patients, but if they wish to become registered nurses, I saw no reason why they should not meet the expected entry-level educational qualifications and undertake the full educational programme. After all, we are trying to produce accountable and responsible professionals. Many may wish to become physicians, but I hear no call from anyone for widened entry gates to medicine.

The student actually agreed with me—a first! I think the problem is, many of our all-you-need-to-be-a-nurse detractors who make statements about nursing are rarely challenged. As a result, their rhetoric sticks in the minds of the public and the profession.

Wanted: An end to ‘I’m only a nurse’

I have been asked, along with others, to address in May a UK Royal College of Nursing forum that focuses on some aspects of nurse education and attitudes toward nursing. In the five minutes I’m allotted, I intend to address the apologetic “I’m only a nurse” reply that many of us give when we are asked what we do—especially if a few “high fliers” have just introduced themselves at a conference dinner table. If I never hear those words again, I will retire happy.

Lancet Commission update

Earlier in the year, after considerable thought, I decided to relinquish the lead of the Lancet Commission on UK Nursing. A few things have changed personally and professionally, and I was beginning to lose sight of our aims and how we would get there. I am glad to say that leadership is now in the excellent hands of Anne Marie Rafferty, PhD, CBE, FAAN, professor of nursing policy at the Florence Nightingale School of Nursing and Midwifery, King’s College London, and I will continue to serve on the commission.

We still aim to report in early 2016 and, despite my negative reflections on the Shape of Caring report, there is much in it that the Lancet Commission may be able to build on. Vitriolic criticism of the commission—its composition, its purpose, and the fact that it was inspired by The Lancet—continues in the nursing press, additional evidence of just how narrow minded we can be in UK nursing.

The Far East and Middle East beckon

I am in the process of packing for a week in China where I will address a conference in Luzhou. After returning for a few days over Easter, I leave for 10 days in Saudi Arabia. You can bet you will hear all about those visits, and I will resume production of my “travelcast” podcasts.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

En route to London from Italy

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

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

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

Regaining inspiration

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

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

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

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

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International. Comments are moderated. Those that promote products or services will not be posted.

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.

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.

Qatar deserves the best

DOHA, Qatar—The title of this entry is the Qatar government slogan, posted liberally throughout the capital city of Doha. I have been here since 17 January, part of a journey that took me through Finland. This time, I recorded a series of podcasts that describe my trip in audio form, but don’t be too critical—I’m only learning.

Land of ice and snow

It seemed strange to be leaving the United Kingdom and heading to Turku in Finland, knowing that, ultimately, after returning briefly to London, I would be in Doha, Qatar. However, that was my itinerary. I left the UK in fairly cold conditions to arrive in a winter wonderland at Helsinki. The short flight to Turku, in the south of Finland, took me to a similar scene. I was told that the conditions were “unusual,” but I could not ascertain if they were unusually cold or unusually warm. Whatever the case, snow had been followed by rain, which was followed by a freeze, and Turku was like a massive ice rink. Walking anywhere was extremely dangerous, so I had to forget about running. Usually, I walk from my hotel to the the University of Turku, but this time, I was grateful for the transport there and back.

While in Turku, I delivered two sessions on psychometric methods to the Finnish Postgraduate Student School. I also had dinner and caught up on Scandinavian and European nursing issues with Helena Lieno-Kilpi, PhD, RN, professor and head of the Department at Nursing Science at the university, and Riita Suhonen, PhD, RN, also a professor in that department.

Qatar

This was my first visit to Qatar. The trip started at 4 a.m. in Finland (2 a.m. UK time) as I had to catch a very early flight from Turku to Helsinki before heading to London and then on to Qatar. This was my first experience with Qatar Airways and their new “Dreamliner,” plane, made by Boeing. There was hardly any noise on board, and the air-conditioning was good. If you are lucky enough to fly business class, there is a lounge at the rear where you can relax, as if being in business class is not sufficiently relaxing. I made no use of the lounge, as I slept for most of the flight.

Downtown Doha

I arrived in Doha at midnight, and my hotel—the Grand Hyatt—provided a limousine, complete with wireless, free Internet. Running was difficult in Doha, due to lack of pavements, but I found a path along the private beach and ran “reps” to get Qatar on my Garmin GPS webpage.

I was here, at the invitation of Richard Gray, PhD, RN, and Annie Topping, PhD, RN, to deliver sessions to staff members of the Hamad Medical Corporation on writing for publication. Annie and I “go back” exactly 30 years, to when I was a student nurse in London and she was the head nurse in the ward where I was doing management assessment.

Yours Truly with workshop participants at
Hamad Medical Corporation.

While in Qatar, I also gave sessions on writing for publication at a workshop sponsored by the British Council aimed at collaborative research proposals between the UK and Qatar, and also at the University of Calgary in Qatar. My visit concluded with a reception at the British Embassy that was hosted by His Excellency Nicholas Hopton and attended by British Council staff working in the region.

I arrived at the embassy compound without any form of identification. During the week, I had carried my passport with me at all times. I have been to embassies in the United Kingdom, United States, and Ireland, so I know “the drill.” The day may have been saved by Annie Topping, who suggested that they Google me! I don’t know if they did but, following a long time with colleagues on one side of the compound fence and me on the other, I was allowed in.

I am returning to Hull for one week, for supervisions and other meetings, before a three-week absence that will take me to Taiwan, Hong Kong, and Italy. Naturally, you will read all about it.

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

Another swipe at nursing

HULL, United Kingdom—This is not the first time one of my blog entries posted this time of year has opened up along these lines: “I was just preparing to relax for Christmas.” I was, in fact, preparing to do just that—relax—but my wife failed to censor the letters page of the UK broadsheet newspaper The Daily Telegraph.

The Telegraph has been a serial offender in the fight against university education for nurses, and these attacks often occur at the end of the year, clearly a time when members of the anti-academic nursing brigade think it safe to have their say. The negative correspondence started on 16 December and continued to the 22nd. A great many of us have tried and failed over the years to get contrary opinions published, and it is a minor miracle that Dame Jessica Corner, PhD, dean of the Faculty of Health Sciences at the University of Southampton, was able to publish such a powerful and evidence-based response.

Not idle

While I did try to spend as much time as I could with the family, one of my projects was to learn, after many bamboozling efforts, how to make a podcast—and I managed to do so! My first effort—ironically about how to make a podcast—is now online. I was so pleased with myself, I decided to learn something else I had seen people do, which was to capture what you are doing onscreen and transmit it as a YouTube link.

I am no stranger to using Articulate Power Points with voice-overs, and have made links to these available in previous entries, but I have always admired online teaching materials where you can follow what the person is doing on the screen and see the mouse tracking and clicking. So, after several downloads of screen capture and editing software—very modestly priced—I made a YouTube presentation on how to make a podcast. I realise I am going to have to vary my material a bit, but it’s a start. Frankly, I am quite pleased with myself, and you should expect more.

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

GAPFON grows

SAN JUAN, Puerto Rico—The second meeting of the Global Advisory Panel on the Future of Nursing (GAPFON) is over. We spent a day and a half in Puerto Rico to review progress since our first meeting in Basel and to plan for the future. Since our last meeting, a website has been created for GAPFON where you can see a list of panelists, our purpose, and sponsors. Additional information will be posted there as work progresses.

The next step is to hold regional consultations on the work of GAPFON, starting in the Middle East­—in Jordan­—and to determine priorities for these regions. In July, the 26th International Nursing Research Congress convenes in Puerto Rico, and, before Congress, two GAPFON consultations will take place here for the Caribbean and Latin America. Did someone mention Puerto Rico? In that case, I’ll be there!

Puerto Rico

This was my first visit to Puerto Rico. It will not be my last. I am glad to see that I have space in my diary to be here in July, and I have already decided that Puerto Rico is the destination for a holiday sometime soon for Mrs. Watson and me, fuelled by air miles and hotel loyalty points. Perhaps it will make up for missing our wedding anniversary—again—today. I have, literally, never fallen in love with anywhere so quickly. 

Buildings of Old San Juan.

This place is an island paradise. It's Hispanic, yet American territory, definitely the best of both those worlds. Coming from London’s Heathrow Airport on a dark, subzero winter morning and landing in this warm and sunny place with friendly people and discovering, as I did, that Puerto Rico is the home of the piña colada only accentuated my enjoyment. For me, it has everything. I could run in the early morning, and Old San Juan is a most beautiful town to visit. It is also inexpensive. My good friends and colleagues of GAPFON helped make this a memorable two days.

Restaurant Barrachina, home of the piña colada,
according to a plaque on the wall. 

I was also delighted to find the tomb of Juan Ponce de León in the local cathedral. Juan is a bit of a hero of mine as some consider him to be the original gerontologist. The claim is a bit spurious. He did not study ageing as such; he merely came in search of the Springs of Bimini which, to drink from, allegedly give eternal youth. He may have found the fabled springs but, as his tomb testifies, eternal youth evaded him. His conquistador colleagues did not, exactly, acquit themselves with distinction. They enforced a new religion upon the populace with considerable violence and introduced local women—and presumably the men—to sexually transmitted diseases.

Flying home for Christmas

I am writing this in San Juan airport, officially known as the Luis Muñoz Marín International Airport. As I await my flight to Miami and then on to London, the holidays are on my mind. I like travelling, but these are the last flights until mid-January when I visit Finland and Qatar in quick succession, and I am quite glad.

When I get home, I have a week of work involving a faculty forum, where I will speak briefly to colleagues about our research and implications of the 2014 Research Excellence Framework, the results of which are published next week. I also have several supervisions with doctoral students, a writing-for-publication workshop for National Health Service colleagues in Sheffield, and a teleconference on the day before we break up. On the evening of the last day of work (December 19), my wife, two of my sons, and I are going to listen to a show by comedian Frank Skinner, one of my favourites. Then I plan to eschew the Internet for two weeks and spend some time with my family, close and extended. Normal service will be resumed after my visit to Qatar.

Happy holidays!

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.

China in November

JINAN, Shandong Province, China—It is Sunday, 16 November. The Beijing airport terminal is so vast that, with the haze of pollution trapped inside the building, it is hard to see from one end to the other. I have barely landed and the pollution is already stinging my eyes and coating my lips with a familiar and unpleasant metallic taste. I was led to believe that Beijing air had been cleaned up for the recent Asia-Pacific Economic Cooperation (APEC) summit meeting attended by world leaders, including President Obama. Perhaps it had.

The taxi journey to Beijing station is gripping, and the lack of functioning rear seat belts adds to the excitement. I keep my eyes on the road ahead, as if I were driving, hoping to see hazards before the driver does and to brace myself accordingly. My blood pressure rises as the driver takes calls on her mobile phone while weaving in and out of the traffic. My student helper, Fancy, seems oblivious to this near-death experience and casually attends to text messages on her iPhone, never lifting her head to savour the excitement. I’m back in China!

This purpose of this visit is to spend a few days in Jinan at Shandong University School of Nursing, from which I reported late last year. As I write this paragraph, I am now in the vast Beijing station. Fancy has disappeared, along with my passport, in search of tickets for the train journey to Jinan. I’m assuming I’ll see her again—passport and tickets in hand—but I always feel vulnerable letting my passport out of sight.

Monday, the 17th

The train journey was uneventful; I slept for the two-hour journey to Jinan. Fancy decided to purchase my return ticket and disappeared again with my passport, but passport and I have now been reunited, and I am in University Hotel at Shandong University.

Breakfast was a déjà vu experience; the food on offer was exactly the same as dinner last night, which did not raise my hopes regarding lunch. Not a word of English is spoken by the hotel staff so, using the international language of pointing, smiling, and showing my room card, I managed to persuade them, both last night and this morning, that I wanted to eat. To me, this seemed an obvious conclusion given my presence in the dining room between the specified hours, but nothing is ever straightforward in China.

My run this morning was one of the shortest ever. I am not sure if it was the subzero temperature or the pollution that was taking my breath away but, once I circumnavigated the block, I lacked the willpower to pass the front door of the hotel and was glad to see my room again. Because of jet lag, I’ve been waking up at 1 a.m., so I had seen my room for most of the night.

My emails this morning were comprised of communications from Fancy with nine manuscripts attached. This is part of my job this week, to advise authors on these documents with a view to publication. I will also deliver a lecture this afternoon on the scientific and ethical aspects of clinical trials. This is not especially my area of expertise, and which aspect of my résumé gave my hosts the idea that it was, I cannot imagine. But, as my wife says, lack of knowledge has never stopped me from speaking about anything.

There’s a stuffed polar bear in the foyer of my hotel. As I say, this is China.

Tuesday, the 18th

There's a polar bear in the lobby of my hotel!

My session seemed to go well yesterday afternoon despite the usual lack of access to the lecture room until exactly the time I was due to start. It is incomprehensible to my Chinese hosts that you would like to see the facilities and load your PowerPoint and infrared slide changer in advance. Thus, the first five to 10 minutes of any session here are spent trying to keep your flash drive in your hand and in sight. The over-helpfulness of my Chinese hosts means that, as soon as it leaves your pocket, it is snatched from you to be inserted, clumsily, into the USB port—nobody does anything slowly or carefully here—often upside down with a lot of damaging wiggling before you can retrieve it and do it yourself.

There is also incomprehension that you need a device to change slides. After all, there are buttons on the computer! In China, you stand behind a lectern, shout into a microphone, and subject your audience to a nonstop barrage of PowerPoint slides. Not my style. I like to be seen, to walk around the stage, and even step off the stage to stand in front of the lectern. My hosts, here and in Taiwan, have warned me that one should not undermine one’s status as an authority figure by such informal behaviour. Again, not my style. I court informality, hate titles and unearned deference, and do my best to undermine these conventions, but they keep inviting me back, so it can’t be upsetting too many people.

I made a fundamental error last night by setting my alarm clock to UK time instead of local time and slept in, which meant no running, little time for breakfast, and then a “set to” with the hotel receptionist who, with translation by Fancy, informed me that, if I had laundry collected today, it should be back tomorrow. I pointed out specific details on the laundry card that clearly stated a 24-hour turnaround if it was collected by 11 a.m. It was 8:45 a.m. “Should” was not good enough, because I was leaving at 6:30 a.m. on Thursday, and my supply of underpants would not last.

“Would I like the express service?” I was asked. “No!” I said, because the laundry card informed me that it was not necessary and was more expensive. There is always a solution here, but it is never “I will do what has been agreed and what you want.” Finally, adding insult to injury, I was told via Fancy that laundry had to be in the laundry bag with laundry card completed. I asked Fancy to translate to the receptionist that 1) I had travelled a lot, frequently used hotel laundries, and knew the system, and 2) I had already referred to the card, which I had duly completed. Also, as I had told her, I had hung the laundry bag for collection on the door handle outside my room. Did she think I had hung my underpants and several pairs of socks, not in a bag, but on the handle?

After the first section of my rant, I think Fancy simply apologised for my behaviour and probably said something to the effect of “Westerners, very rude, aren’t they?” I always travel with carry-on cabin luggage only, no matter how long the trip, so laundry facilities are a constant worry.

To compensate for the lack of a run this morning, I went out this evening for 3.5 miles around Jinan. Several more near-death experiences—one of which left what little hair I have standing on end—convinced me to stop running near the road and go to the local park next time. Motorcyclists here interpret the road-sidewalk distinction in their favour. They also weave in and out of the trees at the edge of the road, so you often end up facing an oncoming motorbike not knowing if it will disappear behind a tree or mow you down. I was glad to see my room again.

Dinner tonight was Chinese hot pot, and I mean hot. Health and safety regulations in the UK would never allow such a thing—a pot of boiling hot water balancing on a flaming pile of carbide. The idea is, you cook your own food in this, and I just cannot relax as I see tables where small children are engaged in dropping in and fishing out their cooked food on a table that is likely to topple and scald the diners. I survived.

Wednesday, the 19th

Hot pots make me nervous.

The past two days have mainly been spent reading, editing, and commenting on manuscripts sent me by master’s students. Despite my occasional lapses into frustration at how things are done in China, I never cease to be amazed at the industry of students here, especially these students. The manuscripts I am reading are the product of one module in their programme, and they all intend to publish in international journals. I had assumed these manuscripts were the outcome of their final dissertations, but discovered they are currently engaged in research for their final dissertations and that these manuscripts are “dress rehearsals,” based on research projects carried out earlier in the programme.

The programmes are long, at least three years. Coming from the UK, where the majority of master’s students no longer carry out empirical work and where many PhD students never publish, the work ethic here is impressive. These are not trivial studies. They are well powered, original, and of considerable clinical- and nursing-workforce relevance.

In the meantime

Back at the ranch (University of Hull), our dean has resigned to take up a clinical post, and the search for a replacement has started—to be appointed in the middle of 2015. Our associate dean for research is on long-term sick leave, and I am acting in her absence.

This week, from a distance, I have been helping to organise colleagues for an upcoming visit by the director of research and development of a major engineering company. They have an interest in health, and I think we can showcase two excellent aspects of our work, one in telehealth, the other an invention related to nasogastric tube positioning. (Patent considerations allow me to say no more.)

The deadline for submitting draft statements in advance of a dress rehearsal is the day after I return from China, so I think I will have to eschew University of Hull guidance that we take a day off following a long-haul flight, in addition to the day before. Such guidelines—I’ve encountered them before—are intended to protect the university in the event that one collapses, either in some far-off place or in one’s office at the university following a long-haul flight, and they are written by people who neither do long-haul flying nor have schedules like mine. I forgot to add that the guideline also advises us to have a day off after arriving at our destination and before leaving. If only!

I take the early train to Beijing tomorrow for the early afternoon flight to London. I leave China at midday and arrive in the UK at 3 p.m. the same day. This will be one of the longest birthdays—20 November, 59 years old—I’ve ever had. My next flight is to Dublin next week, and my next report will be from Puerto Rico in December when I meet Hester C. Klopper, president of the Honor Society of Nursing, Sigma Theta Tau International, and GAPFON colleagues.

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.