China: Hot food and hot weather

LUZHOU, Sichuan Province, China—I have been in China this week, making my third visit to what is currently known as The Affiliated Hospital of Southwest Medical University. On each visit, the name has changed—on one hand, as the status of the institution has risen, and, on the other hand, as objections from elsewhere in the province have risen about the name that is being used. Apparently, there are objections to the current name, and it may well change again before I return. Whatever the name, the hospital I visit here is in the same place: Luzhou, China, on the banks of the mighty Yangtze River.

Ostensibly, my visit here is to deliver a lecture at an international conference on transitional care. My topic? Telemonitoring of older people. When asked by other presenters if I am an expert on the subject, my reply was: “Well, I am now!” I have to admit to only a passing acquaintance with telehealth in any of its varieties, and there is much greater expertise available on the topic at my university. But I am the visiting professor here, and I am expected to know everything.

Yours Truly with Pulon Chang, Yang-Ming University,
Taipei, Taiwan; Frances Wong, Hong Kong Polytechnic
University; and Du Yihua, president, The Affiliated Hospital 
of Southwest Medical University, Luzhou, Sichuan, China.

I enjoyed reading about telehealth and telemonitoring and, with the help of my old friend and interpreter Daniel Liu, I managed to deliver my session. I am also very grateful to David Barrett, PhD, RN, senior lecturer on my faculty at the University of Hull, for some PowerPoint slides based on his recent research. Otherwise and more significantly, I am here to continue collaboration between the hospital and my university. We have already graduated one doctoral student, and we plan to have academic visitors and additional doctoral students.

About the food

Guess who.

Food was plentiful and spicy as ever. My hosts outdid themselves one night when we visited a very traditional restaurant. My advice: If you have doubts about spicy food, avoid anything labelled “traditional.” Not for the first time in Luzhou, I was rendered speechless by some of the food, which combines the heat of chillies and the local specialty spice, which I now know is colloquially called “tip of the tongue,” as it renders the tip of your tongue, lips, and inner cheeks numb. You can’t speak, and neither should you, until the effect passes. The only known antidote is cold beer, also plentiful. I ran on the banks of the Yangtze River again, but the weather was too hot for anything very serious.

Climbing

Finally, after some procrastination, I returned to the climbing wall, my first visit in nearly 10 months. I really enjoyed my half hour (all I could manage) but have been unable to return due to a severe shortage of skin on my fingers, which are mostly healed now. I’m ready for a second visit soon.

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 published.

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.

Saudi Arabia, Part 3

RIYADH, Kingdom of Saudi Arabia—This is the end of my Saudi Arabia trilogy, although an addendum will be posted in May when I come back to speak at a conference. (I suppose I could identify the now four-part series as a tetralogy or quadrilogy.) My visit to Jeddah was over too quickly. For the first three days back in Riyadh, with teaching and other presentations from early morning until late afternoon, I barely had time to think. Now, I have two days to reflect and clear up loose ends before I return to the UK.

Presentation time with Juliana D'Sa and
Raeid A. Faqehi.

My first day back in Riyadh was spent partly in the College of Nursing (male) with Master in Nursing students and partly in the Medical College, where I gave a lecture about detecting similarity in manuscripts (available on podcast). The next day was spent at the leading hospital in Riyadh, King Faisal Specialist Hospital & Research Centre (KFSH), teaching on writing for publication and evidence-based practice. That day was hosted by Marinha Macedo, RN, nursing research senior specialist. By coincidence, I met her counterpart, Gillian Sedgewick, RN, at the Jeddah King Faisal hospital on the weekend. Both KFSHs are Magnet hospitals, the first in the Middle East. The third day was spent teaching at the General Directorate of Health Affairs, Riyadh on research and publishing. It was a thoroughly enjoyable day, but I was glad when it ended, as I was exhausted.

Jeddah memories: Yours Truly with, l-r, Wafaa
Al-Johani, Shadia Abdullah Hassan Yousuf,
Hannah Erfan Banjar, and Ahlam Eidah Al-Zharani.

The day finished back at the Ritz Carlton at a dinner hosted by my former University of Sheffield student, Mansour Al-Yami, PhD, RN, now general director, training and scholarship, at the Saudi Ministry of Health, along with several colleagues from the Saudi Ministry of Health. You know you’re a frequent visitor to a place when you get tapped on the shoulder and turn round to see someone you know. Mustafa Bodrick, PhD, RN, of King Saud bin Abdulaziz University (blog passim) was also dining, and he introduced me to Gwen Sherwood, PhD, RN, FAAN, University of North Carolina at Chapel Hill, with whom I will be dining tonight. Leaving the Ritz, I almost bumped—literally—into Joseph Westphal, U.S. ambassador to the Kingdom of Saudi Arabia. Any closer, and I think the security detail would have “taken me out.” I wonder if he was making arrangements for U.S. President Obama, who arrives today.

Reflections on Saudi Arabia

I have mentioned before in this blog that I am often asked about my safety when travelling to the Middle East. When I ask people to specify more precisely what they mean—I understand the question but am tired of it—they never can. There is an association in people’s minds between Arabs and terrorists. The association is understandable, given press portrayal of the situation in some parts of the region. The same kind of association applied to Northern Ireland for a prolonged period, now euphemistically referred to as “the troubles.”

However, I have also noted a frequent question here—almost daily—in my meetings about my impressions of Saudi Arabia. My answer depends on the question. If I am asked, “Do I like Saudi Arabia?” I find it hard to say yes, simply due to the visual impact of women peeping out over niqabs, an image I find hard to accept. However, while the positional disparity of men and women runs deep in Saudi society, I realise this cannot be a barrier to cooperation and collaboration. I find the women charming, self-deprecating, funny, and easy to work with. This is not my country, and I am a guest.

On the other hand, I was asked if my view of Saudi Arabia was positive or negative, and I replied without hesitation that it is positive. To someone from the West, the intrusive nature of religion is alien. However, I have been coming here since 1991, albeit with a significant gap in time, and things are changing. This is a highly developed society with the best hospitality and the most respectful people I have ever met. As I have said before, we turn our backs on the Middle East at our peril.

Exercise

Running has not been possible here, as there is not enough pavement to accommodate it in the part of Riyadh where I have been staying, so it has been the treadmill for two weeks. My various injuries are starting to resolve, and I can do a full-length pull-up without screaming. This indicates that, if I continue to improve, I should be able to start climbing again.

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.

Saudi Arabia, Part 2

JEDDAH, Kingdom of Saudi Arabia—Between “Saudi Arabia, Part 1,” posted 31 March, and this entry, I have been home to Hull, visited Dublin for one night to give a lecture at the Royal College of Surgeons in Ireland, was in Edinburgh for three nights, and now I have been in Riyadh for a week. This post comes from the Crowne Plaza Jeddah, a 90-minute flight from Riyadh, where I have retreated for the weekend (Friday and Saturday).

My Facebook memory told me this morning that it is, to the day, exactly one year since I was last here. I need this break, because it has been a hectic week with teaching, preparation for teaching, and meetings. I spent a day at the Female Student Campus of King Saud University holding consultations and teaching students who are pursuing their master’s degree in nursing. I visited King Faisal Specialist Hospital & Research Centre to arrange for my day of teaching there next week, and one evening I visited the British ambassador's residence for a function organised by another UK university, the University of Dundee, where I know colleagues well. A farcical taxi journey caused me to miss the address by British Ambassador to Saudi Arabia, His Excellency Simon Collis, CMG, but I caught talks given by the Dundee staff.

Janice Rattray, University of Dundee, and
Ahmad Aboshaiqah, King Saud University.

I was very pleased to see Janice Rattray, PhD, RN, who is also working here this week. The last time I met her was a year ago in the first-class lounge of King Khalid Airport, Riyadh when we were both leaving Saudi Arabia. I also had lunch with her next day in the sumptuous Ritz Carlton hotel.

The journey to the British embassy did not go well from the start. My driver was unavailable, so the hotel staff summoned a taxi. It was clear from the outset that the cabbie had no idea where the British embassy was, nor did he speak English. When getting into the taxi, however, my thought was, “How bad can this be?” Well, it got bad. He drove to the diplomatic area as directed, I think, by the hotel staff, and tried to drop me off at a British school. I had the upper hand, of course, as I still had the 50 Saudi riyal, the maximum taxi fare, in my pocket.

We proceeded to do a tour of the embassies, and when I spotted the Union Jack on a sign, I thought I was safe, but it transpired—thanks to a Dutch gentleman who was trying to hail a taxi outside the Belgian embassy—that this was not the side of the compound where the British ambassador lived. My poor taxi driver was almost as stressed as me and refused to move, even after instructions in Arabic from the guard at the Belgian embassy who, I’m sure, was watching the commotion with amusement. I goaded the driver to move, but he wouldn’t.

I was standing outside the car when another drew up beside us to ask the Dutch gentleman directions to the British embassy. The occupants were two ladies I had met last year, and they recognised me. “Dr. Roger,” they shouted. I did not recognise them, however, as they were wearing traditional Saudi female attire. I paid off my driver, invited the Dutch gentleman to that taxi—he declined—and I joined the ladies in their taxi. The story does not end there, but it would take too long to describe every detail of our two tours round the diplomatic area with me crying, “Stop!” when I correctly identified the proper drop-off point—to no avail the first time, but successfully the second time.

James Smith, founding editor,
Journal of Advanced Nursing.

Meantime, turning the clock back a few days, I was in Edinburgh to attend the UK’s Royal College of Nursing (RCN) International Nursing Research Conference 2016, which celebrated 100 years of the RCN, 60 years of academic nursing at the University of Edinburgh, and 40 years of Journal of Advanced Nursing. I was there to interview James P. Smith, DLitt (honoris causa), OBE, founding editor of the journal, and Alison Tierney, PhD, FRCN, CBE, former editor-in-chief. I also entertained them, along with former editor Jacqueline Fawcett, PhD, FAAN. Fawcett recalled a lunch with my wife Debbie and me, and our then 10-year-old son Charles that took place more than 10 years ago on a very cold Boston winter day. You can hear the interviews in this podcast.

Despite coming to Jeddah to rest, I will be meeting two former doctoral students: Wafaa Al-Johani, PhD, RN, and Ahlam Eidah Al-Zahrani, PhD, RN, who both now work at The College of Nursing, King Abdulaziz University. They invited me to lunch with their dean, Hasnah Erfan Banjar, PhD, RN. I also had dinner with John Sedgewick, RN, director of nursing education and Saudization, King Faisal Specialist Hospital & Research Centre, and a doctoral student at the University of Sheffield, United Kingdom.

I don’t know if will return relaxed and refreshed to Riyadh tomorrow, but I have enjoyed every minute of this short break. I have a busy week ahead before I submit Part 3 of this Saudi Arabia trilogy.

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.

Saudi Arabia, Part 1

HULL, United Kingdom—Absence of a blog post from me for several weeks should not be interpreted to mean that I only write when I am on my travels. Occasionally, I post entries from Hull, where I have been for the past three weeks, but these weeks have been packed with long days, many meetings, learning about new processes, and catching up on supervision of doctoral students. As I remarked to my wife: “It’s almost like having a real job. I’ll be glad to get away for a rest.”

Yours Truly with Mustafa Bedrock.

I have just returned to the UK from Saudi Arabia, the first of three visits scheduled in quick succession. At the invitation of Mustafa Bodrick, PhD, RN, director, Center of Nursing Education, King Abdulaziz Medical City, I have been at the King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), where I attended and presented—keynote, workshop, and plenary—at the 2nd International Conference in Nursing & Health Sciences. We arrived in a dust storm and searing heat, which were followed by torrential rain that cleared the air and cooled things down considerably.

There were about 2,000 delegates at the conference, and I was one of five international speakers, all of whom worked hard each day to fulfill their obligations. I was delighted, for the second time this year, to meet Afaf Meleis, PhD, RN, FAAN, who is now dean emeritus at the University of Pennsylvania School of Nursing. We first met in Tainan, Taiwan. She is sparkling company, and her fluency in Arabic helped us all in several situations.

Yours Truly with local colleagues, Afaf Meleis (in
turquoise), and Shirley Moore (second from left).

I was also glad to renew acquaintance with Janye Smitten, PhD, RN, health administration tutor, Athabasca University, Canada’s Open University and Muntaha Gharaibeh, PhD, RN, former dean of nursing, Jordan University of Science and Technology. I met Smitten the first time a few years ago at the University of Alberta in Edmonton, Canada, and Gharaibeh two years ago in Saudi Arabia. At the conference, I was also very pleased to get to know Shirley Moore, PhD, RN, FAAN, The Edward J. and Louise Mellen Professor of Nursing at Case Western Reserve University, Cleveland, Ohio, USA, and associate dean for research at that school.

I was able to squeeze in a meeting one evening with Ahmad Aboshaiqah, PhD, RN, dean of nursing, King Saud University (KSU), Riyadh, and a prospective doctoral student to discuss admission processes at the University of Hull and the possibility of pioneering an external joint supervision programme between Hull and KSU. There was no great pressure to finalise arrangements, as I will return to KSU at the end of next week. All I have to do between now and then is secure a visa, visit Dublin and Edinburgh, and get back to London Heathrow.

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.

From Utrecht to Tainan and back home again

EN ROUTE TO LONDON—January has been one of the busiest months I remember for a long time. After visiting the Middle East, I was in the Netherlands, and now, after a week in Taiwan, am returning to the United Kingdom from Hong Kong aboard Cathay Pacific’s Flight CX253.

Utrecht

My time in the Netherlands was spent in Utrecht, where I gave a keynote address to the European Academy of Nursing Sciences (EANS) Winter Summit. I was originally invited last year when the conference was in Athens, but other travel obviated that. So I was really pleased to be able to accept this time, especially since Julie Taylor, PhD, RN, FEANS, chair of the summit’s Science Committee and professor of child protection at the University of Birmingham in the UK, is a long-time and very good friend.

My keynote (listen here) was on using social media to promote academic publications. I met many other old friends and colleagues in Utrecht and continue to be impressed by the quality of research carried out by some of the up-and-coming nursing academics in Europe. I am not a political Europhile, but I am very glad we have these trans-European organisations. David Richards, PhD, RN, FEANS, president of EANS and professor of mental health services research at the University of Exeter, UK, gave a very thoughtful and provocative summary of current events in Europe.

In discussing mass migration from the Middle East, he addressed the dilemma of responding with compassion to stateless people while having zero tolerance for the despicable attitudes some male migrants display toward women in the countries that have welcomed them. Moving to academic nursing journals, Richards claimed that a great deal of what is published in them is flawed, not the best introduction I could have had for my keynote address. Nevertheless, he and I have exchanged a great deal of good-natured banter across the years, and a little more never hurts.

The Republic of China

The election of a woman—Tsai Ing-wen—as president of Taiwan put this small island country on the international stage in the week prior to my arrival. I have to choose my words carefully here because describing Taiwan as a nation will upset my mainland Chinese colleagues, and anything suggesting Taiwan is less than independent will upset my Taiwanese Green Party colleagues.

This week, I was in the south of Taiwan in Tainan, the former capital and heartland of the Green Party, where everyone was delighted by the recent election result. I was a guest of the Asian Congress in Nursing Education held at National Cheng Kung University, Tainan. I was there to give a keynote address and was “on the bill” with the legendary Afaf Meleis, PhD, RN, FAAN, dean emeritus of the University of Pennsylvania School of Nursing, USA.

Yours Truly at ACiNE conference.

My keynote (listen here) was on use of nursing informatics in education, and I showed a picture of all eight of my children and pointed to my oldest daughter Hannah Watson, RN, BSc, who, on that very day, was celebrating 10 years as a registered nurse. In fact, on the day she passed her finals, I was also in Taiwan. A critical care specialist, she is just completing her advanced nurse practitioner programme at Sheffield Hallam University, UK.

This was a very special visit to Taiwan as it was the first time my wife had accompanied me. I cannot list all the people in Tainan and Taipei who were so wonderful looking after her, but special mention must go to Tzu-Pei Yeh, RN, who recently completed her PhD under my direction. She attended to our every need. We ate large quantities of Chinese food, listened to karaoke, and copiously toasted everyone with wine at a formal banquet. At least Mrs. Watson got some insight into my sufferings!

Tzu-Pei Yeh (right), my former PhD student, clarifies
a point for an attendee of her seminar.

Two nights in Taipei, where the recent election result was not greeted with much enthusiasm, completed the visit. We met Nanly Hsu, PhD, RN, former dean of nursing at Tzu-Chi University in Hualien, on the Pacific coast of Taiwan and Lin-Lian Huang, PhD, RN, FAAN, former dean of nursing at National Taiwan University, Taiwan. Former president of the Taiwan Nurses Association, Huang is a candidate to sit on the governing body of the International Council of Nurses (ICN).

Much to my embarrassment, Huang recalled that the UK, through the offices of the Royal College of Nursing (RCN), is no longer a member of the ICN. I am a long-standing member and a fellow of the RCN, but I simply cannot agree with us losing our voice on the world stage. There is an All-Party Parliamentary Group in the UK currently working with the RCN to consider nursing’s contribution to global health. My individual response, submitted recently to the group, included the point that the RCN should rejoin the ICN.

A meeting with Li-Chan Lin, PhD, RN, of National Yang-Ming University, Taiwan—my longest-standing Taiwanese colleague—completed our visit. Lin was Leverhulme Visiting Professor when I was working at the University of Sheffield, UK. If I pioneered assessment of feeding difficulty in older people with dementia, it was Lin who took this work to another level by translating my scale into Chinese and using it in the first rigorous intervention trials using Montessori and spaced retrieval methods. She knows my wife and family very well, and we had our annual reunion in “our place,” le ble d'or.

Back in Hull

This coming week, I will be interviewed about nursing education by Jane Dreaper of the BBC; do some “firefighting” over issues that have arisen and for which I am—pro tem—responsible; and conduct an intimate but necessary medical investigative procedure—you don’t want to know the details—before returning to the University of Genoa in Italy for a week. Otherwise, the racing season for us runners has started here, and I need to decide which races to aim for. My ambition remains completing a 10-kilometre race in under 45 minutes.

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.

Back in the sultanate

MUSCAT, Sultanate of Oman—My Christmas holiday was cut short slightly by the need to be in Oman on 2 January. This is my second visit to the sultanate, and I remain impressed by the religious tolerance and relative freedom I observe here, compared with some other parts of the Middle East I have visited. Also, compared with last time, the January weather has been very pleasant, making it possible to walk and even run in the evenings. My last visit here was at the height of their summer when any outside activity is almost unbearable. Virtually all Omanis are Muslim, and minarets and mosques are much in evidence. The call to prayer goes out regularly.

Minaret at Mutrah souk
(market) near Muscat.

Examining at Sultan Qaboos University

I have been here as an external examiner at the Sultan Qaboos University College of Nursing, located at the Sultan Qaboos University Hospital. The college is a cultural melting pot of nationalities with the staff composed of local Omanis, Jordanians, Filipinos, Ugandans, Indians, and at least one Pakistani. Normally, when I work as an external examiner, the job entails reviewing the processes used to examine students, looking at examination content, and assessing how well standards are being met.

All of that is part of my role here, but external examiners are also expected to participate in conducting final examinations of the students. Two days are spent in the hospital listening to students presenting clinical cases and observing them performing a clinical procedure. One day is spent taking part in the oral examinations. It’s very stressful for the students, exhausting for the examiners, and bears no resemblance to what I am used to back home. I am uncomfortable in the clinical areas, as I feel my presence is an intrusion into patient privacy. However, the role of external examiners is explained and, together with previous examiners, I have been able to persuade the college to minimize the time we spend at bedsides.

Aerial walkway at the university.

When I am overseas and invited to visit clinical areas, I invariably refuse, unless I have some specific function there that is related to teaching or research. Nevertheless, my time here in the hospital, as in my previous visit, was informative. Sickle cell disease is very common in Oman. The problem, as with many Arabic and Muslim populations, is consanguineous marriage. Health education advice and genetic counseling is provided in an effort to eradicate the disease, but preference for cousin marriage—a very strong cultural drive to keep things “in the family”—is hard to stop. Recessive carriers are so common that marrying outside of the family is no guarantee of not having children with sickle cell disease.

A resolution and an anniversary

My new year’s resolution, not the first time I have made this one, is to read more, and I made a good start over Christmas with The Alzheimer Conundrum by Margaret Lock. Lock is a social scientist who, equipped with a thorough knowledge of the literature, investigates theories about Alzheimer’s disease by interviewing some of the key researchers. Essentially, causes of Alzheimer’s disease—as opposed to correlates—remain controversial.

The Journal of Advanced Nursing celebrates 40 years this year—our “JANiversary”—and we will run a series of editorials throughout the year reflecting on the first issue and key papers from the first volume. These will be available to download free from our website for a few weeks. You may wish to read my January editorial which reflects on 40 years of JAN.

After leaving Oman, I return to the UK for 10 days, after which I travel to the Netherlands and then almost directly to Taiwan. My trip to the Far East will be a special one because, for the first time in many years, my wife will accompany me. Because it will be her first visit to Taiwan, it is causing great excitement among my colleagues there, as only a few have met her. On this occasion, I may not be the VIP.

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.

Sandstorms and traffic in Riyadh

RIYADH, Saudi Arabia—Arriving at King Khalid International Airport in Riyadh in the early hours of last Sunday impressed on me just how different this place is from anywhere else I go. The streams of young ladies in various queues are stopped past immigration and have their passports confiscated. This violation of human rights means they are the indentured maids of Saudi families. Misbehaviour of any kind ends in corporal punishment, or worse.

Yours Truly with Assistant Professor of
Nursing Joel Gonzales Patalagsa, RN,
of King Saud University.

The other side of Saudi Arabia becomes visible when my Indian driver shakes my hand, this followed by a charming young man in full Arab dress who also welcomes me to Riyadh. The latter is Fayez, the unfortunate member of the teaching staff at King Saud University who has been tasked to meet me. It is 3 a.m. before I arrive at my hotel. Fayez is clearly getting the rest of the day off; I am not. Three and a half hours later, I am up and off to meet the dean of nursing. I had my revenge on poor Fayez, however. My driver had no idea where to take me—nobody gave us instructions. We took in a great deal of Riyadh before I phoned Fayez, waking him up to get directions.

The dean is Associate Professor Ahmad Aboshaiqah, PhD, RN, whom I met earlier this year on a previous visit to Riyadh. Aboshaiqah, who lived in the United States for 10 years and whose doctorate was supervised by a mutual colleague, Marilyn Oermann, PhD, RN, FAAN, commiserates on the loss of my good friend here, Professor James Ware, FRCS, who died a few weeks back. I knew Ware in Hong

Professor James Ware,
8 July 1941 – 9 October 2015

Kong, his death was sudden and, as everyone here confirms, a great loss. He led the team responsible for medical examinations at the Saudi Commission for Health Specialties and also established the Journal of Health Specialties. I wrote his obituary for the journal, and that will be published soon.

Where are the women?

I am on my first visit to King Saud University to advise staff members on writing for publication. Everything is done twice, as there is strict separation of male and female students and, therefore, male and female staff members between the main campus and the “girls’” campus. Apart from the Arab dress and Arab manners—ultimate politeness to visitors and brusque orders to junior staff—everything is quite normal with the men.

To enter the girls’ campus is to enter another world. There is not a glimpse of an undergraduate student and no view of the actual campus, which is behind high walls and large double doors at the end of long corridors. I am in an outer sanctum where men may wander freely and only staff members and masters’ students may venture. Most women—staff and students—are in the hijab, with only eyes visible, which makes it very hard to know who is speaking.

There are few non-verbal clues to indicate what they are thinking. I also keep introducing myself to people—without a handshake—who tell me that I had already introduced myself. There is continual and distracting adjustment of the abaya, the yashmak, and the headdress and, as Arab women do not project their voices, I am both confused and exhausted by the end of two days. However, in two-to-one consultations—no female meets you alone—I was able to advise on research projects and manuscripts and answer questions about master’s and doctoral study at my university.

There is virtually nothing to do in Riyadh. Where alcohol might take the edge off a long evening for me elsewhere, it is not available here. To pass the time, you work your way through a series of tooth-rotting and waist-expanding sickly sweet fruit drinks and mountainous plates of food. Walking is virtually impossible. Pavements—where they exist—are badly kept and where there is construction, piles of bricks, tiles and sand block your way. Magnificent buildings tower into the night sky, but getting to them on foot is impossible and an incipient sandstorm makes being outdoors unpleasant. Crossing the road to get to something that looks interesting is life threatening, as indicated in this podcast clip. There was a gym at the hotel, so I managed to burn a few calories in the evening.

I will be in Saudi at least three times this next year, with one of those visits to King Saud University. I visit Oman in January and Qatar in February, so it seems that the Far East is becoming less of a venue for me as the Middle East becomes more prominent. With the world the way it is now, I am frequently asked about my personal safety. People unfamiliar with the region cannot distinguish between Arab and terrorist, between Moslem and Islamic extremist. The religion may seem incomprehensible and aspects of the culture repellant, but every person who declines contact isolates the region further. As for personal safety, if I change my schedule or the places I visit, I hand a minor victory to the merchants of death.

Good news and bad news

As the joke goes, do you want the good news or the bad news first? The UK government has decided to do two things with nursing education that make perfect sense to me, one of which I have long advocated. Nursing students are paid bursaries by the National Health Service (NHS) to study nursing, and this will end. Despite progress made in moving nursing to universities and the move to all-graduate entry to the profession, we have never completely broken the link to the idea of the hospital apprenticeship model of training. Most other students have to fund themselves or take out loans, which are repaid when they enter employment. The UK is unique. In the United States and Australia, nursing students have to finance their studies at university like any other student. There is evidence—admittedly anecdotal—that some students come into nursing only to be paid the bursary, with a low commitment to the profession. These reports come from fellow students. It has always seemed wrong to me that, in a situation where we are heavily oversubscribed to nursing programmes, that we may be turning away people with a genuine commitment in favour of people doing it for the bursary.

The other thing that will change, mainly as a result of this change in funding, is that the cap on nursing places in universities will be lifted, as it has been lifted for other subjects. Universities can now take as many nursing students as they can manage. These moves are proposed as a response to nursing shortages and the high levels of non-UK nurses working in the NHS. These proposals were raised in a report titled "Supplying the demand for nurses" by Edmund Stubbs, whose credentials include four years working as a health care assistant. When I downloaded my copy, I opened it with relish. Thus ends the “good news.”

Expecting to find a good read, I was horrified to find language that was highly insensitive toward non-UK nurses, inappropriate nationalism, and complete misunderstanding of how nursing education is organised. The insensitive langauge came in the form of negative stereotyping of non-UK nurses who work in the NHS. Stubbs describes how many go home after working for a few years, as if they were to blame for being recruited, many leaving the poverty of their country to earn money elsewhere and support their families. This seems like a very acceptable form of foreign aid to me. 

The nationalism was apparent in the suggestion that, while those who choose to work in the NHS should have their loans repaid, those who work abroad should not. There is no logic to the NHS repaying the loans. I fail to see how this represents a cost-saving (which is at the heart of the report), and it continues to set nursing students aside from other students. Bribing nurses to remain in the NHS by creating a financial differential is just wrong. If we want to encourage nurses to work in the NHS, we must make it a better place to work, and if we want to stop nurses from working overseas, then what about our contribution to global nursing and how do we ensure that nurses gain international experience that they can bring back to the UK?

Finally, the report suggests that increasing the number of nursing students will be beneficial to the NHS as cheap labour. This is ludicrous and, in any case, nursing students have been “supernumerary” for nearly 20 years and are not included as part of the nursing workforce. The author makes no mention of this or about how nursing students will receive adequate supervision in clinical practice. I assume he is unaware of the issues. I wish I could end on a higher note, but, but except for this blog and podcast, where I describe fully what I think of this and some recent research on non-UK nurses working in the NHS, I find myself—finally—lost for words.

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.