How to be a Nurse or Midwife Leader

David Ashton, Jamie Ripman, Philippa Williams

• Publisher: Wiley-Blackwell
• Year: 2016
• ISBN:
  9781119187028
• Edition: 1
• Topic: Medicina
• Subtopic: Infermieristica

How to be a Nurse or Midwife Leader is an indispensable guide for all nurses and midwives who wish to develop and improve their practice as leaders. Written in collaboration with the NHS Leadership Academy, this practical book draws on the real experience of over 10, 000 nurses and midwives to bring leadership dilemmas to life in specific situations.

Key learning features include:

• How to develop your self-awareness
• How to develop your personal impact and presence
• How to survive and thrive
• How to get your message across
• How to get the best out of others
• How to work with and lead other professionals and patients
• How to have courageous conversations
• How to balance conflicting demands and needs

Containing exercises and reflective questions to help apply theory to leadership practice, How to be a Nurse or Midwife Leader is an ideal companion for all nurses and midwives, whether you are newly qualified, or stepping into a team leader role.

Part 1
Leading myself well

Chapter 1
To begin at the beginning …

David Ashton

Identity and self at work

The subject of identity at work is complex and can be viewed from a whole range of different perspectives. It is important that we have an understanding of this so that we can appreciate different views of what it means and feels like to be at work and as nurses and midwives why we do what we do.

This chapter will take you through some of the theoretical aspects of identity, specifically identity in the context of work and also in the context of being part of a profession. The professions of nursing and midwifery can represent, through the work they do, all that is best about the NHS and society more broadly. Society places trust and an expectation on the people in these roles that they will be technically capable and proficient and equally able to deliver that technical capability in a kind and compassionate way. The profession holds something for the collective societal psyche so when tragedies occur, such as the appalling failings in care at Mid‐Staffordshire NHS Trust, they undermine the trust that has been hard won and afforded by society and the best efforts of those committed to excellence in care delivery. ‘Kindness is not a side issue, it is what we are about and it is what leadership is about’ (Ballatt and Campling, 2011). Or as one nurse put it:

‘The technical work of nursing is one thing, of course it can be emotionally difficult and demanding. Leading a team to maintain compassion in care is another matter… it’s what I’ve signed up to do, it’s what I will do… otherwise why bother? You’ve got to be technically up to the job and you’ve got to be emotionally literate, attuned.’

(Ward Sister, acute trust)

In this chapter we will address the notion of how we, and others, might see ourselves as nurses and midwives and specifically as leaders in those professions. We will also explore something of what it means to be a professional. The following vignette refers to the aunt of the chapter author and illustrates the deep attachment of one person to her professional identity – the story of one individual that can be applied to many people.

Edie and the story of is/was.

Edie, my aunt, is/was a nurse. She had been a ward sister in what was termed a psychiatric hospital, in fact her mother had also been a sister at the same hospital and her father had been a charge nurse there. As a nurse I broke the mould a little, but only a little, I was a registered general nurse, my wife was a nurse and midwife and one of our daughters was a dental nurse… as you see, it runs in the family. A family tradition that isn’t that uncommon in nursing or in fact other professions and occupations.

At the time of writing this, Edie was in a state of is/was being a nurse. Again, at the time of writing, she was 86 years old and had dementia. As many of you will know, this cruel disease, which gradually corrupts then wipes your memory, was little by little taking her away from herself and the people around her, at first disconnecting her personal and social constructs, then moving around and finally removing the pieces of her personal and social jigsaw. Yet her identity and recollections of her time working as a nurse are a common touching place in our conversations, somewhere where her memories are clear and still have meaning. The is/was comes into play because there are times when she knows she was a ward sister, she recounts incidents both good and bad accurately, the level of detail and recall is accurate and focused. When ex‐colleagues come to visit, she knows who they are and what they did. There are also times when she still is the ward sister, she talks as if she is on duty, at times referring to the other care home residents as her patients, admonishing the staff if she thinks they are late with meals and then praising them for something she has approved of. By and large people go with the was and is quite readily – it regulates everyone. I think there is something helpful about sharing common ground and looking through a window at a shared memory of what was and who she was.

We, the family, fill her room with artefacts of her past, including a picture of Edie and her mother, my grandmother, resplendent in starched hats and cuffs, big silver buckles gleaming on blue belts – and to be frank looking pretty forbidding! She takes pride in this and refers to it often – it is a powerful connection to her mother and their shared identity. The very way they stand in the photograph speaks of their professional position and their pride in it. For my part, when Edie first arrived in the care home, I too was keen to make sure the staff knew she had been a nurse and had also cared for people with dementia.

The relevance of this story in the context of this book is that Edie’s identity as a nurse still matters to her, it matters to the author and it matters as information to the staff and how they relate to Edie as someone in their care. Until recently, when her condition deteriorated, it mattered to some of the other residents as she tried to organise them in her role as ‘ward sister’! Her state of is/was is a story of her identity and whilst there are other aspects to her personal construct, her identity as a nurse is hugely significant – it forms part of her psyche, the essence of who she is. There is often something very important to people, especially people whose role sits somewhere on a spectrum of a calling or vocation at one end and a transactional paid‐for or waged task at the other. And, like Edie, it can be one of the most significant aspects of their personal construct. This nurse’s description of going back to work after a career break captures the excitement of returning to her calling beautifully.

‘“Nursing is the art of caring” – a tutor told me that when I first started my training and I’ve always treasured it. I’d had a break from nursing while my children were small, and was so excited to return to the bedside. I had missed the action, the passion and that great feeling of making a difference. The night before I could barely sleep – I was back to where I wanted to be. I couldn’t wait to put my medal back on.’

(Unit Co‐ordinator of a frail care unit, BUPA)

First impressions and identity

It’s pretty common in a social setting for people to introduce themselves by their name, fairly obvious really, not to mention immensely helpful. However, the introduction is frequently followed by a question, particularly when meeting someone for the first time, and that question usually goes something like ‘and so, what do you do?’. At one level this is a pleasantry, a show of interest to find out more about the person you have just met. There is also a deeper reason, a question behind the question if you like, something of which the questioner may not even be consciously aware. Why we do this is pretty complex but the reason can be that we need to place the other person somewhere in the social structure or, more specifically, somewhere in the social structure in relation to ourselves – it’s a social anthropologist’s field day!

---

Make a note of this ‘and so what do you do?’ the next time you’re in a social setting – try and gauge the other person’s response and reactions, and just as importantly, note your own! Notice what you feel as well as what you think. If, like me, you’re a people watcher, see how other people interact.

---

The reality is t...

Table of contents

• Cover
• Title Page
• Table of Contents
• Authors
• Contributors
• Foreword
• Foreword
• Introduction
• Part 1: Leading myself well
• Part 2: Leading others with skill
• Part 3: Leading collectively and collaboratively
• Afterword
• Index
• End User License Agreement