Career paths: Four nurses’ journeys

1 August 2014

Nursing Review once again asked some nurses from across the country in senior roles to tell us what path they followed to where they are today. They each have a good story to tell, from schoolgirl volunteering to careers being diverted by motherhood, and of job options closed in their chosen area but opening in another, plus the importance of role models and mentors. They share tips on career planning and the skills, qualities, and qualifications helpful in their roles.

 

Role modelling by nurse leaders and pushes by a mentor helped mental health nurse educator KATHY MOORE’s career fall into place.

NAME: Kathy Moore

JOB TITLE: Nurse Educator Mental Health, Ko Awatea, Counties Manukau District Health Board

NURSING QUALIFICATIONS:

  • Psychiatric Nurse 1974 (Sunnyside Psychiatric Hospital*)
  • General and Obstetric Nurse 1979 (Middlemore Hospital)
  • Postgraduate Diploma in Mental Health Nursing 1998
  • Postgraduate papers in clinical education and supervision

*I was recruited at 17 by Margaret Bazley, the then Sunnyside principal nurse at Sunnyside Hospital, whose later roles have included New Zealand Chief Nurse and Social Welfare Director-General.

 

Briefly describe your initial years as an RN?

I gained a variety of experience in acute inpatient, forensics, older persons, and intellectual disability before I moved to the former Kingseat Hospital to work with those with an intellectual disability. After training as a general and obstetric nurse, I recognised that this was essential to provide holistic nursing practice.

An opportunity came up to be part of the new mental health community services. This was an exciting initiative working with clients across the whole continuum. Doctor cover was minimal, so nurses completed initial assessments, ran groups, day patient programmes, and other psychological interventions with colleagues such as psychologists. This was also the beginning of seeing clients in crisis and completing assessments in general wards and ED.

Commitment to a mortgage and family sent me back to inpatient services to take up a charge nurse position.

 

Did you have a career plan (vague or definite) on becoming an RN? How did those early years influence your subsequent career?

I just wanted to be a really good nurse. I had observed things in my first five years that that did not provide dignified care and I wanted to influence change, and develop patient-centred services.

I did not have a specific plan. I just fell into things. I became a charge nurse and worked for the next four years in inpatient services. The charge nurse role in the 80s was a very autonomous role that allowed me to truly influence nurses’ clinical practice, models of care, and client pathways.

 

What led you into your current field or specialty?

While working as a CN, I was encouraged by a nurse colleague (Tim Wallace, who later became my mentor) to apply for the in-service educator role – an amazing opportunity and challenge that involved me in new initiatives like development of an advocacy service and establishing homes in the community.

 

What qualifications, skills, or stepping stone jobs were particularly helpful and/or necessary in reaching your current role?

Work experience:

  • a wide range of clinical areas developing a generic skill set in both inpatient and community settings
  • being a charge nurse
  • working as an inservice educator across settings and disciplines
  • working as ECT clinical nurse specialist.

Influence:

  • Margaret Bazley – she was a major change agent and told us as new student nurses that we were to be change agents.
  • Learning that:
  • I felt uncomfortable during the management of change process that I had little influence over. This influences me today to recognise the stress of change, even if the change is exciting, and to ensure the process is very transparent
  • clinical work and education was where my passion was.

 

What personal characteristics are particularly important for nurses working in your role?

 

  • To be tenacious in ensuring principles and values are upheld.
  • Deciding the type of nurse you want to be i.e. drawing a line in the sand about your principles and practice for the rest of your career.
  • Being prepared to change and learn as practice changes.
  • To actually want to be a nurse and make a difference in people’s lives.
  • To keep nursing strong by nurturing and developing new nurses to do our job.

 

What career advice would you give to nurses seeking a similar role to yours?

Seek to develop a wide range of clinical skills through experiences and actively take opportunities for new learning. Seek out mentors who are prepared to challenge you to look at your practice. Make a plan for your professional development that extends you and moves you out of your comfort zone. Never underrate the importance of relationships and communication.

 

Describe your current role and responsibilities?

I am nurse educator mental health, which is really a misnomer as my work is far wider than this. I have clear responsibility for support and leadership to nursing but also have a multidisciplinary function, especially around education. The whole team works as part of a professional development unit for the DHB. I contribute to the Safe Practice and Effective Communication education (SPEC) provided for mental health services and security at the DHB and wider afield, including recently delivering SPEC training in Samoa. My role has enabled me to work with, grow and develop nurses across our service and this has probably been one of the most rewarding aspects of my nursing career.

 

 

Rest home nurse manager SUE MILTON sewed the seed for her passion for gerontology during volunteer work as a schoolgirl.

NAME: Sue Milton

TITLE: Nurse Manager, Gulf Views Rest Home, Auckland

NURSING QUALIFICATIONS:

RN 1973 Greenlane Hospital postgraduate qualification in gerontology 1984 AUT health management course

 

Briefly describe your initial five years as an RN?

I worked at Greenlane in a ward dedicated to infectious wounds e.g. postoperative complications and perianal abscesses. There was a mix of medical and surgical cases.

 

How did those first five years influence your subsequent career?

I had always wanted to go nursing from a very young age and never wavered from that ambition. I learnt a lot in those first five years of registration, especially about accountability as sometimes you would be the only RN on a shift, with the balance of the staff being student nurses. Being the only RN meant you had to think on your feet and be confident in the decisions you made. As we rotated around the hospital during our training, everyone knew each other and the areas of the hospital, and we tended to work in collaboration. I can’t say I became more aware of my strengths or weaknesses. We just got on with things.

 

What led you into your current field or specialty?

I volunteered at the old Cornwall Hospital (via the Red Cross) on Saturdays making beds and also worked in a rest home during my school holidays until I started nursing. I had amazing experiences and developed a greater understanding about acceptance and tolerance from this age group. I was also enthralled listening to the stories of their lives. I suspect this was where I developed my passion for this specialty.

I gained a gerontology qualification through AUT and also a health management course. I am currently the chair of the Auckland region of NZNO’s Gerontology Section and previously served on the section’s national executive. Part of my role is to assist with the planning of study days and conferences. Recently, I was awarded the Counties Manukau District Health Board 2014 Health of Older People Residential Care Award for recognition for my commitment to the care of the elderly.

 

What personal characteristics are particularly important for nurses working in your role?

An inherent passion to working with older adults, good listening skills, and a supportive attitude when dealing with both residents and staff. Working in the private sector, there needs to be an ability to accept people as equals and acknowledge every skill level.

 

Any helpful advice for nurses wanting to follow a career in older people’s health – particularly in becoming a nurse manager?

Work your way up the ranks. Consider time in related disciplines such as orthopaedic, medical, and surgical areas. Gerontology is a specialised field now due to the complex needs of the residents. You need to build and lead a strong team to achieve exemplary outcomes for the older adult.

 

Describe your current role and responsibilities?

Being a rest home nurse manager is an extremely diverse role with both clinical and business aspects. I am responsible for the overall management of the facility including clinical leadership, budgets, human resources, risk management and certification. In fact, I am the glue that bind these all together.

 

 

PHO clinical manager BARBARA VARDEY says until recently she has been an “accidental tourist” along her career path…

NAME: Barbara Vardey

TITLE: Clinical Services Manager, Compass Health, Wellington

NURSING QUALIFICATIONS:

  • RN 1980 (Wellington Hospital)
  • PG Cert in Primary Care 2006
  • PG Cert in Pacific Health 2012 (through Aniva Pacific Nurse Leaders programme)

 

Briefly describe your initial five years as an RN?

My first role as a registered nurse was in the orthopaedic ward of the newly built and innovative Kenepuru Hospital. I left after eight months and went to work in the surgical ward of an Australian teaching hospital, which still had student nurses and the model of nursing was still task orientated. I returned to New Zealand after 12 months as my first child was due. I had children over the next few years and worked casually at Kenepuru Hospital and also at a local GP practice.

 

Did you have a career plan (vague or definite) on becoming an RN? How did those first five years influence your subsequent career?

In both my Cook Islands family and my English/Kiwi family, there have been doctors, nurses, and traditional healers. I always wanted to be a nurse as it was a role I identified with. The positions I held in the first five years affirmed my belief that nursing was where I could influence and support people to get well and keep well. I enjoyed the contact and relationships you can develop with likeminded colleagues and also with patients and families.

 

What led you into your current field or specialty?

I have been an accidental tourist in my career to date and have only recently recognised this. There was no active planning to get to my current role. I got my first role in primary care with a GP in Cannons Creek through word of mouth. I recognised the potential that nurses had in primary care to influence people’s wellbeing. I did casual nursing until I got a permanent role in Porirua’s Waitangirua Health Centre. This role worked well with my growing family, and it was close to home. I worked with amazing nurses and doctors; their experience, practice and skills helped build my knowledge. While working there,

I got an opportunity to work in youth health in secondary school clinics and develop a new outreach nursing service working with GP clinics. These new roles built my confidence and increased my awareness of the barriers to healthcare and also the disparity experienced by some members of our community.

 

What qualifications, skills, or stepping stone jobs were particularly helpful and/or necessary in reaching your current role?

I am curious by nature and have been surrounded by some incredible nurses, doctors, managers, and others in all the roles I have worked in. I have observed them and taken from them skills, knowledge, and the courage I needed to grow my ability to be a more effective nurse and manager. Although I did not go down the academic pathway, I have been supported to do courses I felt would assist me support staff and benefit my performance as a nurse and leader. I have had leadership roles outside of my ‘job’ that also helped me form a leadership style which works for me.

 

What personal characteristics are particularly important for nurses working in your role?

I believe you need to have credible leadership skills that are evident in your relationships and performance of the role. You need to be knowledgeable and competent in the area in which you work. Being personable, approachable and direct when required helps teams understand how to work with you. Do not shy away from the difficult discussions but be fair. Your team needs to feel you believe in them and are prepared to support them fully.

 

What career advice would you give to nurses seeking a similar role to yours?

Work in as many roles as possible and learn as much as you can about nursing and how you can influence change. Spend time understanding the communities you work in. Participate in courses or do postgraduate study that will help you understand the difference in clinical leadership and management models. Attend clinical supervision or peer review to self-reflect and continue developing your own style of leadership. Take opportunities to grow yourself.

 

Describe your current role and responsibilities?

I work as a clinical services manager in a large PHO; the role has developed over the last few years. Initially my responsibilities were to manage the outreach nursing team, oversight of the school nursing service, and rheumatic fever service and workforce development for nurses as chair of the nurses committee. I have membership on many local, regional, and sub-regional committees, steering groups, and governance groups. My responsibilities changed in the last month, and I now have clinical leadership of the Pacific Navigation Services (a regional service with some of the team employed by another PHO), Rheumatic Fever Services (which are also regional) and workforce development. I am also ‘2IC’ to the clinical director.

 

Surgical nursing director NICKY GRAHAM’s initial career path diverted from paediatric to adult surgery and she hasn’t looked back.

NAME: Nicky Graham

JOB TITLE: Surgical Nursing Director, Christchurch Hospital

NURSING QUALIFICATIONS:

  • BN 1998 Christchurch Polytechnic Institute of Technology Postgraduate Cert in Health Sciences (Nursing Leadership & Management) 2006
  • Xcelr8 Management Development Programme 2007
  • NZIM Four Quadrant Leadership 2010

 

Briefly describe your initial five years as an RN?

On graduating I worked in paediatrics, both at Brackenridge and in a paediatric surgical ward. I moved to Blenheim and rotated between ATR (assessment, treatment, and rehabilitation), paediatric, gynaecology, and general surgery wards. I returned to Christchurch to a general surgical and vascular ward.

 

Did you have a career plan on becoming an RN? How did those first years influence your subsequent career?

My initial plan was to work in a surgical paediatric area. However, on returning to Christchurch, there were no vacant positions, and I followed an adult surgical path, which I really enjoyed. The first five years cemented my passion for nursing and gave me good exposure to different facets of nursing and the health system.

 

What led you into your current field or specialty?

After developing as a senior RN, I became more involved in informal and formal leadership roles. I became second in charge of the Gastroenterology Investigative Unit at Christchurch Hospital for four years before moving to Australia and a position as the clinical charge nurse of a day surgery and endoscopy unit. I returned to Christchurch and became the nurse manager of the perioperative service on an 18-month secondment. Following a restructure, I continued as the charge nurse manager in this area before being seconded for 12 months to the role of service manager for the General Surgery department. I then had the exciting opportunity to apply for and gain the role of surgical nursing director.

 

What qualifications, skills, or stepping stone jobs were particularly helpful and/or necessary in reaching your current role?

I believe my surgical and perioperative background, nursing leadership, and management papers and previous leadership roles were extremely beneficial in providing the knowledge and skills required for this role. I have been actively engaged in strategic planning, change management, and numerous quality improvement, innovation, and organisational change initiatives during my career, which has assisted with the skill set required for the role.

 

What personal characteristics are particularly important for nurses working in your role?

A passion for nursing and a patient-focused and continuous improvement ethos are essential. I believe it is important to have excellent communication skills and the ability to develop collaborative partnerships with nursing, medical, community, allied health and management.

 

What career advice would you give to nurses seeking a similar role to yours?

It is important to get involved in additional portfolios within the ward/unit setting to grow your knowledge and skills. Make it known to your nursing leader you are interested in career advancement and senior roles within the organisation. It would be advisable to have a career plan in place but with some flexibility within this, as different opportunities may arise.

 

Describe your current role and responsibilities?

My current role is to lead the surgical nursing cluster to ensure CDHB vision and strategy is implemented and that daily operations are maximised whilst delivering quality nursing care. I work in a collaborative manner, embracing nursing innovation and identifying opportunities to improve the journey for the patient and health outcomes.