As we continue our series to highlight the work of our Board members, in this issue we speak with NMBI Vice President, Dr Louise Kavanagh McBride.
Can you tell our readers about your background and why you chose a career in nursing?
My interest in nursing came from having a family member in need of care and support. I became involved in voluntary work in her special needs and residential care unit, this really influenced me in my pursuit of the caring profession and nursing.
Hospitality and teaching were also career prospects, so when it came to the Leaving Certificate, I had a few options in mind. I firstly secured a place in college in hospitality and after completing one year, I got an offer to start general nursing in the Mater Misericordia Hospital Dublin. Commencing my nurse training in September 1986, would become the best decision I ever made.
I loved my nurse training and went on to specialise in the two specialist areas that I enjoyed most as a student nurse, Orthopaedics and Emergency Nursing. My interest in teaching as a career never really left me and I always had a particular interest in patient, family and even staff education. I always enjoyed working with new staff, student nurses, and other allied health care students. I would go through charts, notes, and x-rays with them during quieter times on shifts and night duty. Sharing my experience and imparting knowledge with students or other learners on the ward, I regarded as an important role of my clinical nursing career. This was how I learned as a student nurse. I can still remember all those caring, committed and experienced nursing role models that motivated, shaped, and empowered me as a student nurse during my training at the Mater and as a post-graduate in orthopaedic and emergency nursing.
Your career pathway is interesting as you chose to pursue nurse education. What drew you to this area?
I have always been aware of the importance of preparation, planning and keeping options open. This applies to the nursing and midwifery professions in terms of career planning and continuing professional development (CPD), including post-graduate education. I have a strong lifelong learning ethos as a nurse and educator. CPD is so important, as there is constant change in what we do, care delivery, practices, and research inform our practice to ensure that what we do is evidence-based.
When I reflect on my nursing clinical career and experience, it was enhanced and augmented by post-graduate courses in those specialist areas and my MSc in Nursing. This desire to educate endured during my post graduate courses and ensured evidenced-based practice which brought critical reflection into delivery of nursing care.
My ‘gra’ for teaching and sharing with other learners motivated me to do a post-graduate course in Clinical Health Science at Trinity College Dublin. This was the first of its kind at that time to increase the number of Registered Nurse Tutors (RNT) and Midwife Tutors (RMT) for the transition of nursing to HEIs. This required moving from my then clinical role as GP Liaison Clinical Nurse Manager in ER to the School of Nursing at the Mater Misericordia Hospital incorporating UCD. On reflection, the importance of role modelling, clinical leadership and clinical teaching was probably what drew me toward education. I really enjoyed my teaching and clinical tutor role on undergraduate and delivered teaching on the post-graduate course in Emergency Nursing. As Nurse tutors we would visit students on the wards on a weekly basis which ensured ongoing engagement and connection with students and nursing staff at clinical level.
I left Dublin in 2002 and moved to Donegal. After a short career break, I began working in Higher Education as a post-graduate nursing coordinator, an assistant lecturer, and then as a lecturer. My own CPD pathway motivated me in pursuit of a PhD which was possibly a culminating of my achievement in both my clinical and academic nursing leadership experiences. My PhD focused on nursing, and midwifery education entitled ‘An evaluation of student nurses and midwives’ beliefs of knowledge, reflective thinking levels and approaches to learning over an internship trajectory’. My doctorate findings revealed that through structured reflective practice sessions student nurses and midwives displayed significantly enhanced critical and reflective thinking levels, and deeper (versus superficial) approaches to learning from the start, middle and end of the internship trajectory. Suggesting that protected reflective practice is beneficial and enhanced when structured and facilitated especially in the final year of undergraduate nursing and midwifery degree programmes.
After completing my PhD, I was appointed as Academic Manager, as head of Department of Nursing and Health Care. I am currently involved with several research-funded projects and MSc research supervision. Research keeps nurses and midwives updated and relevant to contemporary changes and best practices from a nursing, midwifery, and healthcare perspective. I cannot emphasise the importance of this to new graduates and clinical nursing and midwifery staff. Taking the time to attend webinars and conferences, reading peer reviewed journals, research studies and HSE developments is important. Now, all of this is so much more accessible with the ability to join sessions virtually or listen back to recordings. CPD is significant also in the context of the development of the Maintenance of Professional Competence (MMCP) scheme ensuring continued competence for all nurses and midwives on the NMBI division. As Florence Nightingale once said, “Let us never consider ourselves finished nurses.... We must be learning all of our lives”.
For any of our readers who may be interested in exploring research as a career option, what advice would you give them?
Many people think you have to be undertaking a MSc or PhD course to be research active. I would say to graduates that it is a trajectory with so many opportunities at clinical level to engage in research, audits, quality initiatives, journal clubs, funded projects/studies, or even as participants in research. These can all influence and enhance you career path, and lead to change and innovation in best practice and care provision. Evidence-based and best practices are informed and changed through research, so clinical staff need to be constantly aware of what is happening in their relevant area or discipline.
It is the responsibility of every nurse and midwife to ensure they deliver the best practice and care available to their patients, and to ensure this, they must know whether their practice is evidence based. The only way to know that it is the best evidence, is to appreciate that evidence-based practice is drawn from published research and hence the importance of research to all.
Sometimes, scientists and researchers can seem removed from the real concerns of the profession. I believe it is important for nurses and midwives on the frontline, including students on NMBI's student Candidate Register, to contribute to the body of knowledge. The idea that researchers and scientists are in ivory towers or white coats in science labs, can do nursing academia and research a disservice and a belief held by many, but it is incumbent on us in academia to bring research to the bedside through clinical leadership, partnership and research collaborations.
The pandemic has certainly revolutionised how we deliver care and even education. It has created innovation and change in how we care and deliver services. It is so important that we continue to maximise on how digital transformation and eHealth can positively enhance care and service provision in the nursing and midwifery professions, whether it is in the public or private sectors at home or aboard.
My advice to anyone currently engaging or contemplating on CPD or research is simple - keep chipping away, find and make the time for CPD and research. We all struggle some days even in academia so stick with it, work through the challenges, build on your resilience and strive for completion, as it is not always about perfection. In my own education and research experiences, I have found that real learning and self-development comes with meaningful critical reflection on the experience, not just the achievement of outputs. I always remember the advice given to me especially in time of challenge by one of my nursing role models who has inspired me throughout my academic career. She would quote the lyrics from Mavis Staples song, “Keep your eye on the prize and hold on”- it’s such sound advice and worth sharing.
In terms of the NMBI Board, when did you join the Board and why did you choose to run for election?
In 2012, NMBI was seeking expressions of interest to participate on the then Ethics Committee and I applied as I felt I had a lot to contribute as a nurse and academic. I found this a valuable learning experience in terms of statutory state bodies, corporate governance, and the important role of NMBI in regulation. Then in 2014, a vacancy for the Institutes of Technology Academic Nursing representative arose and I was nominated by the President of Letterkenny Institute of Technology. I was subsequently appointed by the Minister for Health as the Technological Higher Education Association (THEA) Institutes of Technology representative.
I have been an NMBI Board member since 2015 and a member of the Education, Training and Standards Committee, the Business, Strategy and Finance Committee and the Fitness to Practice Committee. In December 2017, I was appointed as Vice President and then reappointed by the Minister for Health in December 2019 as the THEA nomination for a further three years. I also remain on the same three committees, as well as holding the position of Vice President.
The Board has seen a lot of change in the past eight years. I am very grateful and appreciative to have been part of that change and innovation, working with senior management at NMBI and my colleagues on the Board to achieve NMBIs strategic objectives.
The Board comprises of lay-members, and registered nurses and midwives across the areas of clinical practice, nurse training and administration. Why do you think it’s important for the Board of NMBI to have diversity in its representation?
I think it is important to remember that NMBI as a regulator for the professions of nursing and midwifery is also responsive to sociocultural changes on a national and international context. Diversity and inclusion are of fundamental importance to the Board in terms of representation. Since the enactment of the Nurses and Midwives 2011 Act and the introduction of the lay majority, I have found this very positive in terms of roles and value contribution. Ultimately the role of the Board as nurses, midwives and lay members is protection of the patient and members of the public through the commitment to fulfil this objective by supporting registered nurses and midwives to provided patient care of the highest standards.
What have been your biggest achievements as a Board member?
I have been very fortunate to be a Board member during a time when it has undergone extensive strategic change, innovation, and transformation. We have merged and refined some committees and terms of references.
I was part of the NMBI committee which organised the conference to celebrate 100 years of nursing regulation in Ireland in 2019. The event provided an opportunity to reflect on the past, present, and future of the profession of nursing in Ireland. It was an enormous success and representative of the nursing and midwifery professions including students.
Being appointed by the NMBI Board members as Vice President has been very important to me both personally and professionally. I am immensely proud of working on NMBI’s digitisation agenda (Project Nightingale), the HEI validation of graduates and the new Candidate Register for student nurses and student midwives.
Like everyone who has upskilled and responded to online delivery and work practice, NMBI has also been adaptable and responsive to the Board’s needs in terms of workload and committee operations.
What challenges have you faced during your time on the Board?
My current position as an academic manager is a busy one and certain times of the academic year are busier than others so, being organised and managing my time is very important. We can all struggle with having a work-life balance and I am no different. Having time to prepare for Board and committee meetings can be challenging.
The Covid-19 travel restrictions have in one way made us more reflective of balancing work and home life. As a Board we adapted, holding our meetings online. This has minimised the time spent travelling, with enhanced efficiency of time and sustainability especially when living in the North West. I certainly don’t miss the long waits in traffic on the M50.
You are also part of the Fitness to Practise Committee, the Education, Training and Standards Committee and the Business, Strategy and Finance Committee. Could you tell our readers a bit about what each Committee does and how it affects them?
NMBI committees are established by the Board to assist it in performing its functions. Committee members have a broad range of skills and expertise to ensure their recommendations are in the best interest of patients and the public.
There are eight committees, four of which are statutory and set out in legislation. The Fitness to Practise Committee (2011) is one of the statutory committees and it considers complaints which are referred to it by the Preliminary Proceedings Committee (PPC). There are 33 members, 11 of which are Board members and 22 who are non-Board members.
The Education, Training and Standards Committee is very interesting, and its role is to advise the Board on all matters relating to education and training. The committee provides oversight in relation to the development and implementation of standards, and the approval and monitoring of third level institutions and health care institutions in respect of education programmes leading to registration. It provides support and guidance to the professions in relation to education and continuing professional development and regularly reviews and develops guidance documents to ensure high professional standards.
The Business, Strategy and Finance Committee advises the Board on the areas of governance and finance and makes recommendations to ensure NMBI operates in the best interests of the public and the members of the professions of nursing and midwifery.
Considering the Board experience you now have, what advice would you give your younger self starting out?
I would stress the importance of continuing professional development and planning your career in terms of experience and post-graduate development. We advocate and encourage reflection in undergraduate and post-graduate courses, but we are most likely to reflect on the negative and things we didn’t do well. It is important to acknowledge and recognise the positives, the jobs we do daily in incredibly challenging circumstances and the positive impact we made to a patient, service-user, mother, or child. Most of all the importance of self-care, our mental health and well-being. The old saying ‘you can’t pour from an empty cup’ comes to mind. It is so important to seek the support of peers, colleagues, line managers, employee assistance programmes and online wellbeing webinars. All these things are essential. As nurses and midwives, we are good at looking after others but really need to mind ourselves, and our own health and wellbeing needs attention too.
What advice would you give someone who is interested in joining the NMBI Board or one of the NMBI Committee
Firstly, it is a great privilege and honour to be on the Board and one that requires a lot of time, work, and commitment. But it is rewarding and very satisfying. Different committees have varying workloads and demands, in terms of preparation for meetings, and position papers and documentation review.
NMBI is currently seeking registered practising midwives to participate in the Fitness to Practise Committee and is inviting applications for a vacancy on the Board. I would encourage anyone who is suitably qualified to find out more about the positions in this eZine and on the NMBI website.
It is important to look at your knowledge and experience in terms of your contribution. Being part of the Board and committees is a great opportunity to expand your knowledge and share your expertise in line with NMBI commitment to ensure that the Board operates in line with best practice in all areas of our work. Whether or not this relates to the board or committees, NMBI always welcomes opportunities to hear from nurses, midwives, the public and others on any aspect of NMBI’s work.
