Nurses’ guiding light

June 1, 2020

Sunderland-born Dr John Unsworth has dedicated his life to nursing practice, education, management, research and advocacy. On International Nurses Day, he talked to Alison Cowie about his career and a profession currently rising to the challenges of the greatest healthcare crisis for more than 100 years

It is appropriate that I’m speaking to Dr John Unsworth on International Nurses Day (May 12) in a year that has not only been designated by the World Health Organisation as the Year of the Nurse and Midwife, but where nurses across the globe are battling the devastating coronavirus pandemic.

Dr Unsworth – who prefers to be known as John – has dedicated his 37-year career to nursing in a variety of practice, management, education, research and advocacy roles.

He is currently an associate professor at the University of Sunderland – where he trains and inspires existing and trainee nurses in clinical simulation and patient safety, law and ethics, and infection prevention and control – and is chair of The Queen’s Nursing Institute, a 133-year-old national charity that provides grants, professional development, policy and research for community nurses, employers, policymakers and educators.

At present, John – who was awarded a National Teaching Fellow in 2013 and made a Principal Fellow of the Higher Education Academy in 2015 – balances his daily responsibilities with those of a clinical contact caseworker for Public Health England, a role he was assigned when he answered the call for former NHS workers to return to practice amid the current pandemic.

John knew he wanted to be a nurse from the age of 13 and, at 17, began his training at what was then the Sunderland School of Nursing.

After qualifying, John spent two years working on a ward at Sunderland Royal Infirmary before moving north of the Tyne to take up his first district nursing post – in turn fulfilling his dream to work in the community.

“During my training, I did a week’s placement in the community and, after that, I knew my career ambitions lay in district nursing,” he recalls.

As a district nurse for Northumbria Healthcare NHS Foundation Trust, John covered an area from Cramlington to the Scottish borders and across to Cumbria – caring for patients in their homes.

His aptitude and dedication were recognised  and he was promoted to nurse director.

The move into NHS management presented new responsibilities and challenges but John never lost sight of his core principles.

“I’ve always stayed true to my values as a nurse,” says John, who would attend all his management meetings in his nurses uniform. “As a manager, you walk a tightrope between doing the hands-on stuff and managing effectively, but it was important for me to continue to go out to practice with staff.

“I’d never go into homes expecting to be introduced as the nurse director. To the patients, I was ‘John, the nurse’.”

Being a nurse director did, however, enable John to action workforce change at the trust, which focused on reducing unnecessary trips to hospitals for patients.

“Elderly patients often lose a degree of independence when they’re hospitalised and can become increasingly frail,” says John.

“Putting the current pandemic aside, if you can avoid hospital admission and care for people just as well in the home, it’s better for them.

“It’s not about denying people hospital access,” he continues. “It’s about providing the most appropriate care in the most appropriate place.”

In the mid-1990s, John took a lecturer practitioner position and for the next ten years, balancing teaching with his NHS nursing. In 2007, he then made the permanent move into academia when he took on the role of director of nursing programmes at Northumbria University.

At Northumbria, John was able to address some of the issues he felt had developed in nurse training over the years.

“When I trained as a nurse, I learnt about procedures, diseases, drugs, anatomy and physiology. But in around 2000, training began to move away from that and more towards teaching compassion and communication skills.

“Being a nurse – especially in the community – is all about decision making. A study by one of my colleagues found district nurses make 800 safety-critical decisions a day. Having compassion is, of course, important, but it’s vital to have the medical acumen to be able to assess risk and make those critical decisions for patients.”

John spent eight years at Northumbria University before moving to the Higher Education Academy, an organisation that supports the development of higher education, where he became head of academic development.

During his teaching career, John has worked with nurses and medical educators in Thailand, Hungary, Ghana and China, where he’s found remarkable similarities country-to-country.

“You go anywhere in the world and see exactly the same issues, just at different stages,” he says.

John moved to the University of Sunderland in July 2017, taking up the position of head of learning and teaching enhancement.

He played a pivotal role in the successful bid to establish the School of Medicine at the university – which welcomed its first cohort in September 2019 – and is particularly proud that it encourages students from a range of backgrounds.

“A lot of students who enter our health programmes haven’t followed the traditional entry path. They may have done night classes to get the required qualifications, for example,” John explains.

“We’re helping to open these courses up to people who may have never considered attending medical school – or even university – before.

“For me, that’s is really important because I was the first person in my family to get a degree.”

The coronavirus crisis, of course, has massively impacted the educational provision at the university and John and the team have moved to online teaching.

“It’s been successful, and that’s a testament to the staff and students who have collaborated to make it work,” says John.

“We’re currently preparing for the new academic year, which will have some face-to- face, socially distanced teaching and some online teaching.

“Our mindsets have changed around digital teaching and there’s probably no going back now. Ultimately, things will change for the better.”

John is also focused on how the crisis is impacting frontline nurses.

Across the world, they have been at the forefront in containing the spread of COVID-19, and some have paid the ultimate price for their service. At the time of writing, there have been 181 deaths of NHS workers connected to COVID-19 [reported to NHS England], but the actual figure could be higher.

John – who now spends his evenings and weekends working for Public Health England – is hugely proud of how the nursing profession has responded to the crisis.

“This is the biggest pandemic in more than 100 years in terms of scale and impact, and nurses have been put front and centre of it.

“I’m exceptionally proud of all my colleagues who are working day and night to care for patients.”

John describes the levels of PPE for nurses as “woefully inadequate” and the result has put them at risk. He is also mindful of the lasting emotional impact the pandemic will have on beleaguered NHS staff.

“They’re having to make really difficult decisions in exceptional circumstances. Usually, when somebody is reaching the end of their life, their family is with them. This hasn’t been possible and it’s had a huge impact on the people caring
for them. Those workers are going to need a lot of psychological support.”

John is hoping that the attention nurses is receiving amid this crisis will lead to long-term changes to a profession that’s often overlooked. “We’re facing a massive workforce crisis in nursing,” John explains. “There are nine million nursing vacancies around the world, of which more than 40,000 are in England. We need to get the messaging right about what opportunities there are and what skills are needed.”

Being chair of The Queen’s Nursing Institute provides the ideal platform for John to advocate for such changes.

“I get to meet senior civil servants and health ministers and I must use these opportunities to influence policy in the right way,” he says.

In mid-March, it was announced that John had been invited as part of an elite group of global nursing leaders to attend the prestigious International Council of Nurses (ICN) programme, designed for those who are in a position to influence policy at a national and international level.

While the pandemic has delayed the start of the programme, John recognises the opportunity it presents.

“The mentoring aspect, in particular, is going to be great, and hopefully, when the programme can start, I can learn more about how to influence policy effectively.”

While it seems this dedicated practitioner, academic, researcher and advocate prefers to be known as ‘John, the nurse’, there’s no denying he has the knowledge, position and drive to help shape the future of nursing for the better.

The University of Sunderland

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