Mark Aitken: Hello! And welcome to the Nurse and Midwife Support self-care podcast. Your health matters. I’m Mark Aitken, your podcast host for today. I’m the Stakeholder Engagement Manager with Nurse and Midwife Support. I’m also a registered nurse. Nurse and Midwife Support is the national support service for nurses, midwives and students. The service is anonymous, confidential and free. You can call us about anything, anytime on 1800 667 877. Or contact us at nmsupport.org.au
My guest today is Kylie Ward. Kylie is the chief executive officer, adjunct professor at the Australian College of Nursing. Kylie is also a fellow of the Australian College of Nursing. Welcome, and hello Kylie!
KW: Hi Mark! Great to be here.
MA: Great to have you here. Kylie, would you please tell our listeners a bit about yourself? Why do you think Nurse and Midwife Support is important for nurses and midwives?
KW: I am also a registered nurse, very proud nurse and I’ve been registered in Australia for 27 years. Nurse and Midwife Support is something that I wish existed years ago, when I was earlier in my career.
MA: Me too.
KW: Yes, definitely. But to know that there’s 24/7 access to somebody, where you feel safe and you get advice and you can be free to speak without any implications or repercussions is something that every professional should have and deserves. I also feel that it’s a little bit like an amnesty of knowing that it’s not always appropriate to talk to your colleagues. We shouldn’t, not everybody wants to. So, to me, to ask all sorts of questions and know that you have the freedom and the respect to be listened to and answered is very important.
MA: I agree Kylie, and I think nurses and midwives tell us how important it is to pick up the phone and talk to somebody who understands the world that they live and work in. Because the people who answer the phone are nurses and midwives, trained in counselling. There’s a lot of support and good will out there for the service. So, thanks for your support…
KW: Oh, absolutely!
MA: Kylie, the Australian College of Nursing recently launched the Nurse Strong program. I was at the launch, on the Gold Coast at your conference this year. Can you tell us a bit about the Nurse Strong program and how you think it supports nurses?
KW: Yes, it was a great launch, wasn’t it?
MA: It was fantastic.
KW: And a really important time for nurses and the nursing profession. It was actually in Geneva last year when I was there for the International Council of Nurses meeting and then the World Health Assembly. I was looking around and did realize that a lot of us who have dedicated our careers to health, don’t necessarily emulate the health profession and the health industry. I, myself, am absolutely included in that. I’ve put on a few kilo’s in this job and I understand the pressures. It would have been easier to privately manage that, but I felt that I possibly wouldn’t be alone. As a health professional, and myself included, you give so much of yourself all day every day, everywhere. Nurses are classic for this, we go into this industry and into this profession because we’re caring. The world’s full of givers and takers. Nurses are givers. You give that much of yourself that you forget where the boundaries are, or where the prompts are to stop and say hang on, it’s time to give to self. There’s a lot of guilt associated with that. So, I felt that if I could lose a few kilo’s (not for the point of how I look) it’s not about looking a certain way or fitting societies stereotypes, it’s actually around health. Universal healthcare. I don’t have any conditions or any illnesses and knowing I’m in my late forties I would be perfectly positioned for type two diabetes if I don’t do something. So, it’s from a health perspective that I should do something and be strong and fit. For all of the desires and ambitions that I have regarding wanting to give as a nurse, I need to be the healthiest that I can be. This was really around: imagine if nurses really took care of their health and their strength! There’s 390, 000 nurses and midwives in the country, about 350, 000 of those are nurses. Imagine if every nurse took stock and made sure that we were strong and healthy? That we weren’t going to be needing the health system. What impact would that have on the burden of disease? My other thoughts were that by 2025 we predicted that there would be an 80, 000-nursing workforce shortage in Australia and by 2030 that will go up to 125, 000 nurses. The average age of a nurse is 44. If in the next 10 – 15 years we’re needing the health system because we’re unwell, then who will be looking after all of us?
I just got thinking on the plane, as great ideas do when you can’t sleep, I really thought, what could we (myself and the College) possibly do to lead the health of the nation? Nurses are best placed to do this. So, the fruition of Nurse Strong came about. It’s important on many levels, but it’s also been very exciting for everyone involved.
MA: So, a great idea was born Kylie!
MA: And I think nurses and midwives are really good at developing great ideas that make a difference to the lives of others, so congratulations on this. It is very important that nurses and midwives remain strong because we often do very challenging work.
MA: What do you think some of the challenges for nurses are? In relation to them staying strong and remaining strong?
KW: It’s multifaceted. It’s never simple. If only it was, it would be easy to address. 90% of our profession is still female dominated. So, you need to consider what are womens’ roles in societies. It’s still in those caring realms. Professionally, we know that we’re doing that at our work. But when a nurse leaves his or her shift, then what are they doing? There’s a huge element of caring for families, parents and friends and being that nurturer in their own personal and social settings. In terms of the responsibilities that are predominantly female profession based; it then really is about juggling multiple priorities. Managing the guilt around that, and then how do you take time out? Physically, any of us could probably be inspired to do some exercise. But I think that energetically and emotionally, I think that’s the real battle. It’s in the mind, getting up an hour earlier and finding that extra dollop of energy when you’re giving so much of yourself away.
MA: I couldn’t agree more Kylie. What would you say to those nurses and midwives, who I meet and regularly tell me, “well I walk a lot in my shift.” That their job is about walking. I’ll tell you in a minute what I say to them, but what would you say to those people who think that they already do enough exercise?
KW: Can you do enough exercise? There’s a few elements to that, because I too could say the same thing, I’m running to planes…
MA: And running around the country!
KW: Yes, but it really is also the importance of the body, mind and spirit connection. Walking around at work, or running from place to place, or not getting a break and not eating isn’t a great example of a healthy lifestyle. It’s on the go, it’s fast paced. You’re probably relying on your parasympathetic nervous system. You’ve probably got adrenaline pumping and we’re really fight or flight. Where are we in terms of our bodily functions? Compounded with that is the importance of mindfulness, and being present. The beauty of actually getting out and walking or exercising outside with friends is that there’s something far more therapeutic than just the machine type of exercise. But it is around almost a meditative process. It’s relaxing the body. It’s stimulating. It’s getting out in the fresh air. There are so many more benefits. So, they may well be exercising, do it more. And do it outside of work.
MA: Great response Kylie, and actually that’s exactly what I say! So, no surprise that we’re kindred spirits on this one.
KW: Yes, I love that Mark!
MA: Kylie, we talk a lot about resilience as a quality for nurses and midwives. I know that the college has members who are nurses and midwives. Do you agree that resilience is a key quality? If you do, how do we foster that?
KW: Yes, I recently said in a speech that there are qualities that people align with nurses and the nursing profession. They’re definitely around care, compassion and empathy. We must have those qualities now and moving forward into a robotic era that we are yet to fully experience. That alone, is not enough. To be a really competent, confident and capable nurse that is able to deliver care now and well into the future needs to also be coupled with an enormous amount of strength and resilience and courage and the ability to speak out and seek feedback. So, resilience is just as important as all of the compassion and those elements and attributes that we have. Why is resilience important? Because the pace of change in organizations is so great now, in any organization, wherever you work. From retail, manufacturing to big business. Where it is compounded in the delivery of human services and health care, is that we also have the added pressure of really highly emotive environments.
KW: That will be in our delivery of care, in our patients, in our communities and managing expectations. For each nurse, every day, we’re always dealing with that. Some may be dealing with it directly, as they provide care, others may be dealing with it as they manage the care. Or manage the delivery of education or research. So, it’s for all nurses, everywhere, who experience pressure in the workplace. There are people who have expectations that are not met now, so we always need to do more with less. Technology and change creates environments that never slow down. You never just implement one thing, so the pace of change is so great that you’re lucky to get a bit of a breath on your shift, or in your work environment. Even now in universities, there’s that extra semester over Christmas. Nobody is really taking that break.
MA: No, that’s right.
KW: It does not stop. So, resilience comes in a few forms. We need it professionally. We need it organizationally and we need it individually.
KW: One of the things that I find is that people know the word, but do they really know what being resilient means? Being resilient is about committing to a life of personal and professional development. Knowing how to work effectively in difficult or high pressure environments. Also, seeking feedback and constantly asking what you could do better. So, we’ve dedicated this year to talking about workplace culture, diversity and pressure. That includes some bullying and harassment. There are actual scenario’s, and then there are perceived scenario’s. We all need to take responsibility in acknowledging our role in meeting the organization, patient and community’s needs. Understanding what you need to do to be resilient, and bring your best to work. It’s not one person’s responsibility and it has many facets to it as well.
MA: Kylie, that’s a great overview and a great bundling of resilience as a concept but also how it applies to the lives of nurses and midwives. Thank you very much for that. I think there’s an element for me in there, and for the profession, that we lift each other up.
MA: If we see one of our colleagues struggling, or not in a good place, we actually lift them up rather than pushing them down.
MA: I’m starting to see that a lot more in the profession, really proudly, and I think the work that the college is doing coupled with Nurse and Midwife Support is really enabling that.
MA: We’re in a great place, in nursing as a profession, to be able to move to the future and manage all of those things that you described.
KW: What I love about our profession, and the fact that we do work in the behavioral and social sciences as much as all of the STEM subjects, is that we’re incredibly good talkers. We bring things out into the open that others would keep behind closed doors. I think that we shouldn’t just talk about it or complain about it, we should work out how to come together and lead into a new world. Into a new future. I think we’re just getting stuck airing issues and problems, but we really need to be strategic in how we solve them. And not leave it to somebody else, or be careful with what we say so that we still remain attractive to those kids that are starting kindergarten and are at school now. If all they hear is a profession full of problems, why would they want to become us?
MA: That’s right, and that young boys and girls equally see nursing as a really important profession and that care is really valued by everybody.
KW: Yes! Yes.
MA: Because aren’t we privileged Kylie? To be nurses and work in this wonderful profession.
KW: Oh yes, absolutely! There’s not a day that goes by where I don’t know that. And look, there are some myths, legends and probably dollops of truth. Any child of a nurse knows that they never got a day off.
There was no opportunity to pretend that you were sick. It’s not that we haven’t had our strength and heartiness tested, so we shouldn’t fall back from that now, knowing how we get into the future. If people feel challenged now, then wait until 2030. Wait until a world that looks very different, with driverless cars and robots and all sorts of things. The human element in us will drain us even more, if we’re not careful.
MA: And it’s it also exciting Kylie, because when I was travelling here to take part in this podcast I was talking about my role as stakeholder engagement manager. When I applied for the job, I didn’t really know what a stakeholder person did…
KW: And look at how well you’re doing Mark! You’re a natural.
MA: You’re very kind. I think that many of the jobs that nurses and midwives will do in the future haven’t even been thought of now, which is really what you’re saying.
MA: It’s really, the whole framework of resilience is enabling us to be in that place in the future to jump on that journey with these jobs.
KW: The world bank came out, I think it was last year, and said that nursing will be one of the top five guaranteed professions of the future. Whereas other industries, like manufacturing and others, will see a significant decline. We will still have, for health and particularly nursing, demands of up to 28% increase from what we’re seeing now. I was just doing some reading over the weekend actually, about futuristic projections and careers. Nursing will be a career that will be in great demand, because it has great security that comes with it and people do look for that. My concern is that the wrong people will be attracted to the profession. Our reputation is so strong and unwavering in the community…
MA: I agree.
KW: …I would hate to see that that gets diluted in the future, because we’re a guaranteed industry to work in and not because of the same reasons we joined; because we wanted to make a difference.
MA: We’re hardwired to care and we’re hardwired to nurse. Really, it’s a part of our DNA.
KW: It’s not just what you do, it’s who you are. There’s no way on a weekend or a day off, we’re not going to not stop and help somebody.
MA: That’s exactly right Kylie. In fact, I think that’s why some nurses find that their cup is empty; because they’re on 24/7. Not only are we caring for others in a hospital clinic or community, whatever your work setting is, family members contact you. Friends contact you and say, my mum’s going into aged care and I know you know a lot about aged care. Can you help me with this? And of course, we always do help.
MA: But the reality is that you’re on 24/7.
KW: Like a broad specialist, knowing a bit of everything. Working in aged care for a lot of my career, as a registered nurse, you can’t leave. You might be the only RN on. So, whilst you may be able to have a break and get a cup of tea people are letting you know things and asking you questions. So, you’re never really off the job.
KW: And you need to be physically in the environment. It’s not only about industrial awards and getting paid, it’s actually, when do you then clock off? And have some time to self?
MA: That’s why the self-care conversation that we’re having is vitally important. It’s not selfish to look after yourself. In fact, it should be one of your core values as a nurse and as a person to (as we say at Nurse and Midwife Support) not only fill your own cup first, but fill your own mug first.
KW: Yes, I love that.
MA: And just so our listeners know, they can’t see us, but Kylie and I are drinking our peppermint tea out of our Nurse and Midwife Support mugs.
KW: My lipstick is tattooed on there.
MA: So, fill your own mug first folks. Kylie, can you tell us about a time in your career where you’ve had to dig deep to remain resilient and strong?
KW: Yes, there has been many times to be honest. And on many different levels. There are times when I’ve been providing direct care in aged care and intensive care, which is my background. There are sometimes scenarios with families and loss and death. The pain, you will always empathize, you can see your own loved ones andor someone to loss a parent , you end up reflecting on that yourself. It’s very hard to know how to compartmentalize, or to know how to switch on and off knowing that one day you’ll be faced with the same. And to not go too far into your own thoughts, which I’ve done on many an occasion. I’ve held many families’ hands, the tears, there’s all of that side of it. The last thing that we need to be is robotic, and seemingly uncaring. But you don’t want a patient consuming us and comforting us. I find that that has always been that fine line and that balance. Then there’s definitely other scenarios as a manager; a lot of my career has been in management and leadership. Again, like any manager or boss, there are responsibilities that you don’t necessarily like, but you have to do. So again, even around performance discussions or performance management or needing to go through termination, that is actually quite traumatic. I do internalize that and feel the stresses. Can’t sleep, or I get shakey, you do have a physiological response. Those are not things that I want to do, you know you’re going to get criticized, but it’s a part of the job. That’s what you get paid to do at that, level. But again, it brings about its own level of challenges. To do your job properly, not like you have to do it, but the fact that that’s a part of it.
MA: I agree Kylie. When I talk to nurses and midwives (and I do all the time as a part of this job) I say to people, yes you are a nurse and a midwife. We have a really strong identity in that. But before we’re a nurse or a midwife, we’re human. We’re a person. With all of the normal vulnerabilities and frailties of any person. Give yourself permission to say, I’m not ok. I need something. I need support. That’s where Nurse and Midwife Support is really important, because you can call us, anytime, to get that support.
KW: And look, for someone like me in a very senior position, people are not forgiving. I think the higher you go, I think it’s our duty and our responsibility to care for all of the people that report to us. But it’s only rare that a person might look up and say, what do you need? For everyone, including CEO’s, to have someone like your team makes a very big difference. Otherwise, you know, it can get very lonely.
MA: Kylie, many students and graduates call Nurse and Midwife Support. I’ve really reflected on this. Clearly, they can be challenging but exciting times for people. Embarking on your new career as a graduate or embarking on the next stage of your career. Idealistic, wide eyed, hopeful for your nursing or midwifery future. What are your tips for students and graduates around staying healthy, fit and strong?
KW: It’s very important, because at an early career-stage you have study and all of those compounding pressures of not knowing where your future is going to be. The challenges of securing employment and needing part time employment. I always feel for undergraduates, students and early career nurses. They’re already being pulled in many different directions, depending on what stage of their life that they’re at. It’s always extra important for people like myself and others in workplace settings (as well as the universities and TAFE’s) that we make sure that we’re asking even more, how are you? And you show support, because you know, we all keep a face. We know that there are more pressures, so it’s our responsibility to make sure that our environments are more supportive, or even more supportive for individuals. Unfortunately, I cannot say hand on my heart that you will get all of these wonderful experiences that we would like to think that they do. The best thing that I could offer, in any advice to anyone in early career or undergraduate is your support may not come from where it should, so find it anyway you can. Find somebody you respect, whether that’s family or friends, everybody knows a nurse. So, go and find somebody that you know and talk to them outside of that environment. If you are struggling, then learn the skills very early in your career of how to meet the expectations or manage the expectations and get through. Get through the subject, the course. Leaving is always an option, but it should be the last option. So, do everything you can at those early stages to get through. If you come across a difficult personality, or a difficult culture or a difficult workplace environment then see what you can learn from it. Get through it, and leave it. Hopefully it will be your last one. But there’s always things that you can learn in these environments. If you find a team that’s wonderful, stay. Even if it’s not in the specialty that you wanted, stay and find a home.
MA: Couldn’t agree more. Great advice Kylie, thank you. Well that brings us to the end of our podcast for today, time certainly flies when you have a great guest like yourself. So today, we’ve talked about nursing and the importance of accessing support early. We’ve talked about Nurse and Midwife Support and the Australian College of Nursing. We’ve talked about the Nurse Strong program and it being of great benefit to nurses. We’ve talked about the importance of self-care, and some tips for students and graduates. Kylie, any final words of wisdom for our listeners? There have already been many.
KW: No pressure Mark! Everything that I have done in my role as the CEO of the Australian College of Nursing has been to empower the profession and individuals. Anybody who knows me, knows that I’m not one to want to victimize myself personally or professionally. I think that the language is very important. Everything we do at the college is to make sure that nurses are well positioned. We’re not just at the table, we’re either leading or being heard. We’re standing up and we’re taking our rightful place. We’re standing in our strength and we’re standing in our truth. This is a new era for the nursing profession. This is no longer the day that we’re not invited and we’re not heard. What we actually need is for every nurse to understand their worth, and to understand what empowerment and responsibility means. Any opportunity that you have to stand up, whether that’s for a patient or a process or a system or an environment or a model of care, is to find the skills to do that. Going well into the next part of this century and the next part of the decade, we need to continue to look at who we are and what we do. My advice is, don’t fall into language that doesn’t honor us or serve us. Don’t fall into a victimized mindset. We have had to come out of that through the last century. It’s not ok, those days of the doctors get invited and we don’t are all just gone. We fought to change that, and now we have to stand steadily in our place and command where our future goes. People will always need to be nursed. People have been nursed for thousands of years. Nursing in Australia has existed in this form for 150 years. So, we need to take responsibility of where we’re taking the profession, into the future. People will need to be nursed, but who will deliver it? It’s now time to make sure we stand up, and show the attractive dynamic components of our profession. There are so many areas for future employment and satisfaction. The opportunity to make a difference is where you are, right now. Take it and go for it.
MA: Oh Kylie, such wise and empowering words. Thank you so much, you’ve been a great guest and I know our listeners will benefit from your wisdom. Thank you. If you found this podcast useful, please share it with other nurses and students and get the word out. Nurses, remember, you rock!
KW: High five to that!
MA: Look after yourself, and each other. If you’re a midwife, we have a podcast just for you. I speak to Ann Kinnear, the Chief Executive Officer of the Australian College of Midwives about midwives and why your health matters.
Let’s send that message loud and clear, that your health matters, and I’ll speak to you next time.
See you later.