From graduate nurse to leading lecturer

As a child I was fascinated by my mother’s stories of nursing prisoners of war during the second world war. When I was 17, I took a holiday job at my local hospital and found nursing 'interesting’. I went to the University of Edinburgh and started a course in history and French but after a year I switched to nursing as the possibility of doing something practical appealed to me. Edinburgh was the first university to offer a degree course in nursing studies. I loved the course as the nursing students were integrated with students from other subjects: we really were part of a wider academic community, which is what nursing students today sometimes miss out on. The course was taught by nurses who were each undisputed leaders in their respective fields. For the first time I came across nurses who held a PhD. Inspirational teachers such as Professor Annie Altschul and Alison Tierney were significant mentors who were generous with their time and knowledge.

My first ward placement

Lesley Hardy, a Canadian nurse, was doing her MSc at the time and took me under her wing. During this time I got my first ward placement in a long-term care unit for the elderly, many of whom had suffered neurological damage. I was shocked by the attitude of the nurses I met – they lacked respect for their patients. I challenged the level of care provided and luckily had made sure beforehand that I had people to support me. My advice to nurse leaders of the future is to be bold and inspire change but build strong alliances first or you may suffer.

Working as a staff nurse

My first job as a qualified nurse was at the Royal Infirmary in Edinburgh. The ward was run by Elise Nielson, a remarkable person who had first trained as a teacher and subsequently graduated as a Nightingale nurse. She had a strict protocol of care and her ward was a magnet for talent. One of her key features was that she praised people and told them why they had done a job well. Equally powerful were her remonstrations when a job had not been done according to standard. Her teaching really helped young nurses build their confidence.

Pursuing academic achievement

I missed studying and while looking for a job for a friend, I spotted a masters degree course. This course could be taken in combination with working as a clinical nurse and came with a generous scholarship. José Closs, who today is professor of nursing in Leeds, and I were the first to win the new scholarship. Eventually our studies led to an MPhil. Having worked part time for just over two years I looked for ways to combine my long-held interest in modern history with my nursing experience. The answer was a move to Oxford where I also worked part time as a clinical nurse for five years while doing a DPhil in modern history supervised by Dr Charles Webster. The aim of my studies was to gain a more thorough political education as I was fascinated and frustrated in equal measure by the politics of nursing. My studies taught me how change was brought about. Having completed my DPhil I returned to the University of Nottingham where a new school of nursing had been formed under the leadership of Jane Robinson, whom I valued as a truly inspirational teacher. Here I combined research with lecturing for five years.

International research opportunities

A Harkness Fellowship enabled me to study at the University of Pennsylvania, USA, where I worked with Professor Linda Aiken on the Clinton Health Reform Agenda. Linda was a great nurse leader and understood the mindset of policy makers. I became part of an international collaboration study – the first of its kind in the UK. Our research showed that staffing levels in hospitals were linked to mortality rates: more staff resulted in fewer patients dying.

Returning to London

On my return to the UK I was appointed as a senior lecturer at the London School of Hygiene and Tropical Medicine. Shortly afterwards I was promoted to reader. A focus of my work was research policy for nursing. In November 2004 I took up my present position of dean at the Nightingale School of Nursing and Midwifery at King’s College London. Looking back I regard my DPhil and changing research policy for nurses as my greatest personal achievements made possible through working with some of the best researchers and intellects in nursing and related disciplines.

Top tips

• Take every opportunity to learn and improve your craft and level of expertise.
• Learn from other nurses, managers and doctors.
• Don’t create barriers to your own learning – build networks.
• Learning is lifelong and sometimes you may have to relearn things. Don’t be afraid to do so!
• To achieve excellent care levels we need well-rounded practitioners who are able to self-manage  and have a passion for their field.

Professor Anne Marie Rafferty is dean of the Florence Nightingale School of Nursing and Midwifery at King's College London.