Since her election in late 2016, Professor Christine Duffield has been fulfilling the prestigious role of President of the Australian College of Nurses (ACN). Her leadership appointment follows more than ten years in nursing, and an outstanding 25 years’ experience in senior management, education and research roles in the university sector.
Christine always knew she wanted to become a nurse, but surprisingly never saw herself working in research. Her passion has taken her around the world as she’s led clinical and managerial roles across Canada, Australia, New Zealand and the UK. Following her election as ACN President, Christine shared some of her nursing story.
Tell us about your background and how you moved into the field of nursing.
I always knew that I wanted to become a nurse. The only decision that I had to make was whether I would do it in a university program or a hospital program. I promised my mother I would go to university before she died, so I went to university. It was the best thing I ever did.
I studied Nursing at a university in Canada; the University of Western Ontario. In my last year of study, I received a scholarship and had to travel to where they sent me for my first year of employment – I was sent to a small town north of Toronto. I was one of three single girls working there – a teacher, a nurse and a physiotherapist. At the end of the year, the physio and I came to Australia.
What was your first hospital role outside of university?
My first job was working in a surgical ward at my university hospital. Then I had a year of working in the community, and then I had a year working in Brisbane in the accident and emergency department. I followed that with a year working in accident emergency in the Auckland hospital in New Zealand. After that, I went back to Canada and worked in an orthopaedic ward. Then I had two years in the UK in coronary care and part of the disaster team, moved into teaching and came back to Australia in teaching and administration roles before coming to UTS.
Did you ever anticipate becoming a health researcher?
I wasn’t a very good clinical nurse – I’m ambidextrous so I am not very skilled technically. I can use both hands, but I’m not really skilled with either one. One of my supervisors realised and recommended me for a position in teaching.
If you’d asked me what I was going to do when I graduated, I would never have said this is where I was going be. I didn’t enjoy research at university, and I don’t like public speaking. But my supervisor in the UK referred me to a teaching job at the university, and then I applied to come back to Australia. At that time (during the late 80s) they had a shortage of nurses and nursing educators, and I had a degree in nursing so I got hired very quickly.
I was hired very quickly because I was one of a handful of nurses with an undergraduate nursing degree and a Masters degree in health planning. When I first started here, we were responsible for getting the program started. I was responsible for the nursing science stream. Having been to a research based university as an undergraduate I knew what was expected of academics, so we started doing a bit of research and writing. We published our first article within the first two years of employment.
What are your current research projects?
We have a few. We are just finishing off a program of research in Western Australia that looked at adding unregulated workers to the workforce and the impact it had on patients and staff. I’m part of a project that’s looking at homeless men in Sydney. We’re looking at the impact of screening tools when patients go into hospitals. I’m on an international project in Ireland, reviewing staffing in the Irish hospitals, and I’m leading a review of staffing in a hospital in Australia.
Where has research taken you?
I’ve had a lot of clinical positions in different countries. I did it at the right stage of my life. I travel a lot now but I wouldn’t want to travel and live somewhere like I did when I was young. I was very lucky. I was in a niche area, and at the time there was no research done in Nursing in Australia. I had some very good mentors from the UK, the States and Canada.
I find it [nursing workforce] a sexy topic but no one else does. It’s not seen as a sexy area but it’s taken me all around the world.
What is some of the research you’ve completed on the impacts of staff to patient ratios?
I am particularly interested in the mix of nurses. So we looked at the number of nurses, but also how many of them are registered nurses, and the impacts and outcomes for patients and staff.
There is certainly something about the more staff you have the better your outcomes. However, you can also have too many staff. Most importantly, how many of these staff are registered nurses? For example, in 2012, the UK found countless deaths that shouldn’t have happened (known as the Francis inquiry). It was all related to poor nursing care. However, when you drill down, half of the staff on some of the wards weren’t nurses; they were unregulated workers. It was poor nursing care, but it wasn’t actually nurses providing the care.
How does it feel to be recognised by the ACN for your efforts?
It’s sort of an ‘out there’ position. It’s a high profile role and it’s a bit scary at times. The workload is interesting and varied and it involves lots of networking. There are two offices; one in Canberra and one in Sydney. It’s the national professional body for Nurses and it links to the International Council of Nurses so the ACN is the mechanism for being part of the international nursing community.
Is there anything the ACN is working towards, that you would like to achieve during your presidency?
What we are trying to achieve is raising the profile of nurses and making the politicians aware of the contribution they make to individuals and patient care for which we now have evidence.
People think it’s doctors who make all the decisions, but nurses are the ones who are there 24/7.
We’re certainly trying to raise awareness of the role of nurses. We also want to be more involved in influencing health care policy. A variety of state and national committees often assume that doctors will be members but don’t always consider nurses. Lastly, we want to get nurses on hospital boards, and a whole lot of other boards as well!
And finally, what do you believe makes a good nurse?
I don’t think that there’s one good answer.
I think that there certainly has to be a balance between the caring and compassion and the science behind it. The fact that you can think critically about what it is that’s happening and know when you need to get help is very important. And some of us have more or less than the other…