Career advice

Flexible leadership

Ruth Holt would like to see staff working across community and acute settings

Director of nursing at NHS England and Queen’s Institute fellow Ruth Holt is from a family of doctors and nurses. She has been working with the chief nurse for the north of England in the delivery of a series of healthcare projects.

Why did you become a nurse?

I come from a long line of nurses and doctors so, for me, this was a natural step. I don’t recall considering anything other than the caring professions. I was at school when my mother, who was a theatre nurse, passed away, but I would like to think she would be proud of my achievements as a nurse. I would love to have shared my experiences with her

I enjoy the management aspects of my post and working with a wide variety of people, so I might well have moved into the charity sector. I also have a passion for cooking and would like to run a restaurant sourcing local and natural produce.

I have completed leadership and management courses, which have underpinned my leadership development and given me some of the tools needed to be a director of nursing. I believe you learn your leadership skills from various experiences and sources: good role models, conversations with colleagues and through leadership programmes. Leaders have many achievements and knocks along the way, and need to reflect and learn from these.

As a director of nursing, I work with many different people and in different organisations. I have learnt the importance of being flexible in my leadership style and working out the best approach to leadership. The right balance between challenge, support and action is essential.

Working with and coaching individuals who are delivering care and speaking with patients about the care they receive. I enjoy knowing that it is in my gift to change patient care for the better.

Give nurses and midwives more time and opportunity to develop their profession. I’d like to see more staff working across different clinical settings, particularly between acute and community settings; patient care could be so much better if nurses understood the care provided in other areas. We talk a lot about moving care into the community; I’d like to see this as a reality everywhere.

I will probably have retired and I would like to feel I have made a positive contribution to the lives of patients and nurses.

There isn’t a single individual who inspires me. My father was a consultant rheumatologist and had a significant influence on my life and career. He loved his career and balanced clinical work and teaching, and he always saw the importance of viewing patients as individuals. I am also fortunate to have some inspirational colleagues who are directors of nursing; I value the conversations I have with them and the support we give each other. I often take inspiration from those who are passionate about what they do and turn ideas into big changes.

I am proudest of having received a fellowship from the Queen’s Nursing Institute. My clinical practice has been largely in the community and it is great that I can still maintain my links with community colleagues.

Vision and the ability to develop and communicate it. Strong values and tenacity. A leader needs to be visible and to listen to those they work with, and to lead and ensure he or she understands, supports and develops them.

Rapid change in how care is delivered and difficulties in recruiting nurses and midwives. We need to think about how we train and support staff in different ways, and then develop and use our new strategy for nurses, midwives and care staff to help provide direction. We will see greater scrutiny of our services and a requirement for more evidence that we are delivering to required standards.

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