My job

My Job: director of nursing, midwifery and patient services

When Carolyn Fox joined the Northampton General Hospital NHS Trust as director of nursing, midwifery and patient services a year ago she had to reassure staff she was there to stay.
Carolyn Fox

When Carolyn Fox joined the Northampton General Hospital NHS Trust as director of nursing, midwifery and patient services a year ago she had to reassure staff she was there to stay.

What makes a good nurse leader?

Self-belief, a good sense of humour and resilience that bounce back ability. There are always going to be challenges, its about how you respond and engage your team.

How have you developed your leadership skills?

I was intrigued by the clinical nurse specialists I worked with. As a student nurse [she joined the NHS in 1985] clinical nurse specialists were relatively new. Training in Sheffield in a large university teaching hospital, I watched how they pushed the boundaries of nursing, developing skills and taking on responsibilities that had been the doctors.

I was a clinical nurse specialist in tissue viability

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When Carolyn Fox joined the Northampton General Hospital NHS Trust as director of nursing, midwifery and patient services a year ago she had to reassure staff she was there to stay.

Carolyn Fox

What makes a good nurse leader?

Self-belief, a good sense of humour and resilience – that bounce back ability. There are always going to be challenges, it’s about how you respond and engage your team.

How have you developed your leadership skills?

I was intrigued by the clinical nurse specialists I worked with. As a student nurse [she joined the NHS in 1985] clinical nurse specialists were relatively new. Training in Sheffield in a large university teaching hospital, I watched how they pushed the boundaries of nursing, developing skills and taking on responsibilities that had been the doctors’.

I was a clinical nurse specialist in tissue viability for eight or nine years. Then when I stepped into a leadership role the skills I’d learned as a clinical nurse specialist were probably the most useful: influencing, negotiating, working as part of the multi-disciplinary team with the doctors, meeting the doctors as an equal, having a patient caseload, research into practice.

Professionally speaking, what has given you most satisfaction?

Getting this role was a huge personal and professional step for me. When I arrived in Northampton on my informal visit, I knew that I would fit here and be able to make a huge difference. I tell the team ‘I am never in a room with you guys without feeling that we could change the world’.

I genuinely believe that. I am fortunate to have inherited a really great team.

What big challenge have you had to overcome and how have you done it?

This organisation had 6 or 7 nurse directors over about 6 years. I was told ‘don’t expect anything for up to a year because they won’t believe you’re going to stay’.

There were probably individuals within the team who thought ‘our nurse directors never stay long, this one might not either’.

I’ve had to be a very visible executive nurse director to engage with at times a disengaged, disenfranchised nursing workforce.

It was about having a consistent message: I am staying, I am here, we are going to have a nursing strategy, we are going to be recognised for the delivery of excellence in nursing and midwifery care, we are going to be the first district general hospital in the country to be recognised for Pathway to Excellence. Disenfranchised and disengaged is now in the past.

How did the Pathway to Excellence appear on your radar?

Another director of nursing had said that her organisation was pursuing Magnet status. I got home that weekend, looked at the American Nurses Association website and found the Pathway to Excellence. Its 12 standards resonated with me, I knew that it was something I should do here.

It almost follows Richard Branson's belief of if you look after your staff, your staff will look after your customers.

What achievement are you most proud of?

We have done hugely successful work in the last year around nurse recruitment and retention, particularly with the nurse bank. My mantra has been ‘our patients cared for by our nurses’, moving away from agency [workers]. Our nurse bank has been crucial to the delivery of great patient care.

Are you ever kept awake at night thinking about the working day?

Very occasionally. One of my biggest worries is nurse staffing but I don’t think that’s any different for any nurse director across the country.

What is likely to affect nurse leaders most over the next year or so?

Nurse staffing.

What advice would you give to newly registered nurses?

Stick with it. This is the greatest career. 

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