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Island nursing: why it’s rich in career opportunities as well as work-life balance

A nurse explains the professional rewards of finding a job on a small island

Nurse Liz Cullinane has practised across the globe, but explains why its now good (for her career) to be back home

Working on an island is a recurring theme of matron Liz Cullinanes career not least the Isle of Man, where she has returned home to put down roots.

Born and raised on the island, Ms Cullinane moved to Salford, Greater Manchester in 1991 to train as a childrens nurse. Qualifying in 1994, her first staff nurse post was at the Royal Manchester Childrens Hospital, where she worked for three years before taking up a post as a paediatric nurse in the Cayman Islands.

I was young and open to having an adventure, says

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Nurse Liz Cullinane has practised across the globe, but explains why it’s now good (for her career) to be back home

Liz Cullinane at Noble’s Hospital outside Douglas, Isle of Man

Working on an island is a recurring theme of matron Liz Cullinane’s career – not least the Isle of Man, where she has returned home to put down roots.

Born and raised on the island, Ms Cullinane moved to Salford, Greater Manchester in 1991 to train as a children’s nurse. Qualifying in 1994, her first staff nurse post was at the Royal Manchester Children’s Hospital, where she worked for three years before taking up a post as a paediatric nurse in the Cayman Islands.

‘I was young and open to having an adventure,’ says Ms Cullinane. ‘Lots of nurses applied for the post, and although I wasn’t the longest-qualified candidate, I was used to island life. This is what clinched it I think.’

Work-life balance, and better career progression

With more than 25 years’ experience of children’s nursing, Ms Cullinane has worked in the UK and Australia and is a qualified health visitor. She returned to work on the Isle on Man for a year in 2016 before coming back permanently in 2019 as the service lead for health visiting and school nursing.

‘I prefer to be on the Isle of Man,’ she says. ‘Everyone says the work-life balance here is better than the UK, and after weighing up our options as a family, we chose to come back.’

‘We are trying to break down the layers of bureaucracy that put a gulf between decision-making and those who carry out the care. If you don’t agree with something, you can raise it’

Initially, she thought there might be few chances for career progression on the island. ‘But I soon discovered there were many more career opportunities than I would have had in the UK,’ she says.

Ms Cullinane took up her current post as matron for women, children and families in October 2020, bringing together health visiting, school nursing, family planning, maternity and neonatal services, children’s outreach, outpatients and hospital care into one integrated service.

‘The Isle of Man is very good at bringing people into the nursing family and finding out where your skill set lies,’ she says. ‘Someone may apply for one area and find they enjoy something else, so they are encouraged to move around.’

Come with an open mind: Liz Cullinane’s tips for island job-seekers

  • Find out what links the island has with services and organisations based elsewhere. ‘Sometimes people worry that they might be professionally isolated, but it’s not our experience here. We regularly send people off-island for further education and training, for example’
  • As with any other job interview, do your homework and make sure you understand the values of the organisation you are applying to join, alongside the island’s culture. ‘Although we have a strong Manx culture, we are also interested in the cultures of others, and I think we have managed to integrate them’
  • Be prepared to join in. ‘Come with an open mind and a wish to be a part of the community’

Benefits of nursing in a smaller healthcare system

Among the attractions is a closer connection between the various layers of management. ‘If I was a band 6 health visitor in the UK, I wouldn’t really be privy to the strategic planning of services, which would gradually filter down to me instead,’ says Ms Cullinane.

‘But here, you are much more involved in those decisions. We’re smaller of course, so that helps, but we are also trying to break down the layers of bureaucracy that put a gulf between decision-making and those who carry out the care.

‘If you don’t agree with something, you can raise it,’ she adds. ‘It’s commonplace for any nurse to go and speak to the director of nursing. There’s an open-door policy.’

The Isle of Man healthcare system

The Isle of Man, with its 86,000 population, sits outside UK jurisdiction as a self-governing crown dependency, with its own parliament, government and judiciary.

In April, an arms-length body was established to take over the day-to-day running of the island’s health and social care services.

Manx Care’s inception follows an independent review of health and social care services. It is overseen by the island’s health minister and its Department of Health and Social Care.

‘It’s our equivalent of the NHS and is government-funded,’ explains Ms Cullinane. ‘A transformation programme is well under way and we’re in a much better position now to be able to expand care delivery.

‘It won’t all happen overnight and will take hard work and commitment, but it’s a very exciting time and a good place to be working.’

Managing healthcare in the pandemic – acute and community teamwork

An unexpected benefit of coping with the COVID-19 pandemic has been the closer understanding that has developed between hospital and community staff. ‘As a nursing community on the island, we really pulled together,’ says Ms Cullinane. The island started emerging from its third lockdown earlier this month, having recorded 1,574 cases and 29 deaths.

Many staff were redeployed, including working on hospital wards, carrying out contact tracing, and staffing a 111-helpline which was set up to support patients with suspected COVID-19.

‘The hospital staff found it really helpful to meet those working in the community,’ says Ms Cullinane. ‘It’s been invaluable for services to mix with each other, gaining an appreciation of what each other does, and we’re still riding that wave.

‘For women and children’s services, we’re much more integrated now than we’ve ever been.’


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