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When is a nurse not a nurse?

Source: NHE July/August 2018

The world is changing, the workforce is changing, the workplace is changing, but is the way we work changing? Kirstie Stott, director at The Inspiring Leaders Network & Equilibrium, investigates.

The glass ceiling is becoming less impenetrable in some sectors with the rise of female entrepreneurs. The UK has seen a sustained increase in the number of women in self-employment, rising by approximately 40% (or 427,000) from November-March 2008 to November-January 2016. This compares to a 13% (or 358,000) increase in the number of men who are self-employed.

But why is it that more women are leaving the comfort of a nine-to-five employed role to start up their own business? As a woman, this is quite inspirational, especially when I hear stories of how they have not only set up, but gone on to support more women through their business to work in a more modern and transformational way.

However, on the flip side to this, at a time when entrepreneurialism should be helping innovate and bring a fresh new approach to the way we deliver our public services – and, moreover, when we have a gender pay gap, evidencing that there is not a solid and effective female talent pipeline – what impact is this having on future talent, succession planning and sustainability?

Being one of those women who left a comfortable career in the NHS after 18 years to set up her own company, the main driver for me was the lack of flexibility and innovation in my roles. Having worked clinically as a nurse for 13 years, I decided I wanted to make the transition to management as many clinicians do. However, I felt that the linear route of progression for nurses wasn’t what

I wanted to do, so I left to pursue a more management route. Upon reflection, it was strange that I felt I had to give up one role to do another.

Driving home recently, I was struck by a conversation on the radio by Emma Gannon, who was being interviewed about her recent book (the ‘Multi Hyphen Method’). Gannon explained about this approach being focused on the entrepreneurialism in all of us, and how just because we do one job, such as a chef, we can still be an artist in other times of our week.

This really resonated for me and got me thinking more about the reasons more women are leaving the NHS to pursue their own work. I talk a lot about flexible working to improve gender diversity in the NHS, as I see this as one of the biggest barriers to progression, but what Gannon’s interview made me consider was not just about working hours in flexibility, but flexibility of role.

How often do we see nurses working part-time in a clinical capacity but then the other half of their week as a group accountant, project manager, transformation lead? I absolutely agree that there is a skills issue discussion to be had about how we skill-up a multi-professional, portfolio workforce who can work innovatively and flexibly across health and care. And what if that discussion led to more women progressing in their careers, fulfilling their own potential, and meeting the needs of the people and communities they serve? I think there are three things organisations could do now to move this from rhetoric to a reality:

  • Build these conversations into appraisal meetings to better understand what matters to staff and where their interest and skills lie outside of their traditional role;
  • Advertise new roles as just that: a new opportunity to do something different and be brave;
  • Health and Care Boards need to set the tone, and I would encourage HR directors in particular to have those conversations and to start to rethink and build this into the strategy.

By doing this I believe we can start to really turn the dial on up on inclusive, fulfilling and meaningful talent management. Ensuring that people don’t leave the NHS, that we can truly harness the value of everyone, and that we don’t lose the passion and creativity that comes from entrepreneurialism means we can begin to see it as the solution, not something to outlie.

More and more research is evidencing that women are being held back in their career through a lack of flexibility, and that Gen-X workers – who will account for 75% of the workforce by 2025 – are looking for a more portfolio type career.

Could a transformational approach to how we view roles in the NHS be the answer? With integrated systems and partnerships dominating the way we deliver our public health and care services, this fresh approach to workforce planning could support and begin to bridge the gaps and smooth the fragmentation we sometimes see, feel and hear from service users.

If trusts are to compete for increasingly scarce talent, this debate needs to move from a discussion between individual staff members around the water cooler to a serious discussion in our boardrooms about   a fundamental review on how hours and roles can evolve to sustain individuals and organisations.

When is a nurse not a nurse? When we begin to rethink, and move forward with a transformational, flexible and innovative workforce.


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