The importance of Nursing Leadership and Professional Identity

Nurse Leader and Educator Elizabeth (Matters) Tollenaere (FACN) explores nursing leadership and professional identity.

She is the Inaugural Chair of the International Nursing Community of Interest for the Australian College of Nursing (ACN). She has recently also been elected as a National Board Member of the German Nursing Association (DBfK). After years of working as a Midwife and Cardiac Nurse Educator, in 2016, she decided to expand her professional experience by working overseas and relocated to Germany. Initially working as a medical assistance nurse, supporting foreigners who were hospitalised in Germany, she now has moved back into education and taken up a teaching position in a nursing training institution.

Tell us about your diverse career path to date!

After graduating from my preregistration degree, I completed my graduate year in an acute care hospital in Sydney with rotations in postnatal care, cardiac care and day surgery. The following year, I worked for 6 months in Cardiac Care and then returned to the Maternity Department as a student midwife. After completing my qualifications in midwifery, I chose to split my week between the Delivery Suite and the Cardiac Unit to keep my skillset diverse. I subsequently became a Clinical Nurse Specialist in Cardiac Care while continuing my midwifery work. After five years in the Cardiac Unit, I was appointed to a full-time Cardiac Nurse Educator role but continued to work as a midwife on a casual basis.

In 2016, I decided to expand my professional experience by working overseas and relocated to Germany. I worked for three years as a medical assistance nurse, supporting foreigners who were hospitalised in Germany. In 2019, I moved back into education and took up a teaching position in a nursing training institution.

Is there a particular global nursing issue you are passionate about?

It has taken me a while to really define my specific areas of interest in nursing and midwifery because there are so many things that I enjoy and find really fascinating. There are three areas, however, which I am really passionate about in my work whether it be clinical, educational or managerial.

The first is the issue of transcultural communication not only between nursing colleagues but also between nurses and health consumers. This interest comes from my own experiences in clinical practice in Australia and overseas.

My second area of interest is the concept of professional identity in nursing and the evolution of the public identity of the profession. This interest also ties into the transcultural area because professional identity is shaped significantly by cultural context.

Finally, I am interested in the area of midwifery which supports women who have had perinatal difficulties including traditionally taboo topics such as miscarriage, perinatal trauma and loss. I think that many women do not receive the full support they need in dealing with these experiences and struggle to speak about these issues with their friends and family. I think as a society we can do better to support women in dealing with the challenging aspects of the perinatal journey.

Tell us about your involvement with the Australian College of Nursing (ACN).

I joined the RCNA (predecessor to the ACN) after graduation and really became active in the organisation in 2011-2 when I joined the NewGen Faculty advisory committee. This was a great experience that allowed me to create a network of colleagues beyond my workplace and allowed me to co-present a paper at the ICN Congress in Melbourne in 2013.

Over my time with ACN, I have enjoyed outstanding mentorship from other members and have participated in diverse activities including mentorship of students and graduate nurses, writing projects for the ACN publications and work in the Diversity Working Party and Editorial Advisory Committee. I became a fellow of the ACN in 2014. My most recent involvement with the ACN has been the establishment of the ACN International Nursing COI in 2020.

Why did you start the ACN International Nursing Community of Interest?

I approached ACN with the idea once I moved overseas as an opportunity for Australian nurses working overseas to keep in touch with colleagues in Australia and for Australian nurses looking for overseas opportunities to be able to connect with like-minded colleagues.

The group aims to support ACN Members to maintain their interest in international nursing affairs and extend their intercultural knowledge and competence by running a dedicated online discussion board and facilitating CPD and networking events with a global focus.

Tell us about your experience being selected for the 2018 ICN Global Nurse Leadership Institute in Geneva.

The ICN Global Nurse Leadership Institute was a highlight of my professional life. The group of approximately 30 nurse leaders from around the world met for a week of networking and training in policy and advocacy work in Switzerland. We were given tours of the World Health Organisation and ICN Headquarters and given masterclasses by many nurse leaders experienced in policy and professional leadership.

As a result of this experience, I have a wonderful network of passionate colleagues in all continents of the world who still meet virtually to assist each other with their work and maintain global dialogue on nursing issues. I heartily recommend this experience to any nurse leader who is passionate about extending the reach of nursing on the world stage.

How can nurses have an influence on policy development?

I think the first step is for nurses to proactively seek out opportunities to lend their voice to policy issues. Too often, nurses shy away from political engagement because it seems intimidating or controversial. I also think that nurses can grow their confidence to be able to engage in such discussions by having a clear idea of where their unique expertise lies and also by ensuring that they develop excellent oral and written communication skills to clearly and impressively deliver their message.

What makes a great nurse leader?

In my view, a great nurse leader is someone who has a genuine passion for the profession and their area of speciality and progresses because they inspire others around them with their expertise and enthusiasm. I believe integrity is critical in our profession and nurses are quick to recognise and dismiss aspiring leaders who are primarily motivated by their own ambition.

I also think that optimism and resilience are essential in nursing leadership roles. The strains of the profession are prone to create a culture of pessimism and professional self-pity. I believe a good nurse leader recognises and empathises with the challenges of nursing professional life but remains proactive, solution-focused and positive so that they can give hope to others.

What’s your advice for nurses wanting to get into leadership roles?

Be brave and proactive but take your time to sort out your professional identity first. It takes a while to know why you are in the profession, what motivates you as a nursing leader and where you see need for improvement. Do not limit yourself to one speciality, one workplace or one skillset but take opportunities as they arise and be curious about where they can take you. Opportunities open up when you are open.

Professional identity and Professional Dialogue and why is it important in nursing?

Nursing is a profession that has undergone a tremendous amount of growth and identity shift in the last century. It is also a profession where most of the work is carried out in private and remains unseen. Therefore it is very difficult for outsiders to really get a clear idea of nursing work until they have reason to experience it first-hand.

Unfortunately, there is still a lack of clarity about the definition of nursing work and the nursing profession from country to country and even sometimes from speciality to speciality.

In my view, every nurse needs to take time to reflect on how they describe their work to others. In my classes on professional identity, I ask my students to complete the sentences ‘I have chosen nursing because….’ And ‘Nursing is important because…’ It is always interesting how much students and even experienced nurses struggle to put all their thoughts and experiences into words, yet being able to do this is critical to furthering the professional identity of nursing in the wider community. If we use terms like ‘only a nurse’ then we can hardly resent it when the general public repeat such things back to us.

I admit however that developing a united professional identity is very challenging for nursing across the globe. Therefore I have started working with the US-based International Society for Professional Identity in Nursing this year to contribute to their work to define our professional identity more precisely in a way all nurses can relate to.

What have you studied and why?

I have studied many different areas for many different reasons. Here is a summary:

Bachelor of Arts/Bachelor of Nursing– This degree allowed me to complete my nursing qualifications while pursuing my interests in foreign languages and modern history. At the time, many asked me why a nurse needed to study humanities. Apart from the fact that it was interesting and nurses should never limit themselves in their interests, the training proved very helpful with making the move to overseas practice and bridging the cultural gap.

Postgraduate Diploma of Midwifery– This diploma was very intense but also very practical and set me up well to perform in our clinical environment immediately.

Master of Nursing (Major: Cardiac Care)- This degree allowed me to extend my knowledge in Cardiac Care, Management and Leadership. It is was critical in allowing me to attain Clinical Nurse Specialist status.

Graduate Certificate in Adult and Vocational Education– This certificate allowed me to develop my teaching skills and build on the knowledge I had acquired in the Certificate IV in Training and Assessment. It also articulated to provide credit in the Master of Nurse Education which I am completing in 2021. These education qualifications have been critical is allowing me to secure my current educational role.

What are your tips on balancing postgraduate study with work?

Postgraduate study is a challenging time commitment on top of everyday work. If it is at all possible, I recommend reducing to part-time for the duration of the course. I also think it is critical to only study topics which either a) really interest you and/or b) provide a pathway to a position which you are really interested in. This approach helps to keep you going when an assignment feels like the last thing you would like to be doing. I can say that every course that I have done has allowed me to secure interesting career moves as a result.