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Blog: Nightingale Challenge, Caroline Semple, Smoking Cessation Specialist Midwife

3rd September 2021

Nightingale Challenge Northern Ireland Global Leadership Development Programme – my reflections amidst the Covid-19 Pandemic.

Caroline Semple, Smoking Cessation Specialist Midwife, Belfast Health and Social Care Trust

My name is Caroline Semple and I am a Smoking Cessation Specialist Midwife in the Belfast Health and Social Care Trust. I first began working part-time in the healthcare setting at the age of fifteen in the Independent Care Home Sector, before progressing to complete a BSc Hons in Adult Nursing at Queens University, Belfast. After two years working in a busy surgical ward in the Royal Victoria Hospital, I undertook my degree in Midwifery Studies and graduated in 2011. Since then, I have been practising as a midwife in the Royal Jubilee Maternity Hospital, gaining experience in all areas of maternity care.

Throughout my years of varied nursing and midwifery experience, I always held a keen interest in public health and health promotion which led me to my current role. The Smoking Cessation Maternity Service has evolved as a result of the ‘Ten Year Tobacco Control Strategy for Northern Ireland’ (2012) and we are proud of our high success rate in enabling women and their families to stop smoking during pregnancy. This is in no small part attributed to the close partnership with each individual, empowering and encouraging them to make positive lifestyle changes with far-reaching benefits.

I was absolutely delighted when the opportunity to be a participant on the Nightingale Challenge Northern Ireland Global Leadership Development programme (NCNI GLDP) presented itself. I felt privileged to be one of five midwives from Northern Ireland to be selected. Five midwives and twenty-five nurses from all areas of Northern Ireland commenced the programme in January 2020, later joined by twenty-seven Global Associates (young nursing and midwifery leaders) from all around the world. The timing of this was particularly poignant as it also marked my return to work from maternity leave. I remember sitting in the Stormont Hotel, Belfast, on the first day, which coincided with the Northern Ireland launch of ‘The International Year of the Nurse and Midwife’, feeling inspired, enthusiastic, and excited as we listened to speakers such as Dr Catherine Hannaway, Professor Charlotte McCardle, Professor Fran McConville (Midwifery Advisor, WHO) and Minister Robin Swann. I realised the enormity of the opportunity I had been afforded to develop my knowledge and skills as a leader, to be an effective change agent, policymaker, role model and advocate for improved healthcare locally and globally whilst networking and learning from leadership experts across the world. I also felt privileged to have been selected as one of two programme participants to join the programme Steering Board, ensuring links between the senior management group designing and delivering the programme, and the participants themselves.

I was among the first of the programme’s participants to take part in a learning visit to the Commonwealth Nurses and Midwives Confederation Conference in London in March 2020, alongside Dr Hannaway and Professor McCardle. We made up a contingent of four programme participants from Northern Ireland and three international young leaders (Winnie from Uganda, Abdul from Pakistan and Billy from the USA). Attendance at such a conference was an exciting and novel experience for me and allowed me to gain invaluable insights into healthcare globally, as well as network with nurses and midwives from across the world. Dr Hannaway had a jam-packed programme for us, to ensure we gleaned as much from this visit as possible. A particularly memorable moment was meeting Lord Nigel Crisp, who gave us a private tour of the Houses of Parliament and encouraged us, as young leaders, to never be afraid to lobby ministers to develop and improve healthcare. It was a privilege to be invited to an evening reception at the Royal College of Nursing where we had the fortuity to network with other international nurses and midwives, with whom we found commonality in our purpose and vision despite our diverse global origins. The learning visit ended with an enjoyable trip to the Florence Nightingale Museum which allowed us to reflect on how far healthcare has come and the potential impact one courageous women with a vision can have.

In the days following my learning visit, the pandemic hit, and, as with all aspects of life, adjustments to the programme had to be made. Dr Catherine Hannaway (Programme Director) rapidly redesigned the programme delivery to an online format so we could access the learning safely and continue our leadership journey. One benefit of this was that speakers from all around the world were now more readily accessible and Dr Hannaway seized this opportunity to build on our understanding of healthcare globally, making links with Pakistan, the Caribbean, Africa, Thailand and many more.

Alongside changes to the programme, the Covid-19 pandemic meant that I had to quickly adapt service delivery and accessibility of the Maternity Smoking Cessation Service. Instead of face-to-face consultations, there was a shift to telephone, video and text support as a means of maintaining engagement with women and their partners which allowed us to continue to educate and support them towards a smoke-free pregnancy. Our service engagement increased by 15% in 2020 and we continued to see a high quit rate. The pandemic also impacted other areas of my work, such as the Quality Improvement project, an element of the NCNI GLDP. Access to Nicotine Replacement Therapy within the Smoking Cessation Maternity Service was previously recognised to be a complex process for women and as such created a barrier to service engagement and cessation. The Quality Improvement project I undertook has seen development and approval of a policy allowing Nicotine Replacement Therapy to be available at our clinics. This will commence when face-to-face consultations are permitted again. I believe the NCNI GLDP helped equip me to overcome the challenges that the Covid-19 pandemic presented. Furthermore, the resources made available through the NCNI GLDP took into consideration the evolving health crisis the pandemic brought about. Resources relating to our own mental health and wellbeing were of great personal benefit, helping me to build my personal resilience. My own organisation, Belfast Health and Social Care Trust (BHSCT) also offered a range of health and wellbeing resources that were easily accessible for staff. Personally, I have known the benefit of this as in November 2020 I had my own experience of contracting Covid-19. This brought, and continues to bring, ongoing challenges to my daily life with the effects of long-covid, but I firmly believe that due to the support of my organisation, colleagues, the NCNI GLDP, and in particular, the care and compassion demonstrated by leadership, I am better equipped to face this journey going forward.

Sadly, after 18 months the NCNI GLDP is almost at an end. The opportunity to participate in this programme has surpassed my expectations. I enjoyed creating a learning group with the other midwives on the programme whilst being supported by Dr Dale Spence, Midwifery Officer, Department of Health, Northern Ireland and mentored by Denise Boulter, Public Health Agency. It has been a real privilege to have had opportunity to learn and be guided by senior midwifery leaders, which I’m sure would not otherwise have happened. Meeting Professor Fran McConville (Midwifery Advisor, WHO) and learning about global issues such as the Sustainable Development Goals and the WHO’s 2021 ‘State of the World’s Midwifery Report’, has been key learning. I have also acquired a better understanding of the midwifery profession on the global stage and a deeper comprehension of the sphere of influence achievable through policy development and advocacy for the advancement of both nursing and midwifery. I am determined to apply the learning attained in my everyday practice, seizing every opportunity to improve the outcomes for pregnant women and their unborn children.

Through the NCNI GLDP, I am even more convinced that as young leaders we have real opportunities to make a difference locally and globally and influence the trajectory of healthcare in the future. I conclude with a quote that came to my attention during the past year by John C Maxwell, ‘Leadership is not about titles, positions or flowcharts. It is about one life influencing another.” May we all strive to be leaders of our professions to ensure a better, brighter, and equal future for all.