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Aussie CEO makes WHO list of nurse and midwife leaders

Four Australians have made the 2020 List of 100+ Outstanding Nursing and Midwifery leaders around the world.

The list was announced to mark last year's International Year of the Nurse and the Midwife and is a joint venture from the World Health Organization (WHO), United Nations Population Fund (UNFPA), Nursing Now, International Council of Nurses (ICN), International Confederation of Midwives (ICM), and Women in Global Health (WGH).

The list features the achievements of nurses and midwives from 43 countries and across six global regions, to recognise these women and the millions of nurses and midwives around the world.

Nursing Review caught up with one of the Aussie honourees, Catherine Holliday.

How does it feel to have made such a huge list?

I'm really honoured to have been recognised in this way but also know that there are thousands of nurses working just as hard and making an enormous impact everyday. That's the thing about being a nurse; whether what you are doing impacts one person or one thousand people, you are going to have an impact. I think that all the nurses that made this list probably feel the same way as well, that this list is really representative of all nurses across the world. Any of us could be on it.

I would imagine as a nurse and academic you're not used to such recognition.

You would be right. As a nurse, mixed methods researcher and a woman I guess in some circles I'm seen as a triple threat, and in others, a triple non-threat. What is great about this initiative that highlights so many women and nurses is that it recognises both in the context of leadership. It's not easy for us to get a seat at the table and having nurses in particular at the decision-making table is incredibly important. There are so many decisions that can't be properly informed if nurses aren't at the table.

If we look at the way decisions are made in health technology assessment as an example, panels are usually filled with excellent clinicians and technical experts who are making recommendations on how a treatment might benefit a patient, but they don't often have a nurse at the table which is the one profession that probably spends the most time with patients answering questions, explaining how to use new treatments, how to manage their side effects or why they might not be able to access certain treatments. Anything we can do to acknowledge nurses as leaders is going to help shift this current way of thinking.

It must be humbling to be recognised for a year where nurses have been so integral to our global health and the year of the nurse and midwife. How has the last year been for you professionally?

I work as a telehealth nurse alongside my colleagues in the Patient Pathways program and particularly when we first started to realise what the pandemic meant, I was taking so many patient calls and advocating to government for support so much so, that I'd lose my voice every day. Patients were being asked to navigate a completely new health system and there was a lot of anxiety and confusion that needed to be managed.

It was also worrying to think about people not seeking help, diagnosis or continuing with their normal care out of fear of infection. I think we'll see the true impact of this over time. But given the year we've had and the many healthcare workers that have put themselves at risk, those that have been ill and those that have died, I feel like they are the ones that need to be on this list. Humbling doesn't really even cover it.

Can you run us through your career so far?

I graduated from ACU in the late 90s and worked as a ward nurse for a number of years in Australia. I spent some time working in drug and alcohol nursing in the USA and that's where I started to really get more interested and involved in community-based care. I then worked in the international setting with organisations like the Global Alliance for Vaccines and again, really started to see the value and need for more community-based health care.

In between all of that I also did two masters degrees, one in Health Promotion and another in Health Science, a grad diploma in nutrition and then a PhD looking at the drivers of research and where the community sits within the research process.

I returned to Australia to work at the community level with a focus on oncology, particularly rare disease, and then in 2012 started a charity called the Centre for Community-Driven Research (CCDR). Throughout my career I had seen that there was a gap between what patients were talking about at 'the bedside', and the way decisions were made at the policy level. So CCDR was a way to give patients a platform to talk about their experience and provide their recommendations so that we can turn this into evidence to support decision-making.

From the research we could see that patients needed more access to specialist advice and support, and that's where Patient Pathways program was developed. We started by testing a central telehealth case manager service for pancreatic cancer patients which is a rare cancer. At the time, patients really didn't have a support organisation to turn to so I enlisted a friend – Josie Keneally – who I went to ACU with to work on the program with me.

Then in 2019, Greg Hunt, Minister for Health, announced funding for the program to be expanded to test it in another 10 disease areas. We've just done the first program evaluation and are waiting to hear whether there will be continuation of funding. In 2018, we also expanding CCDR into a global public health initiative with offices in the UK and Switzerland. The pandemic slowed us down a bit but this year we've opened up operations in 19 countries.

Tell us about your work.

If I could sum up my work, I think I would say it is a non-stop process of solving puzzles. My role as a telehealth nurse in rare, genetic and complex disease certainly keeps me on my toes. The patients and families that come into the telehealth clinic are all completely different and there isn't a 'one size fits all' fix for any of them. A lot of the consultation is spent on education, explaining their condition and also explaining how the health system works.

Often patients come to us and haven't had a proper full medical history taken, so I'll often do that with them as well. The nurse intervention side of things varies but tends to focus on symptom management and tracking, and making sure patients are referred back into the health system. We also make sure patients understand clinical trials and where appropriate, talk about participation in trials. I think the thing patients are most appreciate of is the time that we can give them. Telehealth feels less rushed than a face-to-face clinic and people tend to be more relaxed.

The research side of things is also a big puzzle. We have a great research team and my sister, Anne Holliday, looks after the quantitative team while I look after the qualitative team. For the qualitative side of our research we interview patients and then code their transcripts line by line, so literally looking for clues on what their experience has been like and what we need to do better in the future within the health system. 

The last piece of the puzzle is being a CEO and figuring out funding and managing all of the governance requirements. That somehow gets fit in between the telehealth clinic and research.

How have you seen the role of the nurse evolve over your career?

Evolve yes, but the core values that drive nursing of protecting human dignity and advocating for our patients remain stable. It's a hard question because you want to be positive and say it has evolved, but there are still a lot of misconceptions about what it is that a nurse does and until we clear that up in the community and with decision-makers, it will always be a challenge to find our place at the table.

Going into this year and the future what do you see as important areas for the profession?

Going forward, it's going to be important to recognise nurses as leaders and make space for nurses in decision-making roles. If we aren't able to recognise nurse as leaders and have that representation, it's going to be hard to ensure for example that we have a sustainable workforce and that nurses are protected in their workplace. Wherever there is a committee or panel making decisions about health, there needs to be a nurse at that table, not only as health professionals but as patient advocates.

In the coming weeks, Nursing Review will speak with other Australian honourees.

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