Alison Moore spoke with Zena Moore
following her appointment as the new
head of the RCSI School of Nursing and
Midwifery
A fortunate
wind blew
me here
“My 17tH birthday was my first day on
the wards. I was put on the children’s ward
and, looking back, I’m not surprised as I
was only a child myself.”
The new head of the School of Nursing
and Midwifery at the Royal College of Surgeons in Ireland (RCSI), Prof Zena Moore,
in an interview with WIN, thus describes
her very first day of nurse training in the
1980s at St Michael’s Hospital in Dun
Laoghaire, Co Dublin.
Zena officially took up her new position this spring, following her previous
position as acting head of the Faculty.
She brings more than 12 years of academic experience at the College to the
role. A registered nurse, Zena joined RCSI
as a lecturer in 2002, and has since been
academic director and deputy head of the
Faculty before commencing her new role.
Speaking on her early career she explains
how soon enough after her training in St
Michael’s, and after a brief stint in St James’s
Hospital, she was fortunate to get a permanent post in the Meath Hospital at a time
when they were hard to come by.
“I was really lucky to get one in the 80s.
The assistant director of nursing interviewed me and gave me that chance. I
stayed in the Meath Hospital up to the
move to Tallaght,” she said.
Throughout this period, Zena worked in
medical wards and the emergency department, but on suffering the bereavement
of a stillbirth on her first baby she sought
more regular hours. It was this that led her
to her eventual specialty in wound care.
“The hospital couldn’t have done more
for me. They really took care of me. It was
like being in a family. They gave me the
regular hours and it happened to be in a
wound clinic.
Wound care
“There was no established way of taking
care of wounds, not just in that department but anywhere in Ireland, or anywhere
at all really. At that time the European
Wound Management Association (EWMA)
was born so it was serendipitous that I
landed in there as I started working with
the EWMA and my whole interest in the
area grew from there.”
Zena’s work with the EWMA was initially
on the “outside of things” until the consultant she was working with at the time
nominated her to fill his position in the
Association on his departure.
When the Meath Hospital moved to the
new facility in Tallaght, the post of a tissue
viability nurse was advertised and Zena
was appointed.
She explained that up to this point, she
had been running the wound clinic but
not in an official post, and in the interim
had studied at the University of Wales
in Cardiff for a postgraduate diploma
in wound healing and tissue repair. This
involved going over and back to Cardiff
every eight weeks for two years and she
gives special mention to the support of
her husband (Bud) during this period.
“I had three small children but my husband is an absolutely amazing man and
would look after all of them. It was a really
brilliant, multidisciplinary programme and
it opened up my whole way of looking
at things and gave me confidence in my
practice so that when the tissue viability
post came up I got it,” she said.
Zena then continued her study, taking
on a masters programme at the Wound
Healing and Research Centre at the College of Medicine at the University of
Wales. It was at this point that a lecturing
position came up in the RCSI.
Royal College of Surgeons in Ireland
“It was an opportunity to bring education into a wider arena in terms of wound
management. It started with a module and
then we had a small programme which
grew, and now people do a PhD in the area.
So I came to the RCSI as a clinical person
with no experience of academia per se, and
Seamus Cowman, who was head of nursing, gave me that opportunity to grow as
an academic,” she said.
Zena referred to the nurturing environment of the RCSI and the “fantastic
colleagues” who supported her.
“I always describe it as a hand in a
glove; even though I didn’t have a lot of
experience of academia, they provided
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June 2014 Vol 22 Iss 5
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Interview
Prof Zena Moore
A registered nurse, Zena Moore joined RCSI
as a lecturer in 2002. Since then she has
been academic director and deputy head of
the Faculty of Nursing and Midwifery. Her
area of clinical research interest is wound
healing and tissue repair. She is actively
involved in research in this field and has
undertaken 10 systematic reviews with the
Cochrane Wounds Group and the Cochrane
Renal Group. She has published more than
100 articles and book chapters. Currently
she is principal investigator on a best evidence in medical education systematic
review, exploring the impact of peer observation of teaching.
Zena is the chairperson and clinical lead
for the HSE/RCPI National Pressure Ulcer
Collaborative Project and chair of the repositioning group of the European Pressure
Ulcer Advisory Panel guideline development
project. She is an honorary senior tutor at
the University of Wales and a visiting lecturer at the Faculty of Health Sciences,
Hogskolen i Buskerud, Drammen, Norway.
She was President of the European Wound
Management Association (EWMA) 20092011. She remains an active member of the
association, and is the chair of the EWMA
Multidisciplinary Project.
A native of Cork, she holds a postgraduate
diploma, with distinction, in wound healing and tissue repair and an MSc in wound
healing and tissue repair from the University
of Wales. In 2002 she received a Fellowship
of the Faculty of Nursing and Midwifery,
RCSI and in 2009 she completed her PhD.
She also holds an MSc in Leadership in
Health Professionals Education from RCSI.
In her spare time Zena likes to “chill and listen to music”.
the structure so that I could operate and
become competent in what I was doing, in
a very supportive manner.
“Pauline Joyce was one of those colleagues and she is still at the RCSI working
in the Institute of Leadership, and she has
a really fantastic way about her, in terms of
being able to support you in a way that is
very safe and so that you are able to learn
and grow as a result of your mistakes.”
Cochrane fellowship
The next step for Zena was a Cochrane
fellowship with the Health Research Board
(HRB). “That funding gave me time out
and I focused on a systematic review of
wound cleansing for pressure ulcers. Now
I’m doing my 11th Cochrane review so the
52
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June 2014 Vol 22 Iss 5
HRB really gave me a great opportunity
to develop that skill and enabled me to
teach others how to do it.”
Zena subsequently received funding from the HRB to undertake a PhD in
pressure ulcers at the RCSI, which she
completed in three years. “I really, really
enjoyed it. There were stress points up
and down but I had a great network of
people supporting me,” she said.
O n co m p l e t i o n o f h e r Ph D, Ze n a
returned to work at the RCSI where she
was deputy to the head of faculty. “This
time last year I was a lecturer. There was an
opportunity to do a masters in leadership
in health professional’s education, with
Pauline and her team over in the Institute
of Leadership, and I really enjoyed that,”
she said.
As part of this course, Zena and a colleague, Anne Weadick, did a project on
peer observation in teaching, where peers
would observe and support each other’s
classes and help to inform better teaching outcomes in a supportive manner.
“Because it is formative, you should enable
systems to be put in place for training that
benefits teaching. It is part of the quality
agenda and RCSI has a new strategy to
2017 in place and excellence in education
is one of them, so competence and quality in a supportive environment are at the
forefront” Zena explained.
The opportunity to take over as the
head of the nursing school at the RCSI
arose when the former head of the school,
Prof Seamus Cowman moved to a new
role with the RCSI’s campus in Bahrain,
leaving the vacancy.
“I applied for the job and was lucky
enough to get it. I’m really happy. It’s a
lovely team here, it is small but very supportive in all our endeavours,” she said.
While very much ensconced in the
world of academia these days, Zena determinedly keeps her “feet in clinical practice”.
“Prevention of pressure ulcers is a key
priority for the HSE this year. I am leading
out on the Pressure Ulcer Collaborative,
which is about getting people to work
together as teams within their individual
organisations, be that community or hospital,” she told WIN.
Zena explained that the Collaborative
is following a model from the Institute
of Healthcare Improvement in the US
whereby the staff on a ward would know
how many pressure ulcers they have, how
many are hospital-acquired and would
explore the causes for them, with the aim
of getting them to zero.
“I’ve kept my feet well in clinical practice
in terms of pressure ulcer research and prevention. It is very important in here as a lot
of our programmes are clinically based, we
need to have that clinical credibility. If I was
just taking everything from a book I would
have no believability. As a leader, people
need to believe that you do know what
you are talking about,” she said.
Vision
According to Zena, the RCSI wants to
be the leading provider of post graduate nursing and midwifery education
in Ireland and as such, their key focus is
ensuring that it meets the clinical, academic, and professional scholarship needs
of individuals within the health service.
“In plain English, it means that we want
to demonstrate the impact that nursing
and midwifery have on patient outcomes,
and that by undertaking education and
being involved in evidence-based practice
that the staff are generating evidence for
what it is they are doing.
“We want to empower people to be
able to demonstrate the difference that
they make to practice and be able to
respond accordingly to the leadership
and professional challenges that they face
everyday,” she explained.
Discussing the recent Lancet study,
which demonstrated the value of university education in nursing, Zena stressed
that both education and clinical practice
must be valued.
“If you don’t have clinical experience
you can’t apply education as you don’t
know how to synthesize it or make it
applicable for the particular situation that
you find yourself in.
“What we would stress is making sure
that the evidence that you are making
your decision on is based on best practice,
and one way that you can enhance that
is by being actively involved in education and being able to demonstrate your
competency.
“Yes, it could be okay to continue doing
something we have ‘done for years’ as
long as we know that there is no new evidence to suggest that we should be doing
it differently. Being actively involved in
education empowers people, because it
enables you to be a more active part of a
team,” she said.
Leadership
The fundamental aim of nursing and
Interview
midwifery is to enhance the lives of the
patients that they take care of and in
order to do this, according to Zena you
need to be able to respond to ever-changing demands.
“For example, if you are working in an
acute hospital setting it is completely
different than it was 15 years ago. Your
focus remains the same, on the patient,
the expectant mother, the neonate in
intensive care; the needs of the patient
influence the requirements you have for
that nurse or midwife. Expanding our
scope of practice is related to the patient,
or client group, that we have.
“As such it is not so much that more is
expected of you, but that the acuity has
changed, and that the profile of patients
has changed. Patients are much more
informed, so therefore they have expectations that we have to address,” she said.
The RCSI is offering postgraduate
training to newly graduated nurses and
midwives with the aim of developing
their skills and competencies early in
their careers so they are actively able to
respond to the leadership and professional challenges of the health service.
“It facilitates, very early on in the per-
son’s career, the expansion of skills in
terms of leadership, teamwork and communication. So they can look at the whole
concept of patient safety and clinical risk
right from the outset of their careers and
respond as required,” she said.
Their very freshness can be an advantage in such situations according to Zena:
“When new people come into practice
they are able to see things that the rest of
us don’t see, and therefore by giving them
the skills to know what to do when they
are challenged by situations like that, it
enables them to respond more effectively
and empowers them to lead from the outset of their careers.
Outlook
“I just feel lucky that I’ve been able to
work in an area that I love. I love wound
care and being in an organisation like the
RCSI, having a clinical focus is fundamentally important and the fact that I am able
to share that with so many people, while
being given the opportunity to learn
so many other skills, like leadership and
evidence-based practice, and to interact
with people from a wide variety of clinical
areas, has been fantastic.
“The fact that you always feel like you
are driving towards a goal that you can see,
and that your goals change, is great. You
get to develop different skills and I feel very
lucky to be in the position to be doing that.
“Your credibility lies in who you are as
a person. That was one of the things that
I was able to explore in the leadership
programme in the Institute of Leadership
here in RCSI. Really looking at leadership
skills, how you see yourself as a person,
and living your espoused values, for me is
really important. It’s about being credible,
believable and trustworthy. For my students here, if I promise to do something I
will do it,” she said.
Referring to her recent appointment,
Zena told WIN how she felt really lucky to
be where she was at this point in her career.
“It’s a great team here. I feel very comfortable. I know the organisation well. It is
a great opportunity and I feel really lucky
that I’m in this position. I am very grateful to my family, friends and colleagues
for supporting me all the way along my
journey.
What was it that Seamus Heaney said? ‘It
was a fortunate wind that blew me here’.“
We wish Zena the best of luck in her
new position.