my brilliant career - nurse management

Published: 24/04/2003, Volume II3, No. 5825 Page 30 31

Money was not the issue for Shelagh Gowing when she left the NHS - it was about being 'empowered to give the highest quality care'. She talks to Nick Edwards

Name Shelagh Gowing

Job Head of clinical services and matron, Thames Valley Nuffield Hospital

Age 34

Salary 'In the 40s - It is not a huge difference from the job I left in the NHS'

Describe your job

I joined the Nuffield group last year and am now responsible for all clinical services across three sites: a 48-bed hospital near Slough, an inpatients' clinic nearby and a 26-bed hospital in Windsor. We employ about 70 nurses. Two areas I led on have been changing the roles of sisters to mirror the autonomy sisters get in the NHS, and recruiting 14 more staff nurses.

What was your career path?

I qualified as a nurse in 1990 and joined Wexham Park Hospital [now part of Heatherwood and Wexham Park Hospitals trust]. Within six months I was promoted to a senior staff nursetype role, moving up to junior sister in 1992. I then dabbled in private medicine, working for three months on the private patients' suite at the hospital. In 1995, I left the trust to take up a clinical research sister post for a research company. At the end of that year, I was invited back to Wexham as a stroke specialist.

In 1998, I created a new role as neurology specialist. I set up my own nurse-led clinic, seeing new and follow-up patients, which was the first time specialist nurses had really done that.

The hospital now had 12 specialist nurses, all managed in a variety of ways, so in 2000 I became senior manager for nurses while keeping my neurology responsibilities. The following year I stepped away from neurology and became clinical services manager for all specialisms, reporting to the general manager. Most people go into specialist nursing because they do not want to be a manager; they want to be close to patients. But I wanted to change bigger systems.

You joined the private sector group last year - what was the impetus?

I was approached. I wasn't looking, but I was curious - the hospital was five minutes up the road, but I had never been there. The first thing that struck me was what a nice place it was and within half an hour of meeting the hospital manager, I thought: 'I could really work here.'

The job offered me the chance not just to work with the full range of specialties (including major surgery) but also pharmacy, x-ray, theatre - everything.

What are the main differences?

I was very proud of my nurses at the Wexham - in specialist nursing you believe you are the best of the best and all you can do is teach everyone else. But the quality of nursing care here is phenomenal. There is a perception that nurses come to a hospital like this because it pays more - they come because they are empowered to give the highest quality care. We do not pay lip service to clinical governance, we actually do it. This job is much more strategic than I am used to - I found that quite difficult because I just wanted to roll my sleeves up, but what was required was someone to step back. For instance, I am restructuring the nursing hierarchy to improve career progression, but I needed to step back to see the need for that. My fear was that it would be too quiet - I was used to 60-hour weeks and crisis management. Things may be more planned here, but we definitely are not quiet.

Could you see yourself returning to the NHS?

It has raised my expectations on what quality is - in some ways, I would love to go back and spread the message. It is not all about the money - we work on pretty much the same nursing numbers, we have the same recruitment difficulties, the same sickness/stress problems. If I went back tomorrow I would work very hard to make sure my standards, which have now been set at a higher level, were not lowered. We get student nurses coming through, which is quite a new thing, and That is good because it really opens their eyes about what's possible.

What has been your hardest career decision?

Letting go of neurology was absolutely the hardest thing I've done - I was passionate about that job. It is still hard now - I see the consultants I worked with very closely then. I think of the letters I got from patients from five or six years before who heard I was leaving the trust. You realise you did make a difference to those people. When you work with patients, and carers and students you do not realise quite how many times people thank you for what you have done. When you become a manager, you can work your socks off but the words 'thank you' are very rare.

How do you relax?

I am fascinated by forensic science so I have a pretty scary book collection. Working in neurology does make you intrigued about the human mind and why some people behave the way they do. l Just the job Title: Nurse manager in the private sector.

Salary: Up to£80,000 depending on experience.

Distinguishing features: Many are attracted to the independent sector because of the chance to quickly gain experience in a wide range of clinical areas; they therefore tend to be ambitious and focused on rapid career progression.

Prospects: Independent sector now accounts for 20 per cent of the UK's acute elective surgery, a figure that is likely to rise as programmes like Patient Choice start to bite.