Rhona reflects on the Queens Nursing Leadership Programme 07 May 2025 Rhona Martin, Chest Heart & Stroke Scotland Lead Stroke Nurse (Fife) reflects on her experience of being part of The Queens Nursing Leadership Programme in 2023. we as clinicians have to be healthy in mind and body to be able to foster healthy, respectful, and empathetic relationships with our service users I know that “journey” has come a bit of a cliché when describing something new or different that is happening in your life, but I cannot think of a better way to describe this unique and transformational programme that I have immersed myself in. The Queens Nursing Leadership Programme “supports, develops, and inspires Scotland’s community nurses and midwives to become agents for health improvement and catalysts for social change to build a healthier fairer Scotland”. (The Queens Nursing Institute Scotland 2023) On hearing that I had been nominated by my Line Manager to apply for the Queens Nursing Programme cohort 2023 I felt honoured and privileged to be given this opportunity, but it is fair to say that the application process was both daunting and exhilarating in equal measures. For this year’s cohort The Burdett Trust for Nursing has provided funding for 4 applicants to take forward a Cardiovascular Project with a focus on primary prevention of cardiovascular disease which became the basis of my application. Primary Prevention of Cardiovascular Disease How my vision will be achieved is an evolving process, but the fundamentals remain the same: To be proactive in our approach in the prevention of future strokes and cardiovascular events through improved detection of AF and Hypertension and instilling interventions aimed at reducing the risk of stroke in people who have not yet had a stroke. There has to be equity in health and an important factor in my proposal is to ensure that the people living in our more deprived areas have access to this support and attain their full potential for health and wellbeing as unfortunately cardiovascular disease is one of the conditions most strongly related to health inequalities, deprivation, and low health literacy. There were 3,836 stroke related deaths in Scotland in 2021 and whilst there has been a decrease in stroke deaths in the last 10 years it remains the leading cause of death and adult disability in Scotland. The number of people dying after a stroke in the most deprived areas of Scotland was 43% higher than in the least deprived areas in 2021 which is consistent with the previous 5 years. There are of course, non-modifiable risk factors for stroke such as age, sex, and co-morbidities but by identifying modifiable risk factors in individuals and supporting people to make lifestyle changes this could potentially reduce the prevalence of stroke significantly. (Public Health Scotland 2023) The Scottish Government’s commitment to stroke care led to the – “Progressive Stroke Pathway” being published in March 2022. As Stroke Clinicians this paper provides the recommendations in practice that we should be striving to achieve. One significant recommendation is that there should be improved detection, diagnosis and management of AF and hypertension through quality improvement within community settings. (Scottish Government 2022) Bringing learning back to the day-to-day I am often asked how the Queens Nursing programme will assist me in achieving my vision and this is a very difficult question to answer and therefore difficult to put into words. For my vision to reach fruition I need to bring others with me on this journey, to share my ambition and inspire them to commit to what will be a long-term process. The QNIS is at its core a Leadership Programme – “inspiring others with tenacity and resilience”. (The Queens Nursing Institute 2023). The programme blends a range of opportunities and learning approaches including two residential and one virtual workshop, monthly coaching, peer support and online gatherings with person centred care at the forefront. As an experienced nursing professional, I thought that I had person centred care covered, which for the people I care for I probably did. What I didn’t consider was myself and my team being central to this principal and how we as clinicians have to be healthy in mind and body to be able to foster healthy, respectful, and empathetic relationships with our service users and be a champion to their roles as advocates for high quality community nursing and equality for all in healthcare. (McCormack et al 2021) I now hopefully lead through this principal by ensuring that I support my team to embrace self-care, reflect, and to share constructive feedback. I have incorporated the “Mini Kitbag” resource into our team meetings to not only open conversation but to encourage listening without judgement and if appropriate for us to offer advice and support. What is exciting is that my team are now using aspects from this kitbag in conversations out with these meetings to reflect, express their thoughts and feelings and ask for support. (International Futures Forum 2023) I was and continue to be challenged at times on this programme with critical personal dialogue on past, present, and future experiences, exploring my values and beliefs through the eyes of others as I try to make sense of this journey of self-discovery. It continues to be a work in progress, but I have made significant changes physically and mentally in both my work and personal life since starting this programme and interestingly in both aspects people have said “ I can’t put my finger on it but there is something different about you”. This may bring about different challenges as both myself and others adapt to these changes, but I will continue to embrace this opportunity to become the best person I can be not only for myself but for my team and the people that I support in my role as a Chest Heart & Stroke Scotland Lead Community Stroke Nurse. For anyone who may be given this opportunity I would say be “brave and bold and just enjoy the journey”. REFERENCES International Futures Forum (2023) IFF Kitbag Available at https://www.iffkitbag.com McCormack, Brendan, McCance Tanya, Bulley Cathy, Brown Donna, McMillan Ailsa, Martin Suzanne 2021, Person-Centred Healthcare Practice, Wiley Blackwell, Chichester Public Health Scotland (2023) Scottish Stroke Statistics Available at https://publichealthscotland.scot Scottish Government (2022) Strokes: progressive stroke pathway Available at https://www.gov.scot The Queens Nursing Institute Scotland (2023) About QNIS Available at https://qnis.org.uk FURTHER READING Burdett Trust for Nursing – https://www.btfn.org.uk WELL, WHERE DO I BEGIN? Well, where do I begin? Filling the application form in? Or meeting my cohort – a definite win. Pensive, oh yes. But, hey I feel blessed. As without feeling a pest. I have now met up with the best. First lesson to learn. Was a walk with the ferns. Before finding my zen. In a mindfulness cleanse. Wellbeing now a routine. Now to embed this in my team. They are encouraged to see me as a lean. To help decipher what it all means. I felt I had something to prove. So, listening skills have definitely improved. I was probably before very shrewd. Which is certainly something to be booed. Coaching sessions, oh yes please. These are not in the least bit fierce. But have helped me face my fears. Whilst of course feeling safe with my peers. My project remains the focus. Cardiovascular risks are atrocious. Pre having a diagnosis. Lets work to reduce the risk of thrombosis If you or someone you know is living with the effects of a chest, heart or stroke condition or Long Covid and looking for advice and information, please contact Chest Heart & Stroke Scotland’s Advice Line on 0808 801 0899. You can also text ADVICE to 66777 or email adviceline@chss.org.uk.