From Hospital Porter to Head of Dept of Nursing

This week Matt Farrah interviews Dr Dave Barton from Swansea University. Through hard work and sheer enthusiasm Dave’s nursing career has taken him from hospital porter to Head of Department of Nursing at the University. 

So, Dave, when and where did your career in nursing begin?

I started my training at the age of 24 in Kings College Hospital in London.  I had never really thought about becoming a nurse, and it only occurred to me when as a Hospital Porter in a London Hospital I saw what the Nurses were doing, and thought "wouldn't it be great to be able to help people in that way".

In those days it wasn't a University programme, but the three years of nurse training was extensive and hard, no less so than it is today.

When I qualified in 1983 I was a very different young man, and had seen and done things that I could have scarcely thought of previously.

Nursing certainly matures you, it’s physically and mentally hard, but immensely rewarding.  

After working as a staff nurse on a Neuro Medical Ward for two years I decided to specialise in Intensive Care and got an ICU job.

You moved to Swansea 25 years ago and a few years later joined the School of Nursing. What was behind your decision to leave clinical practice and become a teacher of nursing?

I needed the challenge - and it came in the form of a Nurse Teacher role.  It was a big step, and at the start it was strange, but I enjoyed it and have never really looked back.  

There were so many new things to do - transmitting my passion and enthusiasm to the next generations of Nurses;  trying out new ways of teaching; planning lessons; spreading your wings; and bringing the art and science of nursing alive for others.  Plus, I was still out there - doing the job that I taught to others.

Can you describe your ascent from junior teacher to head of department?

Unexpected is one way of looking at it.  

I was never a natural academic, and 25 years ago I would have laughed at the idea of being what I am today.  

No one was more surprised than me when I was offered the job of Head of Department.  

I was, I suppose, always enthusiastic and positive, and in fairness to myself I have gained years of experience working with students and courses at both pre registration level and post registration level.  

I undertook my own Master and Doctoral Studies, and I networked with strategic developments at government and regulator level.  

This long preparation developed me and enabled me for the challenges of leading the Department.  

It certainly wasn't meteoric - it’s been a long hard path.

You've previously said that remaining 'grounded' in practice is very dear to your heart. Can you explain the ways you keep yourself grounded and why it's important to you?

Up until a year ago I was practicing in ICU once a week for four hours - and I saw this as incredibly important - as it keeps you grounded in the clinical nature of nursing.  

Unfortunately I have some arthritis now, and its been difficult to maintain my regular clinical practice.  

However, I have an Honorary Contract and do visit ICU regularly.  In addition, and in fairness, all Nurse Lecturers, no matter how senior, are linked with clinical areas to support our students.  

This is a requirement of our regulator, the Nursing and Midwifery Council.

So we all have clinical input, and having my eldest son and his wife as Nurses brings in regular updates.  

Indeed, just talking to students, and meeting with clinical staff, makes it all so alive - it’s not like you ever stop being a nurse.

Also, Nursing IS practice, whether that is teaching students, frontline care, managing and leading an entire hospital and a multi-million pound budget, or undertaking research.

Practice, Leadership, Education and Research - these are the pillars that are foundational to what we do.  

And every Nurse must be engaged in all of these.  

Nursing is not an office job, it is a caring profession, and that to me is the grounding that I remind myself of every day.

So you have had very good experience of nursing in ICU for many years. In what ways have jobs in ICU nursing changed since you started?

In some ways a lot, and in others not at all.  

Very sick people are the same today as they were then and they and their families are just as frightened, scared and bewildered. The technology has of course developed hugely, and the ability of critical care intervention to preserve and save life has improved.  

The ICU Nurse has huge demands on them in understanding the pathology of their patient’s illness, in monitoring vital signs, interpreting key clinical signs, administering drugs and infusions.  

Today’s patients are supported with multiple systems collapse, they are on respiratory support, cardiac support, renal support, nutritional support and other interventions.  

But what has not changed is that first and foremost there is a human being in the bed, who needs basic fundamental care, hygiene, mouth care and eye care - and most of all dignity and love.  

It is no less important in an ICU to hold a patient’s hand, or to put your arm around a terrified relative. These are the humanities that must prevail despite (and in spite) of all the technology.

One of your key responsibilities as department head is to ensure nursing research is promoted, undertaken, published and funded. Can you explain the importance of academic research in nursing?

Nursing involves dealing with people, delivering care, supporting the dying, alleviating pain and distress, striving for human dignity.  

Florence Nightingale, the very first Nurse Researcher said: "It may seem a strange principle to enunciate as the very first requirement in a hospital that it should do the sick no harm".  

To that end we must have evidence. Evidence may range from knowing what is the right or wrong wound dressing to use, what is the best practice in diffusing violent aggressive patients, what therapies are most effective in enabling recovery from suicidal depression, what are the best ways to treat intractable pain.  

The list is endless.  

Universities are the repositories of such research endeavour, and it falls upon them to deliver, and push back our understanding of our world, of people, and of how we can care best. So I would challenge the notion that research is 'academic' - because for Nursing, research is ALL about practice.

What other direct input into the nursing industry do you have? How does your role affect the day-to-day lives of working nurses?

An industry! Well yes I suppose we do produce something.

* Virginia Henderson, a very famous nurse, said that: "The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge".

Our intention is to produce tomorrow’s nurses, and to produce the evidence that enables our profession.  

We have nearly a thousand undergraduate nurses at Swansea University, and we educate Advance Nurse Practitioners, we work with our NHS Colleagues at Ward Level, and Board Level, to achieve Virginia's vision of what Nurses do.

Almost 1,000 nursing undergraduates is certainly a large department. In fact, the Department of Nursing is the largest in Swansea University's College of Human and Health Sciences. That’s some undertaking.

Do you ever miss ‘just’ walking in to an ICU for a day's work?

Yes and no.  I love hospitals, the atmosphere. I can remember my very first day on a Ward as a Student: a whole new world opening up in front of me.

When I walk onto a Ward today its like going home.

But what I do now also makes the world of Nursing actually work, and I am proud to front a team of 80 Nurse Lecturers, ranging from practitioner lecturers, novice lecturers, through to Professors of Nursing.  

I am proud of what we do here, and of what we contribute to healthcare.  And when I do go to Wards I am proud to see Staff Nurses, Sisters and Charge Nurses who were our students only a few years ago.  

I watch them hold patients’ hands, wipe away relatives’ tears, wash, clean, feed, and preserve dignity - and I am immensely proud of them and of my profession.

There may be nurses reading this who might wish to take their career into the academic environment. What tips would you give to these nurses so that they can also carve out a successful career in nursing education?

Work hard, study hard.  It is a reality that today a Masters degree is an asset, but you can contact your local University Nursing Department, offer them sessions that reflect your speciality, get your foot through the door.  

It is also important to remember that there are many opportunities in the NHS to become mentors, practice facilitators, and these all often have close links with their Universities.  

And most of all - never give up.

* note about nursing as an industry. I [Matt] asked Dave about my choice of the term 'industry' to describe nursing: "I thought that it was interesting the way you put it - as there is debate about what the NHS does? Do we produce something - Health? Or are we just a crisis intervention service - stepping in when all goes wrong. 80% of the NHS budget goes on crisis intervention - 20% on health promotion! So we are a last resort safety net. At its outset in 1948, Bevan estimated that the NHS budget would level out after 10 years as the health of the nation improved - nothing was further than the truth! The NHS is a self fulfilling organisation, it exists because it is there - and successive governments have strived to dismantle it, or turn it into an industry - and the Coalition is currently doing the same - but they have all (so far) failed.

Thank you to Dr Dave Barton for his time.

Find out more about nursing and midwifery courses at Swansea University's College of Human and Health Sciences.

Interviews with nursing students who studied at Swansea University:

Gemma Morgan - mental health nursing student

Dan Yates - mental health nursing student