Gibraltar’s top nurse Karen Norman explains how the country is growing its own staff
Karen Norman has always dreamed of making a difference. “I’ve wanted to be a nurse since I was about four,” she says. “I remember throwing a coin in a wishing well as a child, wishing for a nurse’s uniform for Christmas. Once my dad bought it for me, I never took it off.” She practised nursing on her long-suffering brother as a child, but never thought that uniform would lead her to Gibraltar.
Dr Norman’s journey to becoming the chief nursing officer on the rock off the southern peninsula of Spain began when she was inspired by a friend of her mother’s who was a district nurse.
After completing her training at Addenbrooke’s Hospital in Cambridge and Queen’s Medical Centre in Nottingham, she worked as a sister and nurse manager. On completion of her Bsc in nursing, she took time off to travel to Australia.
Despite planning to travel and learn to scuba dive, she ended up reorganising training materials for Total Quality Management, working with the management consultancy Crosby Associates in Australia and New Zealand, as well as helping Townsville Hospital with its accreditation process, and writing a textbook on quality assurance with a friend.
But she missed being at the coalface so she returned to the UK to become director of nursing at Brighton and Sussex University Hospital Trust, a position she held for 12 years.
After earning her master’s degree and a doctorate in management, she was bitten by the travel bug again and was offered a position as chief nursing officer for the Gibraltar Health Authority.
The challenges of Gibraltar’s healthcare system rest on its small size and remote location. With no other hospitals on the rock to divert A&E patients to, Dr Norman’s team needs to be prepared for all situations.
With the help of Kingston and St George’s Universities, and a local team of three lecturers, she has relished the opportunity in developing the school of nursing in Gibraltar. “Our philosophy is to grow our own nurses,” she says.
About 12 nurses are trained every two years, but the low turnover sometimes proves to be a challenge for the many staff who elsewhere would be applying for more senior posts.
“People tend to stay for their whole career, which means they sometimes have to wait a long time for a senior position to become available. We are addressing this through our CPD programmes, opportunities for secondment, clinical placements and learning opportunities abroad,”
Dr Norman works as part of the GHA Executive to deliver the government’s health manifesto. “Gibraltar has its own publicly funded health service. It is not part of the NHS, we have our own GHA board, accountable to the Government of Gibraltar,” she explains.
Rather than fret over the small numbers, she relishes Gibraltar’s “microcosm” of a healthcare system. “The small size gives nurses the opportunity to focus on direct interaction and care with patients instead of spending an inordinate amount of time on preparing for inspections by external bodies.”
New responsibilities for Dr Norman include being lead executive for mental health and developing Gibraltar’s nursing and midwifery registration board. She is also an associate fellow supervising doctoral students at Hertfordshire University.
And it isn’t like the nurse’s uniform she longed for as a child stays mothballed in the wardrobe. “It is truly a ‘from the ward to the board’ story. I loved running a ward but I also love having the ability to influence. I still occasionally work on the wards and that reminds me of what we are here for and that keeps me grounded.”Abi Getto