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'If you are a good care-giver, you'll be a good manager'

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Caroline Alexander has never stopped learning, which has made her a better nurse leader

What inspired Caroline Alexander to train as a nurse at university was her guidance teacher at school telling her she didn’t need a degree to nurse.

“My belief is never say never,” says the director of quality and clinical governance for NHS East London and the City, who now has several academic titles - including visiting professor at City University.

Ms Alexander’s desire to learn while working has seen her win a Nuffield Travel Award, take part in the Chief Nursing Officer sponsored leadership and personal integrity programme and, in November 2007, scoop a Florence Nightingale Foundation Trust leadership scholarship. This, she says, changed her life, her views and her personal style.

Ms Alexander was always ambitious. “When I qualified, I thought that if I wasn’t a ward sister in five years, I was in the wrong job. I was in Scotland where it was very much dead men’s shoes at that time. Then I got asked to act up as a junior sister in 1989 [two years after graduating]. I hadn’t realised I’d been noticed positively. Usually I was the one asking the awkward questions and getting the frowns.”

Coming to management did not mean discarding her nursing “personality”. She says: “If you are a good care-giver and you care about people, you’ll be a good manager because you’ll care about your staff and naturally nurture them to be the best and to give the best care.”

But she adds: “I didn’t have a plan after I was a ward sister and I never thought I would be a director of nursing.

She graduated from the University of Edinburgh as a BSc/RGN, specialised in nursing older people in Edinburgh then at Guy’s, worked at the Foundation of Nursing Studies, then gained her MSc in Nursing Studies from London South Bank University. She returned to the NHS in 1998, working in Tower Hamlets until February this year in a range of roles, from nurse adviser for older people to director of quality development for NHS Tower Hamlets.

The thing that most shaped her was being a Florence Nightingale scholar. “The idea was to develop my own leadership style and expertise in commissioning. I was given £10,000 and it was my choice how I spent it.”

She took part in the non-healthcare Mastering Leadership Programme at Henley and spent time with commissioners in Chicago. She also visited Istanbul - an area prone to earthquakes - to learn about disaster management and to see where Florence Nightingale practised in Scutari.

“Giving effective feedback is a critical skill - in sessions with chief executives and directors from other industries, I learnt how they approached it and got the chance to test it out on them. I learnt if I couldn’t understand the language the financial director used, it was their fault, not mine. Some people use language to block others’ understanding. That course taught me not to be scared to ask questions,” she says.

“The time in Chicago was interesting. I attended a conference on the role of the board in assuring quality. This came at an important time, soon after the Mid Staffs scandal, and helped me to understand how the board in a commissioning organisation needed to assure itself of the quality of care in hospitals it commissions care from. I also spent time with a private company that commissioned healthcare to understand how they assured quality.

“Not only did I personally learn from this but also I applied it to business in NHS Tower Hamlets by developing a strategic framework for quality assurance that was shortlisted for an HSJ award in 2010.

She urges potential scholars to think laterally. “Do flower arranging if it helps you learn the broader leadership thing. Don’t spend five grand on something you’ve only read about in the brochure - speak to people on the course.

“I learnt what I needed to develop into, why I react the way I do in certain situations, and which buttons can be pressed to make me behave a certain way.”

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