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Queensland nurse, researcher and educator, Dr Isabelle Skinner, has recently been appointed Chief Executive Officer of the International Council of Nurses. She tells QSuper that her priorities in this global role will hopefully be felt in Queensland and Australian health as well as throughout the world.
For QSuper member Dr Isabelle Skinner, improving world healthcare is a team game.
She has just been appointed nursing’s world team captain and will be representing more than 20 million nurses from 130 national nursing organisations as well as nursing regulators around the globe as CEO of the International Council of Nursing (ICN).
Dr Skinner will take up the position as CEO of ICN in Geneva, Switzerland, on 1 August.
“Improving the health care of the world is a team game and we need all of our health care professionals to be doing their absolute best,” Dr Skinner says. “I see it as a privilege to have this role, but it is also important to recognise that every role that I’ve had I’ve found really an important role to be doing and be doing at my very best.”
Dr Skinner said the position would give her the opportunity to advance equity in access to healthcare globally.
Most recently at James Cook University’s Mount Isa Centre for Rural and Remote Health, she has been working to ensure people living in north west Queensland, and areas outside capital cities, have access to the best health care.
“We have a lot of expertise in health care now, we have done a lot research over the years and with evidence-based practice we know how to implement very good quality care, and in Australia we are one of the world leaders in doing that. But we are still not the world leader in equity. How do we get that expertise into our remote communities? That’s the area that I’m really passionate about.”
As chief of the world’s oldest and widest reaching health professional organisation, she said she hoped to have a significant impact on healthcare access that would be felt in western Queensland, and globally for people in remote areas such as rural Zimbabwe, Mongolia and the Patagonia region of South America.
Nurses are the world’s majority health care providers, Dr Skinner said. In developing countries, where access to medical services could be very limited, nurses are often the only providers.
“If you can influence the way nurses work, then you can influence the way healthcare is delivered,” she said.
She said as well as working on policy and advocacy covering what it means to be a nurse, training and regulation for nurses, and how to ensure patients were looked after by qualified people wherever they lived, the ICN could influence how healthcare was delivered by:
Dr Skinner said every nurse had a role to play in improving healthcare for people across the world.
“Every person who is working in health care has a commitment to improving the world and so don’t feel that you’re not doing an amazing job by looking after your patients really well,” Dr Skinner said.
“We need people across the spectrum of healthcare to be really giving it their 110% and that commitment to providing expert care for patients is needed in every area of health care.”
To improve healthcare globally, Dr Skinner said her priorities in the ICN role included advancing healthcare access for patients no matter where they lived, as well as nurses working to change what could be changed.
Social determinants of health – described by WHO1 as the conditions in which people are born, grow, work, live and age such as poverty, environmental factors, transport, and access to good food – were significant contributors to chronic disease.
“These are all huge things that an individual nurse and an individual person seeking healthcare probably feels a little powerless to do anything about,” she said.
“One of the things that I’ve been looking at in my own research over the past five years is the modifiable social determinants of health.”
Dr Skinner said one modifiable determinant of health was sleep.
“It costs nothing to close your eyes, but you need to know that it’s important,” she said.
“Kids need to be getting to bed at a reasonable time in a safe place. In slums and in areas where there’s high rates of poverty, it’s actually something that doesn’t happen, so it’s something that we can modify and something that we can modify everywhere.”
Improving sleep could contribute to improved health, she said.
“When we think about improving healthcare globally, we need to be able to say let’s work on things that are actually modifiable.”
“And I know that if you get good sleep of a reasonable duration in childhood, you have a much lower likelihood of having obesity and chronic diseases as an adult.”
As well as sleep, good nutrition and keeping well in pregnancy were modifiable social determinants of health, she said.
“There are lots of things that we can’t change, and an individual nurse might be thinking, ‘Oh I can’t do anything about climate change,’ or, ‘What can I do about transport issues?’ But you can do something about encouraging your patient to stop smoking, and you can certainly encourage good sleep.”
Dr Skinner said if she could have an impact on modifiable behaviour as well as programs to improve access to care, “then I’ll know that I have made a difference.”
Dr Skinner joined the nursing profession when she was 17. She trained at Royal Brisbane Hospital and, as part of her training, went to Papua New Guinea where she recalls being shocked by how difficult it was for women to access to good healthcare for maternity services.
“After I finished my training I went up to Cloncurry, and I saw that we had very similar issues in Australia. I realised then that we had a really big need to be working not just as a clinician, but also to start thinking about how to improve access to health services,” she said.
Dr Skinner has spent her career working to close the gap in indigenous health disadvantage. She has worked as a remote area nurse, in neonatal intensive care, as a public health nurse, nurse manager and director of nursing, as well as in nursing research, education and leadership.
She has worked in Queensland, most recently at James Cook University’s Mount Isa Centre for Rural and Remote Health, as well as Katherine and Arnhem Land in the Northern Territory, the Kimberley and Broome in Western Australia. She has also worked with health teams and students in Sri Lanka, Indonesia, Singapore, Zimbabwe, and China.
She said while there were great advantages to working in the city, leaving the city could be of benefit if you wanted a global career.
“My advice to people is that if an opportunity comes up to do a project or something that you think is going to be a bit different and add another layer to your expertise and experience, say yes.”
“It’s about having a passion for something, working at it, giving it your best whatever it is – you might be in infection control, you might have a real passion for the magnet hospital movement – whatever you are interested in, give it your best.”
She said working as a nurse made a difference to people’s lives, but nurses were often so busy that they didn’t have time to innovate.
She said she hoped to help nursing leaders see that it was their responsibility to unlock and unleash the creative power of nurses to come up with new ways of doing things.
“Working with an individual patient or group of patients, you impact their lives, but once you start working on policy and education, you impact the lives of many, many people if you get it right,” Dr Skinner said.
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1 World Health Organisation, Social Determinants of Health, accessed 19 June 2018 at who.int/social_determinants/sdh_definition/en/
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