Dr Louise Kavanagh McBride Self Care and Reflection

Dr Louise Kavanagh McBride on Challenges In Nursing

Retention of nurses and midwives is something the NMBI have as a priority, according to Dr Louise Kavanagh McBride President of the Nursing and Midwifery Board of Ireland. In the podcast she talks about the various challenges facing nurses and the profession in general.

“Retention within the profession has become more challenging in the last couple of years, particularly post pandemic” she says, with the cost of housing, the cost of living and accommodation being so much more expensive. “So it is more challenging to retain our nurses and midwives but we must. “We have to take ownership for our profession, in how we can entice and retain our graduates beyond registration, and that needs to be continuously fine tuned” she says.  Retaining nurses is nothing new she believes as nurses have always gone to other countries for opportunities, for experiences and upskilling in specialist areas. “We must remember, there are 85,000 registered nurses, and on our state of the register 79,500 of those are actually working in Ireland, and 70,000 of those are patient facing. So we are retaining our nurses, we’ve always had a migration of nurses and midwives to foreign lands to Australia to America to Europe”.

The nub of retaining nurses and midwives in the profession she says is about  the well-being of staff and self care,  flexibility of their shifts, making sure that they are investing in them in terms of funding or career pathways. “That’s all very relevant and all very important. So I think we need to as a regulator, and obviously as a profession, be it academics, or healthcare providers, that in offering nurses contracts and midwives contracts, that we keep those attributes that they identify as a good work life balance, and that’s not just for our own home produced graduates, but also our overseas nurses of which we attract a significant number.  50% of our nurses and midwives are actually drawn with qualifications from overseas.” Ireland is an attractive place for nurses and midwives”  she says. “We rely heavily on our overseas nurses. So I think it’s the same with every profession.” She believes in Ireland “we have to take ownership for our profession, in how we can entice and retain our graduates beyond registration”.

Self Care and Self Reflection

“Put on your own mask first”. It’s the refrain the air stewards chime when they go through the safety check before take off on an airliner. It applies to all walks of life but especially for those working in the caring professions.  It is a message that Dr Louise Kavanagh McBride uses a lot in her role as an academic, manager, researcher, in charge of teaching nursing and healthcare studies at the Atlantic Technological University, Donegal Campus and especially in her role as President of the NMBI, the Nursing and Midwifery Board of Ireland.

Self care is so important, she says in the podcast especially when you are working with people at their most vulnerable. ‘You can’t pour from an empty cup’, is a theme she returns to when talking about the emotional toll nursing can take on staff who are with vulnerable and sick people and their families at momentous points in their life. The vital role of self reflection and mentoring is something she came to through studying for her doctorate.

“That’s why from an academic point of view, and making sure that our modules are not just theory or skills based they actually embed and embody care, compassion, and commitment.  I think really strong role models in the clinical area in our practice development, and in our academia with regards to having strong role models for students, and for graduates is important.” She believes that there is an onus on nurses as individuals  to actually have reflection, to take time to look back on things  that didn’t really work really well and to ask what went right or wrong in different situations. “So we actually embed reflective practice within our programmes at an undergraduate level at nursing and midwifery, so that they can act out and roleplay and even acknowledge the importance of how one feels coming on duty, going on wards, so that you come wholeheartedly to the job.”

Mentoring and Microcredentials

The importance of the role model or mentor or the clinical nurse manager or the clinical nurse midwife is very important in encouraging nurses to excel she says. “Being somebody’s mentor, and giving appraisal is fundamentally important to just push them that little bit forward.  The other thing that I have always found that works really well is the whole area of micro credentialing.” Rather than signing up for a PhD, a mentor can suggest signing up for a certificate, or a special purpose award or a post grad taking the fear out of leaping into something that’s very, very big with somebody who is working full time she suggests.

Patient Advocates

Advocacy is so so important she believes. Having a patient centred approach whereby a nurse or a midwife sees something that is not right and intuitively they  become the patient’s advocate. “It’s so important that nurses are advocates, in scenarios like that”, she believes. “No different to the midwife being the advocate for the mother during labour or indeed for the baby that is about to be born.”   It is important that nurses do take time out for each other. “That’s why I think critical incident debriefing is so important with reflection, and clinical supervision that is meaningful, not just giving out about something, whereby we can learn from the scenario and think if this happens, again, how would we do it differently?”

Digital Transformation

Louise says the digitisation of registration has been a game changer for the NMBI as a regulator. “We have a state of the art live register. So we have a live picture of how the state of the register actually sits. We’re the envy in Ireland in terms of other regulators, so that that’s been quite transformational, because not only does it give us a live status of those that are patient facing, of those who are non-practicing, of how many are coming from different countries overseas and where exactly where they’re coming from, it now is given us a tool to work-force plan.”


Check out the podcast now here on the website or wherever you get your podcasts.



Angela Mezzetti
Follow Me