Apr 25 2021| Leadership | Interview
by Phil Eyre Founder
Professor Greta Westwood CBE is the Chief Executive of the Florence Nightingale Foundation, a nursing and midwifery charity. The foundation has been in existence since 1934, and its mission is to provide leadership and educational opportunities for nurses and midwives.
Phil: Let’s start by learning a little bit about the foundation.
‘The charity has had many different iterations since the 1930s, as you might imagine, but our mission is to pioneer change and improvements in patient and health outcomes through nursing and midwifery leadership, honouring Florence Nightingale’s legacy.
‘Following the death of Florence in 1910, the international community said, “Okay, what are we going to do about this marvellous woman? We've got to keep her memory alive.” So, the International Council of Nurses agreed to set up an international committee, and then it spread across the world as individual countries set up memorial committees. Ours was set up in 1934 and it's just amazing, it's fabulous and I pinch myself every day that I'm the Chief Exec.’
Phil: when did you join the institution?
‘I joined in 2017 as the Chief Operating Officer and I took on a lot of activity to support the charity’s Chief Executive. This put me in good stead for when she left and I applied for the role, which I have held since September 2019.’
Phil: So, when the Covid-19 pandemic struck in early 2020, you were still relatively new to the role; was that challenging?
‘Last year we had a whole calendar of events organised; lots of fundraising opportunities, and of course none of that happened. But in fact, I think we've benefited from the sort of public goodwill towards nurses during Covid. We've done okay, but it has been very different to what I expected.
‘Before Covid we had seven team members, and then three of them were furloughed. This left us with four for a couple of months and then the others came back. So, we've had seven since June and now we have 16.’
What drew you to the role that you're in, and what drew you to leadership?
‘I've been a nurse since 1983. When I was a student nurse I seemed to excel. I won the prize at the end of the year for the best student nurse, so I went off travelling to investigate amazing nursing practices for a few months.
‘I guess something changed for me after I reached a point in my career that followed a long clinical focus. I wanted a change but, in those days, there weren't many roles that had a clear professional career pathway.
‘In 2005, I was at a crossroads. I remember a very senior nurse who said, “Greta, you need some executive coaching - you need to go on a leadership programme.” She recommended a King's Fund programme called the Athena programme, which is designed to support women to fulfil their potential as leaders. That was kind of a pivotal moment because I realised I didn’t need to stay in a clinical role to be a leader or stay connected to nursing. I took a career change into my first non-clinical leadership role.
‘After two years in that role, I changed to a more senior role and finished my PhD. Those roles gave me leadership experience but I was keen to use that experience to impact on the careers of nurses and midwives, so I left to support them in the development of their clinical academic careers. After a few years in that university role and 39 years in the NHS I decided to leave and provide that support, but this time working for this amazing charity. I had actually been a Florence Nightingale Foundation scholar in 2012, so this was a great opportunity to work for the Florence Nightingale Foundation!
Phil: Perhaps clinicians in your context don't easily make the bridge from technical expertise to the leadership role, what do you see is the fundamental difference or that fundamental step?
‘You just have to go for it. I thought if it didn't work, I could easily go back into the clinical world and there are millions of jobs in nursing. But I decided to immerse myself into this new role. The coach said at the time, if you're going to go and step outside clinical practice, you must commit to this, even if you don't like it.’
Phil: I'm quite a big fan of using personal values as a way to apply decision making and leadership really springs from our bodies. What are your personal values, Greta, and how are those reflected in your leadership?
‘Top of the list is integrity. I will always keep my promise and to my detriment sometimes because it means I must work extra, extra hard. I might take time getting there but I would never let anybody down and I guess authenticity goes with this as well. What you see is what you get. One of my values is being authentic, but also having fun and enthusiasm.
‘Courage. I never know what I'm getting himself into, but I just go for it. What's the worst that’s going to happen? As long as there's the common good. I work really hard, because I love my job. And I love the impact that we're making on improving patient and healthcare through developing nurse and midwife leaders. I want people to work hard, and I encourage them to work to the best of their ability.’
Has there been a moment that really shaped what you do as a leader?
‘Last year, we had a whole calendar of events planned, but on 16th March 2020, as Covid impacted our lives, we decided they weren’t going to be possible. I held a meeting with the leadership team to plan how to manage the next year.
‘All our income is generated from the surpluses that we make from our leadership and scholarship programmes. So, because we could not do any of that, I was looking at an empty bank account.
‘My trustees were unsure about what was going to happen. However, I realised that if I gave them a sense of, “Let's go for it, let's try anything,” something good was bound to happen. Alongside that, there was an element of just being innovative and being courageous.
‘I have a head full of ideas but alongside that I had to remember our beneficiaries - nurses and midwives - they were (and are) the frontline, they were the ones who were seeing these extraordinary numbers of hospitalisations and deaths.
‘My number one concern right now is nurses’ mental wellbeing. For instance working all day in PPE in intensive care, looking after very sick patients, many of whom die, is the work some nurses have been doing since March 2020 day in, day out. So, within two weeks of lockdown, we had an idea that turned into a virtual offer to support nurses and midwives working during the pandemic. We have now supported 1700 nurses through an emotional wellbeing programme, the Nightingale Frontline programme.’
This is a crisis, how are we going to survive this? What do leaders do in the process?
Ritell and Webber describe it as a “wicked problem” - there is no answer to a wicked question. I asked the trustees to just let me launch the programme, and they did. So, my defining moment was very early on in the pandemic.
‘I just kept thinking, “Okay, come on, let's see what we can do,” and because I needed to furlough staff we were left with four, we did the whole campaign with just four people.’
Phil: So, you're rebuilding or have rebuilt your team from four to 16, what would you look for when you're building your team?
‘The foundation was an organisation that had only been offering one thing for many years. I realised about three years ago that we needed to diversify the income to survive. And my vision was to build a nursing charity that was led by nurses. Those in the team who don’t come from a nursing background fundamentally understand the impact they are making for the nurses and midwives who come to us for support. So, I tend to look for energetic, ambitious, capable people who understand the value of nurses and midwives working across the NHS and all healthcare sectors.
‘I am proud to say I have team full of people who have different strengths, all of which complement each other. I am a very creative person and have millions of ideas that I think will benefit the foundation. My team around me help to balance me and pay attention to the detail and advise me on what is achievable. I always say it’s always better to do one thing properly than a lot of things badly.
‘When I appoint people now I want people who are aligned to the direction of the organisation and who really believe in the mission, the vision.
‘I am also quite direct. I would want somebody who would take risks and innovate. They must believe that what they do is something that really matters to them. There must be fire in their belly to do it.
‘So, those are the fundamental things, but I also believe that if you pick the right people, they magnify what it is that you can achieve.
‘Of course, there is always praise for our work, but success comes because I picked a great team. I always use that as my starting point with any conversation. If they've been working hard then I rejoice in what they have been able to achieve and work out what they're struggling with and support them accordingly.’
Phil: I've got a question about ingredients, what are the ingredients you want in your new team?
‘Something like passion or purpose, or both. I'm open to feedback, being clear and direct about some of the issues, and then taking action to improve.
‘I want them to earn what it is that they have. I take every opportunity to talk about the strategic direction, I get them involved in defining that. I take every opportunity to repeat that, and they just need to enjoy the enthusiasm with me.’
Phil: How do you get them to do that, I'd love to hear how we manage this in our teams, how do you get them to buy in and share the enthusiasm?
‘I think that the more you build that sort of enthusiasm, it's contagious, isn't it? And the more you talk about the vision, the less people can say, “I don't understand why you didn't tell me that.” How do I build the team and get them to believe in that vision? I just think it's open communication, get them involved in the vision and build it into the team from the outset.’
Phil: So, in your observations so far and experiences, what do you think holds people back from leading confidently?
‘Often I think it’s their previous experiences of other leaders. For example, one of my team came from a really large organisation where every single thing took ages to be approved. I think she was paralysed by not being courageous to begin with. Recently, just before the start of a launch she said: “What if it doesn't work?” So, I told her that when I launched something three years ago I had no idea if it was going work, and it didn't matter if it failed. Never be afraid to try things differently or different things.
‘I think what also holds people back is a lack of courage, and maybe they've had an autocratic leader before and it's not allowed them to spread their wings.’
Phil: So slightly changing tack a bit Greta, what do you think you'll need to draw on the most in the coming year?
‘Well, we just had a business plan signed off yesterday and in that sits a plan to take the Florence Nightingale Foundation internationally.
‘The trustees asked me to write a strategy about it, and actually I haven't done that, instead I've written a plan about how to get to the strategy, so we've got a scoping period to begin with. If we get it right, it will be incredible.
‘So, yes, again it's building and shaping a vision that people buy into and take forward.’
Phil: That sounds wonderfully exciting and I'm sure will create some sleepless nights for you as well. Are you able to say if you have particular countries in sight or is that not part of the scope yet?
‘Well, I think we're going to start off with where we've got already got international relations. So last February before lockdown, I went to the Middle East, Qatar, and delivered a leadership programme there. Our vision is that every nurse and midwife over the world has access to our leadership programmes.
‘And we will use everything we did during the pandemic, we had to convert everything that was a face-to-face onto a virtual platform. So, because we've got that technology now, that capability, we know it’s possible to be able to do that for every nurse and midwife in the world.’
Phil: How do you ensure that you're continually shaping your own leadership?
‘I've always loved the element of self-improvement and my job is to develop others. That's what the charity does. I'm not the finished article, and there's always new stuff to learn.
‘I think when I get a chance to read something about leadership I do, but I don’t often have time. I have a coach and I have a mentor, that's changed over the years. I have a coach now who's helping me develop as the Chief Executive, it’s my first Chief Executive role so that's tricky in itself, but then Covid has made that harder. I need to develop me as the Chief Executive, my relationship with the Chair, and how I can get the most out of that relationship. Because I'm manically excited about work all the time, I do run the risk of my work-life balance going out of kilter.
‘My continual development is something that will never stop – I’m here for a bit longer so I have to carry on learning.’
Phil: My last question is what one piece of wisdom would you impress on up-and-coming leaders?
‘I think be brave and understand that anything is possible. I mentioned before that I got stuck on the clinical pathway, I went on a leadership programme and realised I needed to change direction. When I wanted to start my PhD I met with the new dean of the local university and she said: ”I agree with your plan” and asked me when I could start working with her, adding that I could be a professor in 10 years! I sat and wept.
‘It had a really difficult time in my personal life, I thought I was rubbish, she said to me, “Greta, you can achieve anything.” She happens to be one of our trustees now. So, you just have to be courageous, aim high and it doesn't matter if it goes wrong, but do get some great mentorship along the way.
‘So, be brave, try stuff, everything's possible.’