An interview with Jacqui Cross, NSW Chief Nursing & Midwifery Officer

Jacqui Cross

This month we caught up with NSW Chief Nursing & Midwifery Officer Jacqui Cross, who shares her reflections on why she became a nurse, what inspires her and how we can each strengthen professional standards in our own practice.

What drew you to the nursing profession?

I came to nursing a bit later on; I was called a “mature-aged student” when I went to study it at age 21! I’ve always been a people person and I think for me it was about wanting to make a difference. At the time I don’t think that I appreciated the diversity that a career in nursing could bring. But I’ve found that every day there is something that inspires you about it. It’s a great privilege.

What is your favourite memory or part of being a nurse?

My favourite thing has been the people I’ve worked with, bumping into people I had met bedside, and experiences like going to see the Essentials of Care showcase and learning what nurses are doing to enhance their work. I often reflect on and value the support and guidance that I have received from those I have worked with throughout my career. 

At the Nursing & Midwifery Council, we focus on promoting safe professional practice as one way of protecting public safety so we would welcome your perspective on professional standards. How would you describe the importance of the understanding and application of professional standards in the workplace?

We all have a responsibility to understand them and how they define our practice. It is a very important individual responsibility. But we’re also responsible for how we come together as a team to make sense of what our practice is about. The Standards framework provides meaning to our practice and are our guiding principles, the glue that holds it all together. The Standards help us make decisions and can help us develop our own practice. 

How do you think the standards such as the Code of Conduct and Standards for Practice can be used in the workplace?

It is all of our responsibility to have an awareness and understanding of the Codes and the Standards of Practice. They underpin what it is to be a professional and ensure that we provide care that is safe and compassionate. A practical way to utilise the codes and standards is as part of our performance development conversations and feedback, and also at a team level, when we are making decisions about models of care, in our focus on safe, quality care, and in our values and beliefs as professionals.    

They are the underpinning values of what we expect from ourselves and from each other as professionals, and most importantly what the public has a right to expect. We have a responsibility to ensure that not only are we safe, but that others around us are also practicing in a safe and ethical manner.

Teamwork and collaboration seem to be a significant part of your leadership style. What can you tell our readers about that?

That way of working really resonates with me, how we collaborate and come together. We’re as strong as the sum of our parts. As leaders, we need to create environments where we maintain dialogue and people can be listened to. Nurses are the biggest part of the (health) workforce, so when we come together we can create strong things. The Essentials of Care program has uncovered many good examples of this.

The Essentials of Care Program aims to enhance the experiences of patients, families and staff in part by developing effective workplace cultures. It talks about developing a culture of critical inquiry in regard to the delivery of care – preventing risk and promoting safety, and having a learning and development culture. How do you think practitioners can create a “learning” culture so that nurses and midwives feel safe to discuss issues in the workplace? Where do you think the standards fit within this culture?

As nurses and professionals, it’s about, how do we ask critical questions and understand the decisions we make? We need supportive, person-centred cultures so we can explore that together. It’s about understanding our values as a team and looking at how we interact as colleagues, which is particularly where those codes fit, underpinning how we work as professionals. Part of that again is our individual responsibility to reflect upon our own developmental and learning needs so that we continue to practice within our scope to ensure safe care.      

What do you think are the biggest obstacles for nurses and midwives in applying professional standards, and how can these be overcome?

I think that there are opportunities for greater awareness and transparency about the Professional Standards. I think that sometimes it can be challenging for nurses and midwives to understand how they are applicable to their everyday practice, and unfortunately for some that awareness comes during a performance or clinical practice issue. The focus for all nurses and midwives is to provide the best possible care that they can. The standards are clear about what needs to be in place from an individual and from an organisational view to ensure that happens. 

How can nurses and midwives find time to focus on professional standards at work?

It’s important to find those opportunities to reflect on the Standards – team meetings, quality and safety projects that you might be involved with, educational opportunities. You can make those connections to the Standards in your work every day. 

In a practical sense, it can be about what you notice and where you focus your attention. Notice when people do make a difference and behave in ways that demonstrate those values. Your yearly registration renewal is also a good time to reflect, and in your performance and development plans. The Standards can be a guide for your career and your continued learning. 

Touching on mental health and how nurses and midwives can be uniquely impacted by the serious and complex nature of their roles, what is your advice regarding nurses and midwives taking care of themselves?

We all know that to be effective in our roles we need also to take care of ourselves. This can be challenging as we juggle work and life commitments. There are a number of Local Health Districts that have developed strategies to support a focus on self-care, which include exercise programs, mindfulness and access to workplace support such as the EAP. 

As nurses we work predominately as part of a team, so another important aspect of self-care is about how we look after each other and how the workplace supports us. We also can’t underestimate the impact of how we work together day-to-day, simple things like ensuring that we take our breaks, that we check in with each other to see how the day is going, and importantly noticing and providing feedback to each other. 

What are the key projects or messages you would like to share with our readers?

We currently have a strong focus on supporting the midwifery and nursing workforce. The Nursing and Midwifery Office provide a range of scholarships to support that, as well as leadership development for Nursing/Midwifery Unit Managers and Nursing/Midwifery Managers. We have a particular focus on developing the Midwifery Workforce, and as part of that we are leading a research project, using Appreciative Inquiry to understand the experience of midwifery students and midwifery staff in supporting undergraduate and post graduate midwifery students. 

Mental health nursing is one area of focus for us, specifically the observation and engagement policy. We have also continued the implementation of the Productive Mental Health Ward program.

The Essentials of Care program has just marked its 10 year anniversary. I think the strong thing about this program is the voice it has given to nurses about their practice and how it has contributed to developing some great leaders in the profession.

For those looking at ongoing professional development, there are many opportunities for scholarships and details are available on our website.