Julia Slark: All care, now responsibility

The new Head of the School of Nursing takes up the role on 15 July, following the resignation of Professor Sandy McCarthy, who was in the job for two years.

Julia has been here for six and a half years, moving to New Zealand from London and taking a Professional Teaching Fellow role for six months. She then became a senior lecturer and academic director of the Bachelor of Nursing Programme about a year later. Four years on, she was Deputy Head and now she will lead the school.
She can’t mask her happiness to have won the role and is also delighted to be living in Auckland.

“It’s magnificent. The coat that I used to wear in England for six months a year, I wear for about a fortnight in Auckland. I love it here.”

She will be taking a week’s break before hitting the ground running, to build on the School’s momentum developed in recent years. In the latest Quacquarelli Symonds (QS) rankings, the School of Nursing jumped from 41 to 36.

“The way that QS ranking works is they look at the size of the school as well as the research and impact outputs,” says Julia. “We’ve got some amazing researchers, and did really well in the PBRF too. We’re on fire. I’m very proud.”

The School of Nursing is well-known for its postgraduate offerings – it’s the biggest in New Zealand with around 3,000 students undertaking post-graduate study each year. Its undergraduate intake is 100 a year, including five internationals, selected from around 1,400 applicants.

In recent weeks the School has been audited by the Nursing Council for the bachelors and masters of nursing degrees. It’s an important part of adopting a high-quality level of training rather than a bums-on-seats approach.

“Having the Nursing Council here was such an opportunity for the school to shine … to talk about the amazing teaching and learning that goes on here. It’s all about how we prepare future nurses for clinical practice to be a registered nurse. It was just brilliant.”

Julia’s own nursing expertise is in stroke prevention and she was a stroke nurse consultant at London’s Imperial College NHS Trust. A key focus of that was creating awareness of the risk of secondary stroke, a critical factor in risk management. “As a nurse consultant, you see patients at follow-up clinics who’ve had one stroke already and they’ll say things like ‘oh well, I’ve finished all my tablets now’. And I’ll be like, what do you mean? And they’ll say ‘I had a prescription for some aspirin and I’ve finished that’.

She says that kind of thinking led to her PhD study of 600 young stroke survivors who were asked whether they thought they were still at risk.

“The fact that you’ve had a stroke puts you at risk of having another and they all thought they weren’t at risk at all.”

She then did a study of a 1,000 members of the general public, assessing their blood pressure, which is the biggest modifiable risk factor for stroke. “People with a diagnosis of high blood pressure, and taking medications, actually had absolutely no idea what a normal blood pressure should be. They’re walking around with blood pressure of 170 over 100 and had no idea that that’s not normal.”

While there may be a lack of awareness about normal blood pressure, awareness about the signs of a stroke has definitely improved.

“The FAST advertising campaign has had a huge impact on presentations to ED with stroke signs and symptoms. It really does work.”

FAST stands for Face, Arm, Speech and Time – sudden changes such as a drooping face, loss of arm strength, slurred speech, and losing no time in calling an ambulance.

Julia has run the postgraduate stroke course for the past six years and wants to keep it running, but will have to find someone to pick up the mantle. “We’ve created another seven clinical nurse specialists in stroke for New Zealand. So I’m really passionate about continuing that course.”

One of her other wishes is to increase our international significance and attract more students here to do their masters and doctorates.

“The School of Nursing is number 36 in the world already. But we have real potential to grow ... New Zealand nurses have such a good global reputation.”

From the moment she arrived at the University she also recognised the importance of collaboration.

“I got in touch with Professor Alan Barber, a neurologist and stroke specialist, and Professor Cathy Stinear, director of the Brain Research Centre, and told them about my experience as a stroke consultant. We’ve got Dr Joanna Black who’s an optometrist, Dr Clare McCann is a speech language therapist and together we can do more research, and hopefully get more HRC grants. I love that way of collaborating.

“There are opportunities for us to do more joint research projects within the faculty too. We’re moving more towards working with our clinical partners on research projects … I think that really is the future.”

She says as far as Māori and Pacific nursing students go, the department works closely with MAPAS (the Māori and Pacific Admission Scheme) and is aiming to build on the 14 Māori third-year students it has this year.

“We have some amazing Māori and Pacific clinical nurse directors out there so it’s a matter of seeing where the gaps are.”

Her own career trajectory saw her come to postgraduate study after nursing for many years. She started her training at Charing Cross Hospital when she was 17. By the time she was 30 she was a clinical nurse specialist doing her masters, and ten years later got her doctorate.

“I was the first nurse to do a PhD at Imperial College London. The Imperial College NHS Trust was the first academic health science centre in Europe so there were lots of opportunities and I applied and got a grant.

“Imperial’s fourth in the world, but they don’t have a School of Nursing so I had to do it in the Department of Medicine. Talk about a duck out of water! They were all so posh,” she laughs.

She was part of a team that reconfigured stroke services, working in northwest London, and was named as a finalist in the Nursing Times Nurse of the Year awards for her work there.

She says it would be “so productive” if more funding was available to support nurses to do a clinically relevant full-time PhD, as it was for her.

“I did four days a week PhD and a day a week clinical … it was just perfect.”

One of Julia’s early tasks therefore will be a roadshow to DHBs to make sure the programme is delivering what they want, and fulfilling their needs for the future workforce. “That is my number one priority.”

Nationally, the future for nursing has some challenges.

“We know the people who have undertaken postgraduate study are more likely to stay in the profession. But we have to make sure they get the pastoral and financial support to continue their education into their postgraduate studies.

“Yes, nurses got a pay rise last year. But they need a safer working environment and to be better resourced. We’re actually starting to struggle to fill the places now because there just aren’t enough nurses in New Zealand.

“By around 2035 we’re going to be short of thousands of nurses.”
That doesn’t mean we’re short of people with the right personality to enter the profession.

“There are definitely people with huge amounts of empathy,” says Julia. “We have incredible people involved in palliative care, for example, including the Te Ārai end-of-life palliative care research group. We have amazingly committed researchers, teachers and health professionals working in the School of Nursing … they’re all so dedicated to the health and wellbeing of others.”

Julia’s own passion for nursing across the board means she’s primed for her next challenge.

“I feel very privileged to lead the dedicated staff in the School of Nursing. I’m just really excited about the future.”