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EXCLUSIVE

Dr Crystal Oldman reflects on decade as head of ‘trailblazing’ QICN 

Dr Crystal Oldman reflects on decade as head of ‘trailblazing’ QICN 
Dr Crystal Oldman, photo credit to the Queen's Institute of Community Nursing.

Outgoing chief executive of the Queen’s Institute of Community Nursing (QICN) sits down with Madeleine Anderson to reflect on the last 12 years as head of the world’s oldest nursing charity.

From building standards for advanced practice, to growing leadership opportunities and a general practice nurse (GPN) network, Dr Oldman says she’s proud of the way in which the organisation has evolved during her tenure and is excited for its future.

Dr Oldman has been at the charity’s helm during a challenging period for community nursing and the profession as a whole.

Since 2012, she has championed community nurses looking to enter leadership posts and recently oversaw the charity’s renaming from the Queen’s Nursing Institute (QNI), to better reflect who the QICN works for and represents.

Field specific standards

A key highlight for Dr Oldman when looking back on her time in post is the launch of the QICN’s field specific standards to support higher education institutes (HEIs) offering the specialist practitioner qualification (SPQ). These include general practice, district and adult social care nursing.

‘We feel like we’re trailblazing,’ Dr Oldman tells Nursing in Practice. 

She explains that the QICN was first founded to support nurses to develop their skills and competence and so the charity’s recent work on standards has returned the organisation ‘back to our roots’.

Enabling patients to understand the title and qualifications of the nurses caring for them also gives ‘confidence’ and provides reassurance that the nurse ‘knows what’s required in that role’, adds Dr Oldman.

Related Article: Queen’s Nursing Institute announces new name 

The standards are based around the four pillars of advanced practice, clinical care, leadership and management, education and assessing learning, and evidence, research and development, and build on the Nursing and Midwifery Council (NMC) SPQ standards from 2022. 

Leadership programmes 

Dr Oldman has also helped develop leadership programmes for community nurses which she says did not exist at the QICN before she joined.

Examples include a six-month programme for senior primary care nurses that was launched in 2019 and is open to nurses in primary care network (PCN) director posts.

Reflecting on the programmes, Dr Oldman says nurses’ ability to lead strategically ‘couldn’t be more important than it is today’, particularly as she believes nurses in the community ‘are not well represented in terms of policy’.

Leadership programmes at the QICN have helped encourage nurses to work more confidently across multiple agencies, including when collaborating with local authority or public health colleagues, she adds.

‘[It’s] part of our DNA to work across agencies and coordinate care, so it’s really important to have that opportunity to lead strategically,’ she says.

The GPN Network

Last summer, the QICN launched a new GPN network which now has over 850 members and aims to ‘raise the profile and voice’ of the profession. 

‘It’s really important to us to set up professional networks for those who are in those positions in general practice, so they can share and learn together, and to be able to have a collective voice for those general practice nurses,’ Dr Oldman says.

The network also encourages GPNs to share examples of good practice to ‘learn from each other’ and keep updated on changes and opportunities in primary care.

The network will also be used by the QICN when updating its GPN SPQ standards, which will be revised every five years.

‘We’re not going to stand still on those, so having a network like this will support us in knowing what’s going on [in general practice], and we’ll feed that directly back into the revision of the standards,’ Dr Oldman adds.

Dr Oldman has previously stressed to Nursing In Practice that GPNs are ‘very much part of the community nursing family’.

Related Article: QNI announces new chief executive

Misunderstanding the community nurse role 

Misunderstandings and misconceptions around the role of community nurses continue to exist, despite work from the QICN and others to address this, says Dr Oldman.

For example, it seems secondary care staff often misunderstand what community nurses do and the level of expertise they have, she says.

And in some cases, this is preventing patients from being discharged in a timely way, with hospital staff sometimes overlooking how community nursing teams can care for patients and prevent re-admission through home-based treatment.

‘I don’t think our hospital-based nursing colleagues understand what can happen in the community and what level of risk is carried and managed in the community,’ adds Dr Oldman.

While ‘it’s not a competition’ between secondary and community nursing colleagues, there must be greater understanding of the ‘different ways of working’ within nursing, she says.

‘It’s not that one’s more important than the other, it’s just different skills.’

Building a team 

As Dr Oldman looks to handover the reigns to the QICN’s deputy chief executive Steph Lawrence – who will move into the chief executive post in the summer – she stresses the importance of ‘building a really capable team’ and a culture where the team all understand ‘what we’re here for’.

‘I am proud of how much we have evolved and how much the team has helped me to lead in evolving the organisation,’ she says.

Related Article: Three more community nursing standards added to list by QNI

She adds: ‘It’s lovely for me to be handing over to Steph, it’s going to be awesome. She will take the QICN and evolve it even further.’

The QICN has grown significantly under Dr Oldman’s leadership, with the organisation growing from nine staff members when she first joined, to 27 today.

Under Dr Oldman, the QICN also publicly committed to becoming an ‘anti-racist organisation’ at the William Rathbone X annual award and lecture last year. 

And last year, she gave a keynote at an exclusive Nursing in Practice event in London in which she warned GPNs were being ‘put to one side’ in place of other staff in GP practices.

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