Ep 26: Professional Nurse Advocacy and suicide prevention: A conversation with Emma Wadey

Posted September 20, 2023

Show Notes —

Today’s guest is Dr. Emma Wadey, a registered mental health nurse and Deputy Director of Mental Health Nursing for NHS England and Improvement.

Emma’s humility shines through in her clinical work and leadership style. We discuss her experiences, including public speaking anxiety, her unexpected path into nursing, the impact of nursing identity, and her love for marathon running.

We also explore the Professional Nurse Advocacy Program, which Emma helped create, in part to prevent nurse suicides.

This episode offers valuable insights and practical takeaways for nurses of all backgrounds, emphasizing the importance of well-being and humility.


Key Takeaways from this Episode

Emma talked about the anxiety and challenges of virtual presentations.

Emma shared about the two things that drive her to keep going:

    • Role modeling means doing as you say.
    • A little bit of anxiety is a good thing.

The balance between advocating for one’s profession and self-care.

Emma talks about the transformative power of engaging in physical activity such as running.

The value of self-awareness and self-care in maintaining a balanced life for Emma, especially with children.

Emma shares about the unexpected career shifts in her life and the lessons she learned from having a flexible career path.

Emma gives an overview of the PNA program.

The link between PNA and suicide prevention.

Emma encourages PNAs, emphasizing their value in promoting self-care and reaching for support.


Today’s Guest:

Dr. Emma Wadey is a mental health nurse with over 20 years of experience and maintains clinical practice in a local psychiatric liaison service. She specializes in treating complex trauma, self-harm, and suicidality, drawing from her experience with suicide’s impact. Emma co-produced teaching materials on supporting those with suicidal tendencies. She contributed to the creation of the StayAlive suicide prevention app. She’s involved in developing the competency framework for self-harm and suicide. She serves as a national clinical adviser for the Mental Health Service Improvement Programme and clinical lead for the National Nurse Retention Programme.

In addition to her professional achievements, Emma embarked on marathon running as a mid-life endeavor, completing four of the Abbots World Major Marathons with plans to conquer the remaining two.


Connect with Dr. Emma Wadey here:

LinkedIn: https://www.linkedin.com/in/emmawadey/ 

Twitter: https://twitter.com/NursingEmma 


Follow Nathan and Nurse Wellbeing Mission for more practical preventative mental health tools for nurses and midwives:


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Transcript —

Nathan Illman 00:00

Welcome to the podcast everyone. This is Nurse Wellbeing Mission. I’m your host Nathan Illman. I am recording today from a very sunny and rather warm office room at my home in Brighton. That’s where the Nurse Wellbeing Mission headquarters are currently based. I’m here to bring you another inspiring conversation. Today’s guest is Dr. Emma Wadey. She is a registered mental health nurse. She is also the Deputy Director of Mental Health Nursing for NHS England and Improvement. She’s a senior NHS leader and she’s someone that I… We’re just so happy to talk to you again. We’ve connected previously. Something I love about Emma is her humility and it just shines through in the way she talks about her clinical work, the way she talks about leadership, the way she engages with other nurses and members of the public. She’s just very down to earth and it was lovely talking to her. So as with all my conversations, we cover a range of different topics. Have a great week. started on talking about public speaking, which was really interesting. I think there’s some amazing little insights in there about how even people who are well-practiced at public speaking like Ember still feel anxious and you’re going to hear a lot about her mindset around how she gets through these big public speaking events that she does. We talk about how Emma got into nursing in the first place and how she kind of fell into it after her initial plans of going into the Navy did not work out. We talk about nursing identity and how that can create burnout and how Emma found running, marathon running in particular. Many years ago and how that’s created an enormous sense of well being in her life We do of course talk about the professional nurse advocacy program Emma was one of the originators and key drivers of this program and She gives such a lovely overview of what it’s all about and we dig into specifically how and why it acts as a suicide prevention intervention for nurses. Overall this episode is just fantastic, it really gives you a window into the mind of a senior NHS leader. There are some really practical and helpful takeaways, I believe, from Emma’s story and her experiences. Whether you’re an individual professional nurse advocate or just a… Any other nurse working out there, mental health nurse or adult, child, learning disability nurse, it doesn’t matter. There’s, there’s lots of wisdom. in this episode for you. So a little bit of housekeeping before we crack on with the conversation. I’ve had a huge response to an event I’m running this week around self-compassion for imposter syndrome with professional nurse advocates. This has really highlighted a need for more of this work for me, and I’ve got some ideas. Something in the pipeline which is going to provide a supportive community to you PNAs and PMAs out there to give you some skills to manage this anxiety, uncertainty, and self-doubt, and equip you with some other resources to make you feel more confident in your role. So if you want to keep in that pipeline, find out more about that, I really recommend following me on Twitter if you’re on Twitter. It’s at NurseWellbeing, find me on there, or drop me an email and I can keep you in the loop that way. It’s Nathan, N A T H A N, at NurseWellbeingMission. com All right, well, enough about me. Let’s speak to Emma Wadey. Amazing. So how are you? Are you feeling quite tired out by your presentation that you just did? Or are you feeling motivated?


Dr. Emma Wadey 04:24

I’m feeling slightly glad it’s over because I don’t like public speaking and it’s harder virtually because you’re not getting anything back from the audience to know if they’re interested or yeah, you’re not getting anything back and you sort of realise when you do virtual stuff how much harder it is. You can pretend it’s not harder because you can’t see anyone, so you think it’s okay, but actually you can’t then see if anyone’s interested and change topic or pick up on points, and people don’t tend to ask questions when it’s virtual, and it’s the questions that really bring stuff to life, so it can just feel a little bit, not stilted, but one way. So you’re talking at people, then you stop and it’s over.


Nathan Illman 04:51

It’s more draining.


Dr. Emma Wadey 04:

I think it’s a bit more intense, actually, because you’re staring rigidly at the screen, whereas, I guess, again, when you’re talking face to face, you’re gaining eye contact, you can walk up and down, there’s a little bit more movement, it’s a bit more spontaneous. Definitely. Particularly because they’re in person and I wasn’t, and I can’t see the room at all, so all I can see is myself, which is a rather scary proposition for most people.


Nathan Illman 05:25

Yes, absolutely. You were being beamed into a room.


Dr. Emma Wadey 05:28

Beamed into a room. That’s slightly, yeah, it’s a scary thought, isn’t it?


Nathan Illman 05:34

Yes, yeah, I did one of those about 10 months ago and it was strange. It was strange asking questions and putting it out to the group and then kind of hearing some responses and having to have someone repeat things and…


Dr. Emma Wadey 05:51

Yeah, it doesn’t work well. I haven’t done many like that actually. I’ve done lots and lots of virtual speaking, but as I say on Teams, at least people can put in the comments. You can answer questions in the comments, even if people haven’t got their camera on. But yeah, this… When it’s a room of people and it’s a bit more tricky actually. Not my preference.


Nathan Illman 06:09

When you’re speaking in public in person, do you have a particular style or any kind of like influences that you’ve had from other people about how to present?


Dr. Emma Wadey 06:19

That’s a very interesting question. I mean, there’s always people that you watch present and you think, I really wish I could be like them. They look so relaxed, doesn’t look rehearsed. It, you know, they command the audience. You know, they, they kind of have that attention. They keep your attention because they’re really passionate and animated and it’s, you know. I like that. I don’t like people that read off slides, so I never read off slides. But I think, again, if you’re doing a virtual and all you can see is your slides, you can almost get caught in that trap. Whereas if they’re behind me, I would just talk a bit more free flow. So I guess you’re sort of influenced by the context, but also influenced by what you don’t want and what I know is I like to. I don’t like talking for long either, normally. I prefer to make it a bit more interactive, ask questions, try and get people involved. Crack a joke that’s obviously not funny, but you know, try to add a little bit in. Yeah, so that’s probably how I like to do it, if I have to.


Nathan Illman 07:15

I like stories as well. I think stories are quite powerful. They can grab people’s attention and if, uh, delivered correctly as well, well, delivered well can drive home a particular point and get people to think about something.


Dr. Emma Wadey 07:29

Yeah, you’re right. I think anything that’s stories, but also that relates to the audience. I always try to know my audience so that you can either say, you know, when I visited your trust or when I was, you know, if I was speaking to students, you know, when I was a student, this is how. I don’t know, there’s something you always try to relate and make it applicable to your audience. I think that’s always really important as well, so it doesn’t feel like it. So it feels a bit more personalised and a bit more bespoke, rather than something you trot out of pat all the time. Yes. Um, and that was quite tricky at the one I did before, because they wanted me to talk about something very specific, to do suicide actually, not PNA. And it’s, it was at a suicide prevention conference, which means then less, they’re not even probably healthcare staff. Mm. And again, I can’t see them. So we normally, if you’re in person, you could have a couple of chats, can’t you? You can kind of go. So I’m not that keen. The last one, wasn’t my best. It’s not how I like to present.


Nathan Illman 08:21

I’m sure you were very valued though, even if it wasn’t your preferred style.


Dr. Emma Wadey 08:27

Yeah. And so, you know, we’ll see. But it’s always hard, isn’t it? I think presenting every time it’s something a little bit different. Do you like presenting?


Nathan Illman 08:35

I do. It’s something that I’ve learned to fall in love with, I think actually. Wow. I had a really incredible PhD supervisor who, to this day, he is one of the most important role models in my life, actually. And I remember watching him on stage and just being really taken by his natural, almost kind of informal style that he’s really able to engage people. And It really helped me when I was doing my research PhD, I had him to guide me, it made this thing that was extremely anxiety provoking to begin with, actually something to look forward to. You know, his mindset was something that I kind of absorbed and, and it, yeah, I mean I was presenting at kind of international conferences from a young age, like 21, 22, and it was, it’s, you know. It’s crazy thinking back that I was off doing that at that time. But I think what gave me confidence was, yeah, my supervisor. So these, these people have a real influence, don’t they? And I think now I prepare myself by reframing that. anxiety and that nervousness as this is something to be excited about. I’m talking to these people hopefully about something that’s important to me and I feel like I can make a difference in their lives. That’s the kind of thing I like to share with other people as well about how to reframe stress and how to reframe anxiety, particularly around public speaking, but other things as well.


Dr. Emma Wadey 10:12

You know, I’m, I get very nervous. And I don’t like it at all. You know, I’ll be awake the night before worrying about it, stressing about it, rehearsing it. But once I get going, it’s okay. It’s just the thought of it. I don’t have notes. I probably look quite informal from that perspective. I tried notes once, spilled my water all over them. The ink all ran. It looked like I’d wet myself because I was standing at a podium. So it was not a good look. So, and I tried to emulate other people that had loads of on YouTube that this is just not going to I don’t have, I tend to have slides of pictures and uploads of words on so that no one knows if I’ve got enough, I’ve got these little, you know, little tricks.


Nathan Illman 10:57

But, um, I think, to share that sort of thing with other people, other, you know, your team or other colleagues. I’m such a believer in that. You know, I’m running this event on Wednesday around imposter syndrome for PNA.


Dr. Emma Wadey 11:11

Oh, I’d be your perfect example probably of that. You know, even as I’m speaking at this thing just now, I’m listening to myself thinking, God, this is boring me. God, this is just boring, especially because you’re not getting interaction. But, um, it’s just, yeah, really. I don’t know, everyone said if you practice it will get easier and I’ve presented a lot over my time because I’ve always pushed myself to do it and it doesn’t get easier. It’s just always something a little bit different every now and then. Next time I’m not going to do that. I obviously need to come to one of your sessions and get over this. Imposter syndrome. I mean, I do joke about different things. I faint as well. So I’ve got Bath and Vagal Syncope. So I gave a talk last. Um, and I was completely unprepared, well, I was prepared, but not for them when I went in. So I thought I was talking, well, I was talking to a group of graduating nurses. So they’re just graduating and they wanted to hear about my career story, which is always awful to have to talk about that, because who really cares about what I’ve done? You know, I was thinking, God, what a ridiculous thing they’re going to be interested in. But, um, when I got there, it was about 250 of them and the room was awful. It was really long, but thin. So. I was thinking how can I, I can’t even see them all, so at least if you’re in a lecture theatre you can see all your audience. It’s really, I thought I’m going to keep walking up and down which is the painting, and I was hot, and I’d run too far in the morning as well, which. Always makes my heart rate go. So I started and I said actually I’m going to have to get a chair so I’ve got my cervical syncope, I’m likely to faint and if I do just carry on talking and I’ll sort myself out and carry on. I thought I might as well just tell, but that’s your story. So I had a chair just in case, but my watch alarmed every 10 minutes to say that my heart rate was abnormal because it was too high. Well I’d obviously go. Yeah, it’s like a comedy of errors, really. I still have to go. You got through it, though. Yeah, and I had really good feedback. Like you say, I think they thought, I don’t know, personable, perhaps a bit more relatable, that you’re not this really senior, stuck up person who’s perfected. But, yeah, it was tricky. I have lots of these stories. You’re gonna wish you’d never asked me to do any kind of presentation.


Nathan Illman 13:19

No, I’m loving it. This is brilliant. Well, look, we’re in this conversation now. Can we just carry on? Are you okay with us using what Just of the things I dislike about doing the podcast is sometimes I myself slip into like overly formal to begin with. You know when I go in wanting to have just more of an informal, just a conversation with people. That’s why I do it. I love it. And then all of a sudden there’s this build up to the beginning where you’re just like, okay right, so let’s start the conversation. It’s so unnatural. Uh, so it’s nice that we’ve just been talking about general things. I always like to reflect on that anxiety that leaders have around things like this, because it really helps, doesn’t it, I think, with people who are aspiring. There can often be this notion image of people who are more senior just being rock solid not experiencing difficult emotions and particularly in certain cultures within organizations there is that image of perfection isn’t there that’s unhelpful so i think people listening to you as a senior NHS leader hearing that you still get anxious about doing presentations, yet you still do them and keep doing them is, uh, is probably really helpful. I have a question for you. What makes you keep going on and doing them then, if you, if you feel anxious? Why don’t you just say no? Sorry, I can’t do that.


Dr. Emma Wadey 14:50

It would be nice sometimes to be able to say no. I’d be lying if I said sometimes when I get asked. That I think is fantastic. Let’s go ahead with it. Because sometimes the thought of some of them are just absolutely terrifying. But at the same time, I suppose there’s two things that always drive me about it. One is, especially now in this particular role, how important it is that I’m visible and that I’m representing the profession. And that’s really important to me. So I can’t advocate on the one hand that we need to have visibility as nurses, as mental health nurses, and not be prepared to put myself in that visible space. So I think there’s something about role modeling that, um, that’s really important. So that will always make me say, yes, go that extra mile, literally that extra mile. Cause I do do a lot of. So I’m always, you know, traveling to get to these places and go out of my way to put myself in these positions as well. So it’s not always that I go for the local places or places that are easy to get to or that I can squeeze in my diary. Often I’m trying to do as much as possible in, you know, between different things and difficult times because it’s so important for me to get that, that message out there. So that’s always been a real significant driving force really about. about role modeling, saying, doing as you say, not just saying it except everyone else to do it. So that’s the first thing. I suppose the other thing as well is things I would always say to others is a little bit anxiety is a good thing. It keeps you sharp, it keeps you focused, but also it shows you care and I’m anxious because I want to do a good job. I want to reflect well in my profession. I want to come across well. I want to share something or share the work of others. And I want to do that in a way that’s respectful, but you know, interesting, exciting, inspiring to others. And so. I think some of the anxiety is also driven, not necessarily by a perfectionist, because I’m not a perfect, you know, I like to try and be perfect, but I’m absolutely not. But it drives because I also want to do a really good job, you know, people have taken the time out of their day to listen to you. I want it to be worthwhile, and that kind of adds a bit of extra pressure, doesn’t it? So, some anxiety is good, but I do force myself because I think it’s important, I think it’s expected, and I think particularly in this scene, it’s an absolute must that we’re out there. I’m willing to be out there.


Nathan Illman 17:08

Yeah, real strong value of advocacy, that’s great. Are there any other ways you feel like you really try to do as you say then? Anything else related to nurse well being, for example?


Dr. Emma Wadey: 17:21

I say generally around nursing per se that I’ve always maintained clinical practice and I guess that’s the other area specifically that I would say. I’ve always stayed true to my nursing roots, if you like. Yeah, I didn’t grow up wanting to be a nurse, but once that decision was made, I’ve absolutely loved it. And it, it brings me back and reminds me about why I came into the profession. So ensuring that I’m clinically active, not just clinically visible, I think is one example. So, and when I’m in clinical practice. I’m the same as everybody else. And that’s really important. I’m a member of the team, the same as anyone else. It’s not, I’m not there giving out orders or delegating I’m doing part of that team. So that’s really important. I think that’s kind of linked to wellbeing as well, because I’ve often joked, but it’s actually not a joke that it’s the element that also keeps me safe and grounded. It keeps you reminded about why we come into what we do and why it’s so important. Some of the things that I have to do to preserve that, and of course part of that is preserving the well being of my nursing colleagues as well as myself. So I haven’t always got it right about role modelling well being, so I’d be lying if, and I’d be lying if I said I got it right now actually in terms of work life balance, but I do, I’m much more aware of when I’m going off kilter, and I really try to keep it in check. So really keep to my boundaries around time, for instance, having time away, having some time supposedly to have a lunch break. I’m not always sure I’m completely away from the desk, but I book that time in. So yeah, there’s quite a few things that I try to role model as much as I possibly can, but I would say I’m still learning all the time to do it, all of the time.


Nathan Illman 19:05

I’m really interested to know about your running. You had done some marathons and this was a few years back. Tell me about the running.


Dr. Emma Wadey 19:14

I’m constantly running. Uh, so I suppose one of the things I noticed that for a long time, I didn’t really have any space for me. It was either work or family. I had my children obviously very young because my eldest son is nearly 28. So of course I was teeny tiny. So I kind of got to quite a senior position. So this is. This is my ninth anniversary of running this year and my children were getting older and I was just work, home, work, home and nothing in between and I think when I look back I was actually getting quite burnt out. I wouldn’t have necessarily called it that at the time but I needed to do something that was just for me. And I was set a challenge by my oldest son at the time who thought it would be hilarious to suggest that we all took it in turn to run a marathon and I was the last one to run it because I hadn’t run anywhere more than 100 metres. No one actually thought I would do it. I didn’t think I would do it because I couldn’t even run for a bus. I remember going up my first run, running around the block and collapsing on the bed for about an hour, but I was determined to prove them wrong because I’m stubborn and obstinate. So I did train for a marathon nine years ago. And it’s been the best thing I’ve ever done, actually, because it opened up a whole new world for me. A whole different space where you’re not a nurse, you’re not a mum, but you’re just yourself. You’re kind of accepted as equal within that space, mainly because you’re trying not to run out of breath and die on a run, literally. Um, opened up a whole new world of people that I wouldn’t otherwise have met. I found that my life had become quite small. You know, it’s either work, colleagues or… as I say, family, which is great, but I just didn’t have anything in between. So it opened up this whole new social. Life, I suppose, or a group of friends in a different space. Um, and it’s something I’ve kept up and I’m quite religiously running, so still run. I run four times a week, run before work now, always make time to do, I used to run late at night after work, but it doesn’t quite work as well, to be honest, in terms of wellbeing if you can’t eat and then sleep properly. But it certainly gave me space. It gives me space to think, it gives me space outside. I love being outside and particularly as we moved. Um, during COVID to more virtual homeworking, although I’m still out practicing and out and about, um, you can be stuck in front of a screen. So again, running gives you that outside space. So I’ve absolutely loved it. It’s done a lot for my mental health. I would say it’s also done a lot, interestingly, you hear so much from the people that run with you that then start to share about their own mental health, it’s quite a leveler, um, which has, has its downside because sometimes I feel if I’m on a club run that. It’s lurching into work. And so I do balance out between running in a group and running on my own. But yeah, I’ve absolutely loved finding that. I don’t think it matters what your outlet is, but certainly I didn’t have an outlet. I needed to find one and running has become for me. So I run everywhere I go. Wherever I am on those days that my running days, I will run. So last week I ran in Nottingham, I ran in Newcastle. I’ll be running in York when I go to visit a trust there next week. I run every Friday after my clinical shift, my home by the sea. So I’ve really, you know, Brought it into that work life balance as well, in terms of also using it as an opportunity to sightsee when I’m out and about.


Nathan Illman 22:33

If you run far enough you really can see some sights, can’t you? I remember when I lived in London it was fantastic when I was training for a half marathon, even at that distance it was, it was wonderful.


Dr. Emma Wadey 22:43

But you don’t want to talk to me about running too much because I become a bit nerdy and tell you all about the training plan that I’m on and how, you know, that would get really sad. And nutrition. That’s the other thing about, I suppose, any sport, you’re more self aware about your own nutrition and sleep. Um, and it helps you pay more attention to those other aspects as well as the actual activity itself. And it was those other aspects that I probably wasn’t paying as much attention to as well. So, it’s, it’s had lots of kind of physiological benefits beyond the actual running. Making sure I’m drinking lots of water, for instance, and keeping hydrated when it’s really hot.


Nathan Illman 23:13

What do you think are some of the takeaways from your experience that are transferable? or perhaps advice you could give to other nurses then who might be burning out a bit, probably focusing maybe too much on work or like your experience really only had work and family, particularly people with kids as well. I imagine it’s quite easy to slip into that, isn’t it? Because there is such a demand of your attention from children. What kind of advice would you give nurses who are perhaps not really Well, they don’t have that much variety of other activities.


Dr. Emma Wadey 23:54

That’s quite a difficult question, I think, because it’s, it’s so unique to each individual. And I, I suppose, and I think that, at the time, I don’t think I could see an alternative. You know, I really wanted to complete all the work that I needed to do at the time. So, often in my career, I’ve been combining work and also study. So, PhD last year, which I did in my own time. stretching myself too thin, but I’m not sure that I could always see it. And I think actually I took up running to avoid doing the PhD if I’m honest now when I think about it as an avoidance strategy probably as well. But, but I, I wonder sometimes when I was really in the thick of that, whether I could actually see it and what I actually needed was someone else to reach out and go and give me permission not to do something, whether it would be to have a, whether it’s just about having a lunch break on your own sometimes or going off and listening to music or. doesn’t have to be something as regimented as running frequently, because that’s difficult when you’ve got your kids are small. And so I kind of waited till they were older, but I do wonder if it’s sometimes looking out for a mate and pointing it out. Cause when you’re in it, you’re kind of on that hamster wheel. And I don’t know that I’d have always seen it. So there’s definitely something about. reaching out to your friends and noticing it in others and when people perhaps can’t see it themselves. I think there’s something also about just acknowledging how hard it is to balance all the time and that sometimes it isn’t balanced and that’s also okay. Yeah. It’s just noticing when it’s like that all of the time. So, you know, it’s okay that some, it’s not okay if you finish work late, but you know, you can manage that a couple of times, but it becomes all of the time and trying to think of strategies, like setting your boundaries and to stick to them and setting them quite small. So one of the first things I did was not answering emails at weekends. Yeah. Sounds quite minor, but just even trying to break up that quality family time from work and just making sure the two, again, if you’re working from home, the two can merge too much and you end up with no break in between. So I think it starts small. There’s something about looking out for each other. And it, as I say, it doesn’t have to be something major like taking that marathon running, so. But it is about just carving out that little bit of space that gives you a bit of a breather, actually. Just some head space.


Nathan Illman 25:57

Yeah, starting small. These things really do make a difference, don’t they? The small changes with setting boundaries and lunch breaks. When you create those new habits, it really starts to snowball, I think.


Dr. Emma Wadey 26:11

And it is about creating a habit, exactly as you say, it’s something you have to work at. You know, most, I’m quite into, you know, I’ve got into running, but most times I don’t really want to run. It’s the hardest step is that first step out the door. And I know it sounds a bit cliche, but it really is. Yeah. But it is taking those first steps and doing it sometimes with a friend, isn’t it? Sometimes it’s great running and certainly in those early days when I was picking up the distances, it’s always better because you don’t want to let someone else down. That really plays to nurses. We don’t like to let other people down and we like to be careful. So if you’ve got someone else that you’re meant to be doing something with, um, it does force you out the door a little bit more.


Nathan Illman 26:44

Yes, I’m a big believer in that as well. Having a partner, buddy, accountability partner can be good, can’t it? For all sorts of things. Exercise is one.


Dr. Emma Wadey 26:53

Even a lunch break, you know. If someone comes to meet you to join you for your sandwiches, it’s a bit more tricky to say, hang on a minute, you know, yeah, it matters. Definitely.


Nathan Illman 27:05

So, I’m not going to ask you to recount your career story.


Dr. Emma Wadey 27:09

I probably don’t even remember half of it at my age, and it’s not very interesting.


Nathan Illman 27:13

I thought something that would be quite good to ask you would be, obviously I know, and people who already know you, know that you’re involved in projects related to nurse retention, the Professional Nurse Advocacy Programme, you’ve done work around suicide prevention. So I’d be really interested to hear from your perspective, What are some of the early experiences you had that you feel kind of shaped the direction that your later life took?


Dr. Emma Wadey 27:42

That’s a very interesting question, isn’t it? Before nursing or just in nursing?


Nathan Illman 27:49

Whatever you think is relevant that you don’t mind sharing.


Dr. Emma Wadey 27:51

So I never ever wanted to be a nurse. It wasn’t the career that I thought I would have. So I was actually wanting to be in the Navy. So I did everything to be… ready and prepared to be in the Navy. So always been quite an active person. So obviously half of these things I’ve not applied in nursing, sort of learning to tie knots and sailing and engineering, but I wanted to be an engineer in the Navy. So I didn’t have this kind of desire, I suppose, or didn’t have a nurse’s outfit. I didn’t have the first aid kit, but didn’t have a desire to cadet and part of being a cadet, there were first aid competitions. So I, I did win a couple of those. So I can tie a very good bandage and make a sling, but I’m not sure there’s been much call for that in mental health nursing. So I’m not sure that that necessarily prepared me per se, but I suppose what did prepare me was that plans don’t always work out how you expect. And certainly that You know, I, I was very committed to being ready, Navy ready and then life happened and that wasn’t to be. So I actually started my nurse training as a single mum. So I had to quite rapidly have a plan B and nursing was my plan B. And I guess that’s quite a good life lesson in itself that you have to expect the unexpected. Sometimes you have to be flexible and that’s not always a bad thing. And you don’t always have to have everything prepped. You know, I spent sort of 10 years, literally from when I was 7 to 17, mapping out the day that I would join the Navy and everything that I needed to do to do that. That regimented and committed to the point, you know, I didn’t apply to go do A levels at university because I was joining the Navy. Everything was good and all of a sudden something else happened. So when I do talks in schools it’s always saying to people, you know, you don’t have to have everything mapped out and sometimes it’s good to have other options and if you… If life takes a different turn, that’s okay too. And I think what that taught me was also to take chances. So probably so I had everything mapped out. But when I came into nursing, I was really open to learning. I didn’t have a set plan or a goal. I kind of let that go a little bit. I was a little bit more, um, yeah, a bit more relaxed and open to opportunity. And that really stood me in good stead in those early days, because in my early roles, So fortunate that it was at the time, which sounds like a completely different world now, but it was a time of real reinvestment in mental health services. And so there was lots of investment, lots of opportunity, lots of new services. So it really was a golden age, which makes them sound very old now. And I think about it sort of the late nineties, but it also meant that I had this mindset that. I would give it a go inside. I took opportunities that perhaps I might not have done if I hadn’t had that kind of side sideways moving to nursing as opposed to something else. So I took on some comments. I was happy to do fixed term and I was really open to that learning and I wasn’t afraid and perhaps the way that I might have been before didn’t have a. a plan. So I think that’s probably one big thing and that’s certainly something I talk to new nursing students about when we talk about, you know, what are your plans for the future? And I’m always quite surprised when people have an end career in Goal already. Um, I still don’t have that now. And obviously my career is nearing the end, not, not that close by, but nearing. Where as much more in those early days, I just wanted to learn, just wanted to try new things. And that’s meant I’ve had the most you know, fantastic opportunities. I’ve had some real difficulties as well. It hasn’t been an easy, hasn’t been a ladder to climb easily, or there’s lots of things that haven’t worked and jobs I haven’t got, but it’s also meant that I’ve had some huge opportunities that I wouldn’t otherwise have had. I think that’s probably one of the big, um, sort of profound things. Other things that stood in my mind is I like to look outside the box and be really positive and try to do things in different ways. I don’t have a history of knowing anyone that worked in mental health or mental health services. So perhaps I wasn’t constrained by some of the, we do it like this around here mentality. So again, when I qualified, I did some really, what might be seen as quite weird and wonderful things now, retrospectively, in terms of how I might engage with people that wasn’t the norm or the done thing at the time. And I got away with it. It was safe, by the way, that sounds a bit dodgy. Completely the same thing, but I did things a different way.


Nathan Illman 32:12

Can you give an example?


Dr. Emma Wadey 34:10

So I qualified, and I qualified as one of the, if not the first, newly qualified community psychiatric nurses. So those roles were normally for people at the end of their career, which is how I thought I might end my career, because it sounded fantastic. Monday to Friday, nine till five, I could pop to the shops, you know. On your visits and sounded brilliant, but I actually had an opportunity to fix term to cover someone else going off to do their court to do a full time course. And so I was given a caseload of people to see. And I just thought, you know, when I spoke to the people that I’d be going to see about. What mattered to them and the role traditionally had been, I always remember someone saying to me, oh, my last nurse used to come and watch the cricket hit. I don’t like cricket particularly, so wouldn’t have worked and give me my injection. And I remember saying, oh really? I’m not sure. That’s what they taught me in nursing school was what I’m gonna be here to do. And I thought, I’m here to talk about your recovery goals and what matters to you. They probably felt, oh my goodness. But then, but they would talk to me about what they wanted and then we would do that. So I would do things like go shopping, go roller booting. I set up a cinema cloud. I set up a swimming club. Um, we also, I set up a forestry club where I used to make the sandwiches and build bonfires with the forestry commission, um, and work with young men that had severe mental illness in that way. So things that were kind of not, normally it’d been you’d visit people, you’d give them their injection, you’d have a chat and you’d come away. And that just never felt enough to me. That’s not a life worth living for someone. They wanted to re-engage. So, so yeah, so I did some really weird and what might be seen as weird and wonderful things, always safe and with the caveat of it being. With the time and that’s probably still a little bit like I am now.


Nathan Illman 33:54

It sounds like you’re really willing to get, you’re on the same level as people, you’re not seeing yourself as above them or superior to them and you’re really caring about, like you said, what matters to people and helping them achieve what’s important to them rather than imposing something else on them.


Dr. Emma Wadey 34:10

I always thought that’s what we were meant to do. And I still think that is exactly what we’re meant to do. You know, our role is to come alongside people. And it is about helping them recover, if that’s the right word. Um, but it’s helping people achieve what they want to achieve. whatever that might be. You know, people would say, what did you do today? It probably sounded quite odd sometimes, you know, that what I might’ve done for an hour is help someone clean out their, well, actually what I did do quite often, one particular person I saw once a week, we cleaned out his goldfish. That was really important. It’s important to the goldfish, but I always felt that’s what we’re here to do. And that’s our gift as mental health nurses, that we see the whole person and we help them see what matters and we help them achieve it. And I like to stay true to that now. It’s not always possible. I work in quite a different role at the moment, which is a bit different to be able to do that in quite the same way. Um, but I absolutely love that job in those early days doing those sorts of things. That to me is, is mental health nursing. Brilliant.


Nathan Illman 35:07

So I’d like to talk about professional nurse advocacy, suicide prevention, topics that you and I started talking about the first time we met. I’d love to expand upon some of the things that we were talking about. Could you just give an overview of the PNA program and I suppose the little origin story you told me before might be helpful for people to hear. for people who don’t even know what it is.


Dr. Emma Wadey 35:34

Yeah, so the role of professional obstetrics from a dry perspective is a postgraduate qualification for registered nurses. So it’s a master’s level programme and it equips nurses with a framework that is called A Equip. And it’s a framework of skills and knowledge and four key areas. And the one that’s most well known and associated, I would say, with the professionalist advocate role is its link to well being and particularly through the delivery of something called restorative clinical supervision. But it’s only one of four key elements. And for me, I always say that it’s the four elements together, which is about creating cultures of learning, of leadership, of development, of quality improvement. Um, and it’s the collection of all that together underpinned by recognizing that all of our work with patients, as fantastic as it can be, is also really, really stressful sometimes and that we, we are emotionally impacted from that. And what restorative clinical supervision, it recognizes and provides a safe space for people to talk about the emotional impact of the work so that we are then enabled. to leave that if you like in the workplace so that we go home and we’re not taking that that burden with us in quite the way that we might always but also that we can then use that to really think differently about how we then support both our colleagues ourselves but ultimately how we improve patient care so from a drive perspective it’s a it’s a master’s level framework but the the joy that it brings is that it it kind of has created a framework and a bit of a social movement that really values the nursing contribution. It provides a sense of identity for nurses, or it certainly has done. It really has demonstrated that, and it was only a very small pilot, which I can talk about started, but for me, I’m always amazed every day about the amazing things that those individual nurses have done as professional advocates. They’ve gone way beyond my expectation of what the role could and will be. ’cause I think it’s still continuing to grow. But for me, the reason why we came up with this idea, and I say we, because when I came into this national role back in 2020, um, I knew two things. Well, I knew three things. One, I was terrified ’cause suddenly you’re the professionally for mental health nursing, which is quite scary to, to think that you are Yeah. The, the ambassador, if you like, for that whole profession. But I also knew that there was a significant mental health impact. of the work on nurses and that for globally, actually, this was demonstrated, if you like, from us having a very high suicide rate, particularly for the nurses, female nurses. And there’s been some work that had some research that had already come out that demonstrated that female nurses had the highest rate of suicide. And I think that’s interlinked. I think that there is a link between suicide is multifactorial, but there is definitely a link to how we feel valued, invested in, how we support ourselves, the skills that we have in order to maintain our own well being and that.


Dr. Emma Wadey 38:32

And then of course, I also knew that COVID was on the horizon and it gave me an opportunity. It gave me a platform because I was a clinical lead for mental health to raise my concerns about the mental health of the workforce. But more importantly than that, it gave me a platform to do something about it. And I used it and I listened and I went out and I spoke to nurses and I asked them, what would it be that would make a difference? Not today, not tomorrow in this crisis, but what’s going to make a difference for us as a profession, as individuals going forward, we’ve got to start doing something different. We can’t carry on as we are. There’d been some work done by a midwifery called the professional midwifery replicates and of course this is fundamentally based on that, but there are some differences and I think the drivers for the work is quite different and I think the timing was really key on this as well, but what was really really critical was that nurses absolutely wanted and needed something that provided credibility. Invested in them, that gave them a collective identity and almost permission. And that’s what I was able to do. I was in a position that I could use my influence, my position, to bring together and gain funding for initially just a very small pilot. Something which could look to transform the way that we think about the work that we do and the way that we need to do that work going forward. And the role that nurses as individuals and collective have within that. So… Yeah, Professional Advocates has been a strange piece of work in a way because it was always a bit of a side hustle. It was always something on the side that I felt was important. Still for it, it’s incredibly important. Probably one of the most important things I’ve done in terms of nursing as a collective. Although not necessarily the most important thing from a patient perspective, for me personally. But certainly when I think about the amazing things that those individuals have done and continue to do, it’s humbling really. And when we hear that. It’s saved nurses lives who have said that they would have died without it. It’s unbelievable, really, the whole programme. So it started from very humble beginnings of just wanting to do something different, thinking about how I could do it. And then those individual nurses who didn’t have a clue what it was, and those universities that decided to develop a programme that didn’t exist in record time, have absolutely taken it to a whole new level. As I said that I never imagined that it’s been a bit of a phenomenal ride, I would say, and everything that’s still continuing a bit like a rollercoaster in terms of the impact that it’s having, but the potential impact that it can have, I think is unknown.


Nathan Illman 41:10

It’s probably the most, uh, impressive side hustle that I know about It’d be great to just dig in a little bit more to the suicide prevention aspect of it. I want you to imagine there are PNAs out there, professional nurse advocates, and professional midwife advocates, who are completely naive or blind to what suicide prevention entails, I know it’s multifactorial. Could you describe… I mean, you don’t have to go into technical things, but kind of some of the mechanisms by which the supervision that people are providing act as a suicide prevention kind of intervention.


Dr. Emma Wadey 41:53

Yeah, so the way I tend to start describing the role of PNA now is In relation to suicide prevention and seeing it as post traumatic growth. So what I was really concerned about that started, I’m really, really pleased that there has been such a focus on the mental health, not just of nurses or healthcare staff, but the mental health of society, really, and a much more openness to talking about the psychological impact things, events have on us. And I really welcome that. But I also worry about how we medicalise normal responses. And how we medicalize everything to almost feeling like it’s inevitable. And I suppose some of the, my concern in the midst of COVID, that although I knew that what individuals had to experience, both personally and professionally, no one should ever have to experience that level of trauma, having to work in ways that did not fit your values, or in which you knew that might cause some harm, is incredibly difficult. They’re all destroying and very difficult to kind of manage on an end. And when that’s on a, you know, on a one off basis, it would be really difficult. And that’s continued. It’s, it can feel impossible. But I also knew that it wasn’t inevitable that people would have post-traumatic stress that they would. There are things that you could do to make a difference. And I knew that there are conditions which we can put in place that mean it’s more likely that people are able to survive, but also thrive. And for me, the PNA was an opportunity and a way of ensuring and creating conditions that people thrive. And some of the most basic elements of that was just telling nurses that even though we’re in this state of crisis, we don’t have enough nurses to run a ward. We don’t have enough resources for you to nurse in the way that you want to nurse. I’m still going to invest in you as an individual. And that was so significant in those early days that even though wish what I value your contribution, the contribution can make enough. To give you the time off. And so I think the most basic thing around PNA was it’s enabled nurses. It made them feel valued and it made them feel invested in, and that’s the feedback I had. And it made them feel less of a number. It made them feel a person. It connected them back to humanity. So at that basic level, what we created was that general sense of being, you know, valued, purposeful, which we know is a significant link to suicide, is when people don’t feel they have purpose, when they lose connections, we know that can be really risky. And what the PNA role has done is it’s created new networks and connections. It’s given people purpose.


Dr. Emma Wadey 44:39

It’s given people agency, so it’s given people confidence as well as competence to feel able to do something about it, to have influence within their areas, to change things for the better. And they’ve done that by creating the safe spaces and saying it’s okay to feel this hasn’t been a good day, it’s okay, through the restorative normalising this as it’s as usual restorative clinical supervision, but it gave nurses agency also in thinking we can do something differently. And so some of the improvement programs and projects that nurses have done have been phenomenal in terms of improving their work life balance, but improving the care environment, improving patient care has just been. Phenomenal and in such a quick space of time, and we know that all of those things have an impact on people’s well being from a positive aspect and create a protective layer, which means that people are more able to cope when things aren’t as good as they should be. And so. It creates that protective layer, but it also means that when people are struggling, they feel more able and less shamed to seek help, because we also know that possibly, I say we know, we think, my hypothesis is perhaps we have a high rate because people feel too shamed to seek help, or they don’t know where to seek help from. And so the other side of this is that these roles take away some of that shame. They create relationships where it’s okay not to be okay. And we’ve been able to give a huge group of individuals knowledge of where they can signpost and support people to seek help when they need it to so that people seek help sooner rather than when it’s too late. And when it’s too late, it’s too late. So I think for me, that’s where it’s really fitted into being a suicide prevention initiative as well as a patient safety critical task, because we also know that it’s evidence that where staff are well, we give best care to patients. So it kind of creates a loop, but all we ever want to do as nurses is do the best by patients, and you’ll hear that all the time. And we think that we do that by putting ourselves second, and I guess the PNA is also rebalancing that, is that we can only do that if we put ourselves, not first, but equal to, equal to patient needs. And I think we’ve started to create that shift in thinking so that it’s much more of an equal partnership, and that one, patient care relies on self-care. So kind of, that’s how I try to describe it, hopefully not too technical jargon, and that’s certainly where we’re starting to see a real impact is in those areas and where I hope we’ll start to see an impact around suicide prevention.


Nathan Illman 47:19

For individual PNAs who are out there in the field at the moment who may feel a little bit uncertain, a little bit shaky, not… particularly confident. Can you share a message of reassurance or something? I suppose a brief message taken from all the things that you were just saying to speak to those individuals who might feel a little bit unsure of themselves, just to remind them of. something important about what they’re doing.


Dr. Emma Wadey 47:48

I think fundamentally the thing to remind themselves is what amazing individuals they are that they’ve been willing to put themselves in these positions because this is an extra ask if you like it and that’s part of the beauty of it because we haven’t Um said that it had to be anyone of a certain bounding or a certain grade. It carries with you. It matches people’s values So I think fundamentally I always think Start with yourself, apply those messages of self-care to yourself, reach out to others. We’ve now got such a strong growing community and we are stronger together as a community. You’re never actually alone. And so what I would say to those is almost don’t panic. It’s good to be uncertain. It’s good to take time to embed, reach out, reach out to your peers, listen to your peers. Um, and yeah, you’re never truly alone with this. And certainly what we’re really thinking about going into this our third year is how we can still continue to support that continual professional development and support and sustainability because we know that it’s growing and it’s growing at a huge rate but there are still some that are feeling quite isolated so. You know, reach out. I’m happy for people to reach out to me personally to help reconnect because, you know, there’s some organizations that are further forward than others. So we can really bring together, but see it as an opportunity, not having something, going back to what I said at the beginning about things not being set out. I often have PNAs. Well, what do I do now? Thinking there’s a set way of doing things. The beauty is that there isn’t, that you’ve got time to listen, to shape it, and really shape it to your strengths. So hold your nerve, that’s probably the shortest way to say it.


Nathan Illman 49:21

Great. Hold your nerve. And it sounds like there’s, you’re encouraging scope for flexibility and creativity within the role. How people… Uh, deliver on the, it’s the overarching framework, but people can apply it in the way that they want to.


Dr. Emma Wadey 49:37

I think that’s been its strength though, because I think if we’d been too prescriptive, this wouldn’t have worked. There isn’t a one size fits all. This really plays to an individual’s strengths as well as the needs of their environment. And that’s what’s allowed this to thrive and will continue to enable it to thrive. That it gives that space.


Nathan Illman 49:56

So you mentioned earlier, you said something about being towards the end of your career, which I find it very hard to believe, but I’d be really curious just to kind of finish this off for you to share a little bit about what is on your mind around this latter end of your career, if that’s the way you’re perceiving it. What are you, what’s your priority and what’s your kind of internal vision of. where you would like to go with your career and the kind of project and impact that you want to have on nurses or, or other things.


Dr. Emma Wadey 50:30

So this is my 27th year in nursing so I kind of feel that I should be, I am in my twilight years although Not, you know, I’ve still got probably at least 10 years, at least my ultimate aim is always that I just want to do the best by patients. And I’m, as I say, I kind of want to keep that open mind to what that might look like in terms of best meeting the needs. And I guess widening that out to think about mental health nursing. I want to continue to strengthen us. You know, we are limited in numbers as a profession. Nursing itself, I think perhaps hasn’t always had the positive image that it could do. And it’s not always obvious the opportunities that nursing as a career can bring. So I still feel like I’ve got unfinished business. on both areas in terms of really championing and role modeling the impact of nursing, not just in England, but internationally. So something I’m really interested in is that international piece and how we can become part, much more closely part of an international community of nursing and have strengthened numbers across. And the PNA work, for instance, and the suicide prevention work we are world leading in, and there is lots of globally. Um, I think there’s lots more we need to do and that we can do collectively together but from a global perspective. So I don’t think my work’s done but I also think I’m starting to be a bit of an old crow and it’s really good to get new people and I’m always really keen that I’m thinking and developing those around me. One, because they have far better ideas than me so it’s much better to have that collective ideas and voice but two, it’s really important that there’s We evolve and there’s change and there’s fresh innovation. So, yes, I’m constantly thinking that bringing the people around me, thinking about how we can further embed the work that’s already underway, but continue to evolve, um, I think is really important. But yeah, I’ve probably unfortunately got about 10 years before I can completely hang up everything.


Nathan Illman 52:22

You can achieve a lot in 10 years, Emma.


Dr. Emma Wadey 52:24

I know, just imagine, and I don’t even know what that is yet. And that’s the exciting thing, isn’t it?


Nathan Illman 52:32

Yeah, absolutely. Well, I want to thank you for all the work that you do. You’ve clearly had a remarkable impact on not just nursing, but obviously with the patients, the service users, the people that you work with clinically as well. And I want to thank you for giving me the opportunity to be a part of the PNA program and helping support the development of those nurses. It’s an amazing opportunity and I really value that.


Dr. Emma Wadey 52:59

Thank you for giving me the opportunity to share.