Two bosses, two roles - it's all plain sailing

April 22, 2005

Caroline Williams is first and foremost a military woman. Although she is not in uniform when we meet, her sharp blue trouser suit is not far off one.

But she is also an academic - she recently became the first military nurse to be awarded a professorship. Her office is that of an academic but with a distinctly military air of orderliness.

She heads the Defence School of Healthcare Studies, one of eight schools within the faculty of health and community care at the University of Central England, Birmingham.

"We are also part of the Royal Centre for Defence Medicine, which was established here in conjunction with the University Hospital Birmingham Trust in 2001. So I have two bosses, two reports and two line managers," she explained.

"I have to be true to both; the faculty and the development of teaching and learning, and likewise remember I'm in the military and have standards to uphold."

This poses no particular problem for Professor Williams. "You learn things from one side that are helpful to your job on the other side," she said.

Without the support of the service, she would not be in her current academic position or able to use her expertise without the university affiliation.

"The coming-together in Birmingham has enabled me and my staff to develop within our professional roles. It makes our military ethos even stronger," she said.

"One of my challenges is to ensure a nice balance between recognising and enjoying those military responsibilities while fostering the partnership with UCE."

The partnership has been trouble free, she said. "We've been very warmly welcomed and just fitted in. We have military lecturers and students as part of this school, but we also have a civilian operating department, with practitioner students and lecturers teaching them. We are a combined military-civilian school."

The division between students was not an obvious one, Professor Williams said. Military students do not wear uniform in university time, but they do when practicing nursing. "A lot of that is to do with encouraging integration in the university, but when they go into practice we want them to demonstrate that they are part of a military environment," she said.

The military students benefit from the mix of cultures and from studying alongside civilians at UCE, but there are strict discipline codes to follow.

"We hoped some of their self-discipline would rub off on the civilian students, but actually there's learning on both sides," she said. "Nurses are very quickly encouraged to be more self-disciplined, more self-aware because they are going to go on to a ward to look after patients."

Professor Williams began her training at Dundee College of Nursing and Midwifery, qualifying in 1984. She then started critical care nursing at Edinburgh Infirmary. She fancied doing something "a bit different", and posters for nursing in the Navy caught her eye. She applied that year and joined the Queen Alexandra's Royal Navy Nursing Service in 1989, specialising in intensive care.

After a year touring Gibraltar, she started training and teaching students but felt her academic qualifications fell short. A degree at Portsmouth University led to an MPhil focusing on the psychological care of patients in intensive care, in particular how nurses communicate with intubated patients. After being advised to develop it into a PhD, she became the first person in the defence nursing service to get a doctorate.

The time pressures of a managerial role mean her research now informs her teaching. She still keeps her hand in, however, and has had one research paper published and three more in the pipeline.

Professor Williams is practical rather than precious about where she publishes. "I try to target my work at journals that will be read by intensive-care nurses, not necessarily the most academic journals, because I want to get the message out. Obviously, it's good to publish, but it's not much good if nobody reads it," she said.

Professor Williams's academic role means she has had no recent operational experience. She did not go to the front line in Iraq, for example. The closest she has come was leading an intensive-care team at Deal, in Kent, when terrorists bombed the Royal Marines School of Music in 1989.

"We supported the local intensive-care unit because it was very small. We were down there for two weeks dealing with burn victims and trauma casualties."

Her focus now is on the students. The first military cohort graduated earlier this year. "It was lovely. They came to Birmingham quite scared and in awe. All previous students had been down in Portsmouth or Gosport, which is a quiet little place by the sea."

The challenge was not only to help them academically, but also to maintain their military ethos outside of a military unit.

Professor Williams uses the word "ethos" a lot. For her, it seems to be a case of "military ethos, academic execution".

Certainly, it works for the students. "We got really good success rates: 33 per cent of the degree students got first-class honours, compared with the national average of about 5 per cent."

She puts this down to the self-discipline the forces instil. "If they've come from basic service training, their first eight weeks is initial training where self-discipline is taught.

"I think they have an extra motivation factor knowing that we are keeping an eye on them. If they fail an assignment, they don't get disciplined but they are put on a learning contract so they can come and get support."

Each lecturer looks after 15 personal students while divisional support officers, non-teaching nurses, provide pastoral care. Professor Williams's military students are also paid, which relieves financial pressures.

Looking to the future, Professor Williams said she wanted to use her position within UCE to raise the profile of defence nursing.

"I'd like to establish a forum for developing other personnel in defence nursing and to raise the profile of how military nursing is unique and slightly different from normal nursing," she said.

Dundee College of Nursing and Midwifery in 1984, Portsmouth University with a BA (Hons) in nursing with education in 1995, and Brighton University with a PhD in 2003.

as a staff nurse on an emergency medical admissions unit at Ninewells Hospital in Dundee.

was undertaking a PhD while working full time.

is middle-lane drivers.

would like to be running a bed and breakfast in the Peak District and teaching nursing part time.

I can never remember any!

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