Frances Hughes ONZM

I first of all would like to begin acknowledging the traditional owners of the land on which we meet, the Gadigal and Guringai people of Eora nation. I also wish to thank the University of Technology Sydney for inviting me to join you for your graduation ceremony, and I particularly would like to thank Deputy Chancellor Brian Wilson, Professor Attila Brungs, Professor John Daly, Ms Jackie Wise, Council members, staff, distinguished guests, and graduates, family and friends. And I also would like to thank the UTS for making me part of the alumni family, and also for accepting me and my doctoral program in the late 1990s.

Being able to study in Australia in this university was very significant for me, because I held a high profile role in New Zealand, and being able to undertake study and research interests, and having the freedom to be able to do that in an academic environment without having the oversight of many of my colleagues that I worked with every day was very important. So I was an international student here, and it’s been something I’ve been very proud of and privileged. And I do hope that the Australian government and the funding for universities always allows to have the opportunity for international students. I know it’s getting harder and harder in today’s environment. I’m a mother, a wife, a nurse and a CEO, and I’ve always been incredibly proud to be a nurse. I became a nurse over 30 years ago, and I’ve always been driven with wanting to make a difference. It’s the human intimacy of nursing with consumers and the public that has always driven me. I always had an amazing sense of inquiry. I always melded my career, even though I didn’t know I had a career. I took opportunities as they came along. I worked in tandem with my graduate education. I came out of two hospital-based trainings, so out of that program, to actually get into having a degree, I had to complete a full bachelor’s program, a full master’s program, and it was indeed, I’ve been able to meld my interests in nursing, public policy and mental health that allowed me to keep driving to make a difference.

I’ve never been afraid to take and look at opportunities. I tackle opportunities, but the biggest thing that I learnt a long time ago was self-awareness. I realised the importance of knowing what I could do, what I was good at, and what were my limitations. And building on those limitations in a strengths-based approach to look for ways of improving myself. Leadership is key to this – it’s not about positions. It’s about the internal fortitude of stepping up when you’re needed. It’s not about when things are going well, but it’s about the time when you’re in a ward or a situation where you see that things aren’t quite right, and you know from the evidence and the practice that you’ve been taught that you can make a difference, and you step into often uncomfortable ground. That is what true leadership is about. It’s stepping in when it counts, and it’s actually being there, supporting and advocating for change within a very strong ethical framework. My judgement has always served me well. It is something which I know and trust innately in my being. My student days of the doctoral program that I undertook was challenging and rewarding at UTS. It was a trans-Tasman experience. Completing doctoral studies and any graduate education for us as nurses now involves usually us working full-time. Many of us are not privileged to be able to study full-time. Whilst completing my last year of my thesis for my doctoral program, as you heard, I was given a Harkness Fellowship to study in New York. During this time of my doctoral studies, two of my supervisors became very sick, one with cancer, one with a brain tumour. On top of that, I arrived in New York on the day before 9/11, so suffice to say, the rest was history. The year of my last study for UTS was based in the US. But indeed, it is times like that were challenges, and you can look back and say ‘I could’ve stopped; I could’ve not kept going.’ But it’s times like that I’ll never forget. I saw the best of humanity come to support me. I saw foreigners getting around me to support my family in a time when the nation was grieving. It also was a time when UTS stepped up for me and provided me with new supervisors. When you’re undertaking your doctoral study, the supervisor is your main friend, and your main support mechanism to get you through. It was UTS that stepped up to provide me for that support, but it taught me many things that year. It taught me that we are not islands – we should never work in isolation. It is about the network of wonderful, talented people that you should build around you. Today, I have the most amazing group of mentors that I’ve had for many years, and I know at any time, they are always there for me. As I travel the globe now, and have done for the last 10 years of my professional career, I know that there’s many times that I reach out to these people. Being part of alumni for you now, and being part of the family of UTS, will be very important. I have worked with donors and funders in over 40 countries. ICN, as you’ve heard, is a global organisation. We provide many programs to make a difference, and it’s nurses that have been making the difference. The challenges of health care today, we need more of you than ever. By 2030 we will be 18 million nurses short in the globe, and somehow we need to keep on delivering. ICN and through our work, we make nursing visible. We advocate, not just for nurses but for better health outcomes for communities. To being a nurse, it’s just as important to know about financing, social determinants and political intervention. ICN, as you heard, is a very old organisation, but we were the first professional women’s organisation in the world, and I’m very proud to sit and represent my profession on the world stage, but I never forget where I’ve come from, and I never forget what makes the most difference, and that is working for patients, consumers, every day in their communities.

The political atmosphere, as you are well aware, is very fraught across the globe, and health is caught up in that politics every day. Never think that nursing doesn’t involve knowing about politics, because it does. The best thing I ever did was study political science in my work for working in global health. Everything is about politics. Politics is about the process of making decisions. More narrowly, it refers to achieving and exercising positions of governance, organised control over human community. It involves the distribution of resources. Today’s world is not about not enough wealth; it’s about the distribution of that wealth, and every day I talk to donors and funders in some way, shape or form and ask them if they could just constantly work together in a different way, we certainly could make a difference in a very small way, in countries that are having a big impact. Another definition of practising politics which I find really amusing is blood-sucking. Poli meaning many and tics meaning blood-sucking parasites. And I have to say that I came up as a nurse thinking politics is not a word that nurses should get into. Nursing needs to be actively advocating for politics. Either way, you see the world stage and you look at politicians and sometimes you cringe, but it’s important that we are there. ICN and the nurses that I work with, we are actively there – the World Health Assembly, your professor, your dean, John Daly, will be with me in a couple of weeks at the WHO in Geneva where we’ll be giving interventions on behalf of communities around the world bsae on the evidence of nursing. To be able to truly influence decision making, one must know how to be articulate. It’s not only about talking; it’s about what we heard before – about doing. It’s about being able to write. It’s about being able to produce arguments and business cases. All of you have come through a program now that has prepared you well, but your postgraduate studies is also what will help you refine this. We need to bring the evidence of the people to the politicians. This is not for the shy or nervy. It means at times standing your ground.

ICN is proud of the coalitions we’ve built, and we have to build them. Every day, I know that it’s not about what I do – it’s about what I do with others of like-minded intent, where we can build a coalition. It could be health care and danger, women’s health, mental health. We are very strong and have been vocal about the bombing of hospitals in today’s world. Years ago, in the military, no one would ever have touched health care workers – they would never have held Red Cross workers hostage; they would never have imprisoned nurses for caring for migrants as they come across the border.  Three weeks ago, I had to represent at an embassy in Geneva, talking about why it wasn’t okay for that government to have locked up 300 nurses in prison for caring for migrants in a time of need. That is today’s world, and it requires different ways of working. Through our foundation and ICN, we also are supporting 350 orphans of nurses. These nurses died giving care, either through HIV or Ebola. The Girl Child Education Fund is the only fund like this in the world that is supporting orphans. Often, when disasters strike, donors go home, governments get on with life after the infectious diseases have gone. Communities are left. And in this one country, I saw many nurses who were taking orphans of other nurses. It’s indeed a privilege to be able to pay back that to the community by nurses. Challenging stigma and discrimination and advocating for human rights is key to nursing, and is key to ICN.

Indulge me as I tell you a short story of the 2014 Time magazine person of the year. Her name was Salome Harris. She was a nurse who fought the fight for Ebola in her community. Through that she became immune to Ebola. She died following a caesarean section with her fourth child last year. Post the birth, she started convulsing. Her family rushed her to casualty, and when they bought her to the staff in the hospital, staff refused to provide her care. They were scared. They had fear because they knew that she’d worked with Ebola clients. The heading that was in the newspaper and in the Time magazine recently read ‘She survived Ebola but not the stigma.’ Stigma plays a major part in creating fear and denying people access. Your job as nurses and health care workers is to fight discrimination and stigma at every turn. I have been charged with decentralising ICN. We are very strong, we are Geneva-based. And I’m required now for the interests of all our members to work regionally. It requires a different way of working. As a nurse and a CEO, it means I have to look at new ways of doing things. I have to embrace technology. I have to look at new employment relations and employment conditions. I also have to attract talent and have faith and security in staff to be able to manage all around the globe. Every day I’m unconscious of the work life balance of nurses, and in my own team, attracting talent as a CEO is very important. But the education of my team also is very important. So working differently and with different cultures across the globe is the reality of today in many global organisations, and ICN is no different. If opportunities come your way to expose yourself to different culture, whether it’s in a different state, territory or out of Australia, please take the opportunity. Use the mechanisms that exist of providing scholarships and fellowships and put yourself forward – do not be afraid.

I can honestly say that the years ahead of you are great. Nursing is a profound and stunning profession. It can take you all over the globe, in many different settings. Be brave, be confident, and believe in yourself. Seize the opportunities. You never get an opportunity twice. Every time it may be different. Have faith, and build a network of colleagues and be involved with your alumni. I would like to thank you for inviting me here today. Your future’s bright, and we need another 17.8 million nurses, so please encourage more into this stunning profession.