‘Giant In Stroke Research’ Focuses On Role Of Nurses

Evidence showing how nursing care can improve stroke patient outcomes has been Professor Julia Slark's focus.

The strength of the waiata at Professor Julia Slark’s inaugural lecture, celebrating her promotion to professor, spoke volumes about her leadership at the University of Auckland’s School of Nursing.

Slark’s purple robe was offset by a korowai and pounamu, gifted by Māori colleagues in recognition of her commitment to transforming the culture of the nursing school with guidance from matua John Tuoro and whaea Erana Poulsen.

“We have daily tikanga, we do karakia together and that connection and learning about matauranga Māori has been a real priority for everybody,” Slark says.

“It has seen a real cultural shift and the creation of a much safer space for our Māori colleagues to come and work with us.”

Slark’s promotion to professor recognised her excellence in research and teaching, yet associate
head of school (pre-registration programmes) Dr Lisa Stewart said what makes her so exceptional is that everything she does comes from a place of caring.

“Whether it’s patients in the stroke unit, students, staff or the nursing profession, it is compassion, kindness, social justice and concern for others that drives her.”

Slark started her inaugural lecture by laying out the importance of both the art and science of nursing.

“The impact of the profession of nursing is based on the application of theoretical concepts and scientific research evidence, which are underpinned by our conscious commitment to the art of caring through the relationship we have with the person we are caring for,” she said.

Slark spoke of her life growing up on the southeast coast of England knowing she was born to be a nurse.

She moved to London at 17 to follow her dream and, after a short stint in a surgical ward, found her home in neurology.

After qualifying as a registered nurse in 1993, the next decade was consumed by her twin passions of nursing and travel, including extended leave to travel around Southeast Asia.

When the money ran out, Slark returned to the UK in 1999, working as a charge nurse at Hammersmith Hospital’s NHS Foundation Trust then from 2001 as a stroke clinical nurse specialist.

In this role, she ‘inadvertently’ became involved in clinical trials, seeking an evidence base to support her experience and intuition.

“I enjoyed the complexity and the variety of patient care in the neurology ward. But, as stroke nurse specialist, I found the lack of evidence-based practices for the acute phases very frustrating.”

A masters degree in strategic leadership in 2007 was followed by doctoral research that concluded with a randomised controlled trial exploring the impact of patient education to reduce risk factors for secondary prevention.

“The results showed significant improvements in lifestyle behaviour changes and a trend towards blood pressure reduction in hypertensive participants.”

There were many more research papers arising out of the challenges of stroke nursing.

“One example was a terrible weekend when a patient died after they received too much IV fluid and an error in their feeding regime.

“We took this failure in care very seriously and developed an initiative of nurse-led ward rounds, specifically undertaken on a Friday afternoon to plan for the weekend.

“We met the nurse in charge of the patients at the door to the bay, and we went to each patient with clear, patient-centred measures to focus on.

“This was three o'clock on a Friday afternoon. It did not take long before the physios started joining us, and then the OTs joined us, patients’ whānau and then the junior doctors.

“We were determined to focus on fundamental patient care such as hydration, nutrition, mouth care, pressure care, bowels and bladders.

“We published that project. It's one of my most cited publications, because it's meaningful and it's about care, and it's about nurses taking charge when things go wrong.”

In 2013, Julia and her Kiwi partner moved to Aotearoa New Zealand to care for ageing parents.

Difficulty finding work as a clinical nurse specialist eventually led to Slark taking up a teaching post in the University’s School of Nursing.

Her energy, enthusiasm and expertise saw her work her way up to head of school in 2019.

It has been a privilege, she says, to work with brilliant students and to encourage quality nursing research.

One achievement Slark is excited about has been writing a stroke course that started as a nurse-led course and has become interprofessional. It is offered online, leads to a masters and is highly accessible for people across the whole country, Slark says.

“It's just such a joy to see these people coming together, learning from completely different areas of practice, paramedics, GPs, nurses, and rural and urban clinicians. It's a fantastic opportunity for everybody.”

At her inaugural celebration, Dean of the Faculty of Medical and Health Sciences Professor Warwick Bagg praised Slark’s outstanding research.

“It used to be that people with strokes would arrive in hospital and we would tell the family the first 24 hours would tell clinicians where the person would land. But now, people come in with terrible strokes and walk out.

“I think we need to recognise the academic giant that Julia is and how she has been part of the journey to provide excellence in stroke care.”

Julia spoke with enthusiasm of looking forward to a symposium later this year of the Council of Deans of Nursing and Midwifery, which she chairs and that includes universities across Australia and New Zealand.

She’s also working on a new research project looking at how to prioritise the relational aspect of care; the connection between a nurse or a health professional with patients and whānau.

“We think that that is a key to improving the patient experience and ultimately patient outcomes.”

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