Josie is an MSF nurse from Hertfordshire. Her first mission with MSF was based in Haiti. Since then, she has completed missions in Ivory Coast and South Sudan.

"I think many people have a misconception of what an MSF nurse is. Of course, you are still a nurse, but you are not so hands on - your main role is to supervise, manage and teach. I’ll be the first to admit I joined MSF as I was trying to get away from having to do that in the NHS, but with MSF it’s different.

Development and progression

We’re not there to take a local person’s role as a nurse. We are there to help them develop and progress into that role; managing and teaching them to develop themselves and gradually hand over more and more responsibility to them.

My favourite line to use on a mission after being asked a question is ‘What do you think we should do?’

The environment that you and your staff work in changes constantly: from malaria outbreaks to hunger gaps and possible outbreaks of violence, and with the changing needs of the population you change the roles of your staff, the layout of the hospital and the patient flow, to ensure those needs are met. This is hugely different from working within the organisational constraints of the NHS.

Each week I would meet with my staff to discuss what changes were needed. But these changes had progressed for years and had already been tried and tested in several ways. You are not there to tell them what to do, but to bring new ideas to the table, discuss theirs, possibly collaborate them and have the knowledge of the capacity of the project to know what can be done and then put it into action.

Once an idea had been agreed upon, the next day it would already be put into action and we were seeing the benefits by the afternoon.

Striving for the best

Teaching occurred in a similar way, I would ask them what they wanted to learn, as well as tailoring it to the current disease outbreak or what was going on around us.

Knowing your staff are working hard to improve their knowledge and skills and the care they are providing, and being a part of those improvements – that push that’s making your staff strive to do their best – is an incredible feeling. Then you’ll sit down and realise that your staff are actually teaching you so much more then you are teaching them. They have so much to offer.

My aim on a mission is not to be hands on, but to be able to pass on as much knowledge and experience to my staff as possible. The ultimate goal is: if you weren’t there they would still be able to run the hospital and provide a high level of care. Really, that’s what it’s all about, giving the staff the knowledge and ability to look after their own community."