Alison McMillan accepted the position of the Australian Government’s Chief Nursing and Midwifery officer in November 2019 – mere months before the COVID-19 pandemic would fundamentally change healthcare in Australia.
Although she’d been a registered nurse for over 40 years, spending at least 30 as a senior manager across the public health system, this was a decidedly new kind of challenge.
“It was an absolute privilege to be part of that leadership team, but often very challenging” says Alison. “I was very involved in developing our approach to quarantine because that had never been done before. And also looking at how we could sustain our workforces as the pandemic developed.”
But despite its challenges, this unconventional start to her role only served to reinforce her pride and dedication to her life-long profession.
“I think there's a legacy of the pandemic that we need to be very conscious of. We need to remember the impact it had on our community and particularly on our health workforce."
“But it's good to see that we're moving into a new phase and we've got new opportunities. And I can do some of the other work I planned to do when I first took the job!”
Beginnings in Australian nursing
Alison began her career as a registered nurse in the UK before migrating to Australia, where she worked as a clinical teacher the Austin Hospital in Heidelberg.
“The training during my time in England was hospital-based training. And while it was fabulous training, it didn't bring the sort of qualifications and academic rigor that that I found much more apparent when I moved to Australia,” she says. "By the time I moved, nurses often had a Bachelor of Nursing so it was important to grow my knowledge and experience.”
She completed a Bachelor of Education at La Trobe, also in Melbourne’s north. The degree was a perfect fit – giving her the tools she needed to grow her career and take on new responsibilities.
“It did help give me that foundation and helped me to grow my confidence to some extent,” says Alison. “As well as things like being able to explore and find evidence base, how to argue a point, and how to make a strong argument for something."
"The founding of the degree provided me that extra knowledge, and to some extent confidence, to aspire to take on more management style roles.”
Education can take you anywhere
As well as teaching undergraduates and acting as supervisor on the wards, much of Alison’s time at the Austin was working in intensive care or critical care nursing. She also worked in the cardiac surgery unit before getting a promotion into the management stream.
“Those were early days of decentralised management,” she says. “I worked at the Austin for a very long time and I did love my time there. But the opportunities provided by the Austin, and my study of course, gave me the confidence to take on different kinds of challenges.”
She worked at Royal Melbourne Hospital before the chance arose to work in the Department of Human Services, part of the Department of Health.
"I worked there in a number of clinical governance roles. I was the director of Safety and Quality, and the Chief Nursing and Midwifery Officer for Victoria. And then I worked as the director of Emergency Management in Health in Victoria, which I did until I moved to the Commonwealth in 2019 to become the Commonwealth Chief Nursing and Midwifery Officer.”
Enabling every generation of nurses and midwives
Alison’s experience means that she’s worked at almost every level of our health system – making her a strong advocate for nurses and midwives throughout their scope of practice. She’s also vocal about nursing and midwifery as a pathway to other kinds of careers.
“The skills you learn throughout your nursing career, the sorts of problem-solving skills, the ability to build trust, to communicate with a diverse range of people – these are often the things that serve you well as you move into management or leadership” says Alison.
“Nurses should be confident to think that they can do these things because the skills you learn in challenging situations, often in direct care, can lead you to other career choices in the future.”
She also acknowledges that opportunities for growth through education are pivotal for health-care professionals.
“Education is the platform of any professional group,” she says. “And in nursing and midwifery we talk about lifelong learning – we need to continue to learn and grow throughout our career, whichever direction we take.”
The more we can equip the workforce to deliver the best available evidence-based care, then patients will see better health outcomes. For health workers, it means they can look forward to more varied and fulfilling careers.
“In the future we’re going to see nurses and midwives working in a much wider scope of practice in new and innovative areas of care, genomics and technology,” says Alison. “All of these things are really exciting, they’re already here and are only going to grow.”
The pandemic effect
It was early in the pandemic that we saw just how pivotal our frontline workers were in our ability to manage COVID-19. We saw hospital workers find new ways to deliver care in difficult conditions – including long hours in PPE and managing patients who were extraordinarily sick with the virus.
“I think we need to remember that they did that, but also that for the female dominated professions of nursing and midwifery, there was often the added burden of often trying to manage care responsibilities at home,” says Alison. “All of the added challenges that came with the pandemic – of looking after kids or older parents – this came on top of their work as well.”
“That has a legacy and I’m certainly very keen to remind all nurses and midwives that it’s a strength to seek advice and help should they need it.”
But despite those challenges, Alison is highly aware of the strength and resilience of Australian nurses and midwives. In the early days of the pandemic, the Australian Government advertised the opportunity for nurses to complete online training in high dependency nursing or intensive care nursing. This was to combat the huge demand on ICU resources that was expected after it occurred in other countries.
“I thought we'd see a few thousand nurses step forward. In fact, somewhere near 16,000 nurses put their hand up to do this. I was blown away,” says Alison. “And that was when there was still much we didn't know about the pandemic. We had no vaccine, and yet nurses were willing to step forward and do that. It made me incredibly proud of my profession.”
Adjunct Professor (Practice) Alison McMillan PSM completed a Bachelor of Education (1995) at La Trobe University.
