Nick Dowling was the only person in the doctor’s waiting room when the practice nurse came out, glanced around and said to the receptionist with a confused look: “I was expecting to meet a student here.” Dowling raised his hand. At 60, he has undertaken an apprenticeship and hopes to qualify as a registered nursing associate this autumn.
Dowling had worked for decades in engineering and manufacturing, but his latest placements have taken him from a general practice to a psychiatric unit, from ward nursing to urgent treatment centres. Sometimes the shifts are 12 hours long, and, at £14 an hour, pay less than he has earned in decades. So why is he doing it?
He grew up in Dundalk in the Republic of Ireland, so close to the border with Northern Ireland that during the Troubles it was nicknamed El Paso. He graduated from a quality engineering degree in the mid-1980s, and, at 21, like many of his peers, headed to the US for the summer.
While living in digs in Cape Cod, Massachusetts, he found work at a local nursing home. Dowling became a nurse’s aide on a “total care” dementia ward, feeding patients and emptying their bedpans.
The shock and initial distaste were so great, he vowed not to return after his first shift. But the senior nurse persuaded him to stick at it – “probably because of the level of care she showed for the patients”, he says. He stayed for six months, after which he settled in England and into a “proper job” and thought little more of it.
The “proper” career was in quality management for a range of manufacturing companies, after which Dowling moved into consultancy, delivering leadership and change-management training with a friend who was a psychologist. At the time, around 2012, Dowling says neuroscience was “still very emergent, and the idea of neuroplasticity” that underpinned their approach “largely unknown”.
He worked on legacy projects including Crossrail in London, the Medupi power station in South Africa, and the civilianisation of the police force in Northern Ireland. The idea was to approach change “from a wellbeing point of view: how can we make the workplace better for employees? Because if it’s better for them, if their mental health is better, their physical health is better … organisations will perform better.”
After a few years, Dowling saw a poster advertising volunteering opportunities with the ambulance service near where he lived in West Sussex.
He cannot remember where he saw the poster, nor why it spoke to him – at the time, he was happy in his work. But he signed up and became a first responder to “acute medical emergencies in the community: chest pains, strokes, trauma, falls, burns, bangs, anything and everything”.
When Covid hit in 2020, Dowling’s consultancy work went online. “Suddenly, you’re just talking to a screen,” he says. “You’re getting nothing back from it. No energy. It’s a very different proposition. I got bored quickly.”
Meanwhile, the voluntary work became more urgent: from taking the temperature of ambulance crews to delivering Covid tests, moving ambulances, and running sustenance trucks for crew.
Rather than having a career plan, Dowling has always kept in mind the advice he once heard to keep his “eyes open to opportunities and have the courage to seize them”.
It was his daughter, a cardiac physiologist, who “pointed me towards the NHS jobs website”, he says. “I knew I needed to start at the bottom. An ad came up for a healthcare assistant with a team called responsive services.”
“It took me a long time to actually make the connection and think: hang on, I’ve done this work before, as a naive 21-year-old. And then there was something about a circle closing … And there definitely is now, further down the track.”
“TS Eliot wrote [in Four Quartets]: ‘The end of all our exploring will be to arrive where we started and know the place for the first time,’” he says. “There might be a bit of that going on.”
While the original work was accidental, now it is a choice. And although it’s tiring, Dowling hopes to have a seven-year career after he qualifies. As a specialist in change management, does he know why he sought this move?
“I value learning,” he says. “And I think learning and change are synonymous.”