Armando Almeida is Coordinator of the Bachelor’s Degree in Nursing at the School of Nursing (Porto) of Universidade Católica Portuguesa. He came to Nursing almost by chance, but it was during his first clinical placement that he discovered the true meaning of the profession. In this interview, he talks about what fascinates him most about Nursing and how he seeks to convey that sense of purpose to his students. He also reflects on the role of nurses in people’s health, the importance of prevention and what sets Nursing education at Católica apart, arguing that “if people are not at the centre, Nursing loses its meaning”.
How did Nursing come into your life?
It was a curious journey because it happened without really being part of my plans. As a child, I wanted to be an architect, but then I discovered that I really disliked Descriptive Geometry. Later, when I chose the Sciences track, I became very enthusiastic about Biology and had a teacher who made a huge impression on me. From that moment on, I was convinced that I wanted to pursue that field. I was fascinated by the environmental protection group I was part of and by the idea of exploring the Amazon or even the Gerês region. When I applied to higher education, I had to include options other than Biology, so I listed Nursing without really knowing what I was doing, because I was convinced I would get into Biology. But I missed it by just 0.1 points and ended up in Nursing. I had no idea what I was doing there. That was when my journey of discovery began, and I had a very difficult first year. I even considered dropping out.
Until…
Until everything changed in my second year, when I had my first observational clinical placement. During that placement, I experienced a particularly transformative moment in my life. One day, I accompanied two nurses who were caring for a woman lying in bed. I actually thought she was in a coma because she did not open her eyes while the nurses were providing care, even though they did not speak directly to her. Afterwards, they asked me to stay in the room with the woman, so I did. At one point, I had the intuition to run my hand through her hair and gently stroke it. I was extremely startled when she opened her eyes and deeply thanked me for that gesture. I later realised that her reaction was because I had treated her as a person. The other nurses had provided the necessary care, but there had never really been a “good morning” or a gesture of personal attention.
That was when I understood the meaning of this profession and realised that, through my commitment and my studies, I could contribute to improving people’s health.
“Whatever we do and produce, whether in teaching, research or clinical practice, must have an impact on people and their health”
What fascinates you most about Nursing?
A nurse has the decision-making power and the ability to improve people’s health in their hands. That is also what, as a teacher, I try to show my students. Let me give you an example: when a student comes to discuss a case study with me, they are often more focused on demonstrating what they know. And I always ask the same questions: “Did you do this for the person? Did it have an impact on them?” Because if what they are telling me is only meant for me, then it had no effect at all.
My guiding principle remains this: whatever we do and produce, whether in teaching, research or clinical practice, must have an impact on people; it must have an impact on their health. If people are not at the centre, Nursing loses its meaning.
What sets Nursing education at Católica apart?
At Católica, students are not just one more number. Each one has a name and a story, and that makes all the difference in the way they learn. The combination of theory and practice, right from the first year of the degree, is another aspect that sets us apart. Take my own case: it was through practice and the clinical environment that I changed the direction of my life and realised that Nursing was truly what I wanted to do. But the opposite can also happen. Through practice, right from the first year, students can realise that this is not, after all, the right path for them.
At Católica’s School of Nursing, all clinical practice is supervised by lecturers, which makes the experience more enriching. There is continuous personalisation throughout the entire journey. Finally, we cannot forget that Nursing at Católica has a long history, with its own knowledge, philosophy and distinctive approach, built on the expertise and experience accumulated over decades. The degree has existed since 1935 and has already trained thousands of nurses who are now working across Portugal and around the world, in a wide range of settings.
“Until we invest more in prevention in Portugal, it will be difficult for people to fully understand the impact nurses can have”
Does society recognise the importance of the role of nurses?
I believe in a healthcare model that is very close to the Nordic approach, where care is provided in people’s homes. In other words, a strong primary healthcare network where people only turn to hospitals as a last resort. The focus is on prevention rather than solving a problem once it has already emerged.
Portugal is not yet at that stage. Our system is still very focused on treating illness. We have institutionalised primary healthcare services, but they face many difficulties. On average, a family nurse is responsible for 350 families, sometimes spread across a large geographical area. That nurse cannot leave that setting. So when do people actually have meaningful contact with nurses? When they are admitted to hospitals. Either because they have a serious illness and are hospitalised at an earlier age, or when they are already older. Often, that is the first time they begin to understand the impact nurses can have.
Until the healthcare system shifts its focus from treating illness to prevention, people may continue to struggle to understand the role nurses can play in their health.
Did the COVID-19 pandemic change society’s perception of the role of nurses?
That became very clear during the COVID-19 pandemic. There was no medication that could simply be prescribed to solve the problem. People became seriously ill, went to hospital, and the people by their side were nurses, providing the care they needed to survive. That was when many people truly understood the impact nurses can have. Until we invest more in prevention in Portugal, it will be difficult for people to fully understand that impact, because contact with nurses often happens far too late.
Does Católica seek to train nurses from a broader perspective, showing them the different dimensions and career possibilities within the profession?
Absolutely. We start right in the first year, when students undertake their first placement, which is observational. This observation does not take place only in hospitals. Students spend time in hospitals, companies with occupational health nurses, clinics, health centres, nursing homes, the National Network of Continuing Care, among other settings. We want them to experience different contexts so that, by the end of the degree, they can identify the area in which they would like to work and understand that they do not necessarily have to work in a hospital. They can work, for example, in a prison or in occupational health nursing.
Occupational health nursing is particularly interesting because it allows nurses to work with a group of healthy people and focus on prevention. If we go to a health centre, we mainly find two types of people: adults who are there because of their children, accompanying them to an appointment, and older people. Where are all the other adults? They are at work. It is a good example of the impact a nurse can have on people’s lives and of the role they can play at a preventive stage.
What advice would you give students who are now beginning their academic journey at Católica, in the Nursing degree?
The message is: come and try everything. Without fear. Or rather, with fear, because fear is great when we are talking about a degree like Nursing. Fear forces us to think before we act. So, come with fear. We are here to help you, essentially to transform all those fears and uncertainties into something that will be very useful in the future, so that you can improve people’s health. That is why we are here. That is why we exist.
