An Indian mental health nurse who has broken barriers to attain a landmark nursing director appointment has said he wants to help his fellow internationally educated colleagues follow in his footsteps.
Manny Gnanaraj was recently announced as North London NHS Foundation Trust’s new chief nursing and allied health professional officer, a post he will take up in April.
The appointment will make him the first internationally educated nurse from India to reach a board-level chief nurse position.
“It will be one of my responsibilities to be a ladder for my community and for my juniors”
Manny Gnanaraj
Mr Gnanaraj, who was born in Chennai, a city in the South Indian state of Tamil Nadu, completed a four-year-long degree in his home country to qualify as a nurse in both physical and mental health.
After a few years working in occupational health nursing, accident and emergency and nurse education in India, he successfully applied for a mental health nursing post in the UK, at Dorset HealthCare University NHS Foundation Trust.
He moved to the UK in 2003 as the youngest of a 16-strong cohort of nurses from India, all brought in as part of an international recruitment drive, and obtained his Nursing and Midwifery Council PIN in 2004.
He said he experienced difficulties progressing professionally early in his career in the UK, which made him feel “disheartened”.
At one point, he recalled facing resistance against improvements to practice he had suggested while working in a mental health inpatient ward treating older patients.
Speaking to Nursing Times, Mr Gnanaraj described feeling “suppressed” and unwelcome: “Even when I tried to make some small changes to make it better for the patients or their carers when they visited, I wasn’t allowed to do that because [staff] were used to a way of working.”
He sought to “spread his wings” and took on different clinical jobs in the South of England including in a crisis home treatment team at Sussex Partnership NHS Foundation Trust and as a liaison psychiatry practitioner at Dorset Primary Care Trust.
Between 2011 and 2015, he worked as a clinical supervisor at South Western Ambulance Service NHS Foundation Trust before then taking further steps into management and leadership.
One of his manager roles was leading an inpatient unit for older people’s mental health at Dorset HealthCare University NHS Foundation Trust, the area of nursing Mr Gnanaraj said was where his “heart” was.
An interest in equality, diversity and inclusion (EDI) was sparked when Mr Gnanaraj completed an NHS leadership programme.
“[It was] fascinating to understand how much EDI is an issue… I thought, OK, this is very much a White, British dominated region, so therefore I’m feeling like that. But I was wrong. [Discrimination was] happening in… regions where I thought it’s more diverse,” he said.
This led him to joining the England chief nursing officer (CNO)’s Black and minority ethnic strategic advisory group as a fellow.
In 2022, Mr Gnanaraj successfully applied to be the divisional director of nursing for older adults at Black Country Healthcare NHS Foundation Trust.
He was later appointed to his current job of Black Country Healthcare’s deputy CNO, a post he will hold until he joins the London trust.
Mr Gnanaraj said he was proud of how far he had come despite the challenges he faced as a minority ethnic nurse who trained abroad, and for whom English is not his first language.
He described the “barriers” for a minority ethnic nurse in the NHS and he thought the expectation for nurses from other countries to fully “adapt” into a White, British culture was a missed opportunity.
With patients treated in the NHS coming from all different backgrounds, Mr Gnanaraj said the diversity of the nursing workforce was a strength, not a weakness.
“It was fascinating to understand how much EDI is an issue”
Manny Gnanaraj
He added: “It should be both ways. If you don’t understand your patient, if you don’t understand their needs, their beliefs, their culture, how are you going to treat them? How are you going to provide the best care for them?”
Mr Gnanaraj encouraged internationally educated colleagues to “pursue, persevere and believe”, and said: “You’ll get knocked down, not purely because you’re an ethnic minority, not purely because you look different.
“There might be someone better than you when you go for jobs, and you have to accept that, and you can’t let that [make you] feel down forever.
“You have to learn from what you take away from that interview process, keep building yourself and try again. Go in next time, more powerful. If you don’t believe in yourself, you’re never going to get there.”
The past years have seen several other landmark appointments for minority ethnic, and particularly internationally educated, nurses in the UK.
Oliver Soriano, in 2023, became the first Filipino-trained nurse to be appointed to an executive-level nursing director post in the NHS.
In 2024, Bejoy Sebastian became the first president of the Royal College of Nursing to have been trained in India.
Mr Gnanaraj said, since the announcement of his appointment, he had felt “lots of eyes” on him and he was determined to be a role model.
“I will be taking [on] a lot of responsibility, not just from a job perspective, [but also] in terms of being the first ever international educated Indian nurse to achieve a board-level executive director of nursing in the UK,” he told Nursing Times.
“It will be one of my responsibilities to be a ladder for my community and for my juniors. It’s not just that I got there, no – I want lots of me.”
He called on other organisations to be “brave” in their leadership choices and urged his peers: “Don’t waste your experiences, step up – let’s contribute and let’s build a stronger community.”
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