From nurse to manager

Taking an MBA at Henley taught Fiona Jacob Elias that she had big ambitions

Medical director Fiona Jacob Elias thinks her international distance learning MBA at Henley Management College is one of the most exciting things she's ever done - which is quite an accolade given the amount of excitement that has already come her way.

Fiona, 37, trained as a theatre nurse in Dublin, then in 1990 flew out to work in an Irish-run hospital in Baghdad. There she found a relaxed and tolerant city and welcoming colleagues, but that August the atmosphere began to change. The airport was closed, rumours circulated that Saddam Hussein had invaded Kuwait and battle casualties began to arrive the hospital. Home-going colleagues travelled to the border with Jordan only to find that that, too, was closed. "Suddenly we realised we were no longer free to leave the country," she says.

The next few months were testing. Non-essential workers were eventually allowed to leave Baghdad, but 250 hospital workers, along with all American and British citizens, had to stay. "And the world began to look on us as hostages, even though we weren't exactly being taken out and wrapped around guns." Nervous weeks passed while Margaret Thatcher and George Bush Snr talked a hard line about "hostages being dispensable for the greater good".

"Then we heard there were ships moving into the Gulf and there was talk about an imminent war and that we were going to be in the centre of it. We lived in blocks of flats and sharing our area were the United Nations, some Russian nuclear scientists, the head of the Republican Guard - so we knew we'd be a good group to target." Night-time entertainment became sitting on the balcony watching anti-aircraft guns lighting up the sky as the country prepared for war.

"Then, in December, we were suddenly told we had two hours to pack and to leave. We were being let go on humanitarian grounds. She was flown out to Amman, then eventually on to hero's welcome in Dublin. "And when my Mum saw me she said, 'I'm chaining you to the kitchen table. You'll never go travelling again!"

Bad luck, Mum. Not long afterwards she was heading back to the Middle East to take up a job in Saudi Arabia. This time, however, she found a country that was much stricter and harder to settle in. But then she met her Lebanese husband, moved up to become a theatre sister and realised that her career prospects in the country were excellent. At that point she decided she needed an education.

This meant returning to Ireland to do diplomas in health services management and psychology, followed by a year in the United States, doing a diploma in computer studies. She returned to Saudi to work, meanwhile completing a (first-class) distance learning degree at South Bank University.

"After that I was going to do a Masters, but a friend said, 'Fiona you've got a management bent, go for an MBA', and when I looked into it, I was so excited by the way it offered so much of what I needed to know. I had a huge amount of confidence as a nurse professional, but I needed to be able to speak finance, to speak technology, to speak strategy - Saudi Arabia is a wonderful place to develop strategy because people there are so comfortable with uncertainty, with the fact that Allah will look after them, that no one plans for 20 years down the line." The result was that she enrolled with Henley for an MBA.

Her current job as director of surgery, perioperative care and emergency care, in a 680-bed hospital in Riyadh, part of a King Abdul Aziz Medical City, and the corporate headquarters of the hospital network looking after the country's National Guard, involves her in operations, strategic planning and politics. In addition, she manages 1,200 staff from 47 nationalities. None of which would have come easily, she says, without her MBA studies.

Three years later she still can't praise Henley enough. Her course drew an international group of nine together for three weeks every six or seven months. "So much of what you learn on an MBA is interaction with other students. I found the third year was the most exciting. I felt I had moved onto a different plain. I could talk to my IT department with expertise and baffle the budgeting people with what I knew."

Unwelcome excitement returned to her life when in May her hospital took in the casualties from the suicide bombings in Saudi Arabia after the Iraqi war. "We had a 60-bed emergency room, which we decanted out. And we opened up 40 more beds. We had 17 patients in the operating room that night, but only one patient died after reaching hospital. How it was handled was amazing." That night brought a life-changing decision. As a blonde Western woman, she found life in Saudi Arabia increasingly tense. Now she has decided to return to the UK - leaving her husband behind for the time being - and pursue her career here.

"What Henley has taught me is that I have a hugely strategic brain. I see myself at director level of a clinical service or working on health strategies for the future in Ireland or the UK. Ultimately, I see myself planning a country's or a region's healthcare. But without what I learnt doing my MBA, I'd probably still just be a theatre nurse, joking around with the doctors - although, actually, I still do some of that."