Claire

Age at interview: 35
Brief Outline:

Claire is a lead research nurse with a background in critical care. She started her first research nurse post eight years ago for health reasons. Claire considers the research nurse role to be essential to delivering high quality and robust research.

Background:

Claire is a lead research nurse. She is married and has one child. Her ethnic background is White British.

More about me...

Claire is a lead research nurse working in intensive care. She started in her first research nursing post eight years ago and has worked at a number of Trusts during this time. Three years ago, she was promoted to have a managerial component to her role. Claire continues to be involved in research delivery and leads various academic projects of her own, including those at a national scale. She is a Principle Investigator/Chief Investigator on a number of studies. At her hospital, Claire has responsibility for overseeing all research undertaken by the team as well as research education of staff. Her role also includes encouraging research activity amongst staff and raising awareness about the importance of research. This includes fostering a positive research culture within the hospital setting amongst all staff and challenging notions that research nursing is not “proper nursing. Claire has also been involved in patient and public outreach activities, including visiting schools and representing health research activity at local festivals.

Before starting in research, Claire had worked as a critical care nurse for three years. However, following diagnosis of a chronic health condition, she needed to reconsider the physical activities involved in nursing sedated patients. She was keen to stay within critical care and came across a research nurse post being advertised. Claire took the job which was fixed-term for one year. She initially saw the short-term post as a good opportunity to see if research nursing was for her. However, the contract uncertainty became a concern – although the jobs would usually roll-over to the following year, the arrangement “was a nightmare for mortgages”. Since being in her senior post, Claire has worked to improve this situation for staff in her hospital – because research work is “always” available, “new staff are appointed on two year fixed-term contracts then made substantive [after the first two years]”.

When Claire initially started her first research nurse job, she had little training and supervision. There was another research nurse who showed her how to do some activities and “the majority of my learning was on the job”. For study-specific tasks, she learnt “through study monitors”. Across her experiences, Claire describes working with research teams who are “incredibly productive, supportive, cohesive and without issues around hierarchy”. However, she recalls one job where she felt quite “lonely” as it was “very much me working solo and calling on a medical PI as and when I required signatures or other tasks doing”. Claire is pleased that more recently employed research nurses that she’s spoken to have had much more support in their posts: “they were reporting all sorts of supervision, teaching, training and buddy systems”. New research nurses starting in Claire’s hospital undergo a training package which she has designed. Claire also sits on a steering group for research training programmes, and this includes courses “for those research nurses who have been in post for some time but never received any formal training”.

The intensive care studies that Claire works on and oversees include phase II, III and IV trials. She has also been involved in research studies in other clinical areas too, including paediatrics. As well as managerial aspects, her current role includes: checking feasibility of potential studies at her site, recruitment of participants, data collection and management, data analysis, and disseminating study findings. Although patient contact has reduced as Claire has become more senior, she feels it is “the best part” of her job. Claire finds that “you build a rapport with patients and families in a way which wasn’t possible on wards or in other departments”. She explains that contact in research tends to be more one-to-one, prolonged over several months or even years, and there is scope to spend more time with each person. Across her experience, Claire has come across a number of studies which have been challenging to carry out. She thinks tensions between research design and practice often occur in studies “which have not included both a patient and a research nurse on the design panel”.

Claire thinks there is a lot of confusion between the role of research nurses and nurse researchers, and this was something she struggled with initially too. She had expected to be conducting some research of her own when she first started as a research nurse; although Claire did eventually do so, she wasn’t aware at the time that this was “unusual”. She sought out opportunities including scholarships to undertake research methods training, a Master’s degree and an intensive care specialist course. Claire thinks the confusion about nurses in research is further confounded by there being many associated job titles. Claire gave examples across various bands – some with similar wording, not all job titles specifying ‘nurse’, and not all requiring the post-holder to be a nurse. She feels it is a big “problem”: “It is difficult enough to demonstrate what we do, to raise our profile and show our worth – having a multitude of titles does not show how valued the research nurse role really is”. Without evidence demonstrating the value of research nurses, Claire fears that these jobs will be (and are being) “swapped for lower levels, grades and those without professional qualification”.

For Claire, a key strength of research nurses is that they have “incredible skills and knowledge of both research and patient pathways in a way which others may not”. She thinks good research nurses have many skills, including advanced communication, “diplomacy”, and abilities “to adapt” and multi-task. She encourages student nurses to seek out a research team placement. For clinical nurses interested in moving to a research role, she advises them to contact the research nurse team and look into opportunities for shadowing.

 

Claire talked about the importance of providing evidence of the value of research nurses, to avoid inappropriate changes to the research workforce.

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Claire talked about the importance of providing evidence of the value of research nurses, to avoid inappropriate changes to the research workforce.

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[The future of research nursing] looks bright as long as we take responsibility and evidence the value of our roles. We all know the value but without evidence our roles are likely (and in some cases already are being) to be swapped for lower levels, grades and those without professional qualification.

I'm aware of many more job titles across the country and I believe it really poses a problem to the workforce having such a huge variety. It is difficult enough to demonstrate what we do, to raise our profile and show our worth – having a multitude of titles does not show how valued the research nurse role really is. I don't think we're doing ourselves any favours by not rectifying this or having some sort of national system. The variety is a detriment to a role which is incredibly important. Job titles have been discussed for years when it comes to research nursing roles and unfortunately I think this takes over discussions about the actual value of the work they undertake.
 

Claire had a positive experience of her revalidation. It highlighted her achievements, both as an individual and at a team-level, for herself and her confirmer.

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Claire had a positive experience of her revalidation. It highlighted her achievements, both as an individual and at a team-level, for herself and her confirmer.

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It was a fabulous experience in my opinion. My confirmer was the Director of Nursing and the experience meant that it gave her a better understanding of my role. The nature of the research role means that you have a number of internal and external colleagues who you may ask for feedback etc. There is plenty of patient contact so feedback from them and clinical hour achievement are also not a problem. The experience made me realise just how much not only my team had achieved but how much I had achieved personally too. It was good to reflect. The DON [Director of Nursing] found it fascinating and interesting as evidence provided was quite different to staff in other areas.
 

Claire had experience of working in environments with negative as well as positive research team dynamics.

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Claire had experience of working in environments with negative as well as positive research team dynamics.

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It [the research team dynamics] has varied each place I’ve worked at to be honest. One ‘team’ was very much me working solo and calling on a medical PI [Principal Investigator] as and when I required signatures or other tasks doing. It was a little dysfunctional as the line manager wasn’t capable of performing or willing to perform certain tasks. It was quite lonely from that respect. Team dynamics in other areas, and for 90% of my research experience over 8 years, have been incredibly productive, supportive, cohesive and without issues around hierarchy. Where PI’s are medics, on the whole I’ve found them to recognise the importance of the CRN [Clinical Research Nurse] role and many have said they wouldn’t be able to conduct research without them.
 

Claire had plans for developing research at her hospital but also wanted to have a role in national strategy too.

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Claire had plans for developing research at her hospital but also wanted to have a role in national strategy too.

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I would like to increase the amount of home-grown NMAHP research at [hospital] and build more relationships, possible dual-posts between the Trust and universities to encourage this, perhaps a PhD programme with competitive entry at some point.
From a hosted study perspective I would like to continue to expand the research workforce and number of study opportunities for patients.

At some point I would like to move in to a national role focusing on increasing the research nursing/midwifery workforce and believe there could be more cross-country working with research from frontline staff with big patient impact.
 

Claire highlighted that some clinical staff continue to hold misconceptions about research nurses – including confusion about this role compared to nurse researchers.

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Claire highlighted that some clinical staff continue to hold misconceptions about research nurses – including confusion about this role compared to nurse researchers.

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This [staff understandings of the research nurse role] has been an issue ever since I entered research in 2010. There is a big confusion around research nurse and nurse researcher in the same way that I was confused eight years ago – there has been some but not huge amount of progress with this in that time. Often student nurses come in to the clinical environment having understanding of research as that being conducted by universities etc. through their lecturers, and less so of clinical research nurses they might meet along their way on placements. Often they consider research as behind closed doors looking at qualitative versus quantitative papers, and not the real life research which many of their patients are probably involved with. A lot of clinical staff consider research nursing as not proper nursing in my experience. That said, where lots of work has been done on raising the profile of the role, other non-research clinical staff embrace both the nurses in those roles and the impact they have on patient care. Then they appreciate the role complexity and enjoy being involved in delivering studies to and for patients, appreciating that it increases safety and outcomes for patients.