Imogen
Imogen has worked in research for about six years. She is currently a senior clinical research nurse in an emergency department. Imogen describes there being a number of challenges to doing research in an emergency setting, including around consent.
Imogen is a senior clinical research nurse. She is in a relationship. Her ethnic background is White English.
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Imogen has been working in research for about six years. She is currently a senior clinical research nurse and works in an emergency department. Imogen’s role involves managing a team of research nurses who work across three hospital sites. She coordinates 12 NIHR portfolio studies, including both interventional and observational studies. When she began her post, the research unit was newly established: “I think we very much learnt how to shape our own posts and develop our team as we saw fit”. Over time, the unit has picked up more studies and staff: “it’s sort of been an explosion of more studies and more activity, and it’s become quite an exciting job”. Imogen feels that, in her department, research has generally been well supported by clinical colleagues, some of whom help identify patients for her studies. Once results from studies come back, Imogen and her team share the findings with the emergency department, working to “implement changes as quickly as possible”.
Before Imogen started her first research post, she worked as a nurse in an emergency department abroad. She decided to pursue research in order to do “something more challenging and something that could help improve practice in emergency medicine”. She took up a post in the UK where she spent half her time in a clinical role and half in a research nursing post. Having never come across a research nurse before, she describes adapting to her role as “a case of learning as we went”. After a while, Imogen took a year out to complete a Master’s degree. On completing the qualification, she returned to the emergency department in a senior position. Although she no longer has a clinical split to her job, Imogen and all members of her research nurse team continue to do a clinical shift each month to maintain clinical skills and presence in the department. In addition, they often help out with patients when the department is busy and it can be easily incorporated into their research: “that definitely helped foster those relationships, and as well as maintaining our skills”.
Imogen describes several challenges with doing research in an emergency medicine setting. The research team often approach patients soon after they have arrived in hospital and many are distressed or in pain. Imogen feels it is important research nurses acknowledge this context but also recognise the value of research when approaching patients or their families: “it’s needing that belief in the studies that you think you’re doing it for the right reasons, and that you think it’s going to have potential benefit in the future”. Consent can be an issue and, where a patient lacks capacity, this may be gained from friends and family or a healthcare professional, or waivered temporarily. Imogen finds that getting patients to return for follow-up appointments after discharge can be a challenge too, although some are willing to do this to access an extra level of care. Some potential participants are concerned over issues around confidentiality of their data and funding of studies. Imogen finds that language can also pose a barrier to research as some patients do not speak English and consent cannot be taken in the time frame needed.
Despite the challenges to recruiting and retaining research participants, Imogen finds that most patients are happy to be included in studies. Although patients may not always understand exactly what the research team do, she feels they are usually “receptive” to this research staff presence. Imogen and her team wear plain clothes to try and communicate their separation from clinical colleagues and “help the patients understand that this is more a voluntary thing to do”. Imogen’s team members sometimes work weekend and evening shifts in order to find and recruit as many eligible patients as possible. Since moving to a senior position, Imogen’s hours are more consistent, which has had financial implications but has given her a better “work-life balance”.
Imogen is on a fixed-term contract and the “anxiety as to […] ‘will it be renewed?’ What’s going to happen next?’ is quite challenging”. She feels that having to give up permanent clinical contracts is a barrier for other nurses considering research. Despite these concerns, Imogen recommends other nurses to consider a research career: “if you’ve found a field of nursing that you love and you want to grow it, then try research”. In the future, Imogen would like to see research become more integrated into everyday clinical practice. She is planning to do a PhD and hopes to continue working in an emergency setting, where she would “ideally like to grow a bit more nurse-led research”.