Jo

Age at interview: 49

Brief Outline:

Jo has been a research nurse for six years. She has been involved in many studies, including her first on dialysis patients. For her, the role of a research nurse is to be “the bridge” between patients and the wider research team.

Background:

Jo is a research nurse. She is married and has children. Her ethnic background is White British.

More about me...

Jo became involved in research nursing after 20 years of working in clinical practice. She was motivated to make the move as she felt ready for a change and believed that her background would be of use in this field. She secured a job in a generic research nursing team at her hospital. Jo described having some concerns over the post being fixed-term (“we’ve all got our bills to pay and mortgages”) but, after six months, Jo’s post was made permanent and she has now been a research nurse for six years. The first research study that Jo worked on was looking at improving cardiac outcomes of dialysis patients. When she first started the job, Jo found that research nursing was “a very different role” to her clinical background and “a big learning curve”. She thinks it took about a year to adjust to her new post. Ensuring that research was carried out accurately was something Jo was aware of, especially with trial staff observing her. However, undertaking training and the support of her colleagues made her transition to the new role a “positive experience”. 

Jo currently works on multiple studies, both commercial and academic. When she first started her post, she found it difficult to juggle these but now finds that this variation makes her work “stimulating”. The tasks involved in Jo’s role include recruiting patients, taking consent, going through questionnaires, and taking and preparing blood samples to be sent off. Whilst there are some patients Jo may only see once, there are others that she sees as often as several times a month. Developing relationships with patients is something Jo enjoys about her job, especially in trials that last for several years: “you get to know these patients very well, you get to know their families very well, you know what’s going on in their lives”. She hopes that the findings from these studies will enable “different kinds of management in the future” and the prospect that the research may lead to improvements in care makes it “worthwhile”. Another aspect of her job Jo enjoys is the regular working hours, which she did not have when doing clinical shifts. A task Jo does not enjoy so much is data entry; nonetheless, this is something she understands to be necessary to the success of the trial. Jo is keen to maintain her clinical skills – her current role involves tasks such as taking blood samples and doing observations, but she is planning on working occasional clinical shifts to “keep my skills up”. 

Jo feels the role of a research nurse it to be “the bridge” between the patient and the wider research team, including the Principal Investigator (PI). In this role, communication is central as research nurses liaise with other healthcare professionals and patients. Jo described having good and mutually beneficial relationships with clinical staff. She finds that if you “make yourself useful”, picking up odd jobs, the clinical nurses are supportive of her work. Jo finds networking with other research colleagues to be valuable. She shares an office with several research nurses who are an important source of support. Similarly, she stays in contact with other research nurses across the UK, meeting at conferences and exchanging emails. She finds their input helpful when dealing with issues such as recruitment difficulties. Jo also feels supported by her two managers: “I can rely on them should I run into any difficulties or there’s things that I’m not quite understanding”. 

Jo finds that most patients are “very willing” to take part in studies and feel there is value in doing so. Nonetheless, Jo is aware that there may be other factors in people’s lives that should be taken into account when considering whether a study is right for them. In particular, the time demands of a study may be difficult to juggle alongside their other responsibilities. Similarly, communication issues may pose a barrier to participation in research. Working on a trial with patients with advanced Parkinson’s, Jo worried about whether participating might put added strain on them. However, Jo felt that taking part in the trial was a positive experience for most and that there were ways to enable communication.

In the future, Jo hopes to stay in her current role and continue learning as she takes part in more studies. She sees this as “a layering up process”, building up her skills and experiences in research nursing.

Jo had a friend who was a research nurse whom she asked about the day-to-day activities in the role.

I’ve been in the job for six years now before that I was a sister on MAU and I was looking for a bit of a change and a friend of mine was a research nurse who worked in the cancer team and so I asked her about her role and when she told me all about it I just thought 'well that sounds quite interesting, I would quite like to find out a bit more about that’.

Well you see she, I always knew what she did but I was like well can you exactly tell me what on a day to day because I can’t quite understand what you do. And so that’s exactly what she did and she, I said just explained what a typical day is and then I’ll know where you are. And so she told me you know, that they run certain trials looking at different things running treatments, you know, different treatments against standard care and then measuring outcomes and all that kind and I thought oh that sounds, you know, interesting, worthwhile. So maybe it’s something that I could get involved in.

Jo said it took about a year to adjust to becoming a research nurse.

Yeah I definitely think that’s because I sort of had that to start with because as a nurse in a clinical environment you definitely feel differently when you go into a research post and it’s like ‘oh, you know, I’m not a proper nurse anymore’ and there is that side to it. And I think that and, you know, and like I said before that is why, you know, you can, you’ve always got the option of going back and doing the odd clinical shift here and there if you want to but I think that its recognised in the value clinically you are tremendous value as a nurse but also as a research nurse there is also inner value in that too. And I think it took me a little while to adjust as, as I imagine it would do you know, other nurses that have been used to working clinically for many years that, you know there is, you know, there’s more, there is more roles out there, isn’t there?

Mm, how long do you think it took you to adjust to that?

Oh I’d say probably best part of a year if I’m honest. Yeah the sort of, because in the clinical environment you’ve just, you just present it, you know, it presents itself doesn’t it and then you just, you go on that and that’s what you do and you don’t, you know, you’ve got a ward full of patients to look after and sort out and you just get on and do it. Whereas this you know, you have a different, it’s very different, you know, you create your own workload, you look at what you’re gonna take on how you’re gonna do it, you know, it is a very different role.

Jo learned about informed consent for research through a training course, watching her colleagues and being supervised. She felt it was an important research process to get right.

Well formal training as in, you know, taking the, you know, the consent process and what to look for and how to do that in a correct manner, you know, I would, I did, that was like a formal course that I attended plus I would have watched colleagues do it and then I would have done it whilst being supervised and then signed off and, you know, told where I was going right or going wrong and sort of. It’s about getting all those points over when you go in the initial consent process so that later down the line if things do change, you know, you can revert back to that as well which is, you know, which is like I have found that out in other trials if you go through it very carefully at the start then if things do change, which they can change then you’ve got that basis then to come back to and work from again.

Jo planned to start working bank shifts to keep up her clinical nursing skills.

One of the things that I’d quite like to do is pick up a few bank shifts and do, go back and do a few clinical shifts just to, just to sort of keep my skills up. So, I mean you do, it’s not the same as working in a clinical environment, you know, I mean I still, there’s, you know, you’ve still got that patient contact, you’re still doing, you know, taking blood samples and all those kind of things, observations and various, but it’s, you know, it is different, most definitely, you know, they’ve, the desk time is different and you know, and all the paperwork is, there’s much more but yeah I would, would, I will go, I have been planning to do it for a while but I’m definitely going to go back and do some clinical shifts and sort of see how I get on.

Jo described the main ways she identified potential participants and approached them with information about studies.

I would usually go, I would either do it in two different ways, I work with the neurologist and with another consultant who does care for the elderly and they either suggest patients or CC me into the bottom of clinic letters that they think may be suitable for whichever study or I’ll screen a clinic and I’ll pick up patients that I think are gonna be suitable and then run it past them, if they’re happy for me to approach that patient. And then I usually send them like the patient information leaflet and then ask them to contact me either by telephone or e-mail if they wanna take it further or if they wanna ask any further questions. Or I might catch up with them at a clinic visit if I see they’re coming in for a routine visit I’ll pop and see them and introduce myself and say you know, “I’ve got this study that you may be interested in taking part, this is a brief outline, take the information home with you if you think you’d like to have like to have a think about it take it further then get in contact with me and we’ll discuss again.” And very often you get a positive response, more, I’d say 8 out of 10 times you get a positive response. 

Jo tended to hear about Serious Adverse Events (SAEs) quickly, which meant she could make a start on the reporting process.

Yes I usually hear about serious adverse events very quickly particularly with patients who are on the renal unit because the renal unit staff are extremely helpful and they always know which patients from which trials and they usually give me a ring and say so and so is, has been in A&E [Accident & Emergency], so and so has been admitted and then I chase that up and then report that as an SAE [Serious Adverse Event] within the, you know, within the required timeframe. Either pop and see them when they’re in A&E or pop and see them when they’re on the ward, have a look through the notes see what’s going on with them and then I can you know, compile a report to start with and then I usually finish and complete on discharge when the whole you know, when the whole story is unfolded and we know what’s what. So there’s, there’s, there’s one trial particularly at the moment that I’m doing which is a pivotal trial which requires a lot of information regarding serious adverse events and as a patient they tend to have quite, you know, quite a lot going on for them because they’ve got lots of co-morbidities and so other, you know they do get admitted to hospital fairly regularly.

Jo liaised with colleagues to plan out the best way to meet recruitment targets.

Well I just say, “We’re doing this study, it’s going to be patients on this, in this area that we’re going to be looking at. The study is whatever it’s about this is what they’re looking for, this is what they think they might find, what do you think about that? Do you think we will find these patients here? What, how many, how do you think is the best way for me to come every morning and have a look, is the best way for you to give me a ring when you see, you know, when you see patients like that, how do you think we should play it?” you know, and see what the feedback is. And then you’d get like you can judge then by the response you get, what input is gonna work the best.

Jo felt that the relationships she built up with participants in studies was one of the “best things about the job”.

Oh it’s definitely, you know, one of the, one of the best things about the job because you really get to know people very well and, you know, you see somebody on a monthly basis or a three monthly or a six monthly basis over, you know, a lot of the trials that I run now are in their fourth and fifth year so, you know, it’s a, it’s an ongoing and enduring relationship and it’s you know on both sides I think it’s really therapeutic in some ways. And, you know, even though you’re not in, you’re not responsible for their clinical care they’ll often tell you things and so that you can pass that on you know, there’s lots of different, you know, benefits I think of having that point of contact and then being able to you know, even if I can’t resolve whatever it is that they want, that they’re concerned about I can certainly speak to, you know the nurse, the clinical nurses, the PI’s [Principal Investigators] and, you know, some resolution will always will always be found. I think that, you know, it is, it’s definitely beneficial to get to know patients in that, you know, in that capacity because in the clinical world, you know, you’re time is very pressured.

Jo felt that communication was key to being a research nurse. She highlighted some of the different roles held by people that she worked with.

Communication massively yeah, you’ve gotta be able to communicate with everybody on every level and that’s if you can do that then that’s key.

That’s key, you know, because you’ve got so many people, you know, you’ve got your colleagues, you’ve got your patients, you’ve got your PI’s [Principal Investigators], you’ve got your study co-ordinators, you’ve got your monitors, you know, for, you know, the concept of that when I first started the role that somebody comes and sits by me and goes through everything I’ve done with a fine toothcomb, oh really, that would be a nice stress free day.

[laughs].

But, you know, it’s, it’s not as bad as you anticipate that to be and, you know, it’s a good thing because if there’s anything that needs picking up it can be picked up along the way and that’s good, sometimes, you know you just need things pointing out to you that, you know, this, this or this and, you know, it can be, it can be rectified more easily than if it’s left to go on and not picked up, so yeah.

Jo found that study centres were not always aware of how research was likely to work on the ground and so there was sometimes a negotiation of expectations.

And particularly I think that you know a lot of the study centres I mean it’s not the same that the PI’s [Principal Investigators] do know obviously but a lot of the study centres they don’t have that idea of what it actually is or how a hospital operates and sometimes I’ll look and, you know, and think oh well why can’t you just get that information, you know, and things don’t all, you know. Things don’t always happen that way and things will always be different to how they anticipate that they will be because of, you know, different reasons than the clinical environment. And that as well it’s about them understanding that-, you understanding what they want but they also understand, they have to understand how, how you’re gonna get that and that might not fit into every box, every time [laughs].

Jo started on a fixed-term contract which became permanent about six months in. It was a concern initially, as was dropping banding.

Yeah well I was, there was, you know, issues of concern around that but I thought well, you know, sometimes when you’ve gotta make a change it’s in all areas of nursing really it’s very difficult for nurses to swap around and not lose their banding which is, which is a problem in the whole of the profession really. Because if you do want to try something new you have to, you’re almost expected to drop a band and you know, and it’s not always, we’ve all got our bills to pay and mortgages haven’t we, so that’s, you know, I was a little bit. But I did it and you know, it all worked out fine.

Jo suggested those interested in research get in touch with their research department/teams and ask about shadowing them for a day.

Come and work with us for a day, go wherever you are in, you know, whatever hospital you’re in there’s bound to be a research department, come down and say hi, shadow us for a, you know, for a, for a day or whatever you can do. See what you think, it’s very interesting, you know, things, you know, studies open and close so you, you move into different areas, different things it’s all, you know, quite stimulating, you get, you know, and what you’re doing I think what is key is it’s very it’s very worthwhile because you definitely get that feeling that you know, that you, you’re gathering information that’s not been gathered before to look at things that need to be, you know, that hasn’t been looked at before to hopefully improve management and care for the future. You know, you only have to look back 20 years to see how things have changed and you look forward the next 20 years and then you can be part of that, you know, part of that change and that’s you know that I think is quite motivational and gives you job satisfaction.