Mary

Age at interview: 58

Brief Outline:

Over the 20 years Mary has worked in research, she has been employed as a research nurse, research health visitor, research officer and now a trial manager. Separate to her research roles, she currently also works one day a week as a health visitor.

Background:

Mary is a trial manager with a background in health visiting. She is in a relationship and has children. Her ethnic background is White British.

More about me...

Mary has worked in research for 20 years. She is currently employed as a researcher and trial manager at a university for four days a week, where she works on research around improving access to antenatal care. She also works as a health visitor one day a week. Mary trained and worked as a health visitor before starting a job for a genetic condition charity; it was here that she was initially inspired to pursue research: “I was aware, in that role, how little evidence there was on all kinds of things that the public wanted to know […] I became increasingly interested in […] being the person who maybe sort of sought those answers”. Following this, Mary completed a Master’s degree in medical sociology and took on a research nursing post. However, she wanted to combine research and health visiting, and found a job as a research health visitor. Mary has worked in both research and clinical posts since then, but currently enjoys the balance and variety of her two roles: “I really like the combination because it gives me a unique edge”. 

Mary’s first research post was as a research nurse. She recalled being “naïve” about what to expect: “I don’t think I had any idea where it was gonna lead. I just thought I’ve got to do this”. In this role, she worked on recruitment for a cancer trial, but had very little involvement in other aspects of the research process. She went on to be employed as a research health visitor delivering an intervention in a trial and enjoyed returning to being closer to health visiting. Compared to the caseload in clinical practice, Mary liked that the research role gave her more time to interact with participants. Adapting to research posts was “a steep learning curve”. She had to become familiar with the terminology used as well as undertake training on different aspects of research, including research methods and safeguarding when the context was not a standard clinical role. Mary found her research group to be very inclusive, which made the transition into this role easier: “there was never that feeling of them and us”. Mary values the qualitative focus of her research unit, and has enjoyed working with her chief investigator. 

Since working in research, Mary has worked on multiple studies around motherhood. Currently, Mary is involved in feasibility and piloting work around an intervention using group antenatal care to improve women’s experiences, including giving them continuity of midwifery care. In her research role, building relationships is key, with everyone from data analysts to participants: “it’s about respecting […] the different pressures on people, and being able to assess-, read people and assess situations quickly”. Since her health visitor contract has been taken over by a private enterprise, Mary questions her future in her current clinical role. However, financially and practically, she feels finding another part-time health visitor post would be difficult. Mary sees several directions of where her career could take her next. Alongside her research post, she has considered options including teaching or taking on a practitioner role specifically around women’s health. Mary hopes to stay in research for the coming years, at least for the duration of the studies she is working on. She would like to integrate research on health visiting into her current research intervention.

Mary feels that there is still a negative, or at least ill-informed, image around health visiting. At the same time, “practitioners are often sceptical about the real value of research”. Because of this, Mary finds it useful to tell clinical colleagues or other staff she works with about her background. This can help counter perceptions “that researchers don’t understand the world of practice, they don’t understand how hard it is to change things […] That’s why I tell people in the hope that they see that I’m not a deluded academic who doesn’t understand, I do understand”. However, Mary also makes sure to keep her research and practitioner roles separate. She doesn’t usually tell participants in her studies that she is a health visitor because “it’s too easy for them to say, […] ‘Would you mind just looking at my baby’s rash?’ […] I didn’t want to be in that position at all”.

Mary feels that funding for research in health visiting has been slower to develop than in other areas such as research midwifery. She thinks this is partly because “people don’t have the same understanding of the health visiting role” and owing to difficulties in measuring health visiting outcomes as these are usually “much more long term”. Although research is encouraged amongst student health visitors, in practice there is often “little/no support for having a research component to your role”. However, Mary believes that there will be more trials around health visiting interventions in the future. She recommends that health visitors considering a research career should take advantage of the support structures that are increasingly in place and opportunities for mentoring.

Mary encouraged health visitors interested in a research career to explore available funding and support.

I think it’s quite an exciting time, because of what NIHR [National Institute for Health Research] are doing in terms of opportunities for clinicians to be funded to be trained and then have sort of joint roles, posts that, you know, so I, it’s, it’s a good time. So, I would say to health visitors now, pursue that route, you know, look at what NIHR offer. The way I did it was just by luck and chance, and an interest in research. I sort of just somehow fell into, you know, but, stumbled along building a bit of a career by chance really than by any, you know, there weren’t particular support mechanisms out there, institutional support mechanisms. So, I just sort of, and I probably, looking back, could have been a lot more ambitious about it, but it’s, I think, I feel I’ve like I’ve had a great career. But yeah, anybody doing it now, I would say the, the structures are increasingly there. And I would say get into those structures, so you’ve got support, you’ve got mentoring, you’ve got, you know, yeah, all the things I didn’t have but, you know, found my way really through luck, ending up here I guess anyway. So that’s what I would, and I would say, you know, because I really believe in health visiting as a service, there’s a, you know, there’s a huge job to be done in terms of the evidence base and the profile and yeah. I would say to health visitors, you know, go for it, do it.

In her current researcher role, Mary liaised a lot with data managers. She saw parallels with the importance of building good relationships in her other role as a health visitor.

For example, in the study-, the trials that I’m currently working on, we’re using quite a lot of routine maternity data, so data collected by clinicians in their role as clinicians, held by the NHS Trusts but, you know, we’re accessing it for research purposes. And in theory it’s a much easier way of collecting data than collecting it fresh, as a research team, but in practice it’s got all kinds of difficulties around it. You know, around completeness and access to that data, and all the rest of it. And one of the things the people who deal with that data-, that’s their day job, are data managers and analysts sitting in Trusts, that’s what they do. So, in order as a research team to access that data you have to work with those data analysts.

And while in theory you’re talking about a spreadsheet worth of data, you know, ‘send us the data’, what you’re actually doing is building relationships with those people so they understand what our needs are, we understand what their needs and pressures are, and you establish trust, even though I don’t speak their language, they don’t really know or particularly care about my precious research study. 90% of what’s involved is me building a good relationship with them, so that they feel valued, they understand what it’s for, I understand their pressures, I know when to ask them for things, when not to ask them for things. Making it as simple as possible for them to achieve what I need them to achieve, and given-, and making it in some way reciprocal so that I gain but they also gain something from it. A satisfying, maybe slightly different angle to their working day.

And I think as a health visitor that, you know, you’re, you’re constantly trying to encourage people to access the service, you are, you have to be humble because you’re a guest in their homes a lot of the time, just in the way that when I’m working with data analysts I’m wanting something from them, they don’t have to give me if they don’t want to. They don’t have to give me. So it’s about respecting people’s-, the different pressures on people and being able to assess-, read people and assess situations quickly.

Mary worked four days a week in research at a university and one day a week as a health visitor. She liked the combination and felt it benefitted her research.

I mean I really like the combination, I like for a personal point of view I like the variety it gives me. I really, I mean I worked full time, I was a health visitor first then I moved into research, and was in research full time, and then I went back into practice about six years ago, because I’d really personally missed the clinical element. I like the face to face work, working with clients, women and babies mainly. So it was very much, and I also realised I was getting to a point, I’d been out of health visiting for ten years, so it was now or never. If I was going to go back I had to do it now otherwise I wouldn’t have had the confidence, and I’d also have lost my registration I think. So, I also thought that, you know, professionally it probably would enhance both roles, research role would benefit from me being a clinician, and the clinical role would benefit from my research knowledge. Yes, I think, I mean it, that is the case, I think the research benefit’s more than the clinical practice. The research benefit’s because I understand the world of clinicians, so I know how to encourage them to participate into research, I know what they’re kind of requirements are, I know what the constraints are. As a clinician it’s very useful for me individually to be able to access research very quickly, I know exactly where to go, what’s available, how to find it.