Office spaces
The topic of space (in terms of offices and locations in which to see potential participants) was a major one for many of the research nurses, midwives and allied health professionals (NMAHPs)* we talked to. Most had an office and desk space, although some people had hot-desked in the past. The office spaces were not always ideal – they were often described as quite small, sometimes a multi-purpose space used by non-research clinical others* too, and did not always have adequate space for filing study paperwork. Most people shared an office with other research NMAHPs, which Ellen liked: “you can share good practice and you can share problems and you can problem-solve together”. Paul found his could get noisy though, so he sometimes booked a room to focus quietly on completing training. Sometimes offices were close to where the research NMAHPs needed to be to see patients or others on their research team (including PIs), but other times they were some distance away. There were pros and cons to both situations. Although she wanted to be closer to where the clinical non-research midwives were based, one bonus for Osi was that she could avoid being “roped into too much clinical [extra work]”.
Simona had a negative experience of the work environment in her first research nurse post, which she is determined to avoid now she is a team leader.
Simona had a negative experience of the work environment in her first research nurse post, which she is determined to avoid now she is a team leader.
Age at interview: 48
Sex: Female
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So in the first job, I started as being alone then we’ve recruited two more staff members. Unfortunately, I felt very let down because of the logistics of the job, we did not, we, we were hot desking for almost three years and, you know, not everyone can manage with that. I’m more resilient and I guess I could deal with it but they felt and I, and it’s only fair, they felt like they never belonged anywhere. And when, one left before me and then I left and then obviously the third one, so that the team disintegrated unfortunately. In the second, in my current post, I started off from a very small team and then we built it up to nine people. And yeah, it’s very different from how I started and where we got. I feel very responsible as a manager, I feel very responsible for every single person in my team. I am trying to make the work environment as being as nice as possible because I think when you’re happy, you, you have a better productivity, you’re more interested in, in doing your work.
I mean space, it’s always been a hot topic in, in our region and I guess it will still remain. But everyone needs to have a feeling of ‘I belong here’ and I can do something, you know, even if it’s a hot desk probably-, other people being more aware of you needing that space, would have helped the situation. But if I was asked again to go into a job where I hot desk, I will never do it again, I will never recommend anyone to do it. And always when you have people coming up, “Oh I have this funding for a new nurse,” “Where are you gonna place that nurse? What are you gonna do with her?” and all those questions. So I feel entitled that I have to ask those questions because I have to say to them, “Well, if you don’t find a place where that nurse will stay, it’s not going to last three or six months”.
Some roles meant research NMAHPs had to work at multiple clinical sites (hospitals, GP surgeries) and/or visit other locations, including participants’ homes, care homes and hospices. Dawn’s role covered multiple hospitals so she tried to “pool my appointments and my visits to either one or the other”. She also encountered problems with computer access at the different hospitals – this is better now she has a laptop, although printing remains a challenge.
Some people really enjoyed going to different locations as part of their job. Sandra liked that “you’ve got more variation, you’ve got more teams to work with”. For Vicky, being able to travel was “a real plus point of the job” compared to her background working in critical care where “you often don’t move very far from one patient’s bedside throughout a long shift”. However, Ella found the travelling to home visits “a bit too much sometimes” and could become “overwhelming” if they were too tightly scheduled in.
Spaces to see participants
Finding appropriate spaces to see research participants (or potential participants) and access to required facilities to carry out study activities was often difficult. This was vital when confidential and sensitive topics were being discussed. It could be a case of trying different options until one was found and having good working relationships with clinical colleagues could be a major asset. As Jo explained, “it’s just about negotiating that space with whoever’s there and doing the best you can. Nine times out of ten, you always get somewhere in the end”. Although Alison recognised it was unlikely, she felt that fundamentally there was a “need to redesign all the buildings of clinical spaces to assume participation in research”.
Like others, Helen felt research staff were “way down the pecking order of whether we can have a clinic room to see patients”. This could mean being resourceful with what was available. Helen had at times used “little corners, sometimes I’ve even sat in a little changing room to speak to a patient because there isn’t the space for us”. Melanie and her research team had sometimes been “ousted out of a room”: “it’s not good for staff morale either to feel that you’re the bottom of the pile”. A lack of space for research could mean that patients missed out on the opportunity to take part in studies.
In Sandra’s experience, the situation with having rooms to see patients about research had improved over time. It still required planning and could be an issue.
In Sandra’s experience, the situation with having rooms to see patients about research had improved over time. It still required planning and could be an issue.
Age at interview: 43
Sex: Female
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Yes so one of the things we try and do is when we’re saying we’re going to go out, is where will we be based? What room is available? Rooms can be difficult. I think over the ten, 15 years I’ve been doing this it’s got better, because I think it’s becoming more of every day, so as I think before it was a case of you were an add on and you just had to find somewhere, you know, this cupboard here. You know, any small place where you could have confidence that your patient was safe but also confidentiality could be maintained, that would be the room you would be in. Whereas now I think there’s more planning gone into that, so, you know, we look for ‘are there any rooms available in clinic that I could come into?’ Or working alongside the CNS’s [Clinical Nurse Specialists] so you could be in the same room as them and that they-, once they’ve done their bit you can do your bit. And sharing that responsibility. But rooms are a premium space. So, find-, you just have to find what works. But part of what the set up now is that you would go in and say, “Okay, these are the rooms available, this is how it’s going to work,” and if there isn’t a room, you can’t recruit people ‘cos you need somewhere that, that’s confidential. So if you want it to work, you’ll find a space, wherever that might be.
Sian was a research nurse in primary care. Generally, each surgery arranged a space for her when she was due to visit and she otherwise tried to minimise any disruption.
Sian was a research nurse in primary care. Generally, each surgery arranged a space for her when she was due to visit and she otherwise tried to minimise any disruption.
Age at interview: 48
Sex: Female
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Yeah, yeah so obviously very similar to secondary care. It’s a multi-disciplinary team and you’ve got all sorts of people going in and it, again it’s respect, it’s respect for their space and not, not impinging on their space either. So I think what’s really important to me in, when I’m working in general practice is that I go in I find out what I need to know what my EMIS logins are, I make sure I’ve got all my equipment in my room and then I try not to bother them for the rest of the day. I mean obviously they’re there if needs be but I think the less that I impact on their time as much as I possibly can do, the better for them because obviously they’ve got their job to do as well. And I think again a little bit like when I said about the patients and them coming back again, you know, the better my relationship is with the surgery and the less that I impinge on their working day, the more likelihood is that they’re gonna have us in again and again it’s all about building relationships and communicating with people.
Some people had dedicated spaces to see patients and access to research facilities. Libby used a ‘pod’ which had been set up as a dedicated space for seeing research participants – this was a “shielded off area of a waiting room” which provided a “private, quiet environment”. Nicky found being able to use a research unit with rooms, beds and equipment “makes life really easy for us when we see patients”. In some circumstances and with careful planning, it was possible to get access to rooms and facilities by fitting around clinic times.
Christine said it was a major challenge to find rooms to see patients, and there were no obvious solutions. She had visited another hospital with a purpose-built clinical research unit.
Christine said it was a major challenge to find rooms to see patients, and there were no obvious solutions. She had visited another hospital with a purpose-built clinical research unit.
Age at interview: 54
Sex: Female
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[Exhales] Beg, steal and borrow really.
[laughs]
It's a bit, yeah, that is- it's a really tough one. Really tough. I mean, there's some room- there's a room that's available, that's been sort of designated a research room but diabetes research have dominated its use. And that's not a problem, because they are constantly using it. But it then means that we've got no other fall back for anywhere else. So, you know, like I today go down to paeds outpatients and a day off tomorrow but one of my colleagues is seeing a patient. And I said, “I just need a small space”. And it ends up being any space. You know, as long as you've got two chairs and a table, that's all we need. And, “I need it for half an hour, and I promise I won't be any longer than that”. So there's a lot of negotiating. I mean, we can go through outpatient systems, but they're- you just know that they're really busy and every space is being used. So yeah, that's- that is always a bit of a headache when it comes to-. You know, some of the studies see their patients in outpatient clinic, as part of the clinic. So that's usually, that's fine, because the consultant's part of that visit. So, they'll, they'll have a-, they know that they can take them in, when they're being seen, and that's fine. But, yeah. Space is a major issue. And it, it's one that we would all just love- you know, I went to [City] and they've got a purpose-built clinical research bit, and you just go 'I'm just so envious'.
[laughs]
And everybody's together. So not only have they got clinical space of like a bay area, but individual rooms. All of the team are in one massive open plan office. So R&D [Research & Development] are there. Everybody from all of the different research nurses, from all the different- are all in one space. And you just think 'that's just so supportive'. It all works. It, you know.
And yeah, they just have the spaces and it’s a bit like ‘yeah, it's nice’. And I think from patients-, you know, when you go to [City], it's the clinical research department. It's got its own door, it's got a waiting area. That means such a lot. You know, and I, and I think- but space is always an issue with a small hospital, it's always going to be, you know, building upwards [laughs].
Most of the studies Nicky works on are carried out at a research unit, which “makes life really easy for us when we see patients”. A new study in a different setting has presented several difficulties.
Most of the studies Nicky works on are carried out at a research unit, which “makes life really easy for us when we see patients”. A new study in a different setting has presented several difficulties.
Age at interview: 52
Sex: Female
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So this one that we’ve got going at [hospital] is going to be a lot more difficult because I don’t even know if-, how easy it’s going to be to book a room [laugh] when we get a patient, let alone, and certainly if we do book a room we’re going to have to bring a car full of equipment over with us. And then, you know, again in our research unit we’ve got an ECG [Electrocardiogram] machine, but this at [hospital] I had to-, you know, I spent probably the best part of a day trying to find someone that could lend me an ECG machine. And eventually I found the cardiac research department said they’d lend one but, you know, it means going over and getting it, and then taking it to the, to the antenatal clinic, and then taking it back again. So it’s not quite as convenient as having it next to your bedside. So, you know, things like that, and also we have to-, I was saying we have to spin the samples, and over at [hospital] we don’t have the facilities to do that. So then it-, we’re trying to decide ‘do we take a portable centrifuge with us, or do we just bring the samples back to the, or, to the [research unit] and spin?’ you know, so there’s all those kind of practical considerations when you’re working out of different centres.
Rachel Y had an office when she was a radiography researcher and also carried out research delivery activities for some studies. She mostly kept the door open and participants could approach her if they wanted to.
Rachel Y had an office when she was a radiography researcher and also carried out research delivery activities for some studies. She mostly kept the door open and participants could approach her if they wanted to.
Age at interview: 53
Sex: Female
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I was actually quite lucky in that I did have a small office on, on the shop floor so to speak. And people used to laugh because it was, it was, it was quite a small study, you could only just fit a desk and a couple of chairs in there and a filing cabinet and that was it. It was one of the few offices in the whole building that actually had a window and looked out to the daylight, because radiotherapy is down in the basement, so you don’t often have that. And it was right opposite the patient toilets, which I found was a very good place to be sited, cos I always had an open door policy and they would often poke their head around the door and say, “Morning Rachel,” and have a chat with me, which was really good. So most of the interviews that I did with patients would be in there, when we did close the door obviously then. So it worked quite well because they would be down there in the radiotherapy centre, I’d usually catch them before they went in for their treatment or when they came out and so they didn’t have to travel anywhere else, or go to a different section to get involved in that.
Footnotes
*The people interviewed for this website were mostly research NMAHPs (i.e. those employed in a research delivery role). However, we also interviewed some NMAHP researchers (i.e. those leading research as independent researchers). The latter group included people who were undertaking or had completed academic research qualifications, such as PhDs, and many had previously been in (or continued to also be in) research delivery roles. For more information about the distinctions between these roles and the sample of NMAHPs interviewed for this project, please see the Introduction section.
*Many research NMAHPs and NMAHP researchers felt strongly that they continued to be clinical within their research roles. As such, the wording of ‘research’ NMAHPs/staff and ‘clinical’ NMAHPs/staff can be problematic for implying that research is not also clinical activity. Where the wording ‘clinical staff’ is used on the website, we mean for this refer to non-research clinical staff (i.e. those who are not currently employed to carry out research or enrolled to pursue research through an academic qualification).
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