Rachel Y

Age at interview: 53

Brief Outline:

Rachel Y is the research officer and the professional and educational manager for a national radiography professional body. She draws on her experience of being a research radiographer and of completing doctoral study to support other radiographers.

Background:

Rachel Y is a research officer and professional and educational manager. She is married. Her ethnic background is White English.

More about me...

Rachel Y currently works for a national radiography professional body. She joined the organisation as the research officer and also become the professional and educational manager. Before this, she was a research radiographer for 10 years. Rachel Y started her career in therapeutic radiography. A few years in, her manager encouraged her to undertake a Master’s degree in social research. Juggling her job with studying was “very hard” and, because research training had not been part of her diploma, she initially doubted her research abilities. When Rachel Y gained her degree, her manager suggested she become the research radiographer in the department. The role did not exist at the time and they were both unsure about what it could entail. Although Rachel Y felt she didn’t have a “full skill set” when beginning the post, she benefitted from a supportive manager with “foresight” and a department who were “really quite excited that we were doing this type of work”. She started on a fixed-term contract which was reviewed every three months for two years before being made permanent: “[it was] a bit scary […] when you’ve got a mortgage, you’re risking it going onto a contract like that. But I had to trust really that it would be okay”. 

Rachel Y was able to shape her research radiographer post to gain experience of research “from inception to publication”. As she gained confidence, Rachel Y “realised just how exciting it was to be able to ask those questions that had been bugging me ever since I would have been a student […] [Research is] an amazing opportunity to be able to look at your practice and then, if need be, change your practice”. It was especially rewarding to see improvements for patients. For example, findings from Rachel Y’s Master’s dissertation led to a support group for patients with head and neck cancers being established. Another study Rachel Y worked on helped to alter outdated guidance given to radiotherapy patients which had unnecessarily restricted their skin care activities. In addition to developing her own studies, Rachel Y worked on a few clinical trials, although her responsibilities in these were restricted to data collection.

Rachel Y had been aware of potential resentment from her radiography colleagues about the workload of being “one person down” when she moved to research. To alleviate this and maintain her clinical skills, Rachel Y occasionally covered staff sickness or helped out at lunchtimes. This could make prioritising her research difficult, but she felt “it’s about a bit of give and take”. Although not all of her radiography colleagues wanted to carry out research themselves, they were very supportive of her decision and Rachel Y made sure to provide opportunities to those who were keen: “every single one of them was involved in something, so they had that on their CV’s and their CPD [Continued Professional Development records]”. However, she encountered some negativity from medical colleagues about her suitability, as a radiographer, to undertake research: “sometimes I felt like it was a constant fight to be able to hold my own territory on that”. She recalled how “rugs were pulled from underneath my feet” by one medical colleague when she was planning to pursue doctoral study. Although Rachel Y thinks it is easier now to “break through those boundaries”, she feels that many barriers still exist for allied health professionals and nurses in research, and for women more generally.

In her current role, Rachel Y advises clinical radiographers on conducting research, including aspects such as getting funding and available support. This is “a lot of work” but Rachel Y finds it rewarding. She felt that, in order to have “credibility” in her role of advising other radiographers, she needed to complete a doctorate herself: “if I’m gonna be giving people advice, then I have to have lived it myself”. As with her Master’s, her doctoral studies were partly funded by her employer and she was given time off for the taught elements of her course. Her thesis was a qualitative study on the experiences of consultant radiographers and the reasons why they were not pursuing research.

Rachel Y encourages more radiographers to pursue further study and emphasises the value of research for the profession: “you cannot say that you’re doing the best patient care if you don’t know what the best patient care is. […] [W]e have to move with that technology and we have to know ‘actually is that working? Is it right?’ And we owe that to our patients”. Rachel Y describes research as having become “quite embedded” in radiography over the years, but she also has some concerns going forwards. For example, she finds that some research radiographers are used only as “an image taker” in studies and denied opportunities for involvement in other aspects of the research process. In the context of a busy NHS, Rachel Y also worries that research is being dropped from diagnostic departments and that the shortage of radiographers makes it harder for some to move into research. She encourages radiographers interested in pursuing research to learn more about the funding support available to them.

Rachel Y was involved in research which challenged outdated guidelines causing radiology patients unnecessary distress.

When I first went into radiotherapy we were using very different equipment, and we were very strict on how patients looked after their own skin, where we were treating them. So we didn’t allow them to wash that part of their skin, which if it’s something like a breast for example, that’s quite a large area. We didn’t allow them to use deodorant under that particular armpit, shave that armpit, wash, or anything. Now back then when they were going through six weeks of treatment, that’s not a very nice thing to do to a lady who’s feeling already pretty bad about her body image, quite frankly. So we did I did a lot of research on radiotherapy skin care. I’ve even gone across to Canada and worked with some of our Canadian colleagues on this, and they’ve just followed another piece of the work that we started here.
 
Thanks to research now, and checking everything out properly, our guidelines here as a professional body now say, let patients wash, let patients use deodorant, let them use the skin care product they want to do. It won’t make any difference. The reason we used to say that was when we were using different equipment that caused different reactions. We were still making patients do that, even though the way we treated them had changed. So our, part of our practice had moved on, but part of it hadn’t gone with it. And thanks to research I would say again patients have, now have a better experience. So that will always be my selling point. And nobody will ever convince me otherwise, that if you don’t do research you might believe you’re giving patients the best imaging or treatment experience, but I would argue very strongly that you can’t be. Cos unless you have reasons for why you’re doing what you’re doing, based on evidence, you could actually be doing things to patients that don’t need to be done.

Rachel Y’s manager encouraged her to complete a Master’s degree and helped her to establish a researcher role in radiography.

And then it was really in the sort of late 80’s, early 90’s I had a very supportive manager, who actually supported me to do my Masters. And again, really, we see a lot more people doing that now, but we didn’t really see that so much for what I would call a job in radiographer back in the 90’s doing that. So, I was fortunate. And that was a Master’s in social research because you couldn’t really find, very easily, Master’s courses that were specifically radiography. I think that was a good thing because I actually, being a therapeutic radiographer a lot of what you do is actually with patient experience etcetera, and so right from that very early time I was very much a qualitative researcher. So very much liked interviewing patients, doing sort of grounded theory work, finding out that sort of lived experiences of patients.
 
And particularly head and neck cancer at that time. So, then I finished that Master’s, and I was still in quite a junior role at that time actually, and again this very forward-thinking manager said to me, “Well what are you going to do with this?” And I really wasn’t sure, I guess I think Abi, up until that point, I, I really didn’t even think I was capable of doing a Master’s, cos you know it wasn’t encouraged really that we would. and she said, suddenly said to me, “Well I think we could make you our research radiographer,” and I sort of said to her, “Well what is one of those?” And she said to me back, “I don’t know, but, but we’ll make it up as we go along,” and that’s what we did really. That role wasn’t really there across the UK before, so it was, it was quite a brave move on her part. And what she allowed me to do was do true research from inception to publication, which again was quite rare. So I mean I’m really thankful for her, for giving me those opportunities. An amazing person really to have that foresight.

Rachel Y’s Master’s degree was half funded by her employing hospital and she had time off work for the taught classes. A similar arrangement was in place with her new employer when she did her PhD.

I was given my time off to go to the university in, in the first year of my Master’s, for the taught modules parts, but the, the year that I was doing my dissertation I wasn’t given any time off, so that was quite hard. So, you know often people will say to me now, “Oh Rachel, you know, we know we should be doing research but it’s just too hard to fit it in,” and you, and I think sometimes in life you know, when you’re doing some of those types of roles you have to accept that some of it will be partly in your own time really. So that, the whole of the, you know the dissertation part was done really sort of evenings and weekends, apart from obviously the interviews that I was doing with patients, was done in my work time. So that was done then. And as regards sort of fees, I think I was quite lucky, my employer paid half of it and I paid half of it, which I think is probably quite fair, you know? They, I think if the expectation of them having to pay for all of it would have back then been quite difficult because it was a gamble really on their part, they didn’t really know what they were going to get out of it. And I think with, there was that part in them that if I at least had inputted some of my own finances I was less likely to pull out of it, which was never going to be on the cards, but it does happen.

Rachel Y expressed concern that radiographers were often not included as part of the research team beyond being “the image taker”.

What I’m seeing in diagnostic imaging is, is very sadly often they’re being used as the image taker in the study, rather than you know a co-author or a joint person on the project.
 
Which is really actually very unfair and something we need to look at because the current statistics I think are something like 98%, 99% of patients that go into a hospital will have some sort of imaging because imaging is, you know imaging is so, is so good now, you can see so much detail, in fact the, we’re even in the awful situation where we might be over diagnosing people because we’re seeing so much. And of course the human body isn’t perfect, so that’s causing us a little bit of problems as well. But I think what’s happening in a diagnostic department is they’re basically, they’re really getting swamped with work. And so the research element is getting dropped.
 
And if any research is being done, and as I say often they’re being used as the image taker in that, rather than part of the study. And there’s something very wrong in that. So going back to what I said, how I used to work before with my colleagues, that’s not the way I would’ve ever done it. I would’ve always said that they were part of it, and the images are a big part of a study. So I, I think that’s, that’s an important thing for me now as the officer who does look after research. I really need to be pushing that much more with other health professionals, to please, you know, when you’re, when you’re having images in a study, you know, involve your diagnostic radiographer colleagues in that as part of the team. Cos actually they could, they could add a lot of value. But I think it’s quite hard in that particular environment for them to break through that.

When Rachel Y led radiography research, she found ways to support her colleagues to have involvement in the studies.

Therapeutic radiography is, is, you have to work in a team. It’s the way that it’s always been, so you’re actually quite close, you spend a lot of time together, and I didn’t have one colleague, not one, who wasn’t supportive of me doing that role. Bearing in mind, you know, that they, they were basically one person down, being able to treat because I was researching, so there could have been resentment there but there never was. And I think the reason that there wasn’t was right from the outset I was very clear with my manager and she was really supportive of this, that every piece of research I did I would bring at least one of them in on it, so that all of them at some point and there was a period that I can look back at where every single one of them was involved in something, so they had that on their CV’s, and their CPD [Continued Professional Development]. And the other thing that we did was, there were a few projects that actually income generated because we were testing out pieces of kit, and so that we, we, we were paid to do that, and what we did was we put that money into a, into a research pot, for other staff so that when they wanted to go to a conference, an event, they could. And they’d never had that opportunity before. So they were always pretty supportive.

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.

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.

Rachel Y thought that statements of support from “high up” organisations would help research to be truly seen as “a legitimate part of professional activity” for radiographers.

And I think that’s the key to this. I think individual professions will struggle to get this mandated. It needs to come through as research being a legitimate part of professional activity that is weighted in somebodies work plan correctly. It’s not an add on extra. It’s part of the work. And that really needs to come out from quite high up across all the disciplines I think for it to be successful. I do think some disciplines have mastered this better than others. I think physiotherapy for example have mastered this better. I suspect that’s because they’ve always worked much more autonomously and I think possibly their leadership skills of their individuals, so therefore stronger.
 
What we’ve had in radiography is we’ve worked under another profession, which is, that’s always been quite difficult. So a diagnostic radiographer works under, you know has worked under a radiologist, a therapeutic radiographer like myself has worked under an oncologist. So that has caused an element of stifling. Whereas I think in a profession such as physiotherapy where they can work independently autonomously, they’ve not had to break through that ceiling. So it’s slightly different for radiography, I think. So I think for us we would benefit greatly from a more overarching, statement or condition even, that comes out from say Health Education England, that this has to be done. Cos at the moment it’s not mandatory. And it, if something is not mandatory it will always drop off the radar. It will be always one of the first things that will drop.