Nurses, midwives & allied health professionals in research
Research nurses’, midwives’ and AHPs’ experiences of working with colleagues: an overview
Being part of a team and working well with others was a key part of the research delivery role for the nurses, midwives and allied health professionals (NMAHPs) we spoke to*. Building and maintaining relationships was important, with communication being fundamental to this. For some people, like Rachel Y, the teamwork needed in research was similar to the teamwork they were familiar with from their clinical work*. Some people described their roles as being “a bridge” between various individuals and groups. Although there was sometimes overlap between these groups, the main working relationships broadly described were with:
- research colleagues (including Principal Investigators (PIs), Chief Investigators (CIs), staff at study centres and fellow research NMAHPs);
- clinical (non-research) colleagues and administrative staff (including other NMAHPs, consultants, GPs, care home staff, and appointment booking staff); and
- line-managers, mentors and supervisors.
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.
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.
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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.
Sandra encouraged research nurses to be “proactive” and keep following up others they work with if need be.
Sandra encouraged research nurses to be “proactive” and keep following up others they work with if need be.
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Most studies had a research team which included CIs (Chief Investigators), PIs (Principal Investigators), study centres and fellow research NMAHPs, but also other individuals and groups too; there were different views on who was or was not considered part of ‘the team’. Graham described there being good dynamics in the research teams he had been part of, which included statisticians, health economists, methodologists and clinicians: “people are interested in what we [paramedics] have to say but we can also learn a lot from all of them”.
And we get the support we need.
Yeah.
As well. It’s recognised that okay now we need to come off the ward for a while because there’s this many jobs to do, and we need to get all of this done first. And I think something our PI highlighted was it, one, recently in one of our away days, it’s like how important it is to set that time aside when you’re not on the ward and not recruiting, to catch up with all of the jobs that need doing in the background. So, I think that was, you know, feeding that back to the whole team was quite important because a lot of the time that is where the problem occurs when you’re expected to be doing that, but then you haven’t got time to do the other side of it. Which, because we have such a good relationship in our team, you know, I can say to the PI [Principal Investigator], I can say to her that you know I, I’m not finding time to do these jobs at the moment because I’m here, and I can’t, I haven’t got time to do both. And it’s taken on board, you’re heard, it’s taken on board and the support is put in place. And I think that has been brilliant.
Because it takes away the stress factor because you are being given the time you need, you are being given the support you need. And you’ve got people to turn to and people that will listen. So it gives, it actually, you know when you’re given that kind, you want to do more, it makes you want to do more, you then go that extra mile too. So, I personally think you know, something, one of our one of our consultants works on excellence and one of our clinical fellows working in an appreciative enquiry and things like that, and that is something they say excellence breeds excellence. And I tell you, they’re bang on.
If you look after your team you get, it’s very much more, it’s more productive. And they’ve got the right culture in this team.
However, based on their experiences, some people were cautious about the notion of ‘teamwork’ in research. A few people felt that there was a divide between research NMAHPs delivering studies and wider research teams. In Ella’s experience, research nurses like herself were excluded from publication writing and acknowledgements, and she felt “taken for granted”. More generally, maintaining relationships with others was not always straightforward and could be challenging at times.
But there seems to be an awful lot of people counting and over counting and doing more counting all the time about how many people you’ve recruited and how many this month and how many other people you recruited and this that and the other. So I think the focus seems to be less about, about the research really and you just feel, or you could feel it’s, like I say it’s a sales job really. I don’t think that’s very good for either the people doing it or for the patients actually because it’s, it’s not what it’s about or it shouldn’t really be what it’s about. And I also think the, I’m talking about clinicians really because they tend to be the people doing clinical trials obviously but it can also be scientists or whoever it is as well, can sort of stand back because the clinicians in particular tend to again have a lovely time designing these things and then they, you know, the ones that have money for a research nurse to do it, who do all the recruitment for them and then they get to, you know, analyse the data and write the papers and that strikes me as I don’t know I don’t know whether it’s unfair exactly because of course you know, that’s fair enough if you’re a researcher you wouldn’t want, you want to be able to do all of that yourself but I think sometimes they don’t- it’s not always teamwork, I think it’s sold as that.
So some clinical trials there’s a lot of talk about, "Oh this is a team thing, oh it’s really important that, you know, people come to our-", I’m saying ‘our’, people come to a clinic where I work and go, "There’s this project, do you want to get involved?" Lots of people go, "Yes, that would be great". "How are we doing?" there’s lots of that talk about how, how well we’re doing but it’s literally what they’re talking about is how many people they’re getting to sign to do something.
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.
Footnotes
Sugrah worked in a very supportive research team. Even though there had been very busy times, she hadn’t felt “under too much pressure”.
Sugrah worked in a very supportive research team. Even though there had been very busy times, she hadn’t felt “under too much pressure”.
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Yeah.
As well. It’s recognised that okay now we need to come off the ward for a while because there’s this many jobs to do, and we need to get all of this done first. And I think something our PI highlighted was it, one, recently in one of our away days, it’s like how important it is to set that time aside when you’re not on the ward and not recruiting, to catch up with all of the jobs that need doing in the background. So, I think that was, you know, feeding that back to the whole team was quite important because a lot of the time that is where the problem occurs when you’re expected to be doing that, but then you haven’t got time to do the other side of it. Which, because we have such a good relationship in our team, you know, I can say to the PI [Principal Investigator], I can say to her that you know I, I’m not finding time to do these jobs at the moment because I’m here, and I can’t, I haven’t got time to do both. And it’s taken on board, you’re heard, it’s taken on board and the support is put in place. And I think that has been brilliant.
Because it takes away the stress factor because you are being given the time you need, you are being given the support you need. And you’ve got people to turn to and people that will listen. So it gives, it actually, you know when you’re given that kind, you want to do more, it makes you want to do more, you then go that extra mile too. So, I personally think you know, something, one of our one of our consultants works on excellence and one of our clinical fellows working in an appreciative enquiry and things like that, and that is something they say excellence breeds excellence. And I tell you, they’re bang on.
If you look after your team you get, it’s very much more, it’s more productive. And they’ve got the right culture in this team.
Ginny felt that research nurses were often confined to recruitment and excluded from wider study activities, despite rhetoric about “teamwork”.
Ginny felt that research nurses were often confined to recruitment and excluded from wider study activities, despite rhetoric about “teamwork”.
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So some clinical trials there’s a lot of talk about, "Oh this is a team thing, oh it’s really important that, you know, people come to our-", I’m saying ‘our’, people come to a clinic where I work and go, "There’s this project, do you want to get involved?" Lots of people go, "Yes, that would be great". "How are we doing?" there’s lots of that talk about how, how well we’re doing but it’s literally what they’re talking about is how many people they’re getting to sign to do something.
Rachel Y expressed concern that radiographers were often not included as part of the research team beyond being “the image taker”.
Rachel Y expressed concern that radiographers were often not included as part of the research team beyond being “the image taker”.
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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.
*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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