Simona

Age at interview: 48

Brief Outline:

Simona was employed by the Clinical Research Network in her first research nurse post for three years. She is now a clinical research manager and draws upon her previous experiences to support a team of research nurses.

Background:

Simona is a clinical studies coordinator with a background as a research nurse. She is married and has children. Her ethnic background is White Romanian.

More about me...

Simona is qualified as both a nurse and a physiotherapist, and has worked in health research for seven years. She has been involved in a variety of studies, including in surgery, gastroenterology and cancer. A combination of interest and health reasons led Simona to pursue a research nurse job. In her first research nurse post, she was employed by a Clinical Research Network to recruit patients and collect data for studies. For the last four years, Simona has been in a different role of building up and leading a research team. She now works on study design, securing approvals from ethics and funders, and supporting other research nurses to fulfil their jobs. Alongside her post as a clinical research manager, Simona is also working towards a PhD qualification and hopes to pursue a nurse-researcher role in the future. Across her different experiences, being a nurse remains an important and enduring part of how Simona sees herself: “regardless of what I’m doing, I’m a nurse”.

When Simona started her first post, she was the only research nurse in the group and there was no training offered. This meant working “in isolation”, having to “find my own way”, and learning new jargon. The wider research team were supportive but lacked understanding of the nurse-specific context Simona was used to and how to help her adjust to an unfamiliar role. Networking was important as she “attached” herself to other bigger, more experienced research groups for guidance. Another issue Simona encountered in her first post was a lack of dedicated working space for her and other research nurses as the team grew. She was expected to hot-desk, but this had challenges (for example, the storage of confidential data) and left her feeling undervalued. However, she liked that the role involved her continuing to do some clinical work alongside research.

When Simona moved to a clinical studies coordinator post and then onto her current role as a clinical research manager, she felt the increased responsibilities were a natural progression. She knew she would have less patient contact, but that there would be other responsibilities – such as designing studies with recruitment targets that are “feasible on the ground, in the real world”. Simona doesn’t think it is helpful to think of nurses in research roles as becoming “de-skilled”; instead, “you build on” skills and knowledge. She thinks that taking informed consent, for example, should be recognised as an important clinical skill. Simona thinks it is unusual for nurses to enjoy the data management side of research but, for her, it is satisfying. She has developed a database for both clinical and research use, and found it rewarding to know it would give accurate, high-quality data.

Simona’s previous experiences as a research nurse in her first post have shaped her activities and outlook in her current post. For example, she developed a structured induction process with training and shadowing for new research nurses in her team. Simona also feels it is important to have good relationships with clinical staff. When she first started as a research nurse, Simona remembers feeling dismissed by clinical staff – something which she felt “really hurt” by. Now, Simona thinks there is more understanding and she routinely trains clinical staff about the research taking place in the hospital, including how and why they may want to support research nurses. This is particularly important because the research nurses in Simona’s team are all university-employed and regulations often mean they must rely on clinical colleagues to help identify eligible participants. Simona would like research nurses to be officially recognised as part of the clinical care team in order to embed research in the environment, ease patient access to research opportunities and recognise the work her research nurses do in supporting short-staffed clinical areas.

Simona thinks a good research nurse must pay attention to detail, work well in interdisciplinary teams and be able to communicate between different groups (e.g. laboratory scientists, clinicians, patients). Her advice to other nurses considering a research role is to try it, although she acknowledges it may not be for everyone. For current research nurses, Simona’s message is to be confident and vocal about their accomplishments, and also to consider becoming a nurse researcher as a route to put their own research ideas into practice.

Simona described the combination of ‘push’ and ‘pull’ factors which led her into research.

Well I think it was just a combination of factors, it wasn’t one straightforward answer. So, first of all, I got to that stage-, I loved being clinical. I absolutely love that patient contact, the knowledge that I have clinically, however because of some health issues, I found it more difficult to deal with shift works, work and perhaps even with the manual handling side of the, the job. 

And it came an opportunity when one of the surgeons I were working, I was working f-, with had an opening for a research nurse and I was very intrigued because where I’m coming from it was no-, there is still no such thing as a research nurse and I was like ‘oh this sounds quite interesting’, because I always felt I’m-, I mean I have an inquisitive nature so I’m curious about things and I like to learn. And I thought this might be something. And I took it from there. I applied for the job, I got the job and I actually liked it [laughs].

Simona didn’t have much training or support when she started in her first research nurse post. Now that she leads a team of her own, she provides new staff with more support.

So I think I was-, the first thing when I came into this new post it was ‘what can I do different so then nurses do not go through what I went through’. And we have a very structured way of inducting any new staff member, they shadow, they have all the training, I set up mandatory training that they should help them to understand the whole thing. And then depending on the person you have from four to six weeks where you’re kind of supernumerary in a way, so we don’t expect them to do things without being fully comfortable and fully understanding what they do. When we recruit someone new and we know the start date of that person, we already set the start-, we set already training dates for them, they are not done internally.

Simona didn’t think research nurses ‘de-skilled’, and instead she highlighted changing skills as an evolution process.

Well, clinical skills.

At the end of the day, I had this debate with other people who keep telling us that we, de-skill and no, we don’t de-skill, you learn a new set of skills. We do, why can’t we say that consent, for instance, gaining consent is not a clinical skill? It is a clinical skill but it pertains to our area. We do collect samples, we do take bloods, you know, we have developed an array of lab skills that also come with this with our job description. So I wouldn’t say you de-skill in any way and I would always argue with that. Yes, but it’s again do you have the same skills as you had in your first year of-, you know, it’s just developing more and I don’t believe that those skills that you had there already are lost, you build on them.

Simona’s current role included leading a team, having input into study design (including feasibility), and setting up as well as closing down studies.

And now in my current position, I actually sit down and I’m fully involved in the design and writing of a protocol and the study, in the study design.

Purely because I know first of all what is feasible on the ground, in the real world, what you can and you can’t recruit in, generally. I mean with all the respect, sometimes medics they have these things they think that-, there is a discrepancy in the numbers, they always seem to think that there are a lot more people that will be recruited than there really are. And I try to tame, temper them on that, kind of probably lets, let’s be a bit more optimistic. But yes, now I’m involved in the design of the study, all the process of the application and granting all the approvals.

And then setting up the studies, to the close of the study, then training the staff and all that.

Simona led a research team and was undertaking a PhD. She encouraged more research nurses to become nurse researchers.

I think go and try it for, it’s not for everyone but if it is for you, you will know it. I also encourage everyone who likes to be a research nurse to become a nurse researcher. If you’re in this job you are curious, you like to know things and surely you have ideas. And in my team I already have people who have ideas and they know what they want to do and it’s just teaching them how to get to that point. And I think it’s very exciting times for research nurses, in a way.

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.

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”.

Simona would like to develop more research in her team with patient input.

I will be a nurse researcher [laughs], that is the key and I will probably I want to be very involved with the patients and go and talk directly to the patient and take their ideas of what is important for them in terms of research and put it onto a, into research projects. So to have absolutely, you know, to get it from the horse’s mouth if you want.

Know exactly what is of importance to them. It’s very nice when you go and you have all these panels and you decide you know, you do all this daily surveys and all the nurses decide what is good for the patients but have we really asked what the patients want? Because we, we probably fall into the, the medics trap, they do tend to do things-, I’m not saying they’re not important for the patient but they do it from their perspective. And now we as nurses, we go and do it from our perspective but what do we do from the patient perspective?

And that’s where I’m, that’s where I’m quite keen on patient experience and patient-, their say.

Simona emphasised that employing organisations should recognise the importance of providing research nurses with adequate office/desk space.

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”.