Sugrah

Age at interview: 48

Brief Outline:

Sugrah is a clinical research nurse coordinator. She has been in research for six years and continues to do bank shifts. She feels there is a lot of encouragement as well as opportunities in her unit to continue developing research experience.

Background:

Sugrah is a clinical research nurse coordinator. She is single. Her ethnic background is British Pakistani.

More about me...

Sugrah is a clinical research nurse coordinator. She has been in this role for three years and in research for a total of six years. She has mainly worked on paediatric intensive care studies and is currently dedicated to a large feasibility study about using a wireless technology to monitor health deterioration. Before working in research, Sugrah was a ward nurse specialising in paediatrics, which she “loved”. After a ligament injury meant she was unable to be on her feet for some time, Sugrah found a position at a research network. In this role, Sugrah supported and facilitated research across several Trusts in her region. She worked on studies sponsored academically and commercially, including drug trials, blinded studies, and pharmacokinetic studies – the activities across these have given her a “broad overview of different parts of research”. She enjoys her job and likes feeling that she is “making a difference”. 

When she began working in research, Sugrah didn’t have many expectations of what it would involve. One difficulty she found when starting the post was learning the acronyms used; over time, she has become more familiar with these. She also had to learn how to use the technology involved in her current study, but appreciated that “there was always someone on hand that we could call on”. In her current role, Sugrah is involved in screening and approaching eligible patients (children), explaining the study to them and their families, and then following them up at a later date to take consent and commence study activities. It is important to Sugrah that the children understand what is happening and have a voice, including being able to make their own decision about participating or not: “I think that’s our job to […] make it easy for them to also say ‘no’ if they really don’t want to do it”. Sugrah also follows up patients who are already on the study. This can involve changing batteries, checking sensors are working, and ensuring that there are no other problems affecting their participation or the data. Having “quality time” with patients and their families is something Sugrah really enjoys and finds rewarding. Sugrah also ensures that paperwork is kept up to date.

Sugrah feels her job has offered her lots of opportunities – including things “I never thought I’d be doing”, such as contributing to study protocols and amendments, writing abstracts and conducting thematic analysis of data. Sugrah values this and thinks it improves the quality of research: “[you can] be involved in the whole process so that the study is not just an idea, the practicalities are considered before we send it off to ethics so that it will actually work in practice”. She is encouraged to go to conferences and participate in events around the research area. Sugrah is supported to pursue training and qualifications, and has been awarded a Bachelor’s degree through taking modules with the support of her job. Although Sugrah felt she was “thrown in the deep end with some of it”, she welcomed the challenge as the team encouraged progression and professional development of the staff. She has been well supported by colleagues, particularly her Chief Investigator (CI)/Principle Investigator (PI) and line managers who offer expertise on different areas. Similarly, Sugrah feels able to approach the PIs of her study who are available to answer questions, and help staff manage workloads. When she has found herself without time to do certain aspects of her role, they have been receptive to her needs: “it takes away the stress factor because you are being given the time you need to, and being given the support you need”. Sugrah values her working environment and feels it contributes not only to maintaining good health but to excellent standards of work: “it makes you want to do more, you then go that extra mile”. 

To maintain her clinical skills, Sugrah continues to do bank shifts and she values this on a personal level too because “I still feel like a nurse”. She thinks that maintaining clinical skills is important for when it is busy on the wards because the research team can step in to help. Sugrah has found that this has helped foster productive and mutually beneficial working relationships with the ward staff who then aid recruitment and put sensors on patients. Although Sugrah doesn’t feel that everyone understands what research nursing involves, there is good awareness within the department the research is taking place. Throughout the duration of the study in the past three years, and understanding of the importance of research to introduce new ways of monitoring and improving care has increased amongst the staff on the wards.

Sugrah is currently on a fixed-term contract owing to the funding of the study: “that’s the drawback in research, but I understand why it’s like that”. Although Sugrah is hopeful that her contract will be renewed, she is keen to keep “family friendly hours”. She has completed training to become a research and training facilitator, and is waiting for approval to teach Good Clinical Practice training. Although Sugrah is not interested in managing large teams of people, she would like the challenge of being the lead nurse on the next phase of the project she is currently working on, “from feasibility to seeing it implemented across the hospital would be an achievement”. Sugrah thinks research nurse jobs are especially well-suited to people who are “meticulous”. She emphasises that she hadn’t previously thought of herself as “academically minded” and this shouldn’t put off other nurses. Sugrah’s key message to research nurses new to the role is to “treat it like you would anything you do as a nurse on the ward, get to know your protocol, check it for yourself. Don’t just go by what someone says. Even though its paperwork and you might not think it’s as important as checking a drug but it is in research. I need to see it for myself and check that that is actually how and what we should be doing according to the protocol. Follow your GCP training. Acknowledge errors. It is a learning curve. We all make mistakes at some point, the main thing is learning from them. Most of all if you don’t know something, it’s ok to ask.

The use of abbreviations and their meanings was unfamiliar to Sugrah when she started in research.

When I first ever came to research, it was horrific. Because as a nurse, you’re taught not to use acronyms, and then you come to research and you’ve got-, at the beginning of the protocol, like a couple of pages of just-, it’s like ‘oh my god’. And we used to laugh about it. ‘Cos in my previous job, I was Clinical Research Facilitator, then you had your Case Report Forms, which were also CRF’s, then we had a Clinical Research Facility, which also a CRF, so we used to laugh about it. “Okay there’s a CRF in the CRF writing a CRF”.

[laughs]

[Laughs] So it was like, how many CRF’s are there? Case Report Form, Clinical Research Facilitator, Clinical Research Facility, and then there was all of the others. And still to this day there’s some that I get tongue twisted with.

Keeping up with data management was an important part of Sugrah’s research activities. These efforts were praised at a recent monitoring visit.

So we would do that, so basically your day was gone by the time you’ve finished approaching, recruiting, consenting patients, recruiting them, setting them all up and then putting them onto the database, recruitment logs, everything.

So, the days were very busy, writing in the medical notes, so that was it was basically from the start of the study it was start as you mean to go on. So, we never left, we did not leave anything “Oh we’ll do it later,” it was like anything you could get done, get it done there and then. So, it’s done, completed and move on. And if anything for any reason could not be done we would leave a note on our handover sheet for the next person to pick up. So, it worked really well.

Recently we had a monitoring visit and we were told our team effort [with the Trial Master File (TMF)] was beautiful. Considering we had over 1,200 patients, we have all our consent forms filed in order and everything the filing has been like I said we started as we meant to go on, and it has been very clearly documented that folders are clear, what’s in what. We don’t keep consent forms in the TMF but we have file notes for any document that should be in there that is not in there, stating where it is, and why. So that worked really well. We had an excellent system.

Sugrah felt her research nurse and study coordination roles had given her a lot of learning opportunities.

My learning has been, over the past three years has been huge, phenomenal [laughs] is a word I’d like to use. Because I feel it has, has developed me in ways like, you know, what writing abstracts and doing thematic analyses and cognitive interviewing - I wouldn’t have, I wouldn’t have thought myself doing all of that. But now, you know, and the team, I feel the team is very good here in the sense that you are involved in all of it. When the protocols-, when we were writing protocols for the impact study I kind of did it in-, helped kind of format it and had a lot of input in it from the practical side of what would work and what wouldn’t work. So, you are involved, encouraged to be involved in the whole process so that the study is not just an idea, the practicalities are considered before we send it off to ethics so that it will actually work in practice and it’s do-able. So, you know, literally writing part and editing all the protocols for amendments and things like that. I never thought I’d be doing that years ago. So no, I feel that I’ve learnt so much more.

In paediatric studies, Sugrah saw it as her role to advocate for the child or young person.

And then there have been times when you are telling them about it and they’re a little bit guarded, and then you let them know that it’s voluntary, they’re in control, and it’s amazing when you see just the expression, everything, the body language change because they know, and it, it turns it around, they actually say yes. Because they’re given the control, like this is voluntary, you don’t have to, it doesn’t affect your care. And even with the youngsters, and you see it on their face, then it’s, where we advocate for them, so I can see on his face he doesn’t want to do it, and you say, “It’s okay to say no, if you don’t want to, it’s alright,” and they’ll start laughing and will say, “I don’t want to,”, “That’s okay.” And I think that’s our job to make sure that they actually, you know, we’re not making it hard for them, and we make it easy for them to also say no if they really don’t want to do it. And if you’ve got a youngster, Mum and Dad want it, and they’re like screaming, ripping it up and throwing it at you, you’re not going to do it. You’re going to take it away and say, “No they don’t want it.” I know Mum and Dad do, but they don’t want it. They’re saying no in their own way, and that’s our job, we need to make sure that we take that on board, and you know we represent that child.

Sugrah worked in a very supportive research team. Even though there had been very busy times, she hadn’t felt “under too much pressure”.

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.