Vicky

Age at interview: 47

Brief Outline:

Vicky was a research nurse in a university clinical trials unit for five years. She has worked on studies with varying methods, topics, settings and participant groups. She is currently undertaking a PhD and is keen to pursue a nurse researcher career.

Background:

Vicky is a nurse researcher (previously research nurse). She is married and has children. Her ethnic background is White English.

More about me...

Vicky describes her career as having “two halves”: first working clinically as a critical care nurse and then as a researcher in a clinical trials unit. She initially became interested in research nursing after moving to a critical care unit with an active research culture, and she liked “the idea of a new challenge”. Vicky started a Master’s degree and came across a post looking for a research nurse. This was a new role for Vicky and a new type of post for the employer (a university clinical trials unit), who were running a study which required more in-depth involvement in a study than perhaps Clinical Research Network (CRN) research nurses could provide. After several years as a research nurse, Vicky was keen to draw upon the research knowledge and skills she had acquired to “pursue a research career of my own”. She is no longer employed as a research nurse. She was successfully awarded an NIHR-funded doctoral training fellowship, which she is about half way through completing. Vicky hopes to use this as a “springboard to new opportunities”. 

Vicky found adapting to the role of research nurse a challenge. There was little training available which meant she had to develop the remit of the job and identify training needs herself – a responsibility which gave her a lot of freedom but was also a bit “scary”. The transition meant becoming familiar with terminology that “wasn't my everyday language” and reconfiguring aspects of how she identified as a nurse, such as by “understanding that you're not part of the clinical team directly, but obviously you need to work with them very closely, and again, your ultimate goal is to make sure that the patients who are participants in your study are well cared for”. Initially, Vicky’s main activities were to provide information to potential participants and collect data. Being in a clinical trials unit meant exposure to a wider range of research designs and Vicky enjoyed this variety. However, it was difficult working in settings where she had not worked clinically before. She found some environments, including care homes, had different practices, routines, styles of communication and paces to adjust to.

As Vicky became more experienced, she gained more responsibilities in her research nurse role – for example, helping design participant information leaflets, protocols and training materials for research staff. She learnt a lot about “working across the whole lifespan of research” and how to support others’ studies “from the original conception of the idea, through to developing a funding proposal and if, hopefully successfully funded, then to helping conduct those studies”. Vicky started her research nurse post on a fixed term contract but this eventually changed to open-ended which means that, when she has completed her PhD, she will have a post to return to. Vicky felt there were some benefits to being a university-employed research nurse, as opposed to being Trust or Clinical Research Network employed. She explained that there are still work pressures but that “they have a different nature to them” and that the university setting potentially gives more options or freedom around research approaches and available resources.

For Vicky, nurses have a lot of skills which are relevant and transferable to research. This includes being able to “understand the [clinical] language used, navigate our way round clinical notes, perhaps more than a researcher who’s not got a clinical background”. Vicky thinks research nurses often have a good understanding of the pressures clinical staff are under. In the past, she tried to develop good relationships in the sites where she was recruiting and seeing patients, including by visiting often to have a “visible presence there” and making herself available in case staff had any questions about the studies. She thinks telling staff about study results at an early stage is also appreciated. 

Vicky suggests that research nurses should be organised, self-reliant, good communicators, flexible and have a good grasp of teamwork. She thinks that, for many nurses, research has a reputation as being on the fringe of clinical work. Vicky is glad there is growing recognition that “actually research underpins everything that we do as clinicians”. She sees research as still caring for patients but on a different scale by aiming to “influence the care of a larger number of people when it can be applied to different clinical settings around the world”. Vicky believes research nurses have an important role in “translating the research world into the clinical practice world, and back”. She also encourages more people to consider becoming nurse researchers to further develop the evidence base around nursing.

Vicky saw research as a way to benefit patients, but on a different scale and timeline.

I guess how I think of it a little bit is that rather than when you're working in the clinical setting, so you're looking after patients, you're able to directly care for them. Whereas research enables you to take a step back, but probably to influence the care of a larger number of people when it can be applied to different clinical settings around the world. So it, it sort of continues my interest in helping to improve patient care, but indirectly. But contact with probably a larger number of people. Sort of going forward in the future.

For Vicky, research nurses make connections between people and enact the research on the ground with patients. As a nurse researcher, she is involved in other activities too, such as study design.

So there's lots of research activity that requires more time and different skills than other roles within a research team could, could actually do. So thinking in terms of the PI, they perhaps have limited time, working across lots of different studies. Whereas a research nurse actually can have a bit more time to develop a relationship with participants, to actually as I say collect contextual information about the experiences of people taking part in the study, and how the study is received by potential participants. How it actually works on the ground. So you might have designed the way that data is collected but actually in practice when you see how it's collected and you have experience of collecting that data, you can see it's quite different. Which can help not only that particular study but also when you're designing studies in the future. So you can, you can sort of tailor how you collect data, for example, based on your knowledge of how it might work in that situation. But also as I say understanding that the patient experience varies in different populations. So it might be a population you have particular experience of or it might be a particular study design you have experience of, that you can contribute in that way as well.

And you can also [sigh]. I think part of the role is that sort of translating the sort of research world into the clinical practice world and back. So that can help both how the study is conducted in practice, but also how studies can be designed as well. Bringing that sort of experience back into the, the sort of research team as well. So you, you have a sort of translation role a little bit, if you like. And that can be everything from sort of language used, to how things work or don't work.

Vicky joined a university unit as the first research nurse they had employed. It required her to think carefully about her role and training needs.

So I was the first person, the first nurse really to work in our unit. So it was quite a unique post, that had been created specifically for study that needed more research nursing input than could be provided from perhaps research networks that might normally support studies. So I was the first one really. So I had an induction as a researcher but not as a research nurse directly. But that provided the opportunity to develop the role myself, and to look at perhaps what training needs I might need, and how the role fitted alongside other existing roles.

And I guess that was probably quite a scary point, really. So moving outside the NHS and being used to having qualified nurses, registered nurses, around you at all times. It was quite a, a, a thing really to step away from that. And to understand that the responsibility really to develop those, that role, those training needs, rested with me. Obviously in conjunction with my line manager, and other members of the research team. So I looked sort of at other research nurse roles and responsibilities and what sort of training they might have. And the sort of competencies that might be involved in their role. And then looked at how I might incorporate some of those into my role as well.

As a research nurse, Vicky was involved in many activities as part of a trial for children with glue ear.

Some of the studies have been recruiting participants, as I say, for a medicines trial. And those were children that had been recruited, to take part in a large study. And so talking to parents coming into outpatient clinic about what would be involved in the study. The clinician would be taking informed consent, and I'd be sort of providing information, supporting the parents and the children through that process.

And then, yeah, collecting all the study information. So, baseline data prior to them receiving the trial medication. And then seeing parents and the children at follow-up appointments as well. So most of that was sort of validated questionnaire scales. But also collecting diaries that the parents were returning. And medication that the parents were returning, unused. And there were also clinical assessments done, in that case by audiologist. So I'd be helping to sort of coordinate that and ensure that the data collected during the clinical assessment was then recorded for the purposes of the study. 

And checking sort of notes, entries, and those sorts of things.

Vicky felt it was important to recognise the clinical pressures that her colleagues were under and to feed back study results to them.

It's very much about communicating and getting to know the clinical team well. I think that helps a lot. Understanding the sort of clinical pressures they're under. And that's where I think you bring some of your knowledge and expertise from a clinical setting into that as well, so you understand that, you know, they have huge pressures on their time. And their- the part that they role-, play in the research study obviously is only part of what they do the rest of the time. So being able to be quite flexible and adapt, and sort of fit into their needs, and communicating to them what you need and what you can provide to them. But a lot of it is about establishing good relationships. So having continuity. So for example, the children's study, going back to outpatient clinics regularly. So, making sure I had a sort of visible presence there. And that I was available if they had any questions, outside of the sort of direct consultation they were having with parents and the children who were participants as well.

And throughout- again, throughout the lifecycle of the study as well. So they've been involved in hearing the results about the study presented back at a seminar we held. So they had the opportunity to hear the results at an earlier stage, and to feed back what the results might mean to them in practice. Which helped sort of shape how we then presented the studies in publications as well, knowing perhaps what sort of clinicians who would be the end user of the message might feel about our findings.

Vicky’s supervisors and line-managers for her research nurse post were not nurses themselves, so she felt it was important to explain about her professional role and needs.

So whilst I've been in a research nurse post, none of my supervisors or line managers are nurses. And again, that's unusual. So, going from working in the NHS where obviously you have quite a clear line management and hierarchy who are all nurses at various levels. Now, it's not. So it'd be a senior research fellow, for example, or a reader in the university. So again, perhaps taking time to explain what my role is, and how that differs from other roles that they're used to managing and supervising. So it- the sort of onus falls to me, I guess, a little bit, to explain more about my role and my requirements in terms of sort of professional development and registration and those sorts of things that are perhaps unique to my role compared to other roles.

Vicky outlined some of the changes in her work life when she moved from a clinical to research post. This included shift patterns but also hours and having work-life separation.

So when I was working clinically, it was 12 and a half hour shifts that could be days, nights, weekends, weekdays. And then when I moved into a research post, it's Monday to Friday, effectively nine to five. Although it's flexible, in terms of hours worked. And also changed from 37 and a half hours, if I were to have been full time. I was part time, but to in my post now of full time, is 35 hours a week. But it brings different aspects to it as well. So obviously when you're working clinically, whilst you might access email a little bit as part of the role, it's not a big part of my role. Whereas now, the boundaries I guess between working hours and not working hours is a little bit different, in terms of accessing email and working on paper-writing, and those sorts of things, which inevitably fall outside working hours. So it, it's different.

Once Vicky has completed her PhD, she hoped to use it as a “springboard”. She planned to develop a postdoctoral fellowship application and carry out more research projects.

I'm halfway through a fellowship. And so that's funded for me personally to work on a project that I designed, that incorporates a number of different studies. So some of those I've completed already. One I'm partway through. And then the next stage will be to develop a complex intervention that I'll be looking to do some acceptability and feasibility testing, towards the end of my fellowship. It's a doctoral fellowship as well, so it's my PhD project so I'm writing up a thesis as I go along as well. So there'll be that to submit at the end of my fellowship as well.

But it's a matter really of looking for how to progress some of that work, but also my own research career from here, using that opportunity I've been given really as a sort of springboard to new opportunities. So I'll be looking to develop a postdoctoral fellowship application and perhaps to do some individual projects, research projects, to help develop some of the work I've already done. To eventually hopefully have a sort of independent research career, so to lead this sort of programme of research that's sort of built on my own work.

Vicky thought there was growing understanding of the value of health research, and how it complements and can be embedded with clinical work.

So I think research sometimes has a reputation as something that is on the sort of fringes of clinical work. That it requires a lot of high educational achievement to take part in, that it's only for some people, that it's not for everybody. But I think as there's a greater understanding that actually research underpins everything that we do as clinicians, it becomes more embedded. Research activity becomes more embedded in the clinical roles. I think there is greater awareness of research roles. And also perhaps understanding that that can be part of your clinical role or actually you can take on a much more dedicated research role, either in a shorter term or longer term, that actually provides different sorts of opportunities in terms of career development, beyond that, that perhaps are linked to a particular speciality or particular role.