Nurses, midwives & allied health professionals in research
Why move into research as a nurse, midwife or AHP?
The motivations to move into research as a nurse, midwife or allied health professional (NMAHPs)* varied for the people we spoke to. In addition to talking about the value of NMAHPs to research, they often gave multiple reasons behind their individual decisions to take up a research role. These included factors which ‘pushed’ them away from their previous roles/posts and those which ‘pulled’ them into research.
Michael had come across research nurses when working on cancer wards. He was initially drawn to the working hours but, once in the role himself, found it very rewarding.
Michael had come across research nurses when working on cancer wards. He was initially drawn to the working hours but, once in the role himself, found it very rewarding.
So motivation initially to go into the role was to get back into cancer care and to have a period of life where I could have nice working hours. Motivations now, having worked in it, is that I get to maintain all my clinical skills. If anything, my clinical skills are enhanced because you have to do the, the next level of intermediate life support because the drugs are so unknown and there is so many risks with them that you need to be fully trained and fully aware of what’s happening clinically, and how to manage that. but equally there isn’t really many night shifts. I have had to do two night shifts though. For some of the drugs where we didn’t get to start the drug until late, and then the series of blood tests that you take run on into the night. So there have been the odd night shift but we can, we can cope with that.
So motivations really to stay in it, is that I like the research side and really I get, I get to be a full-blown cancer nurse and in some respects a specialist cancer nurse.Simona described the combination of ‘push’ and ‘pull’ factors which led her into research.
Simona described the combination of ‘push’ and ‘pull’ factors which led her into research.
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].Libby had always been “a questioner” but hadn’t known that research was an activity that was open to physiotherapists.
Libby had always been “a questioner” but hadn’t known that research was an activity that was open to physiotherapists.
And when I found out that it was I couldn’t think of why, you know, anywhere else that I’d rather be really. It really, I mean aside from practically it ticks a lot of boxes, I just, I love the fact that I, every day is different, I like the variety, I like the fact that I work within a, a team of people that are in a way just like me questioning, you know striving to get the best, information, treatment, whatever we’re doing. We all seem to have the same goals. It’s great, I love it.
Wanting a “change”
Many were drawn to research roles in search of a “change”, “challenge”, and something “new” or “different” to do. For some, this meant moving into a new speciality at the same time as adopting a new role. Others were keen to stay in (or return to) a clinical area they had worked in before but to try a different role and develop new skills.
In some cases, the change was about staying in their profession but redirecting their career. Instead of progressing into more senior clinical or managerial routes, research represented an alternative direction. This was important for Gavin, a podiatrist, who felt his specialism had quite a “flat structure career-wise”. For Katherine, pursuing research as a speech and language therapist felt necessary when she relocated to a small Trust in a rural area as “the [career] horizons had shrunk quite a lot”. Research careers were a route for some people to fulfil key ambitions. Osi remembered thinking that she wanted “to be the person… actually writing those [clinical] guidelines as opposed to just the person that’s doing them”.
Others were drawn to research careers out of frustration with their previous careers. Some, like Paul, felt the climate of the NHS meant that they were unable to do their best for patients: “I was a little bit disheartened in nursing”. Abi felt constrained by tight time limits with patients in clinical practice, whereas her research jobs had provided more scope for using her professional skills.
When Layla felt “ready for a change”, her decision to become a research midwife was a gradual one.
When Layla felt “ready for a change”, her decision to become a research midwife was a gradual one.
Christine hoped that a move into a research job might revive her enthusiasm for nursing.
Christine hoped that a move into a research job might revive her enthusiasm for nursing.
So, that was really- it was more a case of it sort of found me really through a friend. And then I had to sort of find out what it was about, because I had no real idea. Cos it wasn't anything I had really looked into it before.James reached a point where he felt research was the best direction he could take to help patients.
James reached a point where he felt research was the best direction he could take to help patients.
I felt sometimes standards of care were not, not reaching ideal. Sometimes it was quite substandard. And it was hard fighting against, fighting against the system really, to get what you wanted, to get what's best for your patients. You know, to- To sort of stand up and say 'I want this, I want this, these patients deserve this', and be pretty much told 'we haven't got resources to deliver it that way', you know, 'your ideal isn't realistic'.
And after sort of a long time of finding yourself uncomfortably struggling through that, you kind of think 'well, I can't make a difference, maybe it's someone else's opportunity to get on and have a go - maybe my way isn't, isn't the way to do it, so have a look at making a difference in a different way'.
Pressure and shift patterns in clinical work were a ‘push’ factor for many. Louise felt that, as she got older, the length of shifts and/or working nights became too much. Tabitha found “the clinical world… extremely stressful and it was just too much to be honest”. In contrast, research roles usually meant moving away from shifts and did not usually include weekends or evenings. James and Nikki liked that their roles (in nursing and physiotherapy, respectively) provided flexible working.
Significant changes in people’s lives were also important factors. These included being diagnosed with an illness or injury, redundancy, having childcare arrangements to consider, and family bereavement. For Sugrah, Claire and Simona, the physical demands of clinical non-research work and the hours involved became too much. Ellen found a research nurse post after her ward was closed down with restructuring. Some sought research delivery roles to change their working hours for more flexibility, shorter shifts and/or within weekday daytimes (rather than work frequent weekends, nights and evenings)
Ginny enjoyed research from her midwifery training onwards, but the working hours were a major attraction to her first research nurse job.
Ginny enjoyed research from her midwifery training onwards, but the working hours were a major attraction to her first research nurse job.
So [laugh] one of the, so the research job seemed a really brilliant idea, attractive because of what it was as in doing research in a kind of nebulous way but frankly one of the reasons to do it was to get out of shift work as a midwife which, and I’m in my early fifties now so this was, I was probably early forties I don’t mean it’s just age but it’s certainly-. I did midwifery kind of clinically for about not that long maybe five or six years I guess really by the end and it’s just exhausting and yeah a really, really, really, really hard job and I had children growing up and things like that and I think one of the reasons I wanted to move was to get out of that environment. But it’s not just the kind of physical tiredness about it I think it’s just a really difficult job I completely [laughs] hats off for admiration to anybody who can carry on doing it but it’s so hard. So that was another reason really was to kind of find something to do that wasn’t that shift work, endless repetitive exhausting terrifying work it was doing something else. So I’d love to be able to say it’s all nobly wanting to do research but that wasn’t really the only reason.
Views on research and research staff before they started
Some people had been interested in research for a long time. Julie and Rachel X recalled enjoying learning about research in their professional training, others had their interest sparked during a Master’s degree. Jed, Ginny and Alice all recalled knowing that they wanted to pursue research in some capacity in the future. For Gavin, it was a case of finding funding to support him doing so.
However, others had held negative attitudes about research and research staff which initially put them off working in the area. Often people suggested their dislike of research had been rooted in their experiences of education – including their professional training. Some were concerned that research roles would be too difficult or not suited to them; Sandra initially thought it sounded “complicated” and Louise was hesitant about it being overly “academic”.
It could take a while to shed negative attitudes about research. Sian described having a “lightbulb moment” when she realised how exciting health research could be. Some came to see that they could use the skills they had developed practising clinically in a new and productive way through research. Sarah enjoyed the patient contact as a midwife, but felt that being a research midwife would allow her to contribute in a more “strategic” and “goal-oriented” way.
Alison’s motivation to practice midwifery and carry out research went hand-in-hand.
Alison’s motivation to practice midwifery and carry out research went hand-in-hand.
Well, I suppose it begins before that because really I think it was always programmed to work in research or change. So, the whole drive for me to become a midwife was to contribute to the improvement of women's health globally, which sounds lofty and whatever, a huge sort of task. But my way of doing that was through becoming a midwife because I wanted to have a practical skill, but it wouldn’t end there for me. Before being a midwife I'd done a history degree and I was always interested in contributing some improvement globally.
So, I wanted to match that sort of ideological pursuit with having a hands-on skill, and midwifery's the window through which I've done that.
So, it was always sort of a presumption that I would go into midwifery and want to take part at another level.Research practice was not presented favourably when Osi was training as a midwife. Even so, she enjoyed her dissertation and wanted to do more research.
Research practice was not presented favourably when Osi was training as a midwife. Even so, she enjoyed her dissertation and wanted to do more research.
As a student midwife, Rachel X had been on a placement with a team of research staff.
As a student midwife, Rachel X had been on a placement with a team of research staff.
And again, even at that stage I knew that I wanted to do research. So, I think maybe I was very receptive to it, so I really enjoyed it. I think it’s a little bit like marmite though cos I’ve seen that with, with some students that come through now, they either really like it, or they absolutely hate it. I think a lot; some people think they don’t know why they’re there. They don’t really see the point, you know, of doing that. Whereas others they, we had some nice feedback of, some students, saying I never realised that this was a career option, but I’ve, I’m really, really keen to follow this now. So I really enjoyed it, and I, I enjoyed shadowing them, and I enjoyed going around different areas of the hospital and as a newly qualified midwife as I was, so I got a job in [hospital name] but I also did an application for a research midwifery role as a newly qualified midwife, I think slightly naively, cos I thought I really want to do it, and it came up so I thought I might as well apply. And I got an interview, and they said, “Oh we really like you, and we like your enthusiasm, but I think you’d better go and do your first year of midwifery first and then, and then try and look into a research role.” So, it’s, it’s something, every step of the way that I’ve been looking at.Jo had a friend who was a research nurse whom she asked about the day-to-day activities in the role.
Jo had a friend who was a research nurse whom she asked about the day-to-day activities in the role.
Well you see she, I always knew what she did but I was like well can you exactly tell me what on a day to day because I can’t quite understand what you do. And so that’s exactly what she did and she, I said just explained what a typical day is and then I’ll know where you are. And so she told me you know, that they run certain trials looking at different things running treatments, you know, different treatments against standard care and then measuring outcomes and all that kind and I thought oh that sounds, you know, interesting, worthwhile. So maybe it’s something that I could get involved in.
Several people had been involved in relatively small research activities when they were working fully clinically, which gave them a “taste” for more. Barbara had valued the opportunity to “dabble in research”. Rachel Y and Nikki talked about getting “the bug”. Graham took on more research opportunities after his secondment ended and whilst still working as a frontline paramedic; this became “an evolution of one thing which led to the other”. Although not the same activity, Dawn’s involvement in an audit kindled her interest in a research delivery role.
Julie had enjoyed her dissertation as an undergraduate. She took opportunities to become involved in auditing initially and then in research data collection.
Julie had enjoyed her dissertation as an undergraduate. She took opportunities to become involved in auditing initially and then in research data collection.
And then so when there was an opportunity in 2000, 2001 I took on an audit role initially and again, the-, I know obviously audit is very different to research but the principles about the following a process, examining what you do, looking for improvements – I think those principles do cross over, and so actually that kind of led to that interest. And then I got the opportunity to do data collection for a big study, and it really was data collection, but I really enjoyed it because I like-, I think like a lot of research nurses, we like detail, we like a systematic approach, we like to be able to tick things off lists. It’s a very structured approach to things, and that really appealed to me. So then obviously then I had a period of time where I wasn’t doing research, and, but the idea of getting back into that was quite appealing. Laura X felt proud to work in a setting that was research-active and supportive of staff pursuing higher education.
Laura X felt proud to work in a setting that was research-active and supportive of staff pursuing higher education.
I’m really lucky because I’m in a department that’s really, that’s got a huge focus on research, and my, the educational lead he wants everybody to be educated to Master’s level, so he is really pro any opportunity that comes up for nurses to have an opportunity to study at Master’s and PhD level. So, for me there’s been huge amounts of support to support my roster around it, and also because he has done a PhD himself it’s actually quite good to have that, to talk about my research proposal in practical terms.
People describe the many different routes into research jobs and/or qualification schemes. A few described having supportive managers or other types of mentors who guided them in this direction, or at least did not stop them from pursuing research interests. Helen and Dawn were “headhunted” by clinician colleagues and encouraged to apply for research posts.
Many had seen advertisements for research delivery jobs in a casual or opportune way – in leaflets, online or health professional magazines. Christine felt that, in some ways, the job “found me” rather than the other way around.
Rachel Y’s manager encouraged her to complete a Master’s degree and helped her to establish a researcher role in radiography.
Rachel Y’s manager encouraged her to complete a Master’s degree and helped her to establish a researcher role in radiography.
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.Across her thirty year career as a physiotherapist, Karen found ways to carry out research within her clinical job.
Across her thirty year career as a physiotherapist, Karen found ways to carry out research within her clinical job.
I’ve had people who’ve been supportive just in that almost they’ve turned a blind eye and let me do it, and haven’t interfered, and that is great support, cos the worst thing you need is somebody who’s going to be constantly trying to put you back in your box. So, I’ve been, I had, you know, my early career, several physiotherapy managers who, they knew I was doing this sort of thing, but they didn’t do anything to stop you. I wouldn’t say they did anything particularly to encourage me, but they let you get on and do it, as long as you were doing the rest of your job as well.
Expectations and realities
Often people had had little exposure to research before they took on these roles, so they sometimes arrived with misconceptions. There was sometimes a mismatch between their expectations and the reality once they had started. Claire had not known about the difference between research nurse and nurse researcher roles when she took a job as the former, so she had expected there to be more opportunities for carrying out her own studies. Others had not known what to expect when they moved into research. Many NMAHPs said there had been a process of adapting to their research roles.
Footnotes
*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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