Research Nursing…it’s not just about the coffee
So, you’ve landed a job as a research nurse. One of those cushy 9-5 numbers where the biggest challenge of the day is whether or not to have chocolate sprinkles on your cappuccino, right? Well maybe not…admittedly, research nurses do generally escape the antisocial shift pattern that so many ward nurses endure, but there are plenty of other people working similar hours in the health care system, so I am not sure why research nurses are singled out. Sadly, the misconception that research nursing is somehow the easy option is still too readily subscribed to by some of our healthcare professional colleagues. I can only assume that it’s just because they don’t fully understand the complexities and challenges of this exciting and rewarding role.
It is perhaps easy to forgive those who interpret the autonomy of the role of the research nurse as the freedom to do (or not do) what we like, without the traditional pressures that face our ward based colleagues. However, the pressures are very real, just different. Being a research nurse requires balancing a whole range of diverse responsibilities, often requiring us to act as educators, advocates, caregivers, decision makers, secretaries, counsellors and pack horses – sometimes all at once…not so different from ward or clinic based nursing roles!
Of course, the nature of our roles is often such that our ward based colleagues don’t get to see us in action, so the mistaken image of research nursing persists. Maybe this quick view of a day in the life of the research nurse might help everyone understand what research nursing is all about and what research nurses get up to on any given day.
As with any nursing role, research nurses are also patient focussed. We may not always provide care to patients in traditional ward environments; but we are constantly using our nursing skills and expertise. Firstly, we need to understand the requirements of any research protocol we are recruiting to. That may require familiarising ourselves with new techniques for administering treatment, or processing samples, communicating with other departments about requirements that may be specific to the trial we are running, and addressing any logistical issues that may arise.
And of course, we need to recruit patients. Clinical trials need to recruit patients to demonstrate effect, and it is research nurses who are central to this process. As well as spending time in clinic identifying potential patients, we are also often expected to implement innovative and effective recruitment strategies.
Once appropriate patients are identified, we will spend time talking patients through complex procedures and interventions, supporting them in their decision making processes and ensuring they are appropriately informed to give consent for treatment. This is where our skills as patient advocate come to the fore, balancing the pressure to recruit to target whilst making sure that patients feel able to say no to taking part.
Having recruited a patient we need to be coordinating tests and interventions to ensure they are suitable to receive the trial treatment – Coordinating 3 or 4 different departments to see 1 patient on the same day is a challenge that Tetris masters would struggle with – but we want to make things as easy as possible for our patients, so we continue trying to coordinate appointments to reduce the need for additional hospital visits.
Once your patient is ready to receive treatment, even if you are not administering the treatment, then there is still plenty to do on the day. Pharmacy will need to be aware that they need to make up a trial treatment, the staff administering the trial drug will need to be aware of the requirements for that trial – should there be extra observations over and above the standard? Are there blood tests that need to be done at extra time points? What tubes should they be collected in? Who do they ring if there is a problem? What if the patient needs something like a painkiller – is that allowed in the protocol? The research nurse has responsibility to ensure that everyone involved is fully informed and equipped to perform their individual roles. And what if something does go wrong? Then it is the research nurse who is at the end of a bleep to respond and problem solve. Even if it is 5pm, suddenly your cushy 9-5 number is turning into a 12 hour day.
Once your patient has finished their treatments – and that could be anything from days to months, you will be seeing them in clinic on a regular basis as they continue into follow up. The relationship between research nurses and their patients is such that it will be you they ring with any questions or problems they encounter.
This is already sounding like a busy role to me. And I haven’t even mentioned the accompanying paperwork – whether paper or electronic, it takes time to accurately and thoroughly complete case report forms for each patient at each visit AND of course the various educational requirements – regular PREP, mandatory training, as well as ICH-GCP training days and protocol specific training. Time management is one of the first skills a successful research nurses needs to acquire.
So, take in to consideration the fact that most research nurses are working on several protocols at once and have a number of patients on a study at any one time and I think we can safely say that research nursing is not the easy option! So let’s here it for research nurses and the fantastic opportunities this field offers nurses who want to expand their knowledge and skills and help to develop a scientific evidence base to help our patients receive better treatments which will lead to improved outcomes. But for now I don’t know about you, but just reading this has worn me out, I think I need a coffee…..now shall I have chocolate sprinkles on that?