A view of the role of the research nurse from McGill University in Montreal.
I recently visited Montreal and had the opportunity to meet with Linda Chin at McGill University research nurse working at Montreal’s newest hospital.
Well, I was an agency nurse in oncology when their research nurse left. They asked me if I would be interested in taking on the research nurse role and I was ready for a challenge. It was tough at the beginning, I am the only McGill research nurse in the department so I had to teach myself the role by looking back into the notes to see what the previous research nurse did, what she wrote, what her focus was. Over time, as I learned more about the role and the field, I fine-tuned my approach.
How would you describe your role today?
I am very much a nurse in the sense that my focus is the patients. I do line care, dressings, blood draws when needed. I do not deliver the chemotherapy but I will do other nursing tasks (in Linda’s unit the chemotherapy nurses deliver all treatments. They are not GCP trained but they are given a brief teaching session about the new unlicensed drugs and they have a ‘cheat sheet’ about the study drug which they can refer to as needed). I am also the main point of contact for patients so they call me when they have a problem or a question. I feel a big part of my role is to make patients feel safe so patients are free to call me whenever they wish. You would think that maybe patients would abuse this but they don’t. I rarely get called out of hours but I think knowing that they can call me makes them feel more secure. I see patients at their visits, I ask about compliance, side effects, and I collect the data needed at each study visit. I am also very involved in the informed consent process once the initial introduction has been made by the doctor.
What are the requirements for a nurse to become a research nurse?
They prefer you have some clinical experience in the area and some research experience but as you can see with my role, that is not always the case.
I have no cover so I rarely take long holidays. They are looking to expand the team and I look forward to having a colleague so we can offer each other some cover and feel better taking time off. My employer is great at allowing me to carry over all holiday time I do not take so I am happy with that for now.
Another challenge is when patients come off study. It is difficult to just let them go and so I often get involved somewhat with those patients which has an impact on my workload.
I also think PISs are getting too long and it is too much for patients to take on board. The side effects can also seem terrifying but I tell patients to go home and read their little sheet in the aspirin box; if they read that they would likely not take that either as it would seem too scary. I try to get them to see the risks and potential benefits clearly and I let them know that we follow them quite closely to pick up anything untoward early wherever possible.
I also worry that patients are not always honest about their side effects as they are afraid that experiencing side effects may take them off the study. This takes some skill to manage; it is about establishing trust and an open relationship.
How are your relationships with your patients different as a research nurse?
I think they are deeper; I get to know my patients more. There is less hands-on-caring and more conversation. I really get to know them through talking but I don’t touch them as much, I am not bathing them or dressing them, so the relationship is different.
Do you do any PPI activities in your unit?
We don’t do any of that yet but people are quite open and trusting of the system. Consultants are the ones who approach patients with the possibility of taking part in a clinical trial so the nurses do not attend MDTs or screen notes and clinical lists to identify potential patients. The doctors know the portfolio and approach patients themselves leaving Linda to focus on informed consent and caring for patients throughout the study (Wow!). Linda said patients often approach her asking about research opportunities. Their unit runs mostly phase 3 and 4 clinical trials and mostly pharma-led, but they are looking to expand their portfolio and their team to early phase clinical trials.
How do you cope with the pressures of the job?
Humour. People with cancer just want to feel normal; they want to be treated normally. Sometimes it is nice to have a laugh and forget the illness for a moment. If they look bored while they are in the waiting room, I tell them we have an opening in housekeeping; shall I get them a broom? I once was laughing in the chemo day unit and a nurse told me it seemed inappropriate to be laughing there. We all feel better when we laugh and even in the chemo day unit, I think people want to feel normal.
Do nurses want to become research nurses?
I think those who are in roles where they have to do it all, ethics applications, regulations, screening, recruiting, consenting and managing patients on study, they find the breadth of these roles too much so they go back to roles where patients are their main focus. I love my role as I am truly a nurse with a focus on patients. As a team, we work together. Some people are responsible for the regulatory side of the research, some data, the doctors identify and approach patients and I manage the collection of data and samples, safety reporting as well as caring for each patient for the duration of their time on a study. This, I think is good use of my time as a research nurse.
What is the secret to happiness in your role?
Energy, enthusiasm along with love and passion for people. Sometimes I get asked if working in cancer is depressing. I don’t see it that way. I see cancer is a wakeup call or like a firecracker going off in your life. It is an opportunity to do what you have been putting off or change something you have known needs to be changed. The gentleman, who dies from a brick falling on his head while walking past a construction site, does not get the opportunity to do the things left undone. I hope that when my time comes I get a firecracker and not a brick. However, when you watch someone battle this disease for a long time, in the end you wish for them to go, to find their peace.
One thing I noticed while speaking with Linda is that she has this can-do attitude that seems essential to being happy in clinical research; that ability to be open, flexible and resourceful while also knowing when to be firm (when the rules or regulations must apply).
Linda is warm, caring and real. She is funny and she knows her job. I can see why her patients look forward to seeing her at their clinic visits; her energy and positivity are simply: contagious. She is ‘RN’ who loves ‘being a nurse’. In my short time with Linda, I believe she truly does Love. Being. A nurse. She also enjoys the opportunities research nursing has given her…and I think her patients and colleagues are very lucky to have her.← Respect for autonomy What gives us job satisfaction working in clinical research? →