For any healthcare professional working in clinical practice, the role of research is central to providing evidenced-based care.
Often the research is based on new therapeutic agents but increasingly, there is a shift towards integrated and multidisciplinary research especially in people with long-term conditions such as diabetes and heart disease. Nurses play a key role in research but for the general public, the role of the nurse researcher isn’t always fully understood.
A research nurse often works on specific clinical trials collecting data for a physician, whilst a nurse researcher is usually a person who has completed a PhD and designs their research study and is the principal investigator for the study. Of course, we need both for research but the nurse researcher role is often not as well known. This article outlines what a nurse researcher does, how to become a nurse researcher and describes some of the benefits of the role.
Who should be a nurse researcher?
One question I am sometimes asked is, who is suited to research? I would say that there is the need to be a life-long learner, be inquisitive and have the drive to improve patient care. This drive can be very specific to your clinical role, such as heart failure or asthma, for example. In terms of skills and knowledge, being Masters-prepared is recommended as this ensures the nurse researcher knows how to undertake a literature search (asking ‘What is the existing evidence on this topic?’ is always a good place to start) and interpret the existing evidence. From experience, it is advisable for newly qualified nurses to have a few years clinical experience before considering a full-time career as a nurse researcher, but if an opportunity arises to work on a research project, then take it! Sometimes, it’s more of being in the right place at the right time and many of us started our research careers in this way.
Where to start
Often nurses want to work in research but don’t know where to start. I would suggest that the best place to start is potentially seeking employment part-time or full-time, as a research assistant. This gives you a taster for the role and allows you to see all the aspects of research and what it entails as the approach to research differs from qualitative to quantitative studies and also a different set of skills (see table). Having relevant post-graduate clinical experience is useful, as the knowledge and skills gained from being ‘on the floor’ (i.e. having a good set of clinical skills) will be very useful as often you need to undertake a full medical history and comprehensive clinical assessment of the research participants. Nothing can replace clinical experience and having witnessed people from science backgrounds who were laboratory-based trying to recruit patients for studies with minimal experience of non-verbal communication and dealing with people who are ill, I often favour someone with a nursing background for research studies.
|The phases of a research project:|
What you need to be a nurse researcher
There are some things to consider before deciding that you want to work in research. For a start, the hours are not always nine to five! The time commitment can vary and for one particular study, I worked from 7am every morning and couldn’t leave the hospital until at least 9pm as I needed to take blood samples and collect clinical data at very specific times. The responsibilities may also seem a bit alien at first, as often the role can be relatively autonomous without a team nearby, especially if the research involves visiting people in their homes. However, there are strict protocols in place for most studies and specific training will be given before commencing the role. There are also other requirements, such as completing good clinical practice training and being competent in skills such as history taking, advanced assessment and phlebotomy. Some studies also may be testing new technology and as a researcher this may involve training patients with new devices so IT skills will also come in handy.
Benefits of being a researcher
For me, there have been many personal and professional benefits in being a nurse researcher. It has allowed me to develop my own research and focus on what I believe is important. Most of us work specifically in one topic area – mine is on chronic disease management in both hospital and community settings. Recently I have been working with the @home team at Guy’s and St Thomas’ Trust and demonstrating the benefits of treating people in their home as opposed to hospital. Professionally, the researcher’s role can be varied from day-to-day with some days full of meetings and other day spent analysing data on the computer. The most rewarding part for me is disseminating the research findings by writing up the results and having a paper accepted for publication. Once a study has been completed and the data analysed, it can be very satisfying to be invited to speak at a conference and being asked questions about the findings. Sometimes, a chance encounter at one of these conferences can lead to meeting someone with similar research interests and the opportunity to work collaboratively on a research project. Often issues that we witness with patients such as medication non-adherence, is a problem experienced by others and working together allows discussion of the issues and trying to work together to come up with a solution.
The first steps towards being a researcher
The first steps to becoming a nurse researcher are relatively straightforward. Wherever you work, there is probably some research taking place, whether it is in the local GP practice or at the local hospital. It is useful to see what research events or talks are scheduled and attend. This also gives you an opportunity to speak to the presenters and ask them any specific questions you may have. Alternatively, if you know any researchers working locally in universities or in healthcare (either community or an acute setting), you can always approach them. Often there may be part-time opportunities to work on a project and it is an ideal path into research and learning more about the process. Research jobs are often advertised in Trusts or on the jobs.ac.uk website. Some roles will require the applicant to have a Masters or PhD and these are for research associate roles but sometimes research assistant roles do not require any post-graduate research experience. Many of my former students got their first taste of research when undertaking their Masters and several of them proceeded to write up their findings for publication. For them, there was a great sense of achievement and satisfaction in being able to gain a qualification from their MSc and have a published paper to show for all their efforts.
Why I became a researcher
I started my career in research in the early 1990s and it was mainly because I wanted to learn more about research and how two patients could have the same condition, be treated the same way but have very different outcomes. I have been lucky to have worked in a variety of locations including Soweto in South Africa and Melbourne, Australia. For one project, I was screening populations in different communities across regional Victoria in Australia and we screened over 2,000 people in their communities for heart disease. The most rewarding memory was picking up ECG changes on a gentleman. He was asymptomatic but his ECG showed major changes associated with heart disease. We sent him straight to his local hospital where it was confirmed that he had severe coronary artery disease and he had an urgent bypass operation the next day. He came back to see us a few weeks later to say thank you and to tell us that if hadn’t been screened, he would probably not be alive. Our screening had clearly saved his life.
I became a researcher because I wanted to improve patient outcomes. I realised that although I really enjoyed providing direct patient care, I could make a difference to a greater number of patients by carrying out research. For one of the jobs as a lecturer, I was fortunate enough to be able to combine my clinical work and research work in investigating the role of the emergency nurse practitioner and I worked collaboratively with colleagues in implementing the role and ensuring we were able to demonstrate the benefits of emergency nurse practitioners. We published several papers and presented the work at national and international conferences. This work allowed the hospital management to see the benefits of the role in terms of patient satisfaction, reduced waiting times, reduced treatment times etc and use this data to employ more nurse practitioners. There is always the advantage that changing practice in one location and publishing the findings can result in these changes being implemented in other areas – highlighting the generalisability and adaptability of research, all of which improves patient care.
How to be a successful researcher
Like everything, being successful in research involves being efficient, being able to work under pressure and hard work but more importantly, it demands being a team player. No researcher can be truly successful without a good team. Teams can only work well if everyone knows what they have to do, has the resources to do their job but also has a good leader who listens to and develops their team. For the novice researcher, the research team should be welcoming and allow the novice researcher to ask questions, learn from the team and develop and grow their research skills. Like any job, you get more out of the team if there is a good leader and openness between all team members.
Research can be very rewarding and satisfying as a career and for those who think it may be career for them, all I can say is give it a go!