So, it’s an NIHR [National Institute for Health Research] funded Master’s. It’s a Master’s in clinical research. And the way that it works is you, you win an award. It’s quite competitive. So you have to put forward an idea for research, it has to be practical, has to be patient based, it has to be you know of its time, it has to be relevant. You put that forward and that forms the basis of the Master’s really. So, it is, it’s a modular Master’s and we do different modules that are specific to qualitative research, quantitative research, designing research, but what runs through the whole Master’s is your dissertation module. And it’s a practical empirical research project, and the aim at the outcome is not to produce the, you know 20,000 word dissertation, it’s to produce a paper that can be published. And I really like that because I think it’s so much more practical, you know very rarely people have to write 20-30,000 words. And you know very few people read that amount. Whereas you know so many people read articles in a, in a, in a journal, or on a website, you know open access, that kind of thing. It’s gonna have much more impact by doing that. So, I, I really like that. And so that, that goes throughout the whole of the Master’s

I guess the opportunity that I mentioned at the start of the video, to be a consultant on a, research grant, was the only research opportunity that came my way in, you know, during my clinical practice to that point, and by then I’d probably been practicing I guess six or seven years. So yeah that’s the only opportunity that I’d really thought about. And I guess it was from that, I think you know once something is put on your radar you start noticing more opportunities I suppose.

So from that point I suppose that’s when I thought, started thinking about doing the Master’s, and from the Master’s I sat thinking about where that might take me going forward, and I guess I’d enjoyed doing the learning, that sort of like I said deep thinking based learning, that the Master’s gave me an opportunity to look up and outside of my profession, and learn from more broadly sort of healthcare policy and strategy, and how that might inform my practice and my service development.

So, I really liked the idea of looking more broadly across a range of different disciplines, I suppose. And developing and informing my practice from that. And then, like I said, I kind of sought out research opportunities going forward. I still didn’t really ever contemplate a PhD. I didn’t really think that would be part of my career trajectory until sort of much later on.

I think it’s quite an exciting time, because of what NIHR [National Institute for Health Research] are doing in terms of opportunities for clinicians to be funded to be trained and then have sort of joint roles, posts that, you know, so I, it’s, it’s a good time. So, I would say to health visitors now, pursue that route, you know, look at what NIHR offer. The way I did it was just by luck and chance, and an interest in research. I sort of just somehow fell into, you know, but, stumbled along building a bit of a career by chance really than by any, you know, there weren’t particular support mechanisms out there, institutional support mechanisms. So, I just sort of, and I probably, looking back, could have been a lot more ambitious about it, but it’s, I think, I feel I’ve like I’ve had a great career. But yeah, anybody doing it now, I would say the, the structures are increasingly there. And I would say get into those structures, so you’ve got support, you’ve got mentoring, you’ve got, you know, yeah, all the things I didn’t have but, you know, found my way really through luck, ending up here I guess anyway. So that’s what I would, and I would say, you know, because I really believe in health visiting as a service, there’s a, you know, there’s a huge job to be done in terms of the evidence base and the profile and yeah. I would say to health visitors, you know, go for it, do it.

Yeah so I did an NIHR [National Institute for Health Research] Clinical Research Internship, when I’d been qualified about a year, 18 months. And I did that at a university under one of the professors, and that was supposed to give me an overview of the way she worked I guess, and we wrote a paper together. And then after that, because of that I guess I got onto the, one of the NIHR’s MScs so that was really good. And that was about research management, what else did I do? I can’t even remember now. And there was statistics, you know, we did a lot of quant stuff, statistics, and then we did some qual stuff as well. So I feel like I got a good insight to, into the different methodologies as well as like the overarching how you would actually do research within the NHS. And I think that has helped me enormously with my job, I just, like understanding terms and who’s who, and what it takes to get a study rolling and stuff like that. That’s been really good. And then doing my own research, I guess I already had experience of recruiting, yeah so that helped.

So I worked as a midwife on the labo-, done a lot and then ended up on the labour ward which I absolutely loved. But so we used to work from clinical guidelines and I was just like ‘it would be better for me to-‘, I would want to be the person that is participating and actually writing those guidelines as opposed to just the person that’s kind of doing them. So I done my dissertation, usually with the degree shall I say. And I hated it to start off with, but then by the end of it I loved it cos I was just like ‘oh my gosh, I’ve just found out why-. It was a hands-off/hands-on the perineum and I was just like ‘I can justify why I would do what I do. So I just thought I wanna to be able to do that and everything, and actually be able to almost do that for everyone. So not only my practice but more generally like other midwives’ practice.

So, I actually went out-, I talked to some senior midwives and they actually advised me to do a more general Masters. So actually went into public health, which I’m still completing; just finishing off my dissertation now [laugh]. But that then broadened my view in terms of nought to five-year olds, which was really, really good. However, I think I just had a love for midwifery so I kind of went back. And then I randomly applied for a research midwife role. I know that you’re meant to have a Masters and had experience in it, but I literally sold myself like crazy cos I really wanted to do it. And then someone actually just gave me the chance, so it was not the normal way to go in, but I was very lucky. And I worked well within it.

I think go and try it for, it’s not for everyone but if it is for you, you will know it. I also encourage everyone who likes to be a research nurse to become a nurse researcher. If you’re in this job you are curious, you like to know things and surely you have ideas. And in my team I already have people who have ideas and they know what they want to do and it’s just teaching them how to get to that point. And I think it’s very exciting times for research nurses, in a way.

It has actually been an evolution of the role, I think that’s because I’ve had very supportive managers who’ve seen the need to grow and develop the role. The job description itself we’ve changed so during that period of time, I should say, for eight years of it, I’ve been doing a PhD part-time as well, so that impacted on it because during that time you’re obviously becoming a chief investigator of your own study. But it’s also, it’s, we re-did, about 18 months ago we re-did the job description to reflect where I wanted the job to go and where, where the unit needed the job to go. And actually now it’s re-badged from being Research Sister’ to Nurse Researcher’, not with any increase in pay and not re-banded in anyway, but just the focus of the job description changed so it’s much more now about moving from that delivery to being an independent researcher, developing the research culture, supporting other staff, education about what research role could involve, you know, what does good research look like, and actually a lot more of an emphasis on public and patient engagement.

I would like to be someone doing my own research. And so that’s-, I’m kind of banging on my drum about that because I-, I’ve always felt that, but then I’ve been sort of stumbled by how difficult that could be in practical terms, because as I said, I can’t-, I can’t just do a PhD because I fancy it and I’m independently wealthy and that’s what I’m going to do for five years. I need it to be through an awarded really well supported process. So, there are those amazing awards, like the NIHR [National Institute for Health Research] doctorate one. But the doctorate application probably takes a year to do the application and to have a really good supportive team around you. But then, just a few months ago there was the announcement of a new award, which is a pre-doctorate award, which is investing in people’s time to get to be able to submit a competitive PhD application. So, it essentially buys out your time and sets you-, and you-, you submit an application where you’ve set up some supervisory relationships and a bespoke training package for yourself. And then if the lucky people who are awarded this would have a couple of day-, perhaps a couple of days a week, or 50% of their working time, to devote to the development of their own research pathway as a clinical academic.

And that’s what I want to do.

I was given my time off to go to the university in, in the first year of my Master’s, for the taught modules parts, but the, the year that I was doing my dissertation I wasn’t given any time off, so that was quite hard. So, you know often people will say to me now, Oh Rachel, you know, we know we should be doing research but it’s just too hard to fit it in, and you, and I think sometimes in life you know, when you’re doing some of those types of roles you have to accept that some of it will be partly in your own time really. So that, the whole of the, you know the dissertation part was done really sort of evenings and weekends, apart from obviously the interviews that I was doing with patients, was done in my work time. So that was done then. And as regards sort of fees, I think I was quite lucky, my employer paid half of it and I paid half of it, which I think is probably quite fair, you know? They, I think if the expectation of them having to pay for all of it would have back then been quite difficult because it was a gamble really on their part, they didn’t really know what they were going to get out of it. And I think with, there was that part in them that if I at least had inputted some of my own finances I was less likely to pull out of it, which was never going to be on the cards, but it does happen.

If you don’t follow the, this pathway that I’ve followed then I don’t know how people do it. You know, cos either you leave your job and you take a stipend and then you go and almost start from scratch, which if you want people at a reasonable level of experience-, so if you want experienced clinicians, most people can’t afford to do that. So the clinical academic pathway I think is brilliant. They’ve made it a bit inaccessible at points, cos they’ve changed the time scales and it doesn’t quite butterfly to-, it doesn’t quite sort of, I don’t know, it doesn’t quite flow in the way that it could, cos they moved the, the, the sort of time in the year that they advertise things. But it does give you the ability to follow a pathway and receive back-, backfill. So your organisation isn’t penalised. It’s hard if you do an unusual job, because you might not just have someone that can step into your role so I think, you know, that’s, that is an issue. But it does, so my sort of working arrangements for the last three years have been that I’ve taken-, I’ve got like a temporary reduction in my hours, and then, so I work these few hours that I’m allowed to work, and that keeps my pension going, and that sort of thing, although it’s reduced what I’m contributing. And then they, the organisations have got the backfill to employ someone to do the rest of my job. So that’s real-, that’s relied on them being very flexible, you know, and very accommodating of, of my sort of desire to do this piece of research. Many people wouldn’t be, you know, they wouldn’t, they wouldn’t have that flexibility. So the working environment I think is not always that supportive of people doing this kind of thing.

So the NIHR [National Institute for Health Research] pathway, there’s an internship before you do an MRes, and on that we did quite, we did things like Good Clinical Practice and other bits of, you know, training around NHS ethics. Around setting up studies and trials. We spent time in, in sort of the clinical trial unit’s around in hospitals. So, it was a bit like it was like a little mini apprenticeship, and it was really good, particularly if you’ve not been a research nurse, so I think the research nurses found it a bit boring, cos it was what they do, but for all of the rest of us it was really helpful. And then when I did the MRes at [city/university] cos they held the funding for that programme, their approach to the MRes was that you did a thesis but you also did a clinical portfolio, and that was a bit like a kind of enhanced version of what I’d done on the internship. So it had all these competencies that you had to meet as like a fledgling researcher. So it was really good actually, it was really, really helpful cos it meant that I had to go and do things that probably in my research career I won’t, so I probably won’t spend much time in a clinical trials unit because I’m a qualitative researcher and spending time with humans really rather than samples, but it was really helpful to get a sense of what that type of research is like. And you had, so you had to do all of these competencies as part of that MRes programme. I don’t think any of the other providers did that. But it was really, really good and it involved, you know, some of it was sort of taught seminars, there were some modules that you had to do. So quite a lot of research training, not just sort of academic writing.

And the university part of it, I guess it was kind of what I was expecting. It was like an overview of research methods about, like qualitative, quantitative methods, it’s only, it was only one day a week for five weeks. So, I don’t really feel like I got a lot out of that I have to say, but in terms of the teaching at [university], than what I, what I gain at [university]. I feel like I get more, I mean it’s, I think the two of them need to go together and that’s the, the whole point of the internship. But I feel like I’ve learned more from the practical side of things, from doing it.

So, what I expect, what I expected at [university], at [university] was to be more of an observer. As to go there to observe interviews, observe them obtaining consent from, from participants, to go to see an ethics proposal being written. I didn’t really expect to, to have, to have to work if that makes sense. I expected it to be much more of an observational role. But the reality is it’s been quite different from that. There has been a lot of practical hands on with the data analysis, so that wasn’t what I was expecting. I certainly wasn’t expecting to come out of the placement having written a paper. So, in a way I think it’s a good thing and it will really benefit me, I also thought at the time that it was quite, it was quite intimidating, and I felt really overwhelmed and I didn’t have the, the right skill set. Especially when people were sitting there, talking on all these research terms that I had no idea what they were talking about, and thinking, Now I have to go home and go to all these interviews, so it was quite overwhelming initially. But that slowly, as time has gone on, that’s slowly gotten better.

I think for a while I felt like I’d sort of stepped outside of my professional identity and gone into a new one. And so I felt very much like a fledgling health researcher, and that wasn’t my intention, it was because I’d, you know, I’d set off with my research question which was about what an art psychotherapist might offer this particular patient group. And then in my first literature review found such a lack of research that it was like okay, well either I don’t do this, or I go, step, take some of the steps back and do some of that research that hasn’t been done. Which is what I chose to do, and I’m glad because it’s made me much more sort of, you know, it’s put me in contact with a much broader range of colleagues and professions and people and, than if I’d stayed very much as an art psychotherapy researcher, that would have been quite narrow, for me. But as the study has progressed and I’ve thought more about how I’ve collected data, how I’m analysing data, how I might bring the study together, how I might disseminate it, and bring, even write up the thesis, you know, the art psychotherapy part of me has engaged more and more and more. From ethics onwards really. So from sort of going to that panel and having to sort of think-, sort of reassure about the patient group but also then defend the methodology choices, it feels like the art psychotherapy bit of me has kind of re-engaged. And my intention would be, you know, if I could have my wish, [laugh] if you like, would be that I could go back into a clinical-academic art psychotherapy post. And be part of helping the, the kind the health and social care research world understand what art therapists can offer, beyond-.

We are quite a misunderstood profession and we spend quite a lot of our careers, all of us, explaining what art therapy is and isn’t. And I think what I’d like to do is to kind of be able to explain, not only what art psychotherapy is and isn’t as a clinical intervention, but what the, what art therapists have as skills that are useful in their own research world. So how we could be helpful for research teams in facilitating workshops in a safe, ethical way, with vulnerable groups particularly. So I’ve been asked to, you know, get involved and support other people’s studies because they’ve wanted a bit of that. So, you know, where I’ve got a colleague who’s a nurse, and she said, Will you co-facilitate, because then I’m kind of almost covering that bit if you like, I’m covering that, that side of things that so that’s quite interesting cos, you know, it’s not traditionally what we’ve done, but absolutely what we could do.

A part of what we could do.

My supervisor, so my doctoral supervisor was also the supervisor for my internship, and she’s a speech therapist by training, and is now a professor. And she’s been really supportive of me throughout. So, she’s sort of been my supervisor and my mentor. She’s really helped me think about opportunities that the research might present to me. She’s been, she’s really good at networking, so she’s great at sort of putting me in touch with different people, as and when I visit university. And we have quite a good relationship in that she seems to really understand where my strengths and areas for development lie, and she’s quite sensitive to my reactions to things. She knows when I’m going to be overwhelmed by something and will tend to sort of take that off the agenda. So I’ve got a good relationship with her, and she’s helped me put together a really good supervisory team for the project.

And I’ve got clinical supervisor within that team whose got lots of research experience and he’s really great at seeing things through a sort of pragmatic clinical lens. And I’ve also got a sort of very experienced researcher, or a couple of researchers on the team who bring me specific research skills. And again, are really good at looking at things from an academic lens, and through the processes that I’m going to need to engage in, in order for the research to be of value I suppose and rigorous and robust, so I’ve got kind of a really nice balance within that supervisory team, and I consider myself really fortunate to have that, to have a nice sort of balance of skills. And have positive relationships thus far with everyone within my supervisory team.

And so, in terms of recruitment we I mentioned previously that there was a big cohort of people doing their PhD around the same time as me, all this actually sort of benefited us cos there were a number of aphasia projects going on and what happened was that we each project was looking for a slightly different profile of people with aphasia. So, for example my research was about people with very severe aphasia, so people almost unable to express themselves verbally, whereas other people were doing research for people who might have better spoken abilities but had difficulties with reading for example. And a number of others in between, a number of other kind of studies around aphasia in between.

So, at the time of recruitment we, we did a little roadshow, going out around visiting the different community stroke groups and we had like a little booklet, a little menu of different projects offering a variety of different research, and that might be suitable for different people. And that was a really lovely way to work actually because it meant that we could share the load of going out and speaking to people about the, the research, but also that we could present research that wouldn’t necessarily exclude people from the group when we approached them. So yeah, so we ended up with a big sort of collaborative co-operative research drive, and that’s that investment at that time I think has led to us having a very a very good community of research participants that are now connected to us at the university here, so the investment at that time and, and the subsequent involvement in research. And anybody who was happy to stay connected with us at the end of that research project, or who was interested in doing more could, would agree for us to contact them if future relevant research came up.

It was good to be honest, I enjoyed it. Cos I got to do a bit of everything and you don’t-, when you do something all the time, if you’re doing clinical all the time, then you can get burnt out, you can, you know, it can get to you after a while. If you’re doing academia all the time, if you’re studying all the time, that then also takes its own toll but in a different way. Being able to do a bit of both, gives you a relief, you know, when you, when you’ve had a bad day clinically you’ve then got a research day the next day, which gives you a chance to recover. When you’ve had your head buried in the books for a week and you can’t see what you’re doing and can’t think straight, to actually go out and get hands on with some patients and then have to deal with something on that side gives you a relief in a different way and to think about it, and perhaps re-invigorate why you need to go back and do the learning. And I think the two complement each other, if it is a difficult juggling role.

Mm. Mm. Yeah.

But I think that’s something we, we need to develop. We need to develop-, if we want people to go down this route, we need more hybrid type roles, we need this clinical academic role, and that’s something I think we’re only just really sort of exploring.

It’s, I’ve found it quite difficult at the start to switch from one to another. And I spent a while thinking oh this would have been better full time, so I could have done all the study, or all work. And I think that’s kind of to do with the way that the course is designed. It’s very heavy upfront, and then it sort of quietens off a bit. But I found it very difficult to, not very difficult but it was a challenge to change my brain from study back into work mode again and getting into the whole swing of being at work, and, and that kind of thing. It’s absolutely fine now, not a problem at all but it, at the beginning I did find that quite tricky. But then I think at the beginning of anything new, I, so I was the only full-time member of the team, so I was the one that kind of had oversight of everything, purely by the fact that I was there all the time. And when I’m then out of it for 50% of the time, that person with oversight is, has gone. And that’s difficult on both sides I think. It’s difficult for me because I’m used to being that person, it’s difficult for the team who are used to having me as being that person. So, I think, you know for everybody at the beginning it was a bit of a you know transitional period really, of getting used to it being different.

It didn’t take that long really for it to you know become a lot, lot easier and to be able to just sort of switch from one to another.