I guess how I think of it a little bit is that rather than when you’re working in the clinical setting, so you’re looking after patients, you’re able to directly care for them. Whereas research enables you to take a step back, but probably to influence the care of a larger number of people when it can be applied to different clinical settings around the world. So it, it sort of continues my interest in helping to improve patient care, but indirectly. But contact with probably a larger number of people. Sort of going forward in the future.

For us as paramedic’s, research is quite a new thing. Pre-hospital research in general is quite a new thing, and research led by or involved paramedics is, is a relatively new thing. 10 or 15 years ago it, it really wasn’t happening, so it’s, it’s quite a recent development. So going out and talking to the paramedics, getting them involved, getting them interested, that’s been a bit part of a lot of these studies, now I’m doing a lot more in the background with the data and collecting data and collecting outcome data and linking up our data with patient outcomes, and certainly in my own work there’s been a big element of linking up the pre-hospital data with the in-hospital, cos often we, as I say, we don’t know what happens to the patient, we don’t know the final diagnosis, we don’t know the outcomes. But that’s what we need to actually inform our practice and trying to find those and build those bridges and build those links in, is what allows us to change and judge the effectiveness of what we do. So trying to work in that sort of arena has been a big part of what I’m doing at the minute.

Research midwives so, they’re almost like just the everything, they’re the-, they usually know the protocol inside out, they’re the ones that find the patients, keep the patients, approach the patients sometimes. And I think they kind of bring-, they’re almost like the oil to the system they make things like happen and happen smoothly, although it doesn’t actually happen smoothly, they kind of keep things going. And very good at bringing all the different specialities or things that need to-, the different departments together, in order to actually complete it. I think they’re pretty good.

And it took me going to a conference, a national conference, quite early on, when the bigger picture clicked into place really. There were big presentations and things, and pictures of maps and [laugh] where we all fitted in. And I thought ‘oh yeah, it’s a big-, I’m a tiny little cog in a massive machine. But you need all those little tiny cogs. And then you, as you obviously know, you’re changing- changing patient care and changing practice. And if it wasn’t for research, all the little things I’d been doing as a ward nurse, I wouldn’t have been doing [laughs], because we wouldn’t know about them.

And that in essence is the art of being a research nurse. It’s not all science because you know on paper this person might have a performance score of zero, they might have good social support, and they might feel physically not too bad, but if after three weeks of a clinical trial they’re exhausted and, you know, they might have bad venous access and their arms are getting really sore from repeated cannulations, and they don’t want a PICC [Peripherally Inserted Central Catheter] line. Then you have to decide well actually it’s probably not appropriate because this is affecting your quality of life.

And I think as a nurse no matter where you are, no matter what ward you’re on, or whether you’re a research nurse or a nurse, you are primarily the patient’s advocate, you are there to look at the psycho-social holistic care, How are you managing with life? And if that’s becoming compromised it’s your job, I feel, to bring up that conversation of, How is your quality of life? Is this something you want to continue?

Cos I think, I think it’s changing the mind set a bit about research, cos I think people sort of think oh research is something that, I don’t know, using people as guinea pigs or whatever, and there’s nothing in it for the patient. But we’ve since had a few studies where there is something, a lot more in it for the patient, in that one of the studies we do we’re giving the patients an opportunity to try a continuous glucose monitoring system that they wear on their arm. Which means that they don’t need to finger prick so much to test their blood glucose. And so, and it’s a device that’s available on the market to buy, but it’s, you know, relatively expensive and not everyone can afford to buy it, and it’s not at the moment available on the NHS. So we were able to, we were getting quite a lot of people onto this study, so we were asking the diabetes nurses to refer people. And so, I think they began to see that actually this is a study which is really nice for the patients, they’re getting to try something that’s really helping them, you know, for a couple of weeks, and it can, you know, really help with their diabetes, and all the rest of it.

When I first went into radiotherapy we were using very different equipment, and we were very strict on how patients looked after their own skin, where we were treating them. So we didn’t allow them to wash that part of their skin, which if it’s something like a breast for example, that’s quite a large area. We didn’t allow them to use deodorant under that particular armpit, shave that armpit, wash, or anything. Now back then when they were going through six weeks of treatment, that’s not a very nice thing to do to a lady who’s feeling already pretty bad about her body image, quite frankly. So we did I did a lot of research on radiotherapy skin care. I’ve even gone across to Canada and worked with some of our Canadian colleagues on this, and they’ve just followed another piece of the work that we started here.

Thanks to research now, and checking everything out properly, our guidelines here as a professional body now say, let patients wash, let patients use deodorant, let them use the skin care product they want to do. It won’t make any difference. The reason we used to say that was when we were using different equipment that caused different reactions. We were still making patients do that, even though the way we treated them had changed. So our, part of our practice had moved on, but part of it hadn’t gone with it. And thanks to research I would say again patients have, now have a better experience. So that will always be my selling point. And nobody will ever convince me otherwise, that if you don’t do research you might believe you’re giving patients the best imaging or treatment experience, but I would argue very strongly that you can’t be. Cos unless you have reasons for why you’re doing what you’re doing, based on evidence, you could actually be doing things to patients that don’t need to be done.

We do have colleagues sometimes find it difficult to they want to protect the patients. So they don’t want to feel that they are creating a burden or adding things for them to do, but if you can help them to see that it’s about choices, we’re all about choices. You would never say you can’t have this, you’ve got to have that, it’s choices all the way. So, if we can give them, research should be a valid choice for everyone, exactly the same as anything else. And if they say no, that’s okay. And I think being a nurse helps to overcome some of those barriers with colleagues, cos I can, you know they can see I’m a nurse, we’re on the same page. Patients are our priority. Nothing else is more important than the patient. And I think because they know that they then start to trust the process a bit more, so they can be more engaged.

I think it’s knowledge. For me in my role in my Trust, and it may be different in other Trusts, so it’s my knowledge of not just nursing children, whether it’s on the children’s ward or in the neonatal unit. I think it’s a knowledge of processes, whether that is electronically, how-, where to get information from, which system to use, cos we don’t just have one system for one thing. Or it’s a process of if you’re wanting to do swabs for example, where is the equipment? If you wanted to do a throat swab and the study team provide everything, they might provide a swab but they might not provide a tongue depressor, so if you’re on the ward and you think-, or outpatients, and you think where’s the tongue depressors?’ rather than asking other staff and the knowledge of where. Just little things like where things are kept. Where the lab is? What kind of bottles to put-, which bottles to put in what, what samples for bloods and things? Where to get that information?

When-, it’s because if I do bloods on children for studies I always contact the consult-, we liaise. So for the diabetes children, so we liaise with their consultant, because we’ve got a window of time to get the bloods for them. So the consultants may have bloods that they want doing within that six-month window. So and we liaise with the consultants then we do our bloods and I do their bloods alongside our bloods. So, but some bloods- so I might need to go off on a morning before 12 o’clock because of where they’ve got to go to. So it’s a, it’s about knowing like all, I can’t know everything, I’m not saying, I don’t know everything but it’s, it does help knowing how the wards run, what time the handovers are, where certain people will be at certain time, specialist nurses, which specialist nurses do what and work in which areas.