The nurses, midwives and allied health professionals (NMAHPs) working in research* who we spoke to emphasised the different benefits their roles brought to health research, including money/investment, changes in practice and improved clinical outcomes, skills/research capacity, and better patient experiences.
While the income generated by the research delivery activities of NMAHPs was seen as important to NHS management, it was not the main or only contribution. Instead, many people enthusiastically emphasised their value to clinical practice and, ultimately, benefit to patients.
Everyone talked about or alluded to the importance of evidence-based practice, meaning that decisions in health and healthcare should be informed by research. As such, the work carried out by NMAHPs contributed to developing knowledge. The potential to ‘make a difference’ through research was very rewarding, often described as ‘exciting’ and a major source of pride. Speaking of working as a research nurse on studies about treatments for newly diagnosed prostate cancer patients, Paul said that ‘because of what we’ve done, it shows that it’s now the gold standard’.
There were lots of examples of research carried out by NMAHPs leading to improvements for patients (in terms of clinical outcomes, safety and quality of experiences), as well as for the staff and the NHS overall. Carole, a research midwife, was motivated to work in research
because ‘my burning aspiration was to promote better standards of health for women and I think one of the ways to do that is in clinical research’. She explained that health research is not only about ‘finding cures’ and there are many other aspects, including ‘prevention or early detection and management’ of illnesses.
Research NMAHPs as enablers
Many in research NMAHP roles saw themselves as being central to connecting up people and processes (e.g. working with others
like the research team, study coordinators, funders, ethics/research governance support, non-research clinical staff*, and patients) so that research could proceed. Helen described research nurses as ‘the glue that keeps it all together’ and, along with Paul and Ellen, talked of being a ‘cog’ helping the ‘machine’ of research keep turning.
Caring for patients in research
Many people felt that the skills, values and patient-centred approaches of their professional group enhanced their research activities. Helen explained how research nurses ‘know that patients might be upset, we know our patients are vulnerable but we know how to handle that’ whilst providing them with access to research opportunities. Some people felt patients (and the health professionals caring for them) might feel more confident and trusting knowing that the person supporting them through research was a qualified health professional. Claire said that, in some studies, it was ‘incredibly important to have nurses as it may require [them reading] body language and other observations’.
Some people highlighted that many treatment options and pathways currently in use would simply not be available without previous research. As well as helping future patients, some NMAHPs emphasised how they and their activities could benefit current patients too. Taking part in research could offer choices and options to patients which were otherwise inaccessible. As Simona explained, ‘When you’ve exhausted the resources for helping a patient clinically with whatever was clinically available but you had a possibility of probably try[ing] something a bit more via research’. The benefits could also be emotional as well as clinical. Sandra felt her role in providing research access was about choice for patients, which can be especially important to patients ‘when they feel they’re out of control of everything else, Whether that’s to take part or not take part, but it’s that freedom for them [to choose]’.
There were examples of new resources or services developed as an off-shoot of research. One of the studies Barbara worked on led to the development of a specialist clinic for women with genetic predispositions to cancer. Rachel Y established a support group for people with head and neck cancers. She invited along speakers, such as a dietician and a dental hygienist, to address gaps in patient knowledge which she had identified through her Master’s research
Addressing clinical problems and improving practices
Their clinical backgrounds gave research NMAHPs and NMAHP researchers’ hands-on insight into the clinical environments and practices that research was seeking to improve. In addition to working in research, some people also worked in non-research clinical posts, as a split post, as a separate post or as part of a bank. Louise’s split was three days a week as a research midwife and one day on the antenatal ward, and she thought that the two complemented one another: ‘you can see areas that need improving and try to contribute to the bigger picture’.
Familiarity with healthcare environments and the responsibilities of other members of the workforce could help NMAHPs better negotiate or at least understand some of the barriers to conducting research in clinical environments. This included when/how to approach patients about a study and finding rooms to see participants in. Vicky thought her background as a nurse helped her to ‘understand the language used, [and] navigate our way round clinical notes’ in the course of carrying out research with patients.
There was a sense for some that their health professional background gave them credibility with their non-research clinical colleagues
, who would then be more likely to accept and engage with their research activities. Mary thought her split role as a health visitor and researcher helped challenge negative attitudes about ‘ivory tower’ research, by conveying that she did ‘understand the world of practice’ and ‘how hard it is to change things’.
Supporting colleagues to engage with research
Many NMAHPs we spoke to also described ways they contributed ‘back’ to their wider professions and teams. This included using the research skills developed to add to the discipline’s knowledge base and foster a positive attitude towards research amongst others. Examples included:
- helping non-research colleagues become more savvy about using published findings;
- nurturing colleagues’ research skills by offering opportunities for them to gain hands-on experience (including through secondments);
- raising the profile of health research to patients, which often demonstrated its value to clinical non-research colleagues at the same time; and
- helping educate students in the profession (via teaching and placements).
Tabitha ran a seminar for midwifery students about a study she worked on. There were also some studies which, if the outcomes were rolled out, could help reduce or simplify workload pressures on clinical non-research colleagues in the future.
Demonstrating the value of research NMAHPs
For NMAHPs employed in research delivery, being able to demonstrate the value of their role was important. Often people spoke about the need to counter negative stereotypes or misunderstandings held by others, including their non-research clinical colleagues, and many people expressed the feeling that they were not valued or appreciated as much as they should be. By asserting their value, it was hoped this would re-balance the situation and, ultimately, allow them to sustain and grow as a professional group.
However, showing the value of research NMAHPs could be challenging. Many felt that a lot of their contributions (to patients, staff, their organisation/institution, and beyond) could not be neatly captured or calculated. This included contributions to making research-positive work environments and various aspects of patient support
. Some people felt that the way research NMAHPs are a ‘bridge’ or ‘link’ between different people and organisations was not always recognised as valuable, and that this also complicated any attempts to identify the specific contributions of an individual or team of research NMAHPs.
In their roles, many research NMAHPs faced challenges (e.g. when they were first adjusting to a research role
from a very ‘hands-on’ clinical job and when they were under a lot of pressure in their research delivery activities
). Keeping sight of the ultimate aims of their activities‚Äîto improve health care and benefit patients‚Äîcould help maintain their motivations and sense of value.
*The people interviewed for this website were mostly research NMAHPs (i.e. those employed in a research delivery role). However, we also interviewed some NMAHP researchers (i.e. those leading research as independent researchers). The latter group included people who were undertaking or had completed academic research qualifications, such as PhDs, and many had previously been in (or continued to also be in) research delivery roles. For more information about the distinctions between these roles and the sample of NMAHPs interviewed for this project, please see the Introduction section
*Many research NMAHPs and NMAHP researchers felt strongly that they continued to be clinical within their research roles. As such, the wording of ‘research’ NMAHPs/staff and ‘clinical’ NMAHPs/staff can be problematic for implying that research is not also clinical activity. Where the wording ‘clinical staff’ is used on the website, we mean for this refer to non-research clinical staff (i.e. those who are not currently employed to carry out research or enrolled to pursue research through an academic qualification).