Moving into research delivery roles had been a significant adjustment for some nurses, midwives and allied health professionals (NMAHPs) we spoke to*. Ellen recalled feeling ‘quite lost’ in her new job to begin with. There were unfamiliar aspects to get accustomed to. However, many also highlighted similarities with their previous non-research clinical roles* – there were transferable skills and both were ultimately about helping patients. Some people continued to have, or later added in, a clinical role or job in addition to working in research.
Some people adjusted quickly, but most found that it took several months to feel more comfortable and confident in their first research delivery post. Jisha said, ‘In the beginning, everyone struggles but that is nothing to worry about’. It took Sandra about 18 months before she felt sure she was enjoying being a research nurse. Dawn had been a research nurse for two and a half years, and felt it was still an ‘ongoing learning process’.
People weren’t always sure what to expect from a research delivery role. While Tabitha and Nikki thought their Master’s degrees had prepared them well for working in research, others found that their initial expectations of a research delivery job did not match the reality. Sanjos had expected to have more clinical activity as a research radiographer. Claire, Alison and Ginny all thought there would be more scope for activities beyond or in addition to research delivery. Some posts did not have a clear remit or precedent, so researchers such as Vicky and Rachel Y were involved in helping forge their own job description. This could be interesting and enjoyable, but also placed a lot of responsibility on knowing how best to proceed in an unfamiliar territory.
Change and continuity
Clinical research often felt like a ‘different world’ to that of clinical practice. Recognising the differences and learning how to negotiate them in their research role could be challenging. For some, it was a case of un-learning habits and practices they might easily ‘slip into’. However, for others, aspects of their NMAHP background were seen as a big advantage to making research happen and could provide more benefits for patients/participants.
Adjustment to research sometimes involved a careful negotiation. Vicky felt the ‘greatest challenge’ was ‘understanding that you’re not part of the clinical team directly, but obviously you need to work with them very closely, and, again, your ultimate goal is to make sure that the patients who are participants in your study are well cared for’. Becoming a research NMAHP, and others’ views of this (including clinical colleagues), could also affect individual’s sense of professional identity.
Differences and areas of adjustments
The main types of adjustment people described were:
- learning about research activities, governance/regulation and research terminology/abbreviations (often through training, shadowing and mentorship);
- spending more time desk/computer based in an office;
- following protocols strictly (compared to scope for flexibility with clinical judgement);
Karen leads a team of research staff and explained the importance of precise data collection: ‘it’s not good enough to do the way you do it clinically, for this trial you need the patient to stand exactly on these markers and stand here, and you need to do it in this order, with these words, with no variation. Cos if you did that degree of instruction when you’re in your clinical role then you’d be having complaints from the patients about how bossy you were and how burdensome it was’.
- pace of work;
- working autonomously and organising their own workloads;
- working hours;
Rachel X, Imogen and Barbara all felt there was not much for them to do in their research delivery roles at first, which contrasted to the intensity they had been used to clinically. Reading paperwork for many hours could add to this sense of ‘slowness’. Once Layla had un-learnt the feeling she needed to ‘account for every single thing that I do’, she found it ‘quite rewarding’ to have the freedom to plan her own time and workload.
- relationships with, and ways of, supporting patients;
- ways of working with other colleagues (including individuals, organisations and departments such as Research & Development) and especially if the research NMAHP had not worked with them before; and
- for some, working on a new topic and/or within a new department, hospital, Trust or other setting.
While the amount of overall time spent with patients varied, many in research delivery roles felt the quality of rapport with patients had increased. Another part of their role involved working with multidisciplinary colleagues. As Alice recalled, ‘I remember clearly thinking ‘I don’t know anyone, I don’t know who these people are’. I remember meeting the trial coordinators, PhD students and the PI [Principal Investigator] and the CI [Chief Investigator], and I remember thinking ‘I just don’t know where to place these people”. Many also commented on their relationships with (known and new) clinical peers as having changed and requiring adjustment. As Alice highlighted, establishing good working relationships with clinical non-research colleagues could be especially challenging if the new environment was not a very research-active one: ‘being the only person working in research in the department is always hard and especially if you’ve never worked in research before, it can be a bit stressful’.
Karen described there being different power dynamics with patients/participants in research.
Not only did Osi have to adjust to being a research midwife in an unfamiliar hospital, she also found there was not a very research-active culture; it took time and persistence to build this.
Similarities and familiarity
People also described similarities and continuities which carried through from their previous clinical experiences and into research. Examples included:
- values of patient benefit and patient advocacy – including opportunities to help patients with health concerns encountered in the course of research (e.g. through answering questions or signposting);
- transferable skills, such as: communication, reading body language, listening, clinical skills (including taking blood), problem-solving, translating information given by doctors into lay language for patients, and being able to navigate around medical notes; and
- transferable knowledge, such as of particular healthcare settings, how to signpost around these systems, and information about the study topic.
These aspects could be a major asset within research. As Carlos explained of his physiotherapy background, ‘that gave me a certain level of confidence to talk about the injury [being studied]. Like approaching the more clinical aspects of the injury, if patients have some specific questions related to the injury itself or the pathology’.
The process and pace of adjustment
Adjusting to a research delivery role was often described as being ‘gradual’, making it difficult to pinpoint exactly when or how things became more familiar. Although some people had had doubts about whether the role was for them, having supportive colleagues who recounted their own experiences of adjusting to working in research was often helpful.
Learning and adjusting was always ongoing in research jobs. As Paul said, ‘You learn every single day in research something new, something different that comes up’. Many people had messages of encouragement and support aimed at NMAHPs new to research delivery posts. Paul and Sian emphasised that, after a while, things ‘click’ into place and become ‘second nature’.
Some people acknowledged that research delivery jobs were not right for all NMAHPs. Helen explained: ‘you come into research and you either love it or hate it, and I think you pretty much know within about six months whether or not it’s something that’s for you’. Libby agreed that these roles don’t ‘suit everybody‚ there’s an awful lot of paperwork, there’s an awful lot of computer work, and you have to be able to see the long game’. However, most people urged new research NMAHPs to ‘stick it out’ for about a year before deciding whether to leave and change jobs or not.
Several people who had moved fully into a research role (i.e. they did not have a split or additional non-research clinical job) felt that they had ‘lost’ something or were ‘missing out’. This feeling sometimes faded, but other times endured. From their previous clinical (non-research) jobs, some people missed the relationships with both patients and clinical colleagues, and felt it had been easier to see that their work was worthwhile/rewarding. Tabitha had felt a greater sense of satisfaction as a clinical midwife: ‘it’s more tangible and feels more immediate than research. And it’s a closer relationship, more intense, they need you and that feels good’. In addition to treating patients, Sanjos also missed learning about and developing skills in new radiotherapy techniques. Imogen felt she had lost the camaraderie with colleagues of working night shifts in the emergency department. Some people we spoke to had started, or planned to start, taking on additional non-research clinical shifts to gain more of these aspects.
Other people highlighted aspects that they were pleased to no longer contend with now that they were in a research role. This included various types of pressure/stress experienced in clinical roles and changes in the hours/shifts that they worked.
Libby liked that working in research delivery offered her opportunities to help patients without the expectation to fix things.
*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).