Julie

Julie is a nurse researcher working in the area of paediatric intensive care. She has been in her current post for 10 years, during which time Julie has undertaken a PhD. Her role has evolved from research delivery to include managerial aspects, independent research and research capacity building.

Julie is a nurse researcher working in the area of Paediatric Intensive Care (PIC). Julie’s interest in research started during her undergraduate nurse training. She worked clinically for approximately three years before taking on a part-time audit and research assistant role for research studies on PIC. She returned to clinical nursing full-time but was keen to get back into research in the future. She completed a Master’s degree to gain understanding of research governance and methodologies and, on completing this, went to work as a Clinical Research Facilitator’ for Medicines for Children Research Network (MCRN) a newly-established research network. She enjoyed the studies but the network had also mopped up a lot of studies that were floundering a little bit. These included problems with site file management, PI input and research nurse coverage. She missed having a specialty area and felt like a jack of all trades and master of none.

When the opportunity arose, Julie returned to my own speciality of Paediatric Intensive Care as a lead research nurse. The move provided her with a promotion, more autonomy and a fresh slate to design how research was delivered. Over the 10 years Julie has been in post, she and her colleagues have developed the research team in the unit. Her role has become more managerial but Julie is keen to maintain participation in research activities, particularly qualitative studies. She credits the evolution of her post in part to having supportive managers with an understanding of where I wanted the job to go and where the unit needed the job to go, and strong relationships with medical colleagues. Having a research role has affected how Julie feels she is identified by others. She still introduces herself as a nurse to potential participants, but tends to describe herself as a nurse by background rather than a nurse. In my heart I’m a nurse, but actually I recognise that that’s not how people would see me. Julie recently completed her PhD which she worked on part-time over the last eight years. Her official job title recognises her as a Nurse Researcher’ with independent research skills but she feels many people, including nurses, will not know what this means she does on a day-day basis.

Julie describes the structure of research nurse banding and responsibilities in her unit. For example, they employ Band 5 research nurses to provide study support whereas a Band 6 research nurse would more likely be a lead nurse’ for a study. Of the staff that Julie manages, there are currently two clinical nurses working part-time in research as secondments. She believes this is a great arrangement because they’re staying clinically relevant, they’re still maintaining their skills, but they’re getting a grounding in research. In terms of her own clinical skills in intensive care nursing, Julie describes herself as rusty. She would like to do more clinical work but has had to cut it down over the years.

Julie tries to promote a supportive attitude towards research conduct amongst the nursing workforce, but finds there are tensions. She emphasises that research is core NHS business but thinks the pressures in clinical areas can present dilemmas for research nurses, who often feel they are nurses first and research nurses second. For example, Julie felt it was appropriate that the team covered breaks for clinical nurses during the winter pressures but was concerned that this was ongoing and was not a long term solution to address staffing shortages. One way that Julie encourages her research team to foster positive relationships with clinical staff is by being a visible presence on the unit every day and timing research visits to fit around ward activities, so that we’re not adding pressure to staff at busy times. By liaising with clinical staff, Julie feels that research nurses can become more informed not just about clinical details of the patient but also the wider context (including family dynamics and support structures) which might affect whether and how to approach them about research opportunities. In addition, Julie feels that good relationships between research and clinical nurses can highlight new topics to research and the contribution of research to enhancing patient care. Julie is keen to support both research nurses in her team and clinical nurses to undertake their own research, audits or service improvement projects. Staff can access training and are encouraged to draw on the research expertise of the team to carry out projects and then disseminate the findings: you’re not just here to deliver this research, actually you’ve got many more skills.

Julie emphasises that the communication skills of research nurses are crucial in relation to clinical staff and patients and/or their families. Other skills Julie recommends are an attention to detail and thoroughness. In the context of Paediatric Intensive Care, Julie feels it is important research nurses have the ability to judge clinical situations and for this reason favours embedded research staff to deliver research. In terms of her career progression, Julie is looking to pursue clinical-academic pathways in medicine. Her aspiration is to have both a contract within the NHS and the University settings in order to help her succeed in producing well-designed studies which successfully secure funding grants.

The research nurses on Julie’s team covered colleagues when there were staff shortages and additional workload pressures on the wards. However, she highlighted that it was very hard to claw that time back for research.

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Julie felt that communication and team-work were crucial to being a research nurse in intensive care.

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Julie described some of the skills and values that are well-suited to research nursing, and also those gained through working in this area which may help with career progression.

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Julie ran sessions on various training courses for new staff. She thought this had helped develop a research supportive environment and working relationships.

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Julie encouraged both research and ward staff in her unit to present at conferences and publish. There are various ways she supported this, including reviewing drafts of conference posters.

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Julie’s job description was rebadged, from research sister to nurse researcher, since completing her PhD.

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In the context of paediatric intensive care studies, Julie felt it was helpful to talk to ward staff about patient suitability. Communication within the research team was important too.

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In Julie’s research team, Band 5 research nurses took consent for observational studies. She thought it was important to consider the family unit when consenting for paediatric intensive care studies.

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Julie talked about the value of health research for patients, the health professionals caring for them, and the overall health care system.

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Julie had enjoyed her dissertation as an undergraduate. She took opportunities to become involved in auditing initially and then in research data collection.

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Julie thought that her day-day work activity was not what others (including the general public) would recognise as nursing.

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