Rachel X

Rachel X has been a research midwife for just over a year. Through working on several studies, she has become an unofficial specialist on pre-term birth. This has presented workload challenges as she receives a lot of clinical enquiries on the topic.

Rachel X has been a research midwife for just over a year. Before this, she worked in clinical midwifery at the same Trust. She had been advised to do a year in clinical practice before going into research. Rachel X has always been interested in how evidence is translated into practice and, having studied biology before midwifery, she felt a research position bridged her two degrees. She also felt that working in research would be an opportunity to expand her skill set. Currently, Rachel X is on a fixed-term contract. This is not an issue for her at the moment, but could become one: I think if I were continuing, say five years down the line, maybe I wouldn’t be okay with that.

When she began her role, Rachel X had to adapt to the language used in research and undertook training including Good Clinical Practice training. She didn’t have many expectations of what research would involve or anticipate the amount of office-based work she would be doing. However, she now enjoys the paperwork aspects of her role. Rachel X has a strong working relationship with senior research midwife colleagues who understand the challenges involved in the role. Similarly, there is mutual support with another research midwife who began a similar post at the same time: we’ve kind of figured it out together. Rachel X says that, after about three months in post, she started to feel more comfortable in her research role and familiar with the protocols of the projects she worked on.

Rachel X works on several research projects around pre-term birth, a topic which she has become an unofficial specialist on. She is involved in patient recruitment in the studies, and emphasises developing trust and communication with participants when explaining the study and taking consent. She also collects samples and sometimes processes these. One aspect of her job that Rachel X enjoys is having allocated study days, where she can attend conferences. However, Rachel X dislikes that there is often little opportunity to be involved in the analysis and dissemination of study results. She feels this is a contentious issue and gives the example of when papers are published with no acknowledgement of research midwives: people have worked very hard for these studies [‚ It] sometimes feels that it’s not really appreciated from higher up.

Rachel X’s experience of working on pre-term birth studies has meant that sometimes other midwives see her as a specialist on the topic. As such, she is often called upon for clinical advice. One difficulty of this for Rachel X has been navigating the large amount of time spent dealing with NHS patients and clinical enquiries about pre-term birth: we’re being funded for research, but actually some of my time is dealing with NHS patients. Knowing where to draw the line around activities she should do is difficult, especially when other structures are not in place to take over certain responsibilities: it’s a grey area that I find quite challenging.

Building relationships with and between colleagues is a central aspect of Rachel X’s role. This includes bridging between academic institutions, pharmaceutical companies, and other commercial companies or study sponsors. She likes that research offers this opportunity: there is still a hierarchy within clinical practice [‚] whereas in this area, you are the link between everyone. You’re the one in the middle. She also tries to establish rapport with clinical staff. In the past she has faced comments around her job being cushy, and feels more could be done increase awareness and engagement with clinical staff around research.

Rachel X encourages midwives considering research to think from an early stage about how they would like their careers to progress. She feels that you have to be quite pro-active in your own career, as progression is quite self-directed and there is no clear route for promotion once you have been in a research midwifery role for a certain time. Rachel X intends to continue working in clinical research but hopes to gain experience in broader therapeutic areas, such as oncology or infectious diseases.

Rachel X felt there were limited opportunities to be included in the analysis and write-up of study findings. It is an activity she would like to do in the future.

Age at interview 28

Gender Female

Well at the moment the studies that, that the two, two of the studies are from a different university, so not really. Your data goes onto the online database and then gets fed back to the main site. So not with that one. With the main, one, the main microbiome study is from our Trust. Again we’re not really in that phase. I mean clinical research fellows tend to have their own projects going on, but not really, there’s not a lot of writing up involved. There is, there are small opportunities, so there’s an opportunity for some data analysis for a scanning machine that we’re using, it has a new type of technology, that’s needing to be analysed and it hasn’t yet. So, I’m hopefully going to try and take that up at some point in the future just because nobody else is. But there’s no real routine inclusion in that, which I think is a shame, I would like to be involved in, in the end, the endings, the more, more fully rounded picture of the of the study because you can be involved, you’re definitely involved in the initiation of the study, and then you run it, and then it finishes and then all the data goes out to, to whoever, and then suddenly a paper appears and there’s no mention of what you’ve done.

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Rachel X felt she had developed transferable skills for other work situations, but that she would need to be pro-active about career progression.

Age at interview 28

Gender Female

I think you need to be quite careful that you don’t that you move things on quite quickly yourself. Because I, I’m in this role and I’ve done it for just over a year, and I feel that I need to move on. And I feel that there isn’t a clear route, it’s not that if you do this for so many, you demonstrate that you’ve done this and you do it for a year, then we’ll move you up to a Band 7, you have to, you have to be quite pro-active, pro-active in your own career.

So that would be the one thing I would probably tell people to advise, that you have to, you have to know what you want to do next because you could quite easily sit in a role for quite a number of years, doing the same thing. It gets quite comfortable and ultimately, you’re in academics and like I said before, your name doesn’t tend to appear on any papers, so if it’s some, it that’s something that you want you need to fight for it, and you need to really push for that. Or you need to think about your own research and whether you’re going to do a Master’s or a PhD, or just your own research project in general, but you need to, I think you need to think further ahead than I’m just going to go into research.

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Rachel X described some career options available to her. These including moving into a senior research midwife role, undertaking a PhD and moving to work in a pharmaceutical company.

Age at interview 28

Gender Female

Well there’s, there are Band 7 senior research midwives, who, it, again it’s the same as a normal job, you do, you kind of have to wait for the opening and then apply. And they would be, you would definitely need experience for that, and they have more of a, an oversight of a lot more studies, and they’re, they supervise junior research midwives, and then, so there’s the NIHR, have a, a scheme for health professionals, to do their own research project. So they fund it, so you need to, but it’s a bit, bit like kind of applying for a PhD, you have to formulate your own research proposal and apply, and they would give you the funding to, and they would also fund it in such a way that you can maybe continue with a bit of clinical work and then, you know, half your week is actually dedicated to your research. And then you know you write that up. Unfortunately, that used to be a master’s degree, and then when I wanted to do it this year, they stopped the funding.

So, I would, that’s what I was intending to do, but I felt that it was a shame that you would do all of that and not get anything, not get any qualification at the end of it. So there’s that, and then a lot of people go and do PhD’s and you don’t need to do a master’s for a PhD is what I recently found out. I thought that it was a straight line, but that’s what a lot of people do. And then actually a lot of people are going, that I know are going into pharmaceuticals. So, there is a quite a, you can make that step, the skills that you learn within research midwifery can translate quite directly over to a pharmaceutical company.

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As a student midwife, Rachel X had been on a placement with a team of research staff.

Age at interview 28

Gender Female

Yes, so I was, I was coming up to qualifying, so yeah in the summer of my third year.

And again, even at that stage I knew that I wanted to do research. So, I think maybe I was very receptive to it, so I really enjoyed it. I think it’s a little bit like marmite though cos I’ve seen that with, with some students that come through now, they either really like it, or they absolutely hate it. I think a lot; some people think they don’t know why they’re there. They don’t really see the point, you know, of doing that. Whereas others they, we had some nice feedback of, some students, saying I never realised that this was a career option, but I’ve, I’m really, really keen to follow this now. So I really enjoyed it, and I, I enjoyed shadowing them, and I enjoyed going around different areas of the hospital and as a newly qualified midwife as I was, so I got a job in [hospital name] but I also did an application for a research midwifery role as a newly qualified midwife, I think slightly naively, cos I thought I really want to do it, and it came up so I thought I might as well apply. And I got an interview, and they said, Oh we really like you, and we like your enthusiasm, but I think you’d better go and do your first year of midwifery first and then, and then try and look into a research role. So, it’s, it’s something, every step of the way that I’ve been looking at.

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