To find a clinical and a research role combined is very, very rare. To work- so, you could, so you could say, Okay, well I could work part-time clinical, and part-time doing research. Well actually, most clinical jobs are shifts, doing shift work. So then you have to be that awkward person that kind of says, Well I can only work, you know, I can’t work Thursdays and Fridays, you know, I have to commit to a certain kind of-. And most places, unless you’ve built up a very, very strong relationship, they don’t want you to do that.

What about doing some clinical within your research role? Again, funding across departments is very, very complicated. So then, the clinical- the research might say, Okay yeah, that’s valuable to our research, but does your- does your research add anything to your clinical? You’d have to again put forward a very, very strong case for that. And again, I don’t think- unless you’ve got really strong relationships or really good senior support, there’s no natural thing. That doesn’t happen naturally.

I tried for a very long time to get a day a week clinical. Where I was going to be given the time to do that out of my research hours. And the clinical people just couldn’t- even though I worked in the same Trust, they couldn’t find a place for me, even though there’s-. They couldn’t commit to one day a week long-term, even though every single day there’s bank shifts that go out.

So they couldn’t say, Yes, we’ll do one day a week. And there were things like, Oh well, yeah, but what about your mandatory training? We don’t do anything less than two and a half days a week, you have to do two and a half days a week. And my research manager was like, Well, I’m not- that’s not going to happen, I don’t want you to go down to two and a half days a week. So it just- it’s possible [laugh]. Don’t get me wrong. It’s possible. And people have done it. But it, it doesn’t come naturally.

There are all of these research projects going on, where people are doing the protocol and doing, you know, the patient information leaflets. And there’s a format. But is that format the right format? Are the templates-, is anyone looking at these documents? Is anyone really, really thinking about it? And actually- I think there probably is some kind of working group or something somewhere. But I think that, you know, the templates that you get on NIHR and stuff like that, are so old fashioned. The clinical trials units are very old fashioned. And people just need to think about ‘is this actually fit for purpose any more? Does it do-, is it actually helpful to patients? Is it actually helpful to research?’ And actually think about that. Because I think there’s a lot of potential to streamline. Not just add more and more and more and more and more, all the time.

So I initially- I remember when I first joined as a researcher, because- Because you’re not seeing patients in the same way, and you’re not as overstretched. I remember hanging around clinics and just thinking ‘what are we doing, what are we doing?’ [Laughs]. There’s this kind of a feeling of, there’s this feeling that you’re kind of wasting time. Or that you’re not being, you’re not getting stuff done. And I still feel that very, very strongly. Even now, kind of two and a half years later. I feel, you know, am I, is this productive? Is this a productive use of time?’

You know, being a midwife or being, you know, I imagine probably in lots of parts of the NHS, you get things done and you can clearly see what you’ve produced. Whereas being a researcher, things take a lot more time. Maybe not so much when you’re-, depending on the type of research midwife role that you’ve got , but you, you need time to think about things and time for things to percolate through. You need time to communicate with people. And things can take that, things have to take longer for them to be done properly. Whereas working clinically, it’s what needs to be done.

We had quite a long induction process. So we had all of our clinical induction, which I think is really important. Especially if you’re new to a Trust. You need to understand the clinical context in which you’re working, in order to be able to know where your participants might be, know how they’re being looked after. And also have that kind of ‘you are a real midwife’ [laughs], and you know, if something happens, that you can actually support your clinical-. So, if there is an emergency, then you actually know where, what to do, and where you’re going. And also the context in which the woman’s being seen, in terms of her actual care plan. So, how she might filter through a, through the system.

Because of what I do, I often ask them what they know about why they’ve come in, often. Especially if it’s a particularly sensitive topic. So, yeah. Ask them about their understanding about what they-, why they’re here. What they’ve been told already. And then try and see if I can fill in the gaps. And then explain to them how this study kind of fits in with where they are in the process.

People have very, very different understandings. And sometimes incorrect understandings, about why they are in the situation. Or they’ve misunderstood. Or somebody hasn’t given them correct information about why they’ve been admitted, or something like that. What does that help, how does that-, what does that help me do? It helps me not patronise them. It helps me not tell them things that they already know. Which I just think puts people’s backs up. It allows me to actually add something, possibly add something, which hopefully benefits them in some way.