Year of the Nurse and Midwife stories: Mary Anne Fifield
To coincide with the 200th anniversary of the birth of Florence Nightingale, the founder of modern nursing, the World Health Organization has dedicated 2020 to nurses and midwives. We want to take this opportunity to thank the incredible nurses and midwives working in the West of England, and shine a light on the great work they do.
Mary Anne Fifield has worked as a research nurse at Heart of Bath Medical Partnership for over two years. We spoke with her to find out more about her journey to becoming a research nurse and what inspires her within the career.
Can you tell me a bit about your role?
I work as a research nurse in the clinical trials unit at Heart of Bath, together with an incredibly efficient study coordinator and supported by our three most research-active GPs. We’re a dedicated research team, working on a number of commercial studies for pharmaceutical sponsors, as well as on academic studies for universities.
We try to engage all our colleagues in research – often the first person approached is a receptionist, when a patient has seen a poster in the waiting room. We regularly share bite-sized information about our studies with all Heart of Bath staff, to ensure patients receive a welcoming smile when approached. Promoting research to staff and patients has always been a major part of my role as a research nurse.
We have a large and varied portfolio; I might be assessing patients participating in a diabetes study, seeing a baby with their mum and dad for a paediatric vaccination study and then, gaining consent from a gentleman joining a trial involving urodynamic testing for LUTS (long-standing urinary tract symptoms). Currently, as with many clinical trial sites worldwide, we’re preparing to contribute to research into the COVID-19 pandemic.
How did you start your nursing career?
I left school at 16 with every intention of becoming a nurse, but instead went and did lots of other interesting things, which included living and working for five years in the Middle East. I eventually qualified to be a nurse as a mature student and have since gained a degree in Health and Social Care.
My first nursing role was as a theatre practitioner at University Hospital of Wales (UHW) in Cardiff. I enrolled on an 18 months rotation, working as a scrub nurse in most UHW theatres, each for an eight week period. Through this role, I gained experience in a number of very different specialties: ophthalmology, cardiology, gynaecology, neurology and so on. It was a valuable opportunity to gain insight into how teams work best, and it set the groundwork for the collaborative team-working I prefer and try to encourage.
My chosen specialty was cardiology. I started work at the Cardiac Centre at the Royal United Hospital (RUH) Bath, primarily in the cardiac catheterisation labs. The cath lab is an examination room with diagnostic imaging equipment that is used to visualise the arteries and chambers of the heart and treat any abnormality found. We would mainly do balloon angioplasty and stenting into coronary arteries and fit pacemakers, though we did many other procedures also.
I went on to work as a cath lab sister, co-managing a sizeable team of nurses. We carried out cardiac interventions in emergency situations, sometimes with ambulance crews bypassing the Emergency Department to bring us patients experiencing heart attacks. Coordinating the busy cath lab lists, with constant stress levels and the heavy workload pressures, was extremely challenging and probably represents the most significant challenge I have faced in my career.
How did your career in research nursing start?
There was no cardiology research team at RUH and the Trust was keen to start doing research in this area. In 2013 I went to work with the diabetes research team to find out how to run clinical trials, with the aim of setting up a dedicated cardiology research team. I learned so much from my colleagues and really appreciated the opportunity to work alongside them, as even fathoming the clinical trial acronyms seems equivalent to learning a new language. I worked with them on some fascinating diabetes clinical trials and after a while, I started to drop days with the diabetes team to build my own cardiology research portfolio.
That portfolio grew successfully, in parallel with an expanding team, to deliver the studies. Later I left to work with Dr. Ali Khavandi on the Cardiologist’s Kitchen initiative. He was awarded funding by The Health Foundation to set up an 18-month project to improve patients’ cardiovascular health through diet and exercise. This involved engaging patients with evidence-based dietary changes through social media and the project website, which though not research, was a fabulous and enjoyable innovation to be part of.
As I had been working closely with GP sites while project managing Cardiologist’s Kitchen, I decided to stay in primary care rather than return to secondary. Here we have been so productive that we’re high up the list of GP Practices running multiple studies, tenth when we last checked.
When you look back on your career, is there a particular moment, time or person that really stands out?
When I look back on my career so far, it’s been the patients I’ve recruited into clinical trials who inspire me. They really engage with the research and on the whole, as far as they are able to, participate with full commitment from start to finish. I took part in studies myself before becoming a healthcare professional, so I understand something of their input and I always take time to convey how much we appreciate this and simply thank them.
There is one study that stands out above all the others I have worked on, though I am not at liberty to share the results I have observed. Again, it is the patient perspective that I find so impressive and how they respond positively and contribute to help us collect good data to improve treatments, procedures and interventions in the future.
There are many reasons you may hear from patients to explain why they put themselves forward and put themselves out, often it is about giving something back to the NHS. With everything happening in the world right now, this makes so much sense.
What would you say to someone else who was thinking of starting a career as a research nurse?
As I do, take time to listen to what your patient has to say. Research Healthcare Professionals are advantaged with a little more time with their patients than other staff may have. There is evidence to show that it pays to make your interaction patient-centered rather than to follow your own agenda.
This concept is explored in the NIHR ‘Let's Talk Trials’ course, which I have co-facilitated since 2015 with another experienced research nurse, Joanna Nicklin. It is a one-day advanced communication skills course, designed for health professionals who talk to patients about participation in clinical research. One piece of advice that I never tire of hearing from Joanna, something to give confidence when approaching a patient you may wish to recruit, is that everyone deserves an opportunity to take part in research.
So, for someone starting their career as a research nurse, consider signing up to ‘Let’s Talk Trials’. Communication skills are so important in this role. When you recruit a patient you have to feel confident that you’ve shared all the relevant information and that they’ve understood the consent process thoroughly, so they know what they’ve signed up for and they will be more likely to complete the trial. The course is also a great place to meet and learn from other peoples’ experiences.
I would also recommend networking on social media. Both Facebook and Twitter have vibrant research communities where new research personnel can ask questions and experienced people will help and share advice.