Case study: International Nurses Day: A Research Nurse’s perspective
To mark International Nurses Day CRN KSS spoke with Claire Pegg, Lead Research Nurse at Maidstone and Tunbridge Wells NHS Trust about the essential role Research Nursing plays in patient care
Like almost every nurse working today, patient welfare is central to Claire Pegg’s work. Even before she qualified, she knew she wanted to work in Intensive Care. Now, having moved into research nursing, and progressing to Lead Research Nurse for her trust, her commitment to delivering excellent patient care is as strong as ever.
“I qualified in 2004 and after a six-month placement on a respiratory ward went straight onto an Intensive Treatment Unit (ITU), which is where I had always wanted to work,” she says. “I had been working as a nurse in ITU for over six years when a Research Nurse position came up and I was encouraged to apply. But I really wasn’t sure it was right for me at first.”
This initial apprehension is not uncommon for nurses who are asked to consider a move into a research post. Claire says that she has found that this largely stems from a perceived lack of patient contact. “I had wanted to work in Intensive Care since before I started my training - I was, and still am, completely driven by a desire to deliver patient care. I did not want to find myself in a job that took me away from that.”
Maintaining patient contact
Many nurses feel that going into a research post means losing their connection with patients - but that is a common misconception. Claire explains: “I was fortunate enough to have had some great guidance from my senior leadership when considering my first Research Nurse post. They were confident that my fears would prove unfounded, and they were quite right.
“As a research nurse, you deliver all the care to the patients who participate in trials. In that regard, and in some specialities, the role can be similar to that of a clinical nurse specialist, but it has an added dimension - a larger goal.
“While you are caring for the patients in front of you, you are also working towards the care of future patients, who stand to benefit from the trials you are running,” she says. “As an ITU Research Nurse I worked on a number of studies that had a lasting impact on patient care. For instance, we looked at ways to improve ventilation, and methods for feeding and nourishing patients in ITU.”
Research during the pandemic
When you are working on research projects, your work has benefits that really last, and extend far beyond treating the patients in your unit. The pandemic demonstrated this very clearly.
“We were working on the RECOVERY trial investigating the possible benefits of using dexamethasone to treat hospitalised Covid patients,” says Claire. “At the beginning of the trial, many clinicians were sceptical about the use of steroids in treating Covid. But during the study the benefits became clear very quickly. In just a few weeks, the trial results had been translated into new clinical guidelines, which continues to benefit countless Covid patients today.”
Claire admits that managing research projects during the pandemic was one of the most stressful experience in her professional career. “In a way, I hope that was the toughest challenge I will ever face,” she says. “One evening I was sitting at home and watching the Prime Minister on television. He said that ‘the only way we were going to get out of this pandemic was with research’. I remember crying, and not knowing if I was crying because of the enormous pressure we were under, or because the role of research was finally being given the prominence it deserves.”
Encouraging research-active nursing
The pandemic was a highly challenging time for everyone, but one positive thing that has come out of it, is that clinical research is better understood and more widely appreciated than ever before. In her current role as Lead Research Nurse at Maidstone and Tunbridge Wells NHS Trust, Claire is looking to encourage all nurses working in the Trust to be more research-active in their roles.
“At the end of the day, nurses know their patients better than anyone, so it makes sense that they should be centrally involved in their departments’ research activities. Over their career, a nurse will build up many years of specialist experience in their departments, as well as great working relationships with consultants. We need to tap into that knowledge and experience.”
This is very much in line with the research strategy published by Ruth May, the Chief Nursing Officer for England, last year. Her Making Research Matter strategy emphasises the importance of nurse-led research, which she describes as “the cornerstone of high-quality, evidence-based nursing”.
In practice, integrating research into the working lives of nurses means including in job descriptions, and critically, freeing up time and capacity for carrying out research tasks. This is not an easy thing to achieve, and requires major organisational and cultural change. But, says Claire, it is a fantastic goal.
“We need to think strategically, and nationally, about how to harness and use our nursing workforce’s experience and knowledge,” she says. “Not just to carry out research, but to actually drive the research agenda, and help define our priorities.
“I am fortunate enough to have been offered a Scholarship from the Florence Nightingale Foundation, and the project I am working on for that touches on this subject.”
The power of the network
It is in tackling these large national strategic issues is the kind of area where working with the National Institute for Health and Care Research (NIHR) comes into its own. “The NIHR is hugely important in so many ways, but one of the most exciting is how it empowers you to work on big ideas,” says Claire.
“Through the NIHR you feel connected to people with the same goals, and you are surrounded by people who can help you to develop, and achieve those goals together. The Clinical Research Network is exactly that, a network - you can always find people to help you work through a problem, or spot an opportunity for improvement.”
The NIHR, and the clinical research community in general attracts highly driven and motivated people. Claire says, this is the nature of research. “I have found that clinical research tends to attracts people who have a positive outlook,” she says. “This is because at the end of the day, all of us are driven by the desire to improve the world around us.”
“That is, fundamentally, the definition of research. As a research nurse, I feel particularly privileged because I am able to take part in that wider mission without sacrificing the patient contact that I love.”