Case study: South London nurse on working in research: “It’s rewarding, dynamic and collaborative”

A south London Lead Research Nurse has spoken about the many benefits of working in research to mark International Nurses Day.

Bernard Siu is a Lead Research Nurse in The Royal Marsden NHS Foundation Trust in south London and the Principal Investigator for a study led and delivered by nurses. To mark International Nurses Day, we spoke to Bernard about the rewards of working in research as a nurse and his experience of being a Principal Investigator for a nurse-led study.

Bernard was first inspired to get involved in research after meeting a Research Nurse several years into his nursing career. He says:

“I studied nursing in Australia, where haematological cancers and stem cell transplantation stood out for me as a specialty. After moving to London, I worked in a private hospital giving treatment to cancer patients. It was a good learning experience, but I wanted to move into the public sector.

“I was working as a chemotherapy nurse at the Medical Day Unit in Charing Cross Hospital, where I shadowed a Research Nurse and became fascinated with their work. Meeting that Research Nurse was an eye-opener for me. I started looking for jobs in research and joined The Royal Marsden in 2009.

“My first research job involved helping one of the teams obtain breast tissue banking samples from the operating theatre. I would talk to eligible patients to obtain their informed consent and collect samples using freehand biopsy from mastectomies during surgeries. It was a good role to begin this new chapter without any prior research experience. I enjoyed it because it was very different from what I was doing before.”

Bernard eventually joined the Clinical Trials Urology Unit Chelsea (CTUUC) and has been part of it ever since.

Rewards of working in research

Bernard found that becoming a Research Nurse broadened his network and professional horizon. He says:

“Research is very dynamic and collaborative. As a nurse working in a ward, you are just in that small area delivering treatments. You are not involved in decision making; why that patient has that treatment; you just deliver it. Research is interesting in many respects because you work with clinicians, registrars, research fellows, the trial pharmacy team and more or less everyone in the hospital."

“You become specialised in your area. You know the treatment pathway, the disease process and diagnostic factors. I wouldn’t say you become an expert, but you are the key worker for the patient in that trial. You get to know the patient and develop a relationship with them, they tell you about their problems, and you meet their relatives. You want to do the best for the patient with the help of others involving their journey.

“Working in research means you can offer the patient alternatives. The treatment might not work for the patient because it is in a trial setting. Still, you want to do everything you can to give them options besides the standard treatment while ensuring that it is done safely and that the patient understands what they're getting into. This process and going good is what makes research satisfying for me.”

MANCAN2 Trial

The MANCAN2 (MANaging symptoms during CANcer treatment) trial is investigating the effectiveness of a virtual cognitive behavioural therapy (CBT) intervention in reducing the impact of hot flush and night sweat symptoms in men with prostate cancer who are receiving hormone therapy treatment. Sharing updates on the trial’s progress, Bernard says:

“Our Clinical Nurse Specialists are receiving CBT training from a Clinical Psychologist that will be followed by some practice. The Clinical Psychologist will check their competence before they start delivering CBT to trial participants.

“In the meantime, I have started identifying patients. Once we have enough interested patients who have consented to take part, we will randomise them into two groups. One group will receive treatment as usual, which is the current standard of treatment, and the other will receive treatment as usual, plus CBT. Comparing the two groups will enable us to tell whether CBT helps patients better cope with the side-effects of hormone therapy treatment."

Nurse-led and nurse-delivered

The novelty of the MANCAN2 trial is that Clinical Nurse Specialists will deliver cognitive behavioural therapy. Usually, it is delivered by the Clinical Psychologist. Bernard continued:

“It is pleasing to know that our Clinical Nurse Specialists will benefit from an extra set of skills because cognitive behavioural therapy can be used in many different settings. Also, if we can demonstrate that nurses can successfully deliver CBT, this will ultimately mean that more patients can access it.”

New experience

For Bernard, who has worked in research for 13 years, this is his first time as a Principal Investigator (PI). He says:

“Now it’s my turn, so I'm excited and a bit nervous because it is a big responsibility. I have some knowledge of the PI remit from working with many of them over the years, and I can always reach out to the Chief Investigator if there is something that I am uncertain about. I hope that support like this and research experience will open the door for nurses and allied health professionals to be Principal Investigators in the future.”

The MANCAN2 trial is funded by the National Institute for Health and Care Research (NIHR) Patient Benefit programme and is led by the University Hospital Southampton NHS Trust. Delivery of the trial at The Royal Marsden is supported by the NIHR Clinical Research Network South London and the NIHR's Biomedical Research Centre at The Royal Marsden and The Institute for Cancer Research, London.