On International Nurses Day 2020, CRN Wessex spoke with Sue Jackson, a Neurology Research Sister at University Hospital Southampton NHS Foundation Trust (UHS), about her experience of nursing during the COVID-19 pandemic and why she's proud to be working in research.
Tell us about your normal role and a typical day prior to the COVID-19 pandemic?
I am a Research Sister at University Hospital Southampton and one of the co-team leaders of the neurodegenerative research team. The studies we deliver focus on dementia, Huntington's disease, Parkinson's disease and Motor Neuron Disease (MND). Most of my role involves overseeing and delivering various longitudinal observational studies in the neurodegenerative field. I also support commercial studies testing new treatments for patients living with Alzheimer’s disease and Huntington’s disease. My role in these is to carry out cognitive and clinical tests that helps assess the drugs’ efficacy, as well as working as patient liaison between the clinical and the research settings.
How has your role changed as a result of the COVID-19 pandemic? What are you working on now?
As a result of COVID-19, I have been redeployed to the critical care research team as I worked in critical care before I moved to research. Within the space of a week, our entire neurodegenerative research team went in completely different directions to work with different teams in various settings, so we hardly ever see each other now!
Moving to the critical care team has turned my working life upside down. I’ve changed my working hours from three long days to four shorter days to provide more cover across the team, and I frequently work weekends now. I’ve joined a completely new team (made up of several others who have also come from other teams) and had to adapt to a different environment. We have opened several new studies in the space of a few days - a process that would normally take months – and I had to quickly upskill myself to understand how research in an intensive care environment works, and get to know all the different multidisciplinary teams that work there. As a research nurse you gain a good knowledge of the field that you work in, so I have a good understanding of the neurological disorders that I normally work with, but I’ve obviously had to learn very quickly about respiratory disorders and intensive care treatments, which has been a big change and a steep learning curve. However, the same principles of managing and delivering research studies apply across all specialities, so the team’s combined years of research experience helped us to support each other and quickly adapt.
I’m involved in a number of critical care studies at the moment, for example REMAP-CAP
. This is a complex study, trialling several different drugs that are currently used for different diseases, to see if they are effective in treating patients with COVID-19. Patients could be randomised to new treatments from up to five different treatment domains, including antiviral drugs, immune modulatory drugs and convalescent plasma.
What has the experience been like so far?
Initially, it was extremely busy, but thankfully it has started to calm down a bit in the last week or so; there seems to be fewer new patients coming through the Intensive Care Unit, which has given us all a bit of breathing space. Although it has been very busy, it has been a really interesting and valuable experience to be delivering important research and working at the frontline. It’s been a great opportunity to be involved in something completely unprecedented, playing my part in making a difference, and hopefully contributing to a more positive outcome to this worldwide crisis. I have also been really encouraged by the response of the clinical team in ICU to our research; they are so busy caring for very sick patients, but they are always really interested in what we are doing and very willing to help us whenever they can.
At the same time, it has been quite stressful and occasionally it can be overwhelming. I am coming into the hospital every day, not really knowing how much risk I am exposing myself to. Although I try hard not to think about that and just get on with it and protect myself as best I can, when I go home at the end of the day, it is hard not to worry about my own and my family’s safety. Especially working in ICU, where one sees healthcare workers with COVID-19, and some young people who were previously fit and well – it is a scary scenario. Although I am usually a strong and positive person and I don’t really get stressed about things, I must confess to having moments when negative and anxious thoughts have crept in, but mostly I’ve been able to rationalise those thoughts and not let negativity get on top of me.
All the research nurses, research practitioners and clinical trials assistants have had to adapt very quickly in changing our roles and working patterns to deliver these urgent public health studies as quickly as we could while keeping high quality standards. The whole R&D department have also been working hard to open research studies in record time. It is a massive team effort, and it has been very evident how committed every single member of the UHS family is in contributing as much as possible to the success of these studies. We all hope to improve the outcomes for these very sick patients.
How did you first become involved in research?
I qualified as a nurse a long time ago and worked in cardiothoracic critical care until I took a career break when my children were small. During my career break, I studied for an Open University degree in psychology which I really enjoyed and when I was back working in the critical care unit, I saw a DeNDRoN (dementias and neurodegenerative diseases) research role in Oxford advertised. They were looking for a registered nurse or psychology graduate and I felt I met both criteria and it sounded interesting. I applied and got the job and have worked in research ever since, spending a year in Oxford, five years in Basingstoke and I’ve now been at Southampton for two years. I really enjoy it! I am a very methodical person and I like to be organised, so I like being able to combine these project management aspects of the job with my nursing skills and patient contact. I also feel that through research I am making a contribution to finding new treatments for diseases, better ways of delivering care and hopefully improving patients’ and families’ lives.
Why do you think research is important?
Research is always important for finding and developing new treatments, assessing their effectiveness, and improving patients’ experiences and outcomes. All healthcare should be evidence based and now, because of COVID-19, research seems more important than ever. Conducting proper randomised controlled trials is the only way to really understand for certain which treatments work and which don’t. The media coverage of this pandemic has certainly shone a spotlight on research and increased public awareness of it massively. It has a much higher profile and I think people have a greater understanding of what we do now - they recognise the importance of research, and I am proud to say I am part of it.
Reflections on International Nurses Day
When this pandemic began to grow and it became apparent that most of our existing research studies would be suspended, research nurses realised they would be redeployed to work in other areas. We knew we had skills and competencies that were needed, and we were all very ready and willing to step up and play our part. I very much felt that this is what I signed up for, I was proud to say “that's my job and I can do it”, I wanted to step forward and do whatever I could to help. I firmly believe that we, nurses, are hardwired to do whatever is needed to help our patients in whatever way we can, and for us, research nurses, that means giving them the opportunity to take part in research and the best chances of recovery. That is our main motivation, and we feel pleased and proud that we have skills that we can use to make a difference and contribute to something important.
It feels like this pandemic has increased the public’s awareness of the role of nursing and shown how committed we all are to our profession. But there are many frontline healthcare workers who have shown such courage and selflessness throughout this crisis, coming to work and putting themselves at risk every single day; not only many nurses and doctors, but also all the support staff such as cleaners, porters and kitchen staff. They are all just as important to the whole team effort and they deserve recognition too. We are all proud to work for the NHS and we certainly appreciate the recognition that the NHS is getting right now, but I hope that it continues - I hope that people don’t forget once this is all over.
The views and opinions expressed in this interview are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health and Social Care.