ARE YOU DELEGATED?
As a healthcare worker, you probably know your way around the equipment used in your chosen path, be it a blood pressure machine, an X-ray machine or even a centrifuge. So when you start that new job, or change departments, you often would get stuck right in, helping out perform tasks on the ward or department, helping out colleagues and contributing to the patients smooth and safe journey whilst they are in hospital or clinic.
While offers of help are often met with gratitude and appreciation especially in a busy clinical setting and one is left to carry out tasks, within their scope of practice, i should add! The same cannot be said in a Clinical Research setting. That is not to say that your offers of help are not appreciated within a research setting, it just means that, even if your help was needed, your colleagues would not be able to call upon you unless you have been trained and delegated to whatever research study they would be working on.
Clinical research is heavily regulated as you would understand, since new medicines and Equipment are being tested and researched as to their usefulness and effectiveness before being licensed for use on the general population. So one would expect that a series of rigorous sets of rules and regulations are in place to ensure that the end product(s) are indeed suitable for human consumption and use. Amongst the long, essential list of regulations is one known as the ‘Delegation Log’.
The Delegation Log is a vital piece of documentation that is used to keep track of those that have been trained and then delegated tasks on a particular research study. It is an important part of a long list of checks and bounds that are put in place to protect the integrity of a research study. That is the reason why you cannot work on or perform any study related tasks unless you have been trained and delegated to those tasks by the Principal Investigator(PI) in charge of the study.
So when your kind offer of help is turned down next time, it is not because it is not needed and that your colleagues are not grateful, but it is because you are not on the delegation log and thus can not perform any study related tasks!
Clocking Off: How I learnt not to take work home!
Black Woman working on a Laptop
As a Black Woman, I am well aware of the double edged sword( Black & Woman) of having to work twice as hard as everyone else on top of having to constantly assess and reassess your work because if anything would go wrong, you would most likely be the first to be blamed. I am also acutely aware of the racial trauma we endure and the need to be constantly hyper-vigilante in all spaces we occupy, which just adds to our racial injury.
The COVID-19 global pandemic has forever changed how we work and the workplace culture that accompanies our jobs, so to speak. In the midst of a forced shutdown, companies and employers were forced to bring in changes that many have been asking for years that most employers have mostly paid lip service to! Working from home became “THE THING” and the era of employer led as opposed to employee led flexible working came into place. Gone was the so-called rat race and all over the world employees were reflecting on what life meant to them and what changes they wanted to make. I for one was here for all of it.
Woman on Laptop and Smartphone
The world of clinical research is a fast paced one with specific timelines on collecting clinical data and reporting them. For example, more often than not, sponsors require data on SAEs to be reported to them within 24 hours of one being reported. As a clinical research nurse/study coordinator, participants had my work number and preferred to call me as opposed to the emergency number they were provided with at the start of the trials. It was great that i had such a close working relationship with our trial participants and that contributed to the smooth running of our trials but it also meant that i was almost always the first to learn about issues arising like an SAE!
That was how i found myself dealing with an SAE and the paperwork that followed, not to mention the numerous phone-calls to the sponsor on a Friday evening way after work, on my own unpaid time. Having a work phone and carrying it home with me, seemed like a great thing to do as a way of getting on top and planning my work but it also meant that it ate into my private home time and i could not really switch off. I literally carried work home with me everyday! No wonder i was constantly tired, feeling like i was being pulled from all sides, but, hey, wasn’t burnout a great marker that you were doing something right?
Black Woman reading a book.
Fast forward to a new job and I am going through all the IT set-up and but this time I have no work phone, so I would not have to carry work home with me and I could maintain that work like balance that I so craved and had etched out but I am also a work in progress, because in the middle of setting up emails and teams, I found myself synchronising my phone to my work emails and teams! Luckily I caught myself just in time to remind myself that I was already doing enough, giving my 100% at work and that work stayed at work!
But we all know that it takes years to unlearn traits that have been part of ones identity formed from societal pressures and perceptions. So I have to fight the daily urge to be on top of everything and synchronise my phone to work emails and teams and remind myself that when I leave work, I make sure I leave ‘work’ behind!
How do you maintain your work life balance? Drop us a comment.
The Wandering Nurse!
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Research Nursing as a career option.
Nursing has evolved over the years and has opened up many career paths, one of them being research nursing. While nurses have always helped in research in one way or another, it is only in recent times that the role of nurses in research both as clinical researchers in their own right as well as helping run clinical studies as research nurses, has truly been recognised and feted, but there is still a long way to go in dispelling the myths that surround Nursing and Research and also Research Nursing. If you have heard of ‘evidence based practice’, wondered why CPR changed from 15:2 compressions/ breaths to 30:2, or why manual handling has changed over time amongst other things , then you have engaged with research.
Who is a Research Nurse and what do they do?
“ A research nurse is a registered nurse who plays an important role in delivering clinical research which in turn improves treatment pathways and patient care” - RCN.ORG
“ Research Nurses bring studies to life” - Lisa Berry, Senior Research Nurse.
According to the Royal College of Nursing(RCN), a career in research nursing offers nurses the opportunity to use core skills, contributing to the development of new evidence and improving patient care.
“Clinical research is essential- It is the only evidence-based method of deciding whether a new approach to treatment or care is better than the current standard, and is essential to diagnose, treat, prevent, and cure disease” - RCN.ORG
I first came across research nursing while working alongside research nurses as a student nurse, working as a clinical trials assistant in a clinical trials unit, working with healthy volunteers, testing new drugs and devices. Years later after qualifying i worked as a research nurse, a role that was very different from ward based nursing but still utilised the clinical and nursing skills gained whilst working on the wards. There is this disconnect between ward based nurses and research nurses, a misunderstanding amongst nurses that research nurses do not really do much and are not really ‘Nurses’. The roles, while different all require use of nursing and clinical skills. The national body that is responsible for research in the U.K, the National Institute for Health Research ( NIHR) is trying to bridge this gap with their ‘Clinical research is everyone’s future’ which aims to embed a research culture across the whole of the NHS by encouraging a research positive culture and encouraging all NHS staff to be research aware and active. Some NHS trusts with Research and Development (R&D) departments have short/ week long clinical placements as part of the student nurse pathway which is a great way for students to be exposed to the practical side of clinical research.
As a research nurse you work within a wider team as well as autonomously within Good Clinical Practice(GCP) guidelines and your duties include but are not limited to:
Acting as a patients advocate while supporting them through their treatment as part of a clinical trial.
recruiting patients to clinical trials.
Sample collection and processing
Data collection and submission.
Coordinating clinical studies from initiation, management to completion.
Preparing trial documents, submitting trial documents for regulatory approval.
Managing a team.
How to become a Research Nurse.
It is not possible at the moment to come into research nursing as a newly qualified nurse. Some clinical experience is needed, but there are ways you can still get a so called foot in:
Find out if your Trust has a research and development department or your local research network and what research studies are being run in your hospital/ ward and how you can help the research team. You could be the ward/ department research link nurse.
If you work soley for a nursing agency, you could find out if they have contracts with private research companies where you could do some shifts ( training is always provided).
Do your Good Clinical Practice ( GCP) training. Training opportunities can be found on the NIHR website or via your local /regional Clinical Research Network (CRN)
The above will work in your favour when you decide to apply for a permanent research post. These can be found on the NHS jobs website or other job search sites like indeed . Just search for Research Nurse. You can also apply to work as a research nurse for Clinical Research Organisations ( CRO) , G.P practices and Charities like British heart Foundation, Cancer Research just to name a few.
Things worth noting.
Every research study is unique and has a protocol that determines how the study will be conducted. Detailed study specific training is normally provided before each and every study. Research specific training is provided by the trusts local research and development department or the local clinical research network (CRN) or the research organisation that you work for. If in doubt, always ask. There is always a team of people willing to help.
Research and the research network still has a diversity problem in terms of workforce and in patient/ participant recruitment. This is an area that the NIHR are trying to rectify with their key priority of: Promoting equality, diversity and inclusion in research.
“We are committed to equality, diversity and inclusion in everything we do. Diverse people and communities shape our research, and we strive to make opportunities to participate in research an integral part of everyone’s experience of health and social care services. We develop researchers from multiple disciplines, specialisms, geographies and backgrounds, and work to address barriers to career progression arising from characteristics such as sex, race or disability” - NIHR
As earlier indicated, research nurses work within a wider team but also autonomously , which means at times working alone in terms of patient/ participant recruitment, data collection and input, arranging patient visits and all study related actions that do not require the Principal investigator (PI). This can at times be challenging in terms of getting time off or annual leave. So with this in mind, make sure when you are interviewing for a research nursing post or before you sign any job offer contracts, you:
ask what support network is in place to help with studies.
How many studies would you be expected to manage and if an intensity tool is used to access each study.
who you have as back up for your studies if you are the only one in post and not part of a team especially if it is a speciality specific role, who can cover your studies when you are off or on annual leave.
The current Covid-19 pandemic has helped to highlight the importance of research and the important role research nurses play. The research nurse role is diverse and broad, and everyday is different with patient advocacy at the very heart. You can learn more from the links below.
Useful Links/ Further Reading: