Clinical research offers an attractive career option to nurses, enabling them to use core nursing skills, contribute to the development of new evidence and improve patient care
Nurses can have a positive impact on research and clinical research nurse roles can be rewarding career options. Nurses develop many of the skills needed to conduct research in their clinical practice, and since many nurses are now educated to degree level, they have better opportunities to advance a career as researchers. Nurses should consider this career path, so that crucial research roles are filled by people with experience of clinical care and patient contact. This article aims to encourage nurses to consider a research career, highlighting its benefits.
Citation: Brady O (2017) Clinical research offers a rewarding career option for nurses. Nursing Times [online]; 113: 10, 34-36.
Author: Orla Brady is clinical research nurse at the Royal Free Hospital Foundation Trust, London.
- This article has been double-blind peer reviewed
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Nurses have curious minds and need to keep up to date on the issues they come across in practice. The critical analysis skills this enables them to develop provide an excellent foundation for a career in clinical research. Nurses already make immense contributions to clinical research and are crucial to its success, particularly since it requires skills that may well be unique to nurses. The patient contact, support and management skills involved mean research roles can be extremely varied, yet nurses often do not see it as a viable career option.
Research into nursing practice is vital: nurses are expected to justify their interventions, ensuring they are evidence-based and provide high-quality care, so they can contribute to a wide range of research areas (Abbott et al, 2013; McSherry, 1997). Although roles in clinical research may change after Brexit due to changes in available funding (Hervey, 2017), with its large and culturally diverse population and integrated healthcare system, the UK will remain a useful source of knowledge and an attractive location for clinical research.
The growth of clinical research
Clinical research in the NHS is growing. The government has invested £816m in a five-year programme of research in areas such as mental health, dementia and antimicrobial resistance (Department of Health, 2016); it has also invested heavily in medical research and there are major research collaborations with institutions across the European Union (EU) (National Institute for Health Research, 2017a). This should lead to an increase in the number of clinical research nurse (CRN) roles, as their involvement is essential for many clinical trials; however, many nurses do not realise this is a career option.
Although the transition from a ward-based to a research-based role can be daunting, it is also rewarding (Spilbury et al, 2007). Research nurses have the satisfaction of generating evidence for new care standards, identifying medical advances and changing best practice.
Like many other areas of the NHS, clinical research is likely to suffer from the shortage of nurses. There is a full-time equivalent vacancy rate of 9% in adult care alone in the UK, while in 2014-2015, 3,000 fewer graduates registered as nurses compared with the previous year (DH, 2017). The scrapping of bursaries for student nurses and midwives is predicted to further compound the recruitment crisis. Unfilled CRN posts may delay studies and ultimately lead to cuts in funding and worse patient experience.
In 2013, the average age of a UK nurse was 42 years, and one in three were due to reach retirement age within 10 years (International Council of Nurses, 2013). The loss of so many experienced nurses means a wealth of knowledge will also be lost.
Nursing remains on the government’s shortage occupation list, so NHS employers are able to advertise jobs outside the UK (Migration Advisory Committee, 2016). However, in 2015, 7,000 fewer overseas nurses came to the UK than in 2005 (Christie and Co, 2015), despite a major international recruitment drive.
Effect of Brexit
Workers from the EU fill around one in 20 NHS roles (Health Foundation, 2017), but Britain’s exit from the EU may exacerbate the recruitment crisis due to uncertainty around their immigration status. Since July 2016, there has been a 96% drop in the number of nurses from the EU registering in the UK (Health Foundation, 2017); the triggering of article 50 has not reassured them, and some have expressed disappointment in the attitude of the British public towards the EU and the lack of acknowledgement for their work (Boffey, 2017). This, combined with rising inflation and below-inflation wage increases (NHS Pay Review Body, 2017), has already led many EU nurses to leave.
The political changes ahead may affect the funding the UK receives from the European Research Council, which is due to undergo a dramatic overhaul in 2018 to harmonise how clinical trials are conducted across the EU (EU Clinical Trials Regulation, 2014). The UK will need to negotiate carefully to ensure it is part of the new system and remains attractive to the companies funding the many international clinical trials underway. The National Institute for Health Research (NIHR) supports the UK’s research infrastructure; in 2013/2014 it secured £834m of external funding; it has also increased the number of internationally renowned investigators leading research in the UK (NIHR, 2015a).
The UK’s multicultural population enhances the validity of research conducted here, and with nearly 60 million users, the NHS represents a unique clinical research resource (NIHR, 2015a). The government invests considerably in domestic research and has always negotiated viable and attractive options for international investment (Norton Rose Full Bright, 2016).
Chains of collaborative institutions that enable research are unlikely to be broken by Brexit; the publication of 22,000 papers by NIHR Biomedical Research Centres and Units in 2015 alone has contributed to strong collaborative relationships (NIHR, 2015b). High-quality research conducted in the UK gives the country a clear advantage.
Benefits for NHS organisations
Clinical research offers many benefits to NHS trusts. They earn money from recruiting patients into trials and gain funding for hosting research from organisations such as Cancer Research UK. Engaging in research can increase options for patients, and enables hospitals to fund care in a different way, resulting in smaller operational costs. Local clinical research networks provide excellent staff training opportunities, supporting the initial set-up of a trial that can lead to improved services. The outcomes of research conducted close to home can be disseminated more quickly and changes in evidence-based practice implemented more rapidly.
Collaborations with the European Network for Health Technology Assessment (EUnetHTA) and Health Technology Assessment International (HTAi) on research into technological innovations (NIHR, 2017a) ensure a return on investment, improve patient care and highlight the successes of UK research to the international life sciences community.
Nurses naturally develop many skills that transfer well to clinical research roles. Many coordinate care, gain leadership skills and collaborate with international institutions, while their work often requires clinical governance, project management and prioritisation skills. In addition, patient support skills are unique to nurses, while their competence level prepares them for the challenges of research.
Some nurses worry about the workload and uncertainty of research jobs. However, while many posts are funded on a yearly basis, it is rare for clinical trials to last less than three years, as information is only valid if patients are observed over a longer period 0f time.
Nurses already use evidence and research on a daily basis to improve their own practice. A document celebrating the CRN (NIHR, 2015c) highlights that the role is often misunderstood by the rest of the profession. CRNs have considerable contact with patients and spend quality time with them – the role is an extension of nurses’ skills in delivering good, ethical nursing practice (NIHR, 2017b).
Unlike doctors, nurses do not receive widespread encouragement to become involved in research, and CRN posts are often filled by clinical trial practitioners (CTPs) due to the lack of nurse applicants. CTPs generally have a life science background, therefore they do not possess nurses’ fundamental skills in patient contact and clinical practice.
Much of the data needed in clinical trials is routinely collected by nurses on a daily basis. The role of any nurse involves problem solving and evaluating decisions: these skills are essential in research and can easily be transferred, as long as nurses are interested in making sense of the world around them.
How to step into research
Anyone interested in a clinical research career needs to be inquisitive and passionate about improving care. I began working in research through auditing patient deaths due to gastrointestinal haemorrhaging and making correlations in data that led to service improvements. My work as a CRN has enhanced my know-ledge and understanding of healthcare.
In some parts of the country, internships are available for nurses to get to grips with the basics before becoming a CRN (Roberts, 2016). This is a great opportunity to gain useful insight into the role, but there are other ways of stepping into clinical research nursing (Box 1).
Box 1. Steps nurses can take to get into research
- Search specialist departments and institutions for areas in need of improvement
- Familiarise oneself with the ethics of good clinical practice (NIHR, 2017b) and the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (www.ich.org/home.html)
- Look at current research conducted locally and speak to those participating
- Visit the NIHR website (www.nihr.ac.uk) to see what resources it can provide to support nurses in research
- Review CRN job descriptions and identify transferable skills you can offer
Working as a CRN is demanding but also rewarding. Nurses should seek opportunities to be involved in research at all levels, from service evaluation to clinical trials, as they can support the research process in a unique way and already have many of the necessary skills.
Brexit has created uncertainty about the future, but it may also provide new opportunities for research collaborations. Confidence in one’s abilities and awareness of one’s transferable skills is vital for nurses who want to pursue a career as a CRN and take on a key role in research and medical developments.
- Core nursing skills provide an excellent foundation for a career in research
- Transitioning from a ward-based to a research-based role can be daunting but also rewarding
- Brexit has created uncertainties, but the UK is likely to remain an attractive location for medical research
- Research collaborations can benefit NHS healthcare providers in terms of finances, patient care and staff training
- Clinical research nurses have considerable contact with patients and spend quality time with them
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