Celebrating the nurses delivering clinical research in 2020

Check out our collection to celebrate the International Year of the Nurse and Midwife 2020

By Marie Nelson

There has never been a more relevant time to highlight the role of the research nurse and research delivery teams.  The breakthroughs in treatments and potential vaccines for Covid-19 are often in the headlines, but how the drugs get to this point is often overlooked or misunderstood.

The research delivery teams, predominantly research nurses alongside their Allied Health Professional (AHP) colleagues and clinical trial assistants (CTAs) are at the frontline of recruiting patients and participants and delivering clinical care in research trials.

The coronavirus pandemic has highlighted how swiftly the UK has been able to respond in delivering a range of urgent public health studies through the research nurse and research delivery infrastructure that is in place and supported by the NIHR.

The role of the research nurse/AHP is key in ensuring the safety of the research patients and participants. The role includes the oversight and coordination of complex research protocols alongside delivering specialist clinical care. The role of the research nurse/AHP is a specialised role in its own right.

The last few months have demonstrated how effective and essential the role of the research nurse/AHP is.  Responding to this public health crisis has been a challenge but also an opportunity to do what we do best using our skills, knowledge and wealth of experience in setting up and delivering clinical research. Complex research protocols usually taking weeks or months to set-up have been ready to go in a matter of days, the experienced research nurses/AHPs ensuring that implementation is at the same standard and that safety is not compromised. Frequent amendments as evidence rapidly emerges and new treatments are explored have been implemented swiftly

The RECOVERY trial is an example of how a trial, delivered at pace, has been able to quickly evidence a treatment, Dexamethasone, for the poorliest of patients with Covid -19 complications and has been shown to reduce mortality by up to one third.  These patients and their families have been approached by our research nurses/AHPs at what has been a very difficult time.  Patients and their families were frightened, patients were often very poorly with little energy, struggling to breathe however many still wanted to participate in the trial. It is the skill and compassion of the research nurse/AHP, alongside our medical colleagues that ensures the patient and their family are given all the required information on which to base their decision to participate. Whilst there is the hope that any potential treatment will benefit them directly there is also a significant level of altruism required.

As with many in the healthcare profession, this has also been a time of uncertainty for the research nurses/AHPs. Dealing with new and evolving guidance around personal protective equipment guidance, many working in unfamiliar areas of the hospital and working with new colleagues in this whole team effort. However the determination and common goal of all involved can be attributed to the success of the research delivered.

Additionally the vaccine trials have required a vast coordinated response from the research delivery teams with skilled nursing oversight of a complex logistical undertaking involving the highest level of scrutiny for participant safety with the eyes of the world watching and waiting for the outcome. 

A typical day as a research nurse/AHP will involve reviewing and assessing patients/volunteers for eligibility for a research trial, planning and implementing a research visit which will involve understanding complex protocol requirements and planning resources and staffing to safely undertake the visit. The visit itself will generate the research data which will then need to be uploaded to the relevant database.  All this whilst ensuring patient safety and research governance requirements are the top priority. Meticulous clinical and organisational skills are essential.

Alongside the Covid-19 research we are now in the “Restart and Recover” phase for hundreds of research studies that were put on hold while resources were directed towards urgent public health research and to ensure the safety of research participants.  This non-covid research is as important as ever and it is vital for our patients and for the future of healthcare and research delivery that this continues.

Research nurses/AHPs do not work in isolation but play an instrumental role in a multidisciplinary team, working in their own right in delivering research for the benefit of patients.  We are proud to be contributing to the global challenge of understanding, treating and preventing Covid-19 alongside all the other health conditions that affect quality of life for many on a daily basis.  We are proud to celebrate our success in this Year of the Nurse, a poignant irony, testing us to our limits and showing our relentless compassion and desire to provide the best care and opportunities for our patients.

About the author

Marie Nelson is Matron for Clinical Research at University Hospital Southampton NHS Foundation Trust and co-author with Emma Munro of the forthcoming SAGE book Understanding Clinical Research Practice publishing in 2021.