How I've kept patients at the heart of my research career
As a teenager, I knew I wanted a career supporting people in need. Nurses have the most patient contact of any health professional and 30 years later, I remain committed to nursing. I quickly discovered a particular interest in working with people and families nearing the end of life. I am passionate that all people, regardless of age or diagnosis, should have access to quality care and be able to complete their lives well.
I have long been fascinated by the capacity and capability of people to deal with immensely difficult situations, an everyday experience when working in healthcare. However, in a busy clinical setting, it is easy to overlook the capacity of people and to focus only on their disability, and thus undermine their resourcefulness. As my career has progressed, I have been drawn to focus on frailty in old age and those who are nearing the end of their lives.
The decision to include research in my career path
One consequence of my very inquisitive nature is that my path in research has been varied and exciting.
In my early days as a nurse, I didn’t immediately connect with the idea of a health research career, to use the language of that time. I imagined it would take me away from patient care and interacting with people – the part of my job that to this day I continue to love. However, health care research is fundamentally about questioning, and creating evidence to change practice, for the benefit of patients and their carers.
Although it comes naturally to me to question the reasons to do what we do, it wasn’t until I started working as a Specialist Palliative Care Nurse and was exposed to some really amazing multi-disciplinary team working, that I actually considered a clinical academic career.
This was in the 1990s, at a time when this career route was less recognised, especially for nurses and Allied Health Professionals, than it is now. This didn’t stop my colleagues from successfully encouraging me to undertake a Master’s degree. As a result, that learning was incorporated back into my clinical career which continued for a further 10 years.
At this point, I began a full-time Doctoral Fellowship - a fantastic experience. I worked with some inspirational peers and deliberately focussed my research and career on the needs of older generations. Their complex physical, psycho-social, spiritual and practical needs are intrinsically important components of their care. Whilst this has involved working outside direct clinical practice, I made sure that my research was kept very close to practice.
My path with the NIHR
Initially, my NIHR Post-Doctoral Fellowship was focused on delivering supportive care for older people with frailty in hospitals. Although another full-time research role, I again ensured that patients were at the heart of my research. This included spending six months working, alongside nurses and healthcare assistants in an acute older persons’ medical unit in a hospital. I can honestly say I have never worked so hard in my life!
Whilst I wouldn’t swap the experiences I have had in my full-time research fellowships, I knew I wanted to return to clinical practice.
Earlier this year, I started a Senior Clinical Academic Lectureship as part of the joint Health Education England and NIHR Integrated Clinical Academic programme. I plan to make the most of this great opportunity, by improving care both for older people with severe frailty at end of life, and their families. It’s a wonderful opportunity to support clinical academic practice, - I get the best of both worlds. I’m part of an amazing team caring for patients and their families at some of the most difficult points of their lives. At the same time, I am also progressing my research career and supporting and teaching others. I am part of inspirational teams - both at St Christopher’s Hospice and the University of Surrey - enabling me to improve service delivery, educate staff and contribute towards providing accessible and high-quality palliative care for all.
My top tips for early career researchers
- Take time to understand your own passion and connect with those who share it - both clinically and academically. Don’t be shy about contacting them. Find connections and keep focussed on what matters to you. There will be ups and downs but keep beating your drum!
- Get your work published - In your career you have put in hard work and long hours, and you have grounds to be proud. Ensure that your knowledge and learning is shared as widely as possible. Ask for help to identify the appropriate journals in which to publish.
- Be flexible - You may have a clear view of your priorities, but if they don’t match those of your organisation, it’s difficult to get their full support. Be open to other views and learn how these can help shape the course of your research, whilst keeping in mind your own long-term views and goals.
- Make use of organisations like the NIHR and your personal and professional networks to support your work - There’s nothing better than speaking to people who have been on your path, who are working in your specialist area and who can give you help and guidance.
Without the help of the NIHR, I wouldn’t be in my present position. Their support is amazing and very flexible. It has enabled me to continue to focus on the areas of research and clinical practice I enjoy and am passionate about. I’m confident this could be equally true for you.
Caroline Nicholson is an HEE/NIHR Senior Clinical Academic Lecturer who works across St Christopher’s Hospice in London and the University of Surrey. She is also one of the NIHR Training Advocates.
The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health and Social Care.