Abstract
Clinical research nurses work at the fulcrum of clinical trials with clearly defined roles and responsibilities. In England, the National Institute for Health Research (the main funder of health research) has broadened its scope to encompass social care research. The expectation is that clinical research nurses will expand their skill set to support these new studies, many of which will employ qualitative and mixed methods. This discussion paper explores the challenges of facilitating this clinical academic workforce development through a case study of a homeless health and social care research project. This was one of the first studies to engage clinical research nurses in this new and expanded role. Much of what is known about the research nurse workforce has been generated through studies of clinical trials in oncology. The 'caring-recruiting' dichotomy has been used as a heuristic device for identifying workforce issues that can impact on study delivery such as how intense pressure to recruit study participants leads to low job satisfaction. This case study reflects on the authors' experiences of employing a clinical research nurse in a social care research project concerned with the discharge of homeless people from hospital. The 'caring-recruiting' dichotomy is used to generate new information about the relationship between workforce development and the successful delivery of social care research. The case study illuminates how social care research can generate different pressures and ethical challenges for research nurses. The time and skill it took to recruit study participants identified as 'hard to reach' was suggestive of the need to move beyond performance measures that prioritise recruitment metrics. The need for different types of staff supervision and training was also warranted as supporting study participants who were homeless was often distressing, leading to professional boundary issues. This study highlights that performance management, training and supervisory arrangements must be tailored to the characteristics of each new study coming onto the portfolio to ensure research nurses are fully supported in this new and expanded role.
Highlights
Clinical research nurses are registered nurses who are usually employed within research sites to help facilitate and conduct any phase of a clinical trial (Gibbs & Lowton, 2012)
The research reported here evaluated a range of Homeless Hospital Discharge (HHD) schemes delivered by the voluntary sector in England to improve the discharge experiences of homeless patients
Brown et al (2020), for example, report how in a US study of homelessness the researchers often found themselves having to advocate for study participants themselves as overloaded homeless outreach were at full capacity
Summary
Clinical research nurses are registered nurses who are usually employed within research sites to help facilitate and conduct any phase of a clinical trial (Gibbs & Lowton, 2012). The clinical role of nurses in research has been most thoroughly documented and described in oncology clinical trials (Bevans et al, 2011). There has been less clarity about the role of nurses in research studies outside of the oncology speciality. In England, homelessness has increased by 165% since 2010 (Homeless Monitor, 2018). In this same period, attendance at emergency departments by people experiencing homelessness has trebled and there has been a steep rise in hospital admissions (BMA, 2019). In 2013, it was reported that 70% of homeless patients were discharged back to the street without having their housing, care and support needs addressed (DH, 2013). The research reported here evaluated a range of Homeless Hospital Discharge (HHD) schemes delivered by the voluntary sector in England to improve the discharge experiences of homeless patients. Schemes comprised the co-location of housing workers in hospitals in order to help patients find accommodation as well as ‘step-down’ facilities where patients could recover outside hospital while they found somewhere safe to stay
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