Last year, I was asked to talk about the Caudwell Xtreme Everest (CXE) medical research expedition at the British Association of Critical Care Nurses (BACCN) conference in London. As the expedition project manager, and a critical care nurse, I was asked to comment on the expedition team's performance and relate it to team collaboration in intensive care, the theme of the conference that year. The CXE research expedition was the largest medical research expedition ever undertaken at altitude. The purpose of the expedition was to study human physiology pushed to breaking points in this extreme environment to increase our understanding of critically ill patients, (Grocott et al., 2007). The research was carried out by a team of 60 laboratory investigators: a mixture of doctors, nurses, allied health professionals, scientists, medical students and support workers. It involved 198 healthy volunteers, aged 18–73, who had passed two independent health screens and were recruited by word of mouth and via public advertisement. The participants underwent tests related to 10 core, ethically approved, research studies in up to eight laboratories, one in London and the rest field laboratories in the Himalayan Khumbu valley. A further 19 ethically approved studies were carried out on sub-groups. The majority of research participants all trekked to the Everest base camp (5300 m), following an identical ascent profile, in 13 groups of 16 participants. Two groups left London each week for the duration of the expedition. A sub-group of an additional 24 investigators underwent a similar ascent profile and testing schedule over a longer period to the Everest base camp, with 15 participants undergoing tests higher on the mountain, (Levett et al., 2010). The research questions investigated the impact of low oxygen levels (hypoxia) in relation to the brain, the lungs, oxygen utilization and oxygen delivery. The protocols and equipment used to capture the data had all been tested in the field or in chambers prior to the start of the expedition to ensure that all data captured could be validated. This also enabled thorough training of the data collectors to ensure quality control. By the end of the expedition, 95% of planned testing had been completed in the main research participant group and 99% in the sub-group of investigators (Levett et al., 2010). The expedition was the subject of a BBC TV documentary, numerous TV news items, magazine and newspaper articles, creating more than a million opportunities to view. There have been 17 peer-reviewed research articles of data from the expedition published to date, with more in press, as well as numerous commentaries, editorials and reviews, (see www.xtreme-everest.co.uk for links). Results from the expedition have contributed to the development of two National Institute for Health Research (NIHR)-funded studies looking at permissive hypoxaemia, one an observational study and one a randomized controlled trial. Both are studying intensive care patients in the UK. The achievements of this unique research endeavour were, in part, due to the quality of the teamwork in my opinion. I set out to illustrate this using Brindley's framework of teamwork in anaesthesia and critical care at the conference (Brindley, 2014). But this illustration was based on anecdotal evidence. We did not explicitly capture data related to teamwork, and thus, we missed an opportunity for further research. How did we build a team to deliver such a complex project in a remote and dangerous environment? What went well and what did not? We could have explored other questions as well. What was it like to be a research participant on the expedition, pushing oneself to extreme physical and mental effort to provide data to improve outcomes for critically ill patients? How did our participants' experiences compare with those of our critically ill patients, such as those weaning from long-term ventilation? Is the sensation of breathlessness similar? The sensation of breathlessness is a phenomenon I have been keen to investigate for most of my critical care nursing career. Why did I not pursue this question during the expedition? One reason is that I only thought of it as a potential area for investigation with the benefit of hindsight. Another reason is that the more I engaged in research, the more I questioned, and this has since led me to pursue a career as a critical care nurse researcher. But how do I ensure that the research questions I pursue now are relevant? Steve Brett, President of the Intensive Care Society, co-wrote an editorial to promote the joint Intensive Care Foundation/James Lind Alliance research prioritization exercise (Brett and Reay, 2013). He suggested that the prioritization exercise was needed to ensure that clinical staff, patients and their families contributed to the critical care research agenda ‘as opposed to pure researchers/academics’. In his summary, he suggested that this broader participation would ensure the legitimacy of the resulting priorities. This highlights a possible conundrum. Researchers develop the drive to question everything but can become remote from the environment that generates the questions they should be pursuing. Another reflection on the CXE expedition is that the vast majority of the research followed a quantitative methodology as the researchers were mainly experienced in the use of that paradigm. In recent years, there has been more use of a mixed-methods research approach in health care. One way in which this has been demonstrated is in the development of pragmatic clinical trials. These are trials that are designed to capture data using health care clinicians delivering interventions in real time, as part of their day-to-day work (Johnson et al., 2014). This pragmatic approach aims to guard against the problem of a treatment regime delivered successfully in a trial by researchers being found to be undeliverable in practice. If we are to ensure that we carry out research that is meaningful, we need to encourage everyone within health care organizations to actively engage with research using all paradigms. This should be easy. In the UK, the National Health Service (NHS) is undertaking more research than ever before (Dodge, 2017). The Health and Social Care Act 2012 requires the NHS to promote and support research, from the Secretary of State downwards with powers to enforce this. This may be because a positive association has been demonstrated between research-active NHS Trusts and clinical outcomes (Ozdemir et al., 2015). Patients appear keen to be involved in research. The NIHR Local Clinical Research network carried out a survey of research participants in 2016/2017. Of those surveyed, 90% had had a good experience of participating, and 86% would participate again if given the opportunity (Golsorkhi and Steel, 2017). The NIHR is keen to give every patient the opportunity to be a research participant. Interdisciplinary research is encouraged. Health Education England Wessex recently provided grants specifically supporting Team Research. The driver for these awards was that ‘(m)ulti-source and multidisciplinary team research is needed to provide evidence of outcomes to inform future models of care’ (HEE Wessex, 2016). This should provide a driver for more critical care nurses to engage in research to address the questions they have. In the UK, the NIHR and other research funders are providing more support for nurses (and other non-medical health care professionals) to engage in research and perhaps develop clinical academic research careers. The NIHR recently published a review of its Integrated Clinical Academic programme launched 10 years ago. This programme includes a new pre-doctoral clinical academic fellowship providing salary support for individuals wishing to develop a credible application to get funding to undertake a PhD. Finally, the BACCN is working hard to influence the growth of critical care research by its members. It has recently entered into partnership with the NIHR to support research proposals that could be adopted by the Clinical Research Network portfolio (Collins, 2018). This gives recipients access to NHS Infrastructure for research and training and includes NHS Service Support and Research Management and Governance Support. The first BACCN Twitter Chat of 2018 addressed the role of the Intensive Care Unit (ICU) research nurse, and this is also a theme at the annual conference in September – ‘The role of Research Nurses and Nursing Research within Critical Care’. The CXE expedition provided me with an opportunity to engage in critical care research in a unique environment. But more importantly, it has built in me the desire to see us all facilitate critical care research every day for the benefit of our patients, their families, our colleagues and the NHS. How do you try to embed research in your workplace? CXE Study Funding Sources: The research was funded from a variety of sources, none of which are public. Mr John Caudwell, BOC Medical (now part of Linde Gas therapeutics), Eli Lilly Critical Care, The London Clinic, Smiths Medical, Deltex Medical and The Rolex Foundation (unrestricted grants). Peer reviewed research grants were awarded by the Association of Anaesthetists of Great Britain and Ireland (AAGBI), the UK Intensive Care Foundation and the Sir Halley Stewart Trust. The CXE volunteers who trekked to Everest base camp also kindly donated to support the research. Some of this work was undertaken at University College Hospitals - University College London Comprehensive Biomedical Research Centre which received a portion of funding from the UK Department of Health Research Biomedical Research Centres funding scheme.