My role as a Research Practitioner for Rheumatology at Manchester Royal Infirmary and Trafford General

Getting into the role of research practitioner:

I had worked in the Research Office as a research support officer for a few years approving research studies and always enjoyed reading about the various studies that were happening across the Trust. I have diabetes and participated in a couple of studies as a patient and felt this is what I wanted to do, be part of the front end of research.

I spoke to a few Trial Coordinators and Divisional Research Managers about other research roles I could do. I also discussed this with my line manager at my annual appraisal and luckily my manager supported me in my aspirations for a career change and I was able to arrange a couple of mornings and afternoons shadowing research coordinators. I observed them going about their role: from patient contact to the administrative side to see if it was something I wanted to do, and more importantly, could do.

The administration side of the role I could definitely do as I love my processes and planning! But, I was unsure if the patient role would suit me. Would I be able to sell a study to a patient? Would I be able to empathise? And, more importantly, would I be too squeamish?

The defining moment for me was when I shadowed my colleagues at Royal Manchester Eye Hospital and watched ground-breaking treatment up close.  I didn’t feel squeamish. I was totally enthralled and fascinated by the procedure and a few weeks after, I was able to see the impact this had had on each patient, the joy that they had better vision and the difference it made to their lives.

I was full of enthusiasm, knowing that this is what I wanted to do. I knew it wouldn’t all be big impact results, and that most studies don’t involve pioneering procedures on the day but it had confirmed that I wanted to have the patient contact, to be involved, however briefly, in patients’ lives.

I applied for the rheumatology role as it offered the best of both worlds: patient contact and administration. I had no knowledge of rheumatology, other than thinking it was just about aching bones and deformed hands! I got the job and was so pleased to get the opportunity to have patient contact and learn new things.

It has been a huge learning curve and still is. I am constantly learning about all the different complexities of rheumatologic diseases, the medication prescribed and the effect that the disease(s) have on patients’ lives and their families.

I had to learn to be a phlebotomist as some of the studies involve blood testing. I have learnt about centrifuges, spinning bloods and freezing samples, approaching patients and data collection – all new skills.

Working across two sites:

The role involves me working across two Central Manchester University Hospitals NHS Foundation Trust sites: Manchester Royal Infirmary (MRI) for three days a week and Trafford General Hospital for the other two days per week.

As I am not clinical, I am not usually involved in clinical drug trials. I mainly oversee observational studies: generally recruiting the patient, taking samples and completing questionnaires. I enjoy the variety of each setting, both totally unique.

MRI has eight consultants, four registrars, three nurse specialists, four dedicated research nurses, one clinical trial assistant and a clinical trial coordinator.

Here we have a large cohort of patients and because research is now well established at the Kellgren Centre, staff are happy to be approached by patients, colleagues and other staff members, about research studies that may be of interest to them and that they are eligible for. At MRI, a lot of the processes were established and in place and I just slotted in, helping with the already established studies and forging my place within the team.

Being part of the larger team has been invaluable to my learning, members of the research team at MRI are happy to take time to show you new processes and teach new skills for the role of Research Practitioner.

Trafford has two consultants, one speciality trainee doctor and three specialist nurses and I am the research coordinator.

It has taken a while to find my feet at Trafford, especially as it was just me coordinating the research. As I started to settle into the role, I was able to identify the names of suitable patients, and with support from my manager and the Trafford team, we started to see results.  We came up with new ideas and methods for the consultants and nurses to refer patients for a study that was going to mean the least amount of extra work for them.

I attend weekly meetings as often as I can so that I can showcase the studies and inform the Trafford team of the recruitment figures and help come up with new ideas for recruitment. I have research folders that are put in each clinic room so the staff can refer to them. In these are brief summaries of each study. I highlight any patient I am interested in and try and speak to the patient before they go into the consultation and make the staff aware of their decision to participate or not.

Approaching the patients can be difficult as there is no dedicated clinic room for you to speak to potential research patients as we use a main outpatient clinic so I have to be very mindful of confidentiality.

Trafford has more observational studies and recruitment is improving all the time now that I am there on a regular basis to promote research and coordinate recruitment.

Patients:

A lot of the patients come from far and wide so sometimes travel is too much for them to attend an extra appointment. You have to be mindful of each individual patient’s circumstances: can they get to hospital any time or do they work? With the advancement in treatment, patients are more likely to be able to work. You also have to be careful that you don’t overload the patient with potential studies. The last thing you need is for your cohort of patients to get research fatigue. In both settings, most patients are very receptive to participating. It is generally distance or work commitments that prevent them from taking part.

I find as long as you smile, show empathy and LISTEN, patients want to help. They want to be part of something that may change the future of the disease even if it won’t necessarily directly help them at that time. They think of their families and fellow patients who have the disease.

I try and tell patients of my own experience of taking part in diabetic research and why I do it, why I love my role.

My role doesn’t end once patients signed a consent form. Studies can require the patients to come back for several follow up visits. Establishing a rapport with patients is so important so you are able to follow them up and encourage them to complete the two/ three/ four questionnaires they may receive. You want to provide the researcher and study sponsor with the best data that you can so you need processes in place so that patients don’t slip through the net. If patients don’t complete the study, you need to ask why, so that it can be fed back. It’s not a criticism of the patient. Circumstances change, roles change. I always stress to patients that they are under no obligation and it won’t affect their immediate treatment.

I enjoy the differences between each setting. At MRI, I am part of a large research team which is part of the larger rheumatology service, very much dedicated to research. MRI is a big hospital site with its busy bustling corridors and thousands of staff and patients. At Trafford, it is essentially me flying the research flag with the fantastic assistance of the rheumatology team but the hospital is a quieter, calmer setting.

It’s the best of both worlds, which is why I love my job as a research practitioner.