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Academic Career Pathways. Christine Norton PhD MA RN Nurse Consultant (Bowel Control) St Mark’s Hospital, Harrow Professor of Clinical Nursing Innovation & Associate Director of Nursing Bucks New University & Imperial College Healthcare NHS Trust. The only certainty is change.
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Academic Career Pathways Christine Norton PhD MA RN Nurse Consultant (Bowel Control) St Mark’s Hospital, Harrow Professor of Clinical Nursing Innovation & Associate Director of Nursing Bucks New University & Imperial College Healthcare NHS Trust
The only certainty is change • Patients (demographics, expectations) • NHS (technology, community focus, organisation of care) • Nursing (all graduate, support workers, new roles • Research (focus, funding, governance)
What will your ideal job look like in: • 1 year • 5 years • 10 years • 20 years • Is it possible to plan for this?
The issues • Much research has only a medical focus • Many important questions not answered by drugs • Many nurse academics are not clinical (focus on workforce) • Lack of career structure and progression for research nurses • Would career progress for research nurses attract and retain more + enable genuine multidisciplinary research?
Recommendations (Finch 2007) • Annually: • 100 MRes places (35 funded 2009) • 50 PhD Fellowships (5 N&M funded 2009) • 20 postdoc places (6 N&M funded 2009) • 10 Senior clinical academic fellowships (1st round 2010) • Lack of applicants + lack of high quality
Clinical Academic Careers • Aim to have clinically active nurses also having a research role • NIHR: huge new funding for research nurses • But not many have carved out own research programmes?
Why education? • Safeguard patient • Knowledge & competencies • Credibility of nurses • Equal member of multidisciplinary team • Professional and personal development • Role satisfaction • Promotion and pay?? • Enabled to develop nursing service • Become a prescriber • Enabled to conduct nursing research
Not all Masters are the same • Accumulate credits from modules (180) • Some generic (advanced practice) • Some clinically focused (cancer nursing) • Some multidisciplinary • MSc vs. MRes • Thesis may not allow you to do original research • 1 year full time: typically 2-3 years part time (£2k pa) • Choose carefully and ask lots of questions before you sign up
Clinical nurses doing research for MSc thesis - excited • Ward sister: RCT gum chewing after surgery • Nurse endoscopist: RCT Entonox for analgesia • Ward sister: marshmallows to firm ileostomy output • CNS: H Pylori gastric biopsies for IDA • CNS: introduce enhanced recovery • CNS: info giving improved bowel prep for colonoscopy • Need to be organised to achieve
Should PhD be the target? • 3 years full time; 4-6 years part time • Original contribution to knowledge • 1-2 supervisors, 1 project • Register with a University • Training • Thesis 75-100,000 words + viva
Nursing Research – PhD Students • Maureen Coggrave – spinal bowel management • Sue Woodward – reflexology for constipation • Sarah Collings – experience of incontinence • Maggie Vance – nurse led screening for bowel Ca • Nikki Cotterill – questionnaire for incontinence • Denise Hibberts – needs of Muslim women with a stoma • Lesley Dibley – stigma in inflammatory bowel disease
Imperial College Healthcare NHS Trust – Professor of Nursing 2010 • Director of Nursing Janice Sigsworth: 1st job: work out strategy for CAC in AHSC • (+ for EBP) • Where to start? • 25% nurses have BSc – target 50% • 2.3% have MSc – target 10% • 3 have PhD’s – target 0.5% (20+)
Our AHSC model: tripartite mission Research AHSC Clinical Service Education
Career structure – nurses in an AHSC • BSc prepared students (+ MSc route) • with “research enhanced” preparation • opportunity for placement in CTU (10 units) • New staff orientation: compulsory (online) research awareness skills (+ AHPs) • PhD/Preceptorship programme • Research nurses: development programme
Research as a career option • 3rd year student placements • Research nurse posts – often the opportunity is missed – use to develop skills and ambitions – career pathway • Build research into clinical job plans
Issues for Research Nurses • Employer: NHS or University? • Induction • Line manager and nursing reporting line? • Who is responsible for mandatory training & CPD (& pays)? • Career pathway? Short term contracts • Skills development, study leave • Isolation; possibilities for undue pressure • Not a “career” • RCN competencies a start
Develop research from clinical questions – grants • RfPB: £248k, radiation proctitis • Imperial Charity: £436k, improving patient experience • Crohn’s & Colitis UK: £109k: FI in IBD • Big Lottery: £481k: fatigue in IBD • Coloplast Ltd: £10k: pilot anal irrigation • NIHR: £99k, development of constipation algorithm
Conclusions • Why try for academic progression? • Others will seldom take the initiative • It is hard work, but rewarding • Probably the only way we are going to develop genuine multidisciplinary research and enhance patient outcomes • Route to a self-confident research active profession