Academic Career Pathways

Christine Norton PhD MA RNNurse Consultant (Bowel Control) St Mark’s Hospital,

HarrowProfessor of Clinical Nursing Innovation & Associate

Director of NursingBucks 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

AHSC

EducationClinicalService

Research

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

PhD

MSc

BSc

Evidence-based practice (effectiveness)

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