Transcript
Speaker: Welcome to the third episode of the UKPS s Podcast Career Spotlight Series. I'm Malvika, I'm a Plural Research Fellow based at Oxford and I'm joined by my colleague, Beanish. Today's episode focuses on careers in Plural Nursing and we have well-experienced Plural Specialist nurses as our guests and two other Plural Specialist nurses who will be interviewing them. And so I'm going to hand over to Hannah and Jen who will be interviewing our guests. So over to you guys. Thank you very much. I'm Jen Rees and i'm a clinical nurse specialist over in Manchester in plural medicine. And our co-host today is Hannah and she is based over in Cambridge. Thank you for inviting Hannah and i to co-host this podcast, which I think may be slightly different, but very exciting that we have the opportunity to discuss plural nursing and the differences of a clinical nurse specialist in floral medicine and the role of a research nurse.
Speaker: We are incredibly lucky today because we've got two wonderful guest speakers. Maria Parsonage is our respiratory nurse consultant and a plural nurse specialist. And Adam Peel is our nurse researcher today and he has a specialist interest in respiratory research, very much in plural medicine.
Speaker: Thank you, Jen. I'm Hannah. I just want to say how fortunate we are to be involved with the UK Plural Society. And thank you for giving us this opportunity today. Thank you, Maria and Adam, for joining us today. and Firstly, just looking at your pathways into plural nursing, can each of you share your journey, one from the clinical patient-facing angle and one from an academic research pathway? And what would you say your key moments are that have shaped where you are today? Should we start with you, Maria? Yeah. yeah Thanks, everybody.
Speaker: As colleagues have said, my name's Maria Parsnir-Jam, a respiratory consultant nurse and pleural disease specialist based up in North Cumbria. I moved from the Wirral, which is where I got most of my pleural training, and I've been a consultant nurse for about 10 years now.
Speaker: Before all of this, my pathways leading onto my pleural disease journey was through advanced practice. So I was an an an advanced nurse practitioner. I was working through rota of different specialties and whilst in respiratory, began to develop a passion in pleural disease.
Speaker: So really develop that service as an AMP with consultant colleagues to go from nothing to a whole fully fledged all s singing in and all dancing multidisciplinary team for plural services in the Wirral.
Speaker: I moved up to Cumbria about three years ago and I've transferred those services to Cumbria so I'm just developing business cases and in fact just about to start our thoracoscopy service over in North Cumbria which is due to start in January so I'm really excited to see that we've been able to translate what happened over in the Wirral now in North Cumbria.
Speaker: I'm passionate about pleural disease along with other areas of respiratory medicine because I think there's so much value in looking after this type of cohort of patients in terms of providing them with information, performing advanced procedures, thinking about what we can do to reduce the burden of these really disabling symptoms and hopefully allow our patients to be managed in the place that they call home.
Speaker: So that's a little bit about me. and I think we're going to talk a little bit about research as we go through and my role in research. But from a clinical perspective, that's where um my journey's led me. Thank you, Maria. Adam, can we bring you in there? Sure.
Speaker: Thank you very much for the introduction. It's a real pleasure to be here talking today. and I'm based at the Northcombe Norwich University Hospital and clinically I'm a respiratory nurse specialist. I work in the COPD and home oxygen team, but I'm also a nurse researcher here at the Northcombe Norwich and an honorary senior of research associate at the University of East Anglia.
Speaker: And so running the two roles alongside one another. In terms of how I entered the field, I was working as a gastroenterology nurse. I was very keen on research and i was looking for a PhD. I applied for a PhD in respiratory medicine. That was in Astner looking at exhaled biomarkers. So it was respiratory metabolomics. And then on completing the PhD, I returned nursing full time. while kind of finishing up and writing the publications from the PhD. And that was when the pandemic came along.
Speaker: And I was working as a respiratory nurse by that time, and I was redeployed. And I spent a little bit of time with the Plural Service. I'd always really enjoyed more interventional sides of respiratory medicine, bronchoscopy, using eBus.
Speaker: And then working with the plural team, it was a really great team, I guess, is the thing that made the difference for me here at the Norfolk of Norwich. So the consultant and the plural specialist nurse, was impressed at how they worked together, how mutually supportive they were, advanced scope of the practice in plural nursing and the autonomy that the plural nurse had. And I became interested in the field that way.
Speaker: sort of coming out of the tail end of the pandemic, I was looking to progress, but couldn't find the right clinical post. So actually went the other way and jumped into being a research nurse out in the community.
Speaker: And i was while i was working as a research nurse, and I should probably just kind of flag up the difference. So if you're working as a nurse researcher, you're developing and leading your own research.
Speaker: Whereas if you're working as a research nurse, you're helping to deliver that other people's research. So I was working as a research and nurse on various different projects and during that time I got back in touch with the plural team and worked together with the plural team at the hospital to develop a project idea, research study,
Speaker: We applied for funding for that and thankfully work was successful and at at that point I moved back into their secondary care, um took on specialist nurse role that I currently have with the CPD and Oxygen Service and started running this below research alongside it.
Speaker: So that was my initial introduction and connection to the plural medicine. That's great. Thank you. Really interesting, isn't it, about how you talk about developing a real interest in plural medicine and now being a nurse researcher. I think actually lots of plural nurses out there are incredibly interested in research and, you know, it's quite inspiring to hear about the path that you've taken. throughout your career.
Speaker: i'm So as we know, plural nursing is incredibly varied throughout the country and the different job roles that we undertake. So i thought it'd be nice to have an understanding of you both of what your typical day looks like for you. so just an idea of what your responsibilities are, but essentially what you do on your normal working day.
Speaker: Should we start again with Maria? So my focus is clinical, so specialist practice. As a nurse consultant, the governance lies with me. So these are my cohort of patients.
Speaker: And from a day-to-day sort of basis, things that I'm doing are running pleural clinics, running plural procedure lists, involving other multidisciplinary professionals in that, thinking about education and training for others, and obviously involving the patients in the care that they're having delivered to them. so that's the sort of the clinical side of things in terms of the types of procedures that I might do on a day-by-day basis range from simple diagnostic pleural aspiration to medical thoracoscopy depending on what's needed for that patient through a shared care decision-making process very personalized care the procedures are all performed under ultrasound guidance so I have to be ultrasound competent And I have to be working to an expert level of practice as per some recent guidelines and some newer guidelines that are due to be published, actually, hopefully at the BTS Society meeting in a few weeks' time.
Speaker: In terms of what happens in my research role into plural medicine, I'm PI for several trials dealing with plural medicine. So that means I'm the principal investigator in charge of those trials.
Speaker: So working with both local but research colleagues, but also regional and national colleagues as well, so that we can get an evidence base for this specific area of respiratory medicine, which I think is really important.
Speaker: And we're very good at doing plural research. But I think where I would like to see things move a little bit further forward is around the patient reported outcome measures and involving the patient in that research as well. And I think this will give us some really rich data about what matters most to patients rather than what we think matters most to patients. Definitely. I definitely agree with you there. And Adam?
Speaker: Adam? So a typical day for me, I won't talk about my clinical role because that's lies chiefly with CPD and home oxygen. so in terms of pleural medicine, it's really just my research, which makes up the bulk of my time.
Speaker: And I think this is the really lovely thing about research is that it changes throughout the course of a project. So in the early stages, it was doing PPIE, so Patient Public Involvement and Engagement, taking the research idea to them and giving some feedback and shaping the project according to their input, developing or the patient-facing documents, so participant information sheet, that sort of thing.
Speaker: And then moves on to, it's a qualitative piece of research that I'm doing at the moment. So it was then lots of driving out to see patients who were arranging for patients to come in and doing semi-structured interviews with them.
Speaker: Then as other sites around the country opened up, it was doing kind of phone and virtual interviews with them. And and that currently I'm now based at home a bit more, which is lovely, cracking on with the data analysis. So The lovely thing is that over a two-year project or a three-year project, the work you're engaged in on a day-to-day basis is changing. So you're going on a real journey and it's there's loads of variety in there. So it's, yeah, fantastic.
Speaker: As we've already alluded to, there's a lot of autonomy within Plural Nursing, whether it be research or whether it be within clinical practice. And accountability and a lot of decision making, but along with that, there's got to be an element of safety. So from procedural accountability to research governance, Plural demands a high level of responsibility.
Speaker: How do each of you approach decision making and accountability in your roles and what prepared you for this? You're absolutely right. There is significant governance structures that we need to put in place to make sure that we are performing safe and effective patient care procedurally in the consultation model, in the describing of medication.
Speaker: And it's really important that we fully understand the scope of our practice within this field. As an advanced nurse practitioner doing this, I had to report back to a consultant physician to make sure that my decisions were appropriate and that my practice was being monitored from both safety and and complications perspectives.
Speaker: Now, while I still do that, the governance does lie with me as the consultant. but I would still be involving members of the multi-professional team, such as the cancer MDTs, but I would be making the decisions based on a personalised care approach with my patients in line with my knowledge, skills and experience in field.
Speaker: So I think it's extremely important we're taking this seriously. It's very important that we understand risk and that we are risk reporting. It's really important that we are taking part in national surveys of risk and harm. So for instance, there's a plural NC pod.
Speaker: So that's the National Patient Confidential Inquiry into Deaths and Outcomes for Patients, which I'm very excited to see what that shows us and where the gaps are and what we need to do as a national service to improve our care, both in and out of hours.
Speaker: So I would say governance as a nurse, you really want to make sure that you have the capabilities to be able to do this and that you are making sure that you are training in line with what's expected from any practitioner performing plural skills.
Speaker: and that you are capturing your practice and incident reporting. We know there are expected and recognised risks for plural intervention, but we have to make this as safe as possible and act in line with any other practitioner that would be doing so. Really interesting to listen to you speak.
Speaker: Adam, so your role is, I believe, quite different to Maria's. So when we're talking about governance within research and decision making and accountability, could you just give us an idea of what is in your role? And you talked about driving to meet patients and bringing them in and Even just deciding on what research and how you go about that research, what you how you come to those decisions would be really interesting, I think, for us to listen to.
Speaker: Yeah, well, I feel I'm very, very lucky I don't have the same level of have pressure in terms of clinical decision-making and so forth that you do as a clinician in oral medicine. So the luxury we have with research is that you're never having to make these decisions in a hurry and you're never having to make these decisions on your own. So in terms of the things that prepared me for decision-making,
Speaker: The PhD is often been described as ah like an apprenticeship in research. So obviously the PhD played a role, but there's lots of training available from the and NIHR, National Institute for Health and Care Research. They do modules in informed consent, seeking a good clinical practice, being principal investigator, that sort of thing. so there's a lot of training available.
Speaker: But in terms of making those decisions about research governance and how you run and administer the study, it's always a group activity, it's research. You're never doing that on your own. So I've got really experienced co-applicant who I'm doing most of the work with. Then we've got a wider study team with some very experienced researchers and also patient part of that group as well to help steer things.
Speaker: We've got a really supportive research development department here at the hospital. So when you're doing research, even if it's a multi-site, multi-centre research study, you'll have one site, which is the study sponsor. And and that study sponsor site has a lot of responsibility in terms of oversight of the research government's kind of processes that you've got in place.
Speaker: Once you've got your study running after the first few recruits, they will come and inspect and make sure, not alone in a scary way, but they will just come and make sure that you're processing the data and storing things appropriately and you're dealing with things in the right way. So there is a lot of support. That's brilliant. Thank you, Adam. I think it would be really interesting to hear both of your perspectives on how plural nurses can get involved in research in any form. and Maria, you're such an experienced plural nurse or just nurse consultant in your own right that you're way up the ladder of research as well and being PIs. But for the new plural nurses or the more junior plural nurses who are in a developing role, what would your advice be of taking first steps into getting into research?
Speaker: And I'm sure you've both got similar ideas, but it would be really interesting to see the different views as your job role or your day-to-day life in plural medicine is different. So, Maria, how would you recommend or what would advice would you give to new plural nurses that you're training up in this speciality How would you encourage them or what would your advice be to get them into research?
Speaker: Thanks, Jen. I think it's so important for nurses to get involved in research because it translates to patient care. Now, as a whole, nursing and research have never been great bedfellows, have they? But that is improving. Now, I'm the chair of the Association of Respiratory Nurse Specialists, or ARNS,
Speaker: and we're really keen to get more nurses involved in research. My reach really is through that organisation at a national level, but also at regional and local levels that's talking to the nurses that I'm working with as well.
Speaker: Hopefully giving them an overview of my experience in getting involved in research from really just having that interest, reading research papers, having ideas such as quality improvement ideas and putting those into practice.
Speaker: Right the way across to being involved in writing national standards and reviewing things like randomised controlled trials and systematic reviews.
Speaker: and It's a scary place to be, I think, when you're starting out. But speak to people, reach out to people who have been involved in research and express your interest.
Speaker: There are loads of people that are out there that will help you with this and point you in the right direction. Other things that you might want to do is things like the GCP training, which just goes through a really nice pathway of how you would introduce yourself to research.
Speaker: And it is something that you should have ah on your CV, really, if you're going to take part in research. There are also really great things out there. There's an associate PI scheme. So you can work with somebody who is already a PI. And that's a really great starting experience for when you want to become a more advanced researcher.
Speaker: So there are loads of opportunities out there and there are people that will help you. And I would just encourage you to speak out, seek from those that have the experience in research and And always remember that this is to translate back to the patient's bedside. So your research will make a difference to the patient care that you're delivering.
Speaker: I think first of all, i'd kind of echo what Maria has said in terms of nursing not typically being great bedfellows with research. Certainly at the moment, you might not have any nurses who are actively engaged in legal research, etc., within your department. So it may be important to seek support from medical colleagues. Certainly the medics I've worked with have been, you know,
Speaker: actually pivotal to my career and really supportive. So that's that's probably very important. But things are changing and the NIHR, the National Institute for Health and Care Research, they're really important. So they're described as the kind of research arm of the NHS. You've got the Department of Health that funds the NHS, but also funds the NIHR.
Speaker: and they're the kind primary funder and deliverer of research within the UK. And they run plethora of different schemes for getting people just dipping their toe in the water through to PhDs and fellowships.
Speaker: And I'm imagining that people listening to this podcast are already working clinically at a fairly advanced level and going to want to do a kind of clinical academic role where you do the keeping your clinical practice going but also building research alongside that which is really important as Maria said to keep that research clinically focused and relevant to the bedside and there are some nice funding opportunities with the and NHR to kind of buy you out of your role and develop advanced research qualifications while still practicing clinically but also
Speaker: MHR are putting some money into creating roles to support nurses into research. So some more acronyms here, but your Regional Research Delivery Network, your RRDN, will probably have a nursing or NMAP, nurses, midwives and allied health professionals, the research lead, who can help a signpost you to opportunities and support you to take advantage of those opportunities.
Speaker: And i think they're also creating some senior research leadership roles within NMAPS in secondary care. So these will be nurses, physios, OTs and so forth who are there to support and signpost and get colleagues into research. So there's a lot of things on the way up that support nurses in this, but NIHR is a good place to start.
Speaker: Oh, and as Maria said, sorry, GCP, good clinical practice qualification. You need that before you can do anything. So that's a really good, and it's a great training. So it's a really, really good place to start. Wow. Thank you both. I'm just, I'm just listening. I'm just concentrating so much on what you both have to say. And and so many people are going to be inspired by what you do.
Speaker: and I've worked in plural nursing for a little while now, but I think it's always important to kind of know, I might be biased, but I feel like we are very, very special nurses because we sit at the heart of this speciality and we combine technical skills and clinical decision making with a patient's advocate. And we're always there to be able to support these people through what can be a really anxious time. And I do feel that there's always something new to learn within this speciality.
Speaker: So for those nurses that want to build a career within plural medicine, whether it be academic or clinical, what advice would you give to these nurses who want to develop in plural care? And whether they're aiming for advanced practice or clinical academic pathways, what should they do and where should they start?
Speaker: I just want to say that I would 100% recommend a career in Plural Nursing for all of the reasons that Hannah's discussed there. It's a really special speciality in my opinion. And there are so many diverse and varied roles within Plural Disease for nurses that you could end up on any type of pathway through clinical practice to research.
Speaker: In terms of building your career pathway, I think in advanced practice and consultant level practice, you have to be a clinical expert, but you also have to have the ability to be a nurse researcher or leading in research because this is one of the four pillars of advanced practice and consultant level practice. So it's absolutely ah crucial to our role. So your pathway, in my opinion, will be a dual pathway, although you will see separate entities. But for those performing advanced clinical skills in a clinical setting, research will just sit hand in hand with this.
Speaker: Again, plural medicine is just a lovely area to be in. So there's the the yeah UK Plural Society Annual Research Conference. It's, in my opinion, they get it just right. It's a big enough event that you get to meet everybody and it draws in international attendees, but it's small enough that it's not overwhelming.
Speaker: The plural community seems really supportive and up for collaboration. So as a researcher, it's a really nice field to be involved with.
Speaker: Just looking at the research side of things, sometimes it can be, it's slightly insecure. It's difficult to always know the best pathway forward. And because some of these pathways are relatively new within nursing, things can be a little bit tricky, but As I said, things are changing and lots of it is being driven nationally by the NIHR. So I think these pathways for nurses are becoming clearer and more established and with better support available.
Speaker: So I just think it's a really good time to be involved in pleuromedicine and interested in surgery. That was really insightful. Thank you. That's come to the end of the questions. So essentially, I'd like to thank you both for agreeing to talk to us today. i think it's been really insightful. And like we've all said, it reminds everybody of how incredibly lucky we are to be in... the speciality of plural medicine and how varied that is and how there is lots of different pathways that we can take to develop our career opens up lots of doors for us which I think is incredibly valuable. i think we should thank UKPS for allowing the nursing community to have this forum. Not only will this be really insightful for nurses but also really insightful for our physician colleagues and also just another reminder to them of like Hannah said that the Plural nurse is an incredibly valuable member of any Plural team.
Speaker: And as nurses, we really commit to the service, really commit to our patients. And if we can have our physicians really commit to us and help us develop our careers, offer plural nursing, their extra teaching, allowing the nurses to go on as many study days as possible, as many conferences, like Maria said, ARNs, UKPS, BTS, they're all full of really insightful information, which isn't just designed for our medical colleagues. So as plural nurses, we can gain so much from those. And I think To enable us to continue that and to build our careers, it's really important that we have the backup of of all of these societies like UKPS, which I'm glad that we do. So we've been really lucky to have this. I think building our careers going forward for all of the new plural nurses or the nurses that are interested in research or just enhancing their career, like Maria and Adam have both said, reaching out to
Speaker: your colleagues within your local environment, the people that you work with closely, but also reaching out to the wider community. There's a plural nurse, very active WhatsApp group. There's a plural nurse, very active email. And it's on a daily basis, people are asking for advice, policies, what would you do in this instance? That's not just about patients, it's about careers as well. So It's important that we just flag those to continue from this podcast that any other questions people may have, they're always welcome to ask us as a community of nurses. And like Adam said, Anne-Maria, just echoing, all of us should be GPC trained and looking into the research opportunities that we can have. Not only is it exciting to be involved in new and upcoming developments within plural treatments and plural medicine, but also it's great for us to be able to completely appreciate and have confidence that we're offering evidence-based care. And it's one thing, us reading the information, but being involved with it is, it's another string to our bro. And we are just as important as all of the other people in the medical society and bring such valued insights into it all. So I think, thank you again to everybody involved in the podcast and to talk about our important roles and how exciting it can be to be a plural nurse.
Speaker: Definitely. i think, yeah, just echoing what Jen said. And I think we started this podcast talking about clinical plural nursing and research plural nursing. But I think essentially we've realised that you need to cover both aspects. To be a good plural nurse, you need to be able to do both, which is very insightful. So thank you both for speaking to us today. Thank Brilliant. Thank you so much. Thanks, Maria, Adam, Jen and Hannah for this amazing conversation about careers in plural nursing. And thank you to our listeners once again. And hopefully we'll catch you soon with the next episode. so Thank you, everyone.
