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Authors

  1. Kerr, LeAnne MSN, Ed, RN, CPN, CPEN

Abstract

Trauma research nursing and nursing research in general are not always understood or readily embraced by clinicians in the nursing profession. A reflective journey of a trauma nurse, new to the world of trauma research, is presented with an overview of the lessons learned along the way to becoming more experienced in this role. Various aspects of the role of a trauma research nurse are discussed along with suggestions for how a nurse can potentially make the transition into and growth in this role a smooth one.

 

Article Content

The concept of research causes many nurses to run in the opposite direction. Many of us have posttraumatic stress disorder from our experience(s) in undergraduate or graduate school and have promised our first born to the "powers-that-be" so that we never have to do research again. Yet for other nurses, those who gasp-willingly choose -to take on the role of a research nurse, the concepts behind research continuously fascinate and engage us. So what is the difference between these 2 groups of nurses? Is it a matter of different personalities? Are we, as a profession, doing enough to educate each other on the role of a research nurse, specifically one dedicated to trauma research? Or are we simply not sharing the fun and excitement that trauma research has to offer?

 

The purpose of this article is neither to define all types of research nurses nor to provide a broad-spectrum analysis of a nurse's role in the world of research. Instead, this is my reflective journey as a relatively new trauma research nurse attempting to understand the concepts and "remove the cobwebs" (so to speak) that can somewhat clutter a clear understanding of this role. Whether you are a bedside/staff nurse working with clinical research nurses, or a clinical research nurse working with trauma nurses, or just skimming this article looking for something to read, the goal is simple-to share the lessons I have learned in my role as a trauma research nurse, and provide insight (however small) into some of what a trauma research nurse does at the community-based level I trauma center, where I work.

 

Although not typically synonymous with fun, research is, at the very least, interesting. The process of testing theories and ideas to see what procedures, medications, or devices improve patient care makes most nurses stop and think. In fact, many nurses, at one time or another in their nursing career, have thought "there must be a better way to do this." As a bedside/staff nurse, if that was you, there is a research nurse inside of you too! I know for some this may be a scary thought ... take a deep breath, there is no need to hide your first-born children; it will be OK. The reality is that the nature of nursing and the critical thinking component of our role require a researcher's thought process.

 

Most research nurses reading this article would likely attest to the fact that research is not about "us versus them" (ie, the research nurse vs the bedside/staff nurse). Rather, research is about the collective "us"; all of us who interact with the patient and strive to implement a plan of care that will determine whether what we are currently doing in clinical management is the best way to care for our patients; or whether, through one clinical trial or another, we can find a better and safer way to provide care.1-3 Indeed, the role of a research nurse can take on many forms, usually depending on the type of institution where that nurse works. What research nursing looks like at a major academic teaching hospital is likely to be distinctly different from the role of a research nurse at a smaller community-based facility or even a single-specialty practice outpatient center. Some research nurses are required to sit on their hospital's Institutional Review Board, others are expected to write grants, and many are expected to complete peer-reviewed publications or literature reviews and poster presentations.1 Although the job titles may be similar, the job duties can be vastly different. Much of that is attributable to resource availability and allocation. Larger facilities may have more diverse resources allowing for these job duties to be split among several research nurses, whereas at smaller facilities one research nurse may be required to "do it all."

 

As a new trauma research nurse, I spent the first few months in my role learning about the overall research process. The initial preparation for this role was multidimensional. Between the online modules, extensive reading, federal guidelines, and compliance expectations, I (like many of my predecessors) suffered from "brain overload" and would have gladly given informed consent for someone to put me out of my misery. This preparation process included taking courses such as Biomedical Research, Health Information Privacy and Security for Clinical Investigators, and Good Clinical Practice with a US Food and Drug Administration focus. These courses were offered online through the Collaborative Institutional Training Initiative program at the University of Miami.4 Collaborative Institutional Training Initiative is exhaustive (and exhausting), but is a great starting point for any new research nurse or any nurse considering a transition into this role. Looking back, each online course/module laid the foundation for what I can now only describe as my "ongoing increasing comfort level" as a trauma research nurse.

 

As mentioned previously, this is not an attempt to define or explain the multidimensional concept of a research nurse, but rather to reflect on and discuss aspects of the role of a trauma research nurse. In doing so, one must accept that trauma research is not primarily about clinical research studies. As I grew in my role, I became more aware of the various aspects of the trauma research standard and the expectation of trauma research at both the state and national levels. Although clinical research studies play an important role in improving trauma care, when most nurses at level I trauma centers take on the role of a trauma research nurse they are exposed to the trauma center's obligations to a wide variety of nonclinical research activities. The nonclinical aspect of trauma research incorporates many things including, but certainly not limited to, publications, regional, state, and national presentations, and various educational expectations through the dissemination of knowledge and participation in trauma scholarly activities. Fortunately, much of my graduate degree preparation assisted in enhancing my comfort level with the nonclinical aspect of trauma research. In general, nurses with advanced degrees become familiar with scholarly writing and presentations, and with an MSN focused on nursing education, I also became familiar with teaching and presentation strategies.

 

At the trauma center where I work, there are numerous studies to review, studies to open, pending publications to edit and submit or follow-up on, case presentations to help residents prepare, and a number of other items that all fall under the scope of this role. Although all these items and opportunities are important and valued within any trauma program, I have found that the trick to being successful is to not get overwhelmed by the expectations of the trauma standards, but rather to become exceptionally skilled at balancing the many trauma research priorities. Although the role may vary among trauma centers, a trauma research nurse is usually considered instrumental in ensuring the trauma program's compliance with the trauma research standard (regardless of the verification, i.e. via a state-run trauma system or through the American College of Surgeons).

 

That being said, a trauma research nurse is not a journal approval wizard; you will need, however, to learn some tricks about the journals to which you should submit specific manuscripts. There is no magical formula designed to guarantee manuscript acceptance (believe me I have searched for one and it simply does not exist). However, through trial and error I have learned that it is helpful to take a look at the recent articles published in the desired journal. Be aware of writing styles most commonly published and pay close attention to the journal's specifications regarding formatting and referencing. Do not assume that the journal's word count requirements are mere suggestions. Read and follow the manuscript checklist that is provided for authors (the checklist was developed to guide potential authors for a reason!). Most importantly, do not get discouraged if your first submission is not accepted or is returned with a long list of edits and comments. Remember the manuscripts you submit for publication are as much for the readers as it is for the authors. Journals want to ensure that their distribution audience will benefit from reading your work.

 

Although instrumental to the execution of clinical research studies, a trauma research nurse is not an informed consent genie; but somehow you garner the skill of approaching a family, in the midst of their catastrophic life changing event, with a great deal of compassion, to discuss the opportunity to enroll their loved one in a clinical trial.5 I was fortunate enough to receive informed consent training from my director at the Office of Human Research, the lead department for clinical research in the health care system where I work. There are also many online resources that can serve as a guide for conducting the informed consent process. When all else fails, and you are not sure where to start, reach out to your local Institutional Review Board and see whether you can shadow other research nurses while they obtain informed consent. The proper conduct of the informed consent process is crucial to the integrity of any clinical research study. It is important to ensure it is done correctly.

 

Albeit imperative to assist with trauma-related scholarly activities, a trauma research nurse is not a case presentation guru; you will however learn the art of effectively engaging an audience and will hopefully be able to coach residents and medical students to do the same. And although a trauma research nurse is not the be-all and end-all of the trauma program, the role is important and your contribution to the team's trauma research initiatives positively impacts the center's trauma program. The journey of a trauma research nurse is not for the faint at heart (to be honest no aspect of trauma nursing is for the faint at heart), and success in this role may look different as the focus of the trauma program changes.

 

As the journey continues, there are many more publications to submit, presentations to prepare, and research subjects to enroll. If you did not think about trauma research nursing with excitement and glee before I would not expect that to change now. But hopefully the concept of trauma research (and research in general) no longer creates the anxiety that you may have had initially. In my personal journey, I continue to grow as a trauma research nurse. At the center of this role is a continuously engaging process with countless opportunities to do more to, directly or indirectly, enhance trauma patient care. For those nurses about to take a "leap-of-faith" into the trauma research world, remember to be flexible, prioritize your goals, and align them with the goals of the trauma program, and breathe ... there are many challenges in trauma research but none have proven to be insurmountable (so far).

 

REFERENCES

 

1. Kleinpell RM. Promoting research in clinical practice: strategies for implementing research initiatives. J Trauma Nurs. 2009;16(2):114-119. [Context Link]

 

2. McCaughan D, Thompson C, Cullum N, et al. Acute care nurses' perceptions of barriers to using research information in clinical decision making. J Adv Nurs. 2002;39(1):46-60. [Context Link]

 

3. Athanasakis E. Nurses' research behavior and barriers to research utilization into clinical nursing practice: a closer look. Int J Caring Sci. 2013;6(1):16-28. [Context Link]

 

4. University of Miami. Collaborative Institutional Training Initiative Program. http://www.citiprogram.org. Accessed December 18, 2012. [Context Link]

 

5. Leske JS, McAndrew NS, Evans CRD, et al. Challenges in conducting research after family presence during resuscitation. J Trauma Nurs. 2012;19(3):190-194. [Context Link]

 

Trauma research; Nursing research; Trauma research nurse