Engaging Nurses in Research:

Professor Laura Serrant-Green

Professor of Community and Public Health Nursing

Research and Nursing Practice

Friendly strangers....or strange friends?

What is missing is history………….

In 1902 the female inspector found

... a particularly unsavoury case, owing to the vermin infesting the children’s heads, in addition to the filth of the whole place. The kitchen ... was occupied for all purposes by two old and invalid sisters, the dissipated son of one of them and his feeble-minded wife and threechildren. There was one bed, those who could not find a place at night on this filthy and uncomfortable couch ‘slept anywhere’; the feeble-minded wife has made no attempt to inculcate habits of elementary decency in the children; the husband drinks and ill uses her; and food appears to be an infrequent item in the daily programme ... The one bedroom of the cottage was allotted to the brother of the occupier and in this I found four dogs and several birds; the atmosphere of the whole house was pestilential.

(FSI report 26 Mar 1902: 5)

Fit for purpose?

women inspectors should be:

• “young, handsome, attractive, beautiful, pleasant, tidy, well-educated and up to date”.

(Perth Sanitary Journal 1904)

Health and Professional Practice

“Science and art of promoting health, preventing disease and prolonging life through organised efforts of society,

organizations, public and private, communities and individuals “ (Wanless report 2004, p.3)

Those who cannot remember the past are condemned to repeat it.

George Santayana, The Life of Reason, Volume 1, 1905US (Spanish-born) philosopher (1863 - 1952)

Mary Seacole

What counts as nursing?

Winifred Raphael (1898-1978)

What counts as nursing research?

• Industrial psychologist • Took part in suffrage procession

aged 11• Began work as a sanitary

inspector• Researched user perspectives

including patient views of hospitalisation

• Photo ©National Portrait Gallery, London

Background and Policy Context

• Key policies have called for nurses to be innovative and evidence based in their practice

• Yet the education, attitudes and infrastructure are not supportive of nursing research and scholarship

• Period of economic challenge: Timely to critically examine what is nursing research and why do we need it?

What is Nursing Research?

• Seeking answers to those questions which limit our ability to understand, determine and deliver “best care” and optimise “life chances”

• Entrepreneurial: ….the transformation of an idea into an enterprise that creates value: economic, social, cultural, or intellectual.” (University of Rochester 2008)

Why does (UK) nursing need it?

Broader need for innovation in health care e.g. new products

Creative, enterprising nurses: new ways of thinking, ingenious problem solving

Knowledge translation UK reliance on ‘other’ scholarship

Purpose of Research in Nursing• Improving science/art of preventing disease• Promoting health and social well being• Developing policies and interventions

Via• Using/extending the evidence base• Knowledge transfer/ translation• Commercialisation of knowledge

Opportunities: Transforming nursing services

New ways of delivering services Internally driven change Active as well as reactive engagement Social entrepreneurship

Challenges: Socio-cultural

• Professionalism: Nursing a semi profession?

• Professional identity: Conflict?• Professional beliefs, perceptions and

attitudes• Public acceptability and perception of nurse

role

Challenges: Organisational

• Organisational culture• Professional power structures• Limited access to research education,

knowledge and skills• Reliance on old service models and old

ways of solving problems

Challenges: Politico-economic

• Infrastructure• Regulation and funding• Clinical targets• Employer nurse relationship• Role of the nurse limited in the knowledge

economy

Advancing Nursing Research

• Contemporary nursing education should include understanding, utilising and generating research evidence

• Nurses should embrace research as a legitimate part of their role wherever they practice

• Health systems should ensure that structural measures that create the environment in which nursing research and scholarship can flourish, are in place

How?

• Individual (Developing leaders)• Theme groups around areas of

expertise/research clusters• HEFT/Clinical Directorates• Personal CPD

Individual

• Valuing individuals (recognising potential)• Identifying/assessing needs and opportunities (link

with personal/professional CPD)• Optimising and identifying links and partnerships to

assist development• Focussed and needs led Interdisciplinary

scholarship/awaydays• Direct supervision/buddying/mentorship

Theme groups/clusters

• Identifying clear focus for nursing research/Supporting current and prospective partnerships

• Horizon scanning via policy/DoH links• Working in (new) cross sector teams re:

policy/practice calls (LA/PH)• Conferencing/consultancy and policy

influence

HEFT/Clinical directorates• Facilitation of nurturing/supportive environment

(enabling philosophy)• Ensuring the research infrastructure and

administration• Strategic planning/vision for research development

across nursing practice sectors• Effective networking with new/existing partners • Intelligence: Competition/opportunities and

addressing constraints

Frontline Care....lessons for nursing? Prime Minister’s commission on Nursing and

Midwifery• Evidence to reflect the community• Scholarship and evidence informed practice• Whole systems approaches• Championing the ART and SCIENCE of care• Focus on workforce as much as service delivery• Educating and leadership for future research

Standing on the Shoulders of Giants• Mary Seacole• Florence Nightingale• Felicity Stockwell• Edith Cavell• Sr Eleanor Cooke, Liz Towell and Freda Ingall• Mo at POW• Neslyn Druee-Watson • Professor Elizabeth Anionwu• Dame Audrey Emmerson• Mr Joe E

Future Proofing Nursing Research and Practice

Begins here………..all graduate profession• Mid Staffs enquiry – ‘failure to act’• ‘Care quake’ (Frontline care) • Clinical academic careers• Nursing research professors • Service Improvement and Innovation

“As a profession, we need to move beyond simply selling nursing labour to commercialising nursing knowledge”

(Johnson 2009)

Future proof…or lost in translation?