Cancer Nursing & Research: Janice Richmond

Dr Janice Richmond is an Advanced Nurse Practitioner in the Oncology Department at Letterkenny University Hospital, who is currently researching ways in which cancer patients who have gone through treatment can feel better, both physically and psychologically. This research is funded by the Irish Cancer Society with support from Relay for Life Donegal.

From Belfast, to Kenya, and finally Letterkenny, Janice has held various roles as Staff Nurse, Nurse Manager, Clinical Nurse Specialist and Practice Development Nurse. She was the first accredited Advanced Nurse Practitioner in Oncology in Ireland (2006) and currently she remains in this post in Letterkenny University Hospital.

In addition, Janice teaches undergraduate nurses in Letterkenny Institute of Technology as well as providing education for registered nurses and junior doctors in Letterkenny University Hospital. Janice has consistently been involved in research and since 2004 has been widely published on the studies and projects that she has worked on.

The Irish Cancer Society asked Janice about her experience of entering the research world from a nursing background.
 

When I was given the brief for the contribution to the research newsletter my first thought was to start with ‘to research or not to research, that is the question.......’ While I wavered on this as an opening sentence, I think overall it reflects the experience of many nurses who have research as part of their job description or who want to perform research. The first step is often deciding what to do that hasn’t been done before, is of enough personal interest to sustain the research process, is of sufficient merit, and is within one’s own personal abilities. There really is no easy answer, yet as with so many things in life, the benefits come with diligence, team work, and often some setbacks along the way.

I have many things to be thankful of in my professional life but one is that I never left clinical practice, even when I opted to do my doctorate full time in 2000. I did the opposite to most others by studying full time and working part time in cancer care. I’m always thankful for maintaining my clinical practice while doing my research as, I believe, had I left clinical nursing I would never have had the confidence to return to it. Research has been a consistent part of my job in my different roles as Clinical Nurse Manager (CNM1), Practice Development Nurse, Clinical Nurse Specialist (CNS), and now as Advanced Nurse Practitioner (ANP). Sometimes the studies have been very small scale (Richmond & Devlin, 2003; Richmond 2004; Richmond et al, 2009) yet this work still answered a clinical question or provided data to facilitate a service improvement or practice development.

When considering the challenges of research it’s no surprise that money usually helps smooth the route taken. The research publications referenced above were all undertaken with little or no funding - €3,000 being the maximum grant obtained. Obtaining funding for research can be a challenge, yet there’s probably more research grants available now for nurses than ever before. While the application is often tedious, the process of applying helps to consolidate the research methodology and anticipate the challenges upfront.

An aspect of any research work that I found so beneficial and enjoyable is to work with nursing colleagues from research question development to data collection and analysis of results. Most hospitals now have a clinical trials department and while the focus of this work may be different to clinical nursing care, the experience and analysis of these research nurses should always compliment any clinical nursing research. Over the last ten years or so, I have worked consistently with Mary Grace Kelly the Clinical Trials Nurse who has been a co-investigator with me on all research undertaken since her employment here. Her input has been a backbone of all research done since then and carries a significant amount of the research caseload. In addition, Mary Grace is a member of the local ethics committee so the process of obtaining ethical approval is facilitated as she is aware of the requirements for this. It’s true that a problem shared is a problem halved which would better read as a ‘research question shared is a research process halved.’

Partnering with an academic, which is what many research applications require, also bring shared learning. Especially with the process of data collection and statistical analysis an academic co-investigator can be very helpful. In addition, their skills with writing for publication can be well used especially as clinicians find this publication work difficult to achieve.

Research also provides the opportunity to work closely with other staff, often from other disciplines and within that team the dynamism and energy can be infectious when we start the data collection and see results emerging. In 2017 we performed a large scale study entitled ‘a pilot trial to investigate the impact of a personalised self-management lifestyle programme using mobile technology on the health and wellbeing of cancer survivors’ (funded by Relay for Life Donegal/Irish Cancer Society). The collaborators included psychologists, physiotherapists, and dieticians and was performed alongside the Psychology Department in NUIG (Dr Jane Walsh). I personally learned so much working with this group of collaborators. In addition, the data collection process with the 107 participants at three time points were probably my most enjoyable days ever as a nurse as we visibly saw positive health benefits emerging within the participants.

Getting released from the 9-5 clinical role can be challenging. This requires organisation, delegation, and the ability to say ‘no’, a skill that I’ve had to learn albeit still difficult and one that causes me angst. I don’t think saying ‘no’ to aspects of clinical work will ever come easily to nurses, yet nobody else on the clinical team will facilitate this so the onus rests with the nurse researcher. In the ANP role, research is identified as a core aspect so removing oneself from the daily clinical work does not mean that the job requirements aren’t being fulfilled. Quite the opposite in fact, as performing research completes the job description to the fullest and it’s helpful to be cognisant of this.

While clinical practice and the care of patients remains my passion, research helps to provide some perspective on the daily routine job. Clinical practice fuels the research questions yet performing research gives me reprieve from what is a demanding and psychologically challenging job. I am delighted to see the Cancer Nursing Research Award 2019 which is in collaboration with the Irish Cancer Society, Health Research Board, the National Cancer Control Programme, and the Office of the Nursing & Midwifery Services Director. This is a great opportunity for clinical nurses to obtain funding to perform high level nurse led research and I thank the organisers for this opportunity. I hope many cancer nurses have clinical questions to answer and use this as a means of answering these questions and ultimately changing practice for the benefits of the individuals we care for.

Richmond J.P., & Devlin, R. (2003) Assessment of nurses’ knowledge on constipation. British Journal of Nursing, 12(10), 600-610.
Richmond J.P. (2004) General Nurses’ perceptions of the role of the clinical nurse specialist in Ireland. Cancer Nursing Practice, 3(6), 33-39.
Richmond, J.P, Rodgers, N & Houston, M. (2009) Description of patients’ knowledge of neutropenia and their experience of patient education following a neutropenic episode. Irish association for Nurses in Oncology, 3(4), 3-5.