Year : 2020 | Volume
: 7 | Issue : 3 | Page : 229--231
Research Nurse Residency: New Registered Nurses Transition to the Role of A Clinical Trials Nurse
Debbie Cline, Brandi Showalter
Nursing Workforce Planning and Development, MD Anderson Cancer Center, Houston, TX, USA
DNP, RN, CNL, NEA.BC, OCN Debbie Cline
Nursing Workforce Planning and Development, MD Anderson Cancer Center, Houston, TX
|How to cite this article:|
Cline D, Showalter B. Research Nurse Residency: New Registered Nurses Transition to the Role of A Clinical Trials Nurse.Asia Pac J Oncol Nurs 2020;7:229-231
|How to cite this URL:|
Cline D, Showalter B. Research Nurse Residency: New Registered Nurses Transition to the Role of A Clinical Trials Nurse. Asia Pac J Oncol Nurs [serial online] 2020 [cited 2020 Jul 7 ];7:229-231
Available from: http://www.apjon.org/text.asp?2020/7/3/229/287576
Clinical research is essential for the advancement of the science in healthcare. Currently, in the United States, over 32,000 active clinical trials are registered on the Food and Drug Administration website ClinicalTrials.gov and billions of dollars are spent annually on clinical research., Successful clinical trials require extensive collaboration and coordination with multidisciplinary research teams. At the center of that team is the research nurse. From initial protocol development to final study close-out and all points in between, the research nurse is an integral member of the team. The research nurse assists in day-to-day management and conduct of clinical trials while also caring for the research participants. In 2016, the American Nurses Association recognized clinical research nursing as an official nursing specialty and published the scope and standards for the practice. Despite this recognition, the role of the clinical research nurse remains a relatively unknown area of nursing.
In a large comprehensive cancer center located in Houston, Texas, the need for research nurses is constant. More than 200 research nurses are employed to conduct clinical trials in over 40 departments within the institution. The expansion of trials, opening of new studies, normal cycle of nurses transferring, and nurses leaving for a myriad of reasons add to the need. In 2016, an interprofessional group was formed to evaluate the vacancy rates of research nurses at The University of Texas MD Anderson Cancer Center and to identify the ways to incorporate newly graduated nurses. The Houston area has an abundance of nursing schools, and classes graduate at variable times. Historically, within the institution, the research nurse position required at least 2 years of nursing experience, so the question posed to the team was whether it was feasible to create a program for newly licensed RNs to be successful in the role of the research nurse.
The clinical nurse residency program at MD Anderson has more than 10 years of outcomes related to the placement of newly licensed RNs in inpatient settings. Through a collaborative effort between the nursing leadership related to clinical trials and the leadership of the clinical nurse residency, the team worked to develop the Research Nurse Residency (RNR) program. Success for the development of the new program was enabled through executive leadership support.
The role of the research nurse is unique and is an area that many nursing students are not aware of as it is not part of the standard curriculum. The team identified a need to educate potential new hires about the role and utilized a video about the role of the research nurse to help applicants understand. In addition, interviews provided time for questions related to the role to be answered. Incidentally, we found that there is a small percentage of nursing students who worked in research before entering nursing school. While experience in research is not a requirement for applying or being selected for the program, it does give an applicant a good understanding of the role requirements.
The RNR program was unique in that conventionally, only experienced RNs had been hired for the role. This was primarily due to the level of autonomy and independent nursing judgment required for the role. The RNR curriculum was designed to promote these characteristics. By combining general nursing orientation, clinical research knowledge, and residency program support in a collaborative manner, the program provides a solid foundation for the new research nurse.
The 12-month program includes an intensive 4-week orientation up front providing the new resident with fundamental oncologic nursing education and enhanced clinical research training. The orientation is followed by monthly residency classes concentrating on transition to practice, advanced oncological nursing principles, and additional clinical research content, which includes a research simulation exercise. Program description and curriculum are outlined in Showalter et al.
A large part of the success of the program is related to the personalized support provided by the clinical research educator, a preceptorship in the hiring department, and the nurse residency program. The dedicated clinical research educator closely monitors the residents' progress throughout the program, acting as an advocate and working with the preceptors to ensure that the resident is receiving the support and learning experiences needed. This is accomplished, in part, by monthly individual meetings with the resident to gauge the progress. One resident remarked after completing the program that the additional support of the research educator was crucial to hi/hersuccess in navigating the new role.
Since initiation in October 2016, a total of 46 residents have entered the program, and 42 have completed or are currently in the program. Of those, 32 are working in the research nurse role. Nearly 25% of residency graduates transferred internally to a clinical position, most being a just after 1 year. It is notable to mention, however, that three former residents returned to the research role <2 years after transferring, with two returning within 1 year.
Program evaluation is completed using a validated survey focused on newly licensed registered nurses. During the 1st year of the program, the survey was given at baseline, 3, 6, and 12 months. Over time, it was changed to at baseline and completion of the program. The research nurse residents also self-evaluate progress toward clinical trials nurse competencies from the Oncology Nursing Society at the same intervals. Early data revealed that nearly all of the residents reported feeling confident in these competencies.
While many in the hiring departments had initial reservations about newly graduated nurses in the research nurse role, the feedback has been overwhelmingly positive. Managers and supervisors have commented on the enthusiasm of the residents and their eagerness and openness to learn this new and unique role. The confidence gained through the RNR program has led to early professional development and high engagement in sharing externally. Many participants of this program have succeeded in writing and submitting abstracts, presenting at national conferences, and co-authoring scientific articles related to the protocols they support. Further, several have been promoted to a senior research nurse role.
The success of the program and the expertise of the graduates have successfully filled the need for research nurses and lowered the vacancy rates. The residency is offered up to three times a year corresponding to academic graduation dates.
The success of the program relies on many: the nursing educator, research departmental support, the preceptor, consistency in education and support from the clinical research educator, and the residency program itself. This program is successful due to the executive support and commitment to the program. Although turnover at the 1-year point has been noted, those data can be used to drive change. Understanding the reasons why the research nurse residents have left the role is a good way to identify the interventions to retain research nurses longer.
The RNR program has had many benefits to the organization, including evaluation of the orientation process and modifications to improve onboarding for all research nurses, not just the residents. Thinking beyond the norm is needed as we continue to have shortages of experienced registered nurses and an abundance of newly licensed RNs. This program is a good example of thinking differently and approaching an issue with an open mind and a team willing to try something new.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
|1||NIH U.S. National Library of Medicine. Available from: https://clinicaltrials.gov/ct2/home. [Last accessed on 2020 Mar 31].|
|2||Biopharmaceutical Industry-Sponsored Clinical Trials: Growing State Economies. Available from: https://www.phrma.org/-/media/TEConomy_PhRMA-Clinical-Trials-Impacts.pdf. [Last accessed on 2020 Mar 31].|
|3||American Nurses Association. Clinical Research Nursing: Scope and Standards of Practice. Silver Spring, MD: American Nurses Association, Inc.; 2016.|
|4||Cline D, La Frentz K, Fellman B, Summers B, Brassil K. Longitudinal outcomes of an institutionally developed nurse residency program. J Nurs Adm 2017;47:384-90.|
|5||Showalter B, Cline D, Yungclas J, La Frentz K, Stafford S, Maresh K. Clinical Research Nursing: Development of a research nurse residency program. Clin J Oncol Nurs 2017;21:633-6.|