By Dr. Lisa Whiting @LisaWhi35145237; Prof. Celia Harding @CELIAHARDING1 and Dr. Julia Petty @petty_julia
We have all been taught about the need to obtain ethical approval before conducting research as it ensures that studies are undertaken with “due care and regard towards all those who are involved” (Heath et al., 2009, p. 21), this includes participants as well as the researchers themselves.
On 1st October 2021 we were awarded funding from the Burdett Trust for Nursing to undertake a study entitled: Exploring neonatal nurses’ and parents’ understanding of the factors that enhance and hinder communication and early interaction between preterm infants and their parents. The need to explore infant interaction in the early stages of development is crucial; the COVID-19 pandemic and the need for increased mask wearing (as part of protective personal equipment use), as well as reduced parent visiting, highlighted that, whilst communication and interaction is essential for infant development, it is largely poorly understood (Green et al, 2020). As our research involves data collection in an NHS Trust in the South of England, Health Research Authority [HRA] approval is required. Although, the application process was set in motion almost immediately, following receipt of our funding, our Research Ethics Committee meeting was only held on 18th May and, whilst our amendments were minor and easily remedied, we will not be able to start data collection until July/August at the earliest (given that we first need to recruit staff and parents from the NHS Trust). The HRA ethics process (such as the forms, the need to acquire a research passport as well as organisational sponsorship) means that there is a reliance on others and that the approval can take many months to acquire; when there is a timeline for completion of a study, this can cause substantive anxiety for the research team.
There are also implications for students wishing to undertake research. The time that it can take for ethical approval to be granted means that pre-registration and post-graduate nursing students can be deterred from undertaking primary research with many Masters programmes now offering alternative options such as literature reviews, policy analyses and audits. The consequences of this are that nurses may have little insight into the practicalities of research and may feel ill-prepared to be involved in it – this is despite the fact that the Department of Health (2014: 29) mandated that Health Education England: “develop a more flexible workforce that is able to respond to the changing patterns of service and embraces research and innovation to enable it to adapt to the changing demands of public health, healthcare and care services.”
However, aside from the challenges, research is (on the whole) a very practical skill that is not only enjoyable and satisfying to be part of but, most importantly, can also provide unique insights into nursing practice with the potential to positively impact on patient care. As a profession, we need to ensure that nurses have the skills and attributes to undertake research, failure to do so means that they are not adequately prepared when studying at masters or doctorate level, but may also not be as well placed to provide evidence-based care. Part of this preparation, of course, is an understanding of ethical considerations, so that nurses become ethically responsible researchers, akin to how we care for our patients. Navigating the processes of applying for ethical approval may by lengthy and challenging at times; however, there is so much to be learnt that is valuable and lasting.
We are very excited to start the data collection for our study and, despite the length of time that ethical approval has taken, we absolutely support the processes – without these in place, the safety of our participants (and potentially ourselves) may not be wholly protected. We urge others, if given the opportunity, to have the resilience, commitment, and motivation to conduct primary research; please do not be deterred by the word ‘ethics’, it is a ‘journey’, but a surmountable one that will provide rich and insightful rewards enabling us all to provide higher quality care to our patients and families.
References:
Department of Health (2014) Delivering high quality, effective, compassionate care: Developing the right people with the right skills and the right values A mandate from the Government to Health Education England: April 2014 to March 2015. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/310170/DH_HEE_Mandate.pdf Accessed on 23rd May 2022.
Green, J., Petty, J., Staff, L., Bromley, P., & Jones, L. (2020). The implications of face masks for babies and families during the COVID-19 pandemic: A discussion paper. Journal of Neonatal Nursing. 27(1) 21 – 25.
Heath, S., Brooks, R., Cleaver, E., & Ireland, E. (2009). Researching young people’s lives. London: SAGE.