Dr Ben Bowers, Clinical Academic Community Nurse and former ARC East of England fellow, was named this year by The Nursing Times as one of the top 75 nurses and midwives who have contributed significantly to the NHS since its creation. In this blog, Ben reflects on his research journey and discusses the important role that nurses play in shaping the future of research.
I am a Clinical Academic Community Nurse with the Palliative and End-of-Life Group (PELiCam) at the University of Cambridge, where I lead a programme focused on improving last days-of-life symptom control for adults dying at home. This year, I became an Honorary Nurse Consultant in Palliative Care at Cambridgeshire and Peterborough NHS Foundation Trust.
It’s taken a long time to get here. I left school with no qualifications after struggling with dyslexia and I became a Healthcare Assistant, where I completed an Access to Higher Education Course to train as a nurse. Over ten years, I worked within and led district nursing teams and then specialised as a palliative care nurse. It was in this role that I realised that a lot of what we do in practice is based on a limited evidence base. This was a complete pivot point in my career; I decided to create my own pathway to help strengthen person-centred care. I wanted to do research to better understand what's happening in end-of-life care and help improve it.
In July of this year, I was named one of the top 75 nurses and midwives whose work has contributed in a significant way to the NHS since its creation. To be named as one of the leading lights in my field by Nursing Times is still hard to process. I remain shy and introverted and am focused on research and developing our community nurse researchers of the future.
How I shaped my path in research
During my Masters, I wanted to learn more from some of the leading researchers in end-of-life care, which led me to apply for the ARC East of England fellowship. The fellowship opened doors for me that had felt closed before. For my fellowship, I conducted a systematic review of the evidence on anticipatory prescribing and an explorative interview study with GPs about their decisions in prescribing these medications. My systematic review identified substantial knowledge gaps and this helped me secure and complete a competitive PhD scholarship with the NIHR School for Primary Care Research at the University of Cambridge. This gave me three years of full-time funding to lead my own research and develop my skills and knowledge.
“The NIHR and NIHR ARC East of England have been there as dynamic, steadfast support and advocates through my research career to date. The Fellowship gave me confidence in my abilities, personal growth and the support of world-leading clinical academics.”
My widely read and published doctoral research (fourteen papers and editorials to date) has challenged some established practices regarding anticipatory medications for end-of-life care. Initially, this was not my intention, but as I started asking more open and curious questions, it helped me think more critically about current practices and whether they are truly best. For example, clinicians believe that having access to anticipatory medications at home offers comfort and helps relieve symptoms promptly. However, conversations about the process of dying and the purpose of these medications are often unclear or insufficient, causing increased stress for family carers and district nurses. It is important to involve patients and families more to make decisions simpler and more inclusive and I will be researching this during my Wellcome Early Career Fellowship.
Continuing my clinical practice grounds my research in real-life questions and gives me credibility when I challenge the status quo, which I often do. My ambition is to become a Clinical Professor of Palliative Care, and to continue leading the way for more nurses and allied healthcare professionals to get involved in research.
“I have not looked back and love what I do. I encourage everyone to become research-active, regardless of background and qualifications. It’s about making our own opportunities and seeking answers to those tricky problems and dilemmas in clinical practice.”
The important role of nurses in research
Nurses play a crucial role in healthcare and their involvement in research can have a profound impact on patient outcomes. This is due to nurses working closely with patients and families and having different and rich insights into patients’ and families’ care. The questions that we ask about care are insightful and practical. However, there is a lack of nurses and midwives leading and contributing to research and generating evidence to underpin care. This is a particular problem in community and primary care healthcare. Lack of evidence prevents policymakers from commissioning high-quality healthcare and enhancing outcomes for patients and their families.
As a research-active nurse, I have found that we have a huge range of transferable skills, including communication and problem-solving skills, resilience and a nuanced understanding of complex clinical contexts. We often don’t realise just how adaptable we are and play down our contributions. My learning has been to recognise my abilities and insights, seek advice and support from generous, knowledgeable experts (from different disciplines) and pay it forward by being kind and supporting others to grow.
“We need more nurses and midwives leading research! This is something the NIHR is actively addressing through growing the range of opportunities and personal funding awards.”
Where to find like-minded nurses
It's vital to spot and support talent early on and to get nurses involved in research because they make up the largest part of the workforce. That’s why I co-founded and led the Queen’s Nursing Institute (QNI) Community Nursing Research Forum, which is open to all UK-based nurses and midwives working in community and primary care settings. The Forum has grown rapidly to over 850+ members keen to get involved in and lead research. Our members are very engaged and inclusive; they’ve been involved in seven research studies through the Forum so far.
Ben’s top tips for nurses considering getting into research:
Find people that you admire in your field and approach them. Good research leaders will welcome your interest and ideas, as they’re very keen to get more clinicians involved, so reach out and go from there. Good peer support is vital too.
- Believe in your own abilities. Overcoming challenges, taking risks and believing in yourself are key as you try to juggle clinical and academic pathways.
- Practice the skills of writing. I think writing a paper for publication on something that really interests you and then getting a peer, whose view and skills you value, to comment on it is a great first step into the clinical academic world. Writing has become my favourite clinical academic activity.
- Don’t let barriers deter you from your path in research. It took much longer than I would have liked to find a way into research and there was reluctance among several of my nurse managers to release me from leading teams as patient care needed delivering too. Try and encourage your managers to see the benefits that research can have on your career, the service and patient outcomes.
The NIHR ARC East of England fellowship programme offers health, social care, and third-sector professionals an opportunity to develop research and implementation skills. Find out more and apply by Thursday 30 November.
Led by Professor Stephen Barclay and Dr Anna Spathis, the Palliative and End-of-Life Care in Cambridge (PELiCam) works closely with patients and the public, people with personal experience of the palliative and end-of-life care of their loved ones, to understand and improve care.