Seeing the difference a clinical trial drug can make to a patient reaffirmed the reason why I wanted to be a clinical research nurse
Before her recent retirement, The Christie’s most senior research nurse and operational director for the National Institute for Health Research (NIHR) Manchester Clinical Research Facility (CRF) at The Christie, Elaine Blowers, shared some of her proudest moments, the key developments she’s seen in experimental research during her career, her reasons for getting involved in research nursing and her hopes for the future.
Looking back, my initial interest in clinical trials came when I was a student nurse in Birmingham and participated as a healthy volunteer in early phase clinical trials of cardiac drugs. I recall being intensely monitored all day long and was given a fried breakfast to test the effects of the drug with a fatty diet - I got paid too which helped me with my rent!
I qualified as a registered nurse at the Queen Elizabeth hospital in Birmingham in 1986 and worked in a number of roles such as coronary care and acute medicine before moving hospitals and working in oncology at the Dudley Road hospital in Handsworth, Birmingham. From there I pursued my interest in oncology and started my science degree at the Royal Marsden, working at both the Fulham Road and Sutton sites. I went on to work at Mount Vernon regional cancer centre as a senior nurse manager in oncology before moving to St Mary’s in Paddington to a take up a clinical nurse specialist post in breast cancer.
I became a Macmillan nurse specialist for Mount Vernon and Watford General hospital before moving to the North West in 2000 where I worked for Healthcare at Home Ltd, delivering chemotherapy and long term treatments in patient’s homes and clinics in the North West. Through this role, I became involved in a clinical research trial being conducted at The Christie where part of the trial involved delivering treatment in patient’s homes as one of the trial arms for breast cancer patients.
I was approached by the breast cancer research team to apply for a research nurse post and was successful. As a breast cancer research nurse, I was part of a team that became one of the most successful breast cancer research teams in the UK and I was one of two first nurse advisors for the breast NCRI clinical studies group. I became the breast research nurse team leader in 2007. In 2014, I was appointed as the operational director for the NIHR/CRUK CRF at The Christie and divisional lead research nurse.
The NIHR is the part of the NHS that helps to fund clinical research, and the Clinical Research Facility at The Christie is one of four centres in Manchester that have joined together to provide integrated health research across Greater Manchester.
I’m very proud to have had the opportunity to work at The Christie. As a specialist centre, all staff are committed to ensuring patients and their families have the best possible experience and care. Staff are proud to work here and care for each other; they continually look for opportunities for innovation and are supported in making change for patients’ benefit. Walking through the hospital, people acknowledge each other and it normally takes me quite a few minutes to get to my office in the morning as I talk to staff and patients along the way.
Patients at The Christie are always pleased that they have been given the opportunity to participate in a clinical trial as one of their treatment options. They feel special and confident being cared for in a dedicated research centre with highly trained research staff and receiving the best care. They hope that the trial will make a difference to their health, although they also understand that it is a trial and therefore may not benefit them directly but they are pleased to be able to make a difference for their own and their children’s future and are aware that it’s only through trials that we learn if a new treatment is better than the current best treatment we have available.
I am thrilled to have been fortunate enough to be involved in a number of breast cancer trials where drugs from an early phase trial have gone on to become standard care for patients, for example, Herceptin, Perjeta and Lapatinib. This is not a daily occurrence, as only a small number of drugs are both clinically more effective and also pass through all the safety phases before being licensed for standard care delivery.
One of the major breakthroughs I was involved with back in 2003/2004, which was unprecedented, was when early results indicated that Herceptin improved outcomes for early breast cancer. It was a very rewarding experience and reaffirmed the reason why I wanted to be a clinical research nurse - to make a difference to patients’ outcomes.
Since 2017 when NIHR/CRUK Christie CRF , NIHR/Wellcome Trust Manchester CRF and NIHR South Manchester Respiratory and Allergy CRF came together to form the NIHR Manchester CRF, I have played a key role in driving the successful integration of the Manchester CRF. This collaborative bid for NIHR funding, which brought the previous CRFs in Manchester together under one single management structure, has helped to create the largest (and hopefully most influential) NIHR CRF in the UK.
I was also delighted to have helped organise the UKCRF annual conference in Manchester in 2016. The conference was the first time that the Manchester CRFs came together to work collaboratively before the formal bid to become one Manchester CRF. I played a key role in winning the open competition to host it in Manchester along with Professor Andrew Wardley.
Looking back, I’ve seen a lot of changes over the years. There has been an increase in the complexity of delivering experimental cancer medicine trials and the science behind them since I started. And whilst the increasing number of trials for personalised medicine and targeted treatments is wonderful for the patients who are eligible, it brings its own challenges of screening large volumes of patients to find the right patient with an identified mutation and then to receive the appropriate treatment for this in the context of a trial.
I’ve also seen a big increase in digitalisation at a number of levels in clinical research, from using IT to set up and conduct clinical trials to the use of IT devices by patients to inform decisions whilst participating in experimental cancer medicine trials.
One of the most rewarding changes has been that clinical research nursing has been recognised as a speciality in nursing in its own right – and now has its own clinical research nursing strategy.
I‘m really going to miss the wonderful staff that I have had the privilege to work with over many years - especially the clinical research nurses who demonstrate such commitment and passion for this very specialised complex area of nursing on a daily basis.
Looking ahead, I’m leaving behind an amazing team. The redesign and reconfiguration of the Manchester CRF facilities at The Christie in 2017/18 have ensured that patients now have a dedicated reception area and there is a big increase in space for experimental trial delivery. Thousands of patients will benefit from this fantastic facility in future years.
Moreover, I hope that a growing number of patients will have access to experimental cancer medicine trials and to clinical trials closer to their home.
I also hope that the NIHR Manchester CRF will go from strength to strength and continue to be the most successful and largest CRF in the UK, in addition to receiving growing international recognition for the superb work being done.
It’s been a privilege to work at The Christie and to help so many fantastic and inspiring patients.
Patients can learn more about clinical trials on the research section of the website.