I have been involved in the role of Clinical Research Officer actively seeing clients since the end of March 2006.  I generally see clients on the ward and once discharged, at home.  Here are a few thoughts on my experience so far and a brief insight into the role of a Clinical Research Officer:-

• Once I have found a client who is potentially eligible, I will approach staff, the Named Nurse where possible – to find out more about the client’s presentation and current mental state.  I will then screen the MDT notes and gain as much information as possible.  If the client is eligible and in a position to give valid informed consent I will ask a member of the team to introduce me to them.  I give the client a verbal handover of the Patient Information Sheet and leave a paper copy for them to read.  After a minimum of 24 hours I will go back to see the client and go through the information again, answering any questions or concerns they may have.  I then ask if they are interested in participating in the study, and if so, ask them to sign the consent form.  I arrange another appointment at a mutually convenient time to start baseline assessments.

• I tend to see the clients once a week for anything from 15 minutes up to over 1.5 hours; this depends on their mental state, their attention span and ability to concentrate on the day.  Where necessary, the client has “comfort breaks” – generally a cigarette break before we recommence the assessments.  The assessments are conducted at the client’s pace – this is a particularly overwhelming time and some of the assessments are in-depth and can evoke strong emotional responses.  I might have planned a fairly lengthy semi-structured interview but on arrival find that the client is only able to concentrate for a short period.  I make my initial contact with the client informal, and decide, depending on their presentation, whether to do a brief or more detailed assessment.  It can be difficult to predict. It is important to be flexible.

• The ward environments can be difficult too, in terms of room availability and privacy and assessments can be cut short if the room is required for reviews/ward rounds etc.  Once again, it is very important to be flexible and expect the unexpected!

• I find that seeing a client over a period of approximately 6 weeks (based on a weekly visit) helps to develop rapport and trust.  If the client is particularly unwell and suspicious in the early stages of our interaction, I tend to leave the more sensitive assessments until later – as the trust develops.

• I think that the time invested with the client at baseline also impacts in a positive way on whether or not they are interested in pursuing the study at the six month follow up.

• Overall, the clients I have worked with have welcomed my visits to the ward and the time for 1:1 interaction.  They have told me that it has helped them to reflect and gain an understanding of their experience.  In addition, one individual stated that being involved in the study and talking about her illness has facilitated a more open relationship with her keyworker.  This particular patient also commented that she felt less like a “patient” and more like a valued individual and having time to talk about her experience helped alleviate her feelings of boredom whilst an in-patient.  Some clients have informed me that they expected more in-depth questioning and investigation of their past history and have been quite happy to work systematically through numerous assessments.

• I, personally, have felt privileged to be allowed an insight into an individual’s experience – and to see them improving throughout my visits.  It is often quite difficult to “end” our interaction after the baseline assessments, and I look forward to contacting people again at six months to see how their lives have progressed.

• Assessments have been facilitated by the input and involvement of relatives/carers – and once again the opportunity to ventilate and share their experience has been welcomed.  One mother informed me that she found it very difficult to talk to other people about her son’s illness and the effect it had on the family but was able to talk openly to me knowing that I had a background in mental health and therefore able to empathise with her often painful disclosures.

• I have also found it rewarding working closely with other mental health professionals.  A member of staff I worked with helped facilitate recruitment to the study and once her client consented to participate in the study, she supported me throughout the baseline assessment process, offering supplementary background data which proved to be most useful to the project.  We established an effective, mutually beneficial working relationship – a relationship we would like to model with other colleagues within the trust.