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The 21st century has seen a remarkable growth in clinical research work in Malawi, with an increasing demand for research nurses. The pathway for career development for clinical research nurses is not explicitly designed to prepare student nurses to progress to the next level of employment or education in research. Most of the nurses who join research institutions do so with little or no knowledge of what research is all about. Unlike those in the medical profession (physicians) who have a clearly defined path for those who would like to become research scientist, the nursing profession curriculum mainly focuses on clinical nursing and nursing education.
However with the mushrooming of research organisations in Malawi more nurses are now joining research and many are developing the interest to pursue a career in clinical research. As the number of nurses in research keep growing a sizable number of nurses are taking up responsibilities of managing research projects based on knowledge and skills gained through experience. But with the expanding knowledge in medical science and technology nurses also realise the demand for high qualification in clinical research in order be keep the pace with the ever developing medical world.
The career path for a nurses to progress from a research nurse to a professor is uncertain in Malawi whereby pursuing further studies in the field is mostly reliant on support from the research organisations where competition with other professions is very high. As a result a majority of nurses take up jobs as research nurses where their main work revolves around consenting, collecting samples, data collection, dispersing study drugs, educating communities, etc.
For those with Bachelors in Nursing and with research experience have a greater opportunity to become clinical research coordinators working under the direct supervision of the principal investigator (PI), their responsibilities include but not least; study site preparation, hiring and training study staff, recruitment of study participant; data management; reporting AEs and SAE and ensuring overall site quality performance.
At Master’s degree level nurses are taking up institutional position by becoming managers of several studies under same or different Networks or Themes like HIV, Malaria, NCDs, etc... Some are working in the clinical research support units (CTSU) to take up duties of centralizing clinical research resources that standardize clinical and administrative procedures like developing SOPs for the conduct of human research. The CTSU also provides investigators with resources, the know-how of research conduct, and facilitates needed legal approvals to conduct clinical research in a manner that adheres to good clinical practice guidelines to withstand both national and global legal scrutiny.
A few who have progressed to PhD level have been awarded fellowship scholarships in the field of their interest to join a field dominated by those with medical or scientific background. Still the future looks bright as we hope that these scholars, with a nursing background, will lead the nursing profession in developing scientific knowledge through research.
The global research network has opened a lot of endless opportunities for research nurses in Malawi to further develop their career in clinical research through participating in training, taking short courses and merely interacting with other research nurses globally. The interest is growing as well-paying job opportunities are becoming available within research institution, evidenced by nurses going back to college than ever before to enroll for higher nursing qualification to enable them compete well with other professions.
The Malawian situation might be similar to other countries in Africa or beyond and it would be encouraging to learn what is happening in other countries where nurses have excelled in their career as research scientists.