This time, we're speaking with Sean Harrington. Sean started his Centre for Translational Medicine (CTM) pre-doctoral Clinical Research Excellence Fellowship in autumn 2025. These fellowships provide funding to allow protected research time and training for health professionals working in translational medicine. Sean is a registered nurse with a background in critical care. In this interview, he discusses how interrogating current clinical practice can generate valuable research questions, and how his CTM fellowship project arose from his experience of caring for patients with delirium in critical care.

Can you talk us through your career so far?

Currently, I have two roles. One is as a King's Health Partners Centre for Translational Medicine Pre-doctoral Fellow, and the other is as an advanced critical care practitioner (ACCP) in the Critical Care Department at King’s College Hospital (KCH). An ACCP is a bit like a nurse practitioner, and that's my professional background – I've been a registered nurse for over 10 years. Clinically, I've always worked along the critical care continuum, so either within intensive care units (ICUs), post-anaesthetic care units, on the wards seeing patients who need critical care support or in the emergency department. I've been at KCH for about four years. Prior to that I worked in various hospitals across London. I’ve also worked in Sydney, which was a great opportunity to see how other health systems work, and the challenges they face.

Why did you decide to pursue research and alongside your clinical work?
I think I must have been one of those children who would always ask “why?” about everything, because nowadays I do that in my clinical work! So much of our practice is done without necessarily having answers and evidence to support our decision making. The prospect of being able to find some of those answers, by asking why we do things in clinical practice and how we can make things better, is what inspired me to go into research.

The opportunity to do research alongside clinical work is exciting, because the two activities are closely related; you can bring what you learn from your clinical practice into the inquiries you make during your research. I think that’s a great way of making sure you’re doing valuable work.

What research experience have you had so far?
I had a taste of research during my undergraduate degree and my nurse training, but the biggest project that I’ve done so far was part of my master's degree in nursing a few years ago. It was a qualitative study looking at the experience of men who have sex with men, who were using what was at the time a novel pharmacological HIV prevention strategy. The timing of this worked out really well, since I was doing my dissertation project just as this drug was becoming available, and so it was a real opportunity to find out how the people who were using it felt and what their experiences were. This was also just before the drug was available on the NHS, and so lots of my participants were self-sourcing it from online pharmacies, which was entirely allowed but also created a project that allowed me to explore interesting ideas and themes.

I got to publish the project and so I also experienced the publication pipeline, which is valuable preparation for a career in research. It’s also the sort of knowledge of that, as a nurse, is not necessarily included in our standard career path.

Since my master’s degree, I've been involved with the delivery of research in my day-to-day clinical practice. We have quite a large portfolio of studies that happen in critical care. Our research nurses do amazing job of screening for patients, but sometimes I can point them to recruit someone who I’ve just admitted. I’ve also had opportunities to get involved with service evaluation projects and quality improvement, which obviously aren't strictly research, but they employ similar methodologies to answer local questions.

Why did you decide to apply for the CTM Pre-doctoral Fellowship?
At the time of the call, I was developing a question around improving delirium care in ICU. Delirium is a syndrome characterised by acute deficits in attention and other aspects of cognition which normally occur during a period of acute illness, such as an infection. It’s quite common in critical care and is associated with longer hospital stays, increased mortality and cognitive impairments. Looking through the call guidance, I thought that the fellowship presented an opportunity for me to explore some of the options for undertaking future research in delirium. I would like to apply for a PhD fellowship one day, so the CTM fellowship seemed a good way of getting some exposure to the research environment and developing my ideas further.

The fellowship will also help me build networks and collaborations with people across King’s, which I think is invaluable preparation for the next stage of my research career. I didn't realise just how important collaboration is for achieving good research and making it relevant. Although I’m only at the start of my fellowship, I’m already finding opportunities to work with different people, learn from others, and develop my own ideas into a good project.

What sort of collaborations have you already formed for your fellowship project?
Delirium presents a real challenge because up to 70% of patients can experience the condition when they're in ICU. Historically, delirium in intensive care was often seen as something that was transient and had no lasting effects, and it was often conceptualised as a nursing issue as opposed to an injury in itself. In fact, delirium comes up in a few different disciplines, such as psychiatry, gerontology, neuropsychiatry, critical care and palliative care. In this fellowship, I'm working with a neuropsychiatrist, a geriatrician, and a nurse researcher, as well as people from a critical care background.

What will you be working on during your CTM pre-doctoral fellowship?
During this fellowship, I want to collect some pilot data to try and assess how feasible it is to carry out a bigger project investigating potentially modifiable risk factors of delirium. We know that altered circadian rhythm or disordered sleep-wake cycle can contribute to delirium, so we’ll be looking at markers of altered circadian rhythm in patients. We’ll also collect environmental light data in intensive care units and see if the light patterns relate to delirium.

The other thing that we're doing as part of this fellowship is looking at potential biomarkers of neuronal damage in patients with delirium, because this has been proposed as one of the pathophysiological processes that underpins the delirium that we see. These markers will hopefully help with recognising the condition earlier, or at with understanding the mechanisms underpinning delirium a bit more.

What impact do you hope your work will have?
Within intensive care, some of our practices for reducing delirium and improving the sleep-wake cycle has been to make sure the lights are off and to reduce interruptions at night, but actually one of the things that is important in a normal sleep-wake cycle is having good exposure to light during the day, and exposure to the right type of light. I therefore think there's lots of potential to change the environment or develop a new therapy to promote a normal sleep-wake cycle. This might even make use of using existing technology such as SAD (seasonal affective disorder) lamps, since we could test whether these work as an intervention that can improve sleep-wake cycles in patients. This presents opportunities to change clinical practice very easily.

This pilot work will take place within critical care, but I think there's scope for my research to lend itself to some of the other areas where we see delirium since the underlying pathophysiological processes are probably similar.

What opportunities do you hope the fellowship will lead to?
When I was pulling together my application for the fellowship, I had to conceptualise a training plan. This helped me to see where my experiences can be further developed. As I said, I gained experience doing qualitative work during my master’s, but my CTM fellowship project is a predominantly observational quantitative project. I hope that getting some exposure to quantitative work will help with a future doctoral fellowship application.

The thing that most excites me about my fellowship project is its collaborative nature. Delirium is such a problem in intensive care, but it's seen in lots of different areas of the hospital, so being able to work with people from gerontology and psychiatry is really valuable and presents a great opportunity for me and for the project. Networking with other people who have got different ideas and are working on different projects has already been really useful. I'm sure that this networking will help me develop my thinking and reveal different approaches my clinical training hasn't exposed me to. For example, I’m aiming to get some wet lab experience during the fellowship.

I’m also excited by the opportunity to go to a conference and engage with the academic community in a different way. I have been to conferences before, but more as an observer – it will be great to be part of a conference, and to share and develop ideas with other researchers.

What sort of wet lab work are you hoping to do?
We'd like to do run some of the biomarker testing in lab space here at King’s. This would save the cost of getting the assays done externally or by a big supplier, but it would also improve my research skillset since it’s not something that forms part of my clinical experience to date.

What's the most rewarding thing about being a research-active health professional?
I think that there's an opportunity to have a big impact potentially. You could start by having a question about your clinical practice, at the bedside, think about how you might answer that question, and turn it into a project that ultimately changes practice and has a positive impact on patients. I get a buzz from that!

What advice would you give to a health professional who's looking to get into research?
I've been pretty lucky with the opportunities that have presented themselves to me and with the people who I've worked with. I've had a lot of people around me who are very supportive and encouraging, so when I've said I want to go and do something that's related to research, they've supported that. I think that finding those mentors, collaborators and networks who can support you is really key.

As a nurse, sometimes it feels like research is separate to a clinical career, and those doors to research aren't open all the time. So I think nurses often wonder how they can get through the doors and start a research career. I would say start with curiosity. Find something that you're passionate about, or something that frustrates you in clinical practice, or something that keeps coming up that you don't know the answer to – not because you've not read about it, but because the answer doesn't exist. Following that winding path of curiosity is often a good starting point for research, because then you're going to do something you're really enthusiastic about and the topic will direct you to some extent.

Finally, what do you enjoy doing in your spare time?
I like cycling. I spent some time living abroad and cycled a lot when I was there. When I moved back to London, I was initially nervous about cycling on the roads, but I’ve been back for a few years now and I’m loving it, which is great.