Year 1 - Complete

Hi one and all! 

I have finished my final placement of year 1 and it has been amazing.

I had a great last day! We had a chippy takeaway, cake, juice and chocolate cake. Amazing.

I will really miss that place.

In six weeks, I was able to accompany the students on outings. I was able to assist with making decorations for the summer fete. I was able to run an art class which was super fun to do! I was able to assist with personal care. I was able to discuss oxygen therapy for seizures. I had so many learning opportunities.  

I went to epilepsy training ran by a RNLD and she was amazing in helping to go over the training and then assist in how we would write nursing care plans and assessments.  I know we have to do this next year so I was able to discuss this with her and gain some very useful information about this. The RNLD was in the process of writing up a nursing assessment for a new student starting at the centre, so I was fortunate enough to see how the process works of introducing the student to the centre and seeing how they settle.  They are assessed to see which room they would like to go in to and what activities would suit them.  They are then also able to look at the student and what assistance they may need in the centre and how they will get to the day centre, so their likes and dislikes of travelling and any requirement are also looked at in regards to buses and other students in proximity to them. The staff are then also looked at to see if they need any extra training, for example if the student has a PEG or a stoma or a tracheostomy.  This enables the students to attend the day centre and feel as included as possible.  The RNLD would then also train the staff where needed and formulate action plans and in case of emergency plans for the student and the staff.  

I was also able to then talk to the Speech and Language therapist who comes to the centre to work with the students.  I was able to see how she works with different individuals and I was also permitted to take part in a swallowing assessment for a student.  Listening to that with the stethoscope was a fantastic learning opportunity too. I then had the chance to look at the equipment that some students use, including apps on tablets that are very good for interactive learning. The technology out there is amazing, but the waiting list for assessments and access to some pieces of equipment is quite astounding. 

 We do have pages in our portfolios in each placement where we can get another health professional to write in it, so the SALT was able to do this for me.  I was then able to put this in that I had taken part in the various activities with the other health care professionals.  

The placement also allowed me to learn more about people with learning disabilities who have dementia.  I was able to support an individual who has been greatly affected by her dementia and is increasingly needing more support in the day centre.  Her care meetings would look at this, and how best to support her so she still enjoys coming in to see everyone as she has been attending for many years now.  The staff were able to facilitate her leaving a little earlier so she was not extremely tired by the time she returned home. 

I was also taught how to knit by several of the students! I thought this was amazing, they were so patient with me and so eager to help.  They were also amazing at giving advice and were brilliant in helping one another.  The relationships between the staff and the students are incredible and it is nice to see that there is that support and that trust amongst everyone.
I also learned that on an almost daily basis I would be getting hugs, my hair played with, my bum tapped, I would get asked how my family and pets were doing, the students would even bring in cardboard boxes or treats for my pets too! 
In many places I have been, many people worry about professional boundaries and this can seem a little closed off to many with learning disabilities as they may not understand this.  Especially for those who have no contact with any family. So the only close proximity or touch they may have, is with staff.  If I have learnt anything in one year of nursing. It is this.  It is okay to give someone a hug.  It is okay to laugh and cry with them.  It is okay to be there for them.  That's what nursing is about.  Of course, you still have to remain professional and you still need them boundaries.  However, we are all human.  And all of us like to have a hug when we feel bad or for someone to just offer a shoulder to cry on and an ear to listen.  It is all about striking the right balance.  

I am sad that my first year has come to an end, but I am so exhilarated and thrilled too! 
It means I am one third of the way there! 
It also means that I have learned a lot, I have experienced so much and more importantly, I have used that to ensure that I will be a great RNLD. 

Final Placement of Year 1

Hi all!

I have finished two weeks of my final placement of year 1 already!

It has been amazing.

For my final placement I am in a day centre for adults with learning disabilities. The day centre is brilliant. There are a big mix of students in their abilities and likes and dislikes.  As it is a day centre, I do not have the opportunity to do clinical nursing care, but it is still nursing care all the same.  

So far I have assisted with personal care, eating and drinking and assisting the students (this is what the service users prefer to be called) in activities. 

I have been able to see the students take part in cookery activities; art; snoezelen; music therapy; sensory activities; going to clubs outside of the day centre and soon there will be summer activities as part of summer scheme.

The day centre is big and there are over 150 students on the books.  The students are lovely and so very welcoming to us nursing students! 

There is such a range of learning disabilities and syndromes that the students have, so it has been invaluable as a learning experience.  My mentor has also been able to give me information on the syndromes and how this may affect the students physical health as well as their mental health and well-being.  Each student has a care plan in the day centre that is put together by the centre staff and a learning disability nurse that comes into the centre.  The students may come from referrals or be transitioning from children's services to adult services.  

Each student comes in for short periods to begin with so they can get to know the centre and the centre's routine.  They may go around various rooms to decide which they like better or they be allocated a room depending on their needs and wants.  Each room has different student in it, with differing activities that it is centred around.  I am in a room that does a lot of arts and crafts and hands on activities. There are other rooms, for example, IT (Information Technology), skills and sensory.  There are various rooms and the students have the opportunity to have taster sessions in the other rooms and take part in activities in them.  

I am on placement with 3 others from my cohort so it has been nice being on placement with others that we know so we can all help one another.  It also means we can share knowledge of the room we are in for when we see the other students around the centre.  

I have also had the opportunity to talk to another nursing student who is on placement there as part of their 'out of field' placement.  

Recently, I was able to take part in a focus group for the NMC in relation to the nursing course, the structure and what we were happy or unhappy with.  It did come up that many people are confused about what we do as Learning Disability Nurses. Many of us felt that for those that are having their out of field placements, they should be in those challenging behaviour settings or those who may also have mental health needs.  As there has been some students from other years that said they have heard remarks that Learning Disability Nursing is not hard, or it is like being a 'glorified baby sitter'.  Of course, placements come down to a lot of things, but, by saying such things as the aforementioned, those people are creating inequalities.  Therefore, we want people to experience the challenging part of learning disability nursing.  Not so they may see us as Learning Disability Nurses in a different light (not all people have this view, just a small minority) but so if a person with a Learning Disability is admitted to A&E, or has to use what we may deem as mainstream services, they are given the appropriate level of care for them.  The staff will have a greater understanding and the individual with the learning disability will have a less stressful hospital stay or less waiting time, or even just a more understanding and knowledgeable practitioner in understanding their communication needs.  

So, if this day centre has taught me anything these past 2 weeks, it has been this;

Always get to know the person and be patient. 

Individuals with learning disabilities are amazing people. They may need extra support or they may need a helping hand every now again. 

And more often than not, you'll learn a lot from them!