The Struggles of Being A Learning Disability Nurse

I've completed my first placement and my first week back in lectures. 

We have had a tutorial where we have reflected on our placement and had chance to talk to fellow students about who was able to experience what in placement. 

It has been good to have that opportunity to do so. It has also allowed us to see the difference in placement areas and the different experiences that each of us had during our six weeks in placement. 

It did come up in discussion how some of us had struggled and had faced negativity towards the branch in which we are studying. 

It is disheartening that even today, in 2015, that we are still facing negative attitudes and opposition in studying learning disability nursing. I have even received some emails from readers of this blog in regards to this as well.  I had a interesting conversation in regards to a student's placement and how they had faced some nurses asking why they had chosen to do learning disability nursing and if they thought they would be able to succeed in finding a job after they graduate.

As I have previously stated, learning disability nursing is still seen as a small niche of nursing.  However, with the population living longer, reproducing later on in life and living riskier lives, we are all experiencing a different level of health and disease than we ever previously have in our modern day world. As you may have noticed, the Ebola outbreak has been onoing for a while now and this has taken many lives.  We are still not yet able to say if the vaccines they are trialling will even work.  It is hard to even say what may happen if the vaccines do not work.  There are also many more people suffering from conditions such as dementia and multiple sclerosis.  This is because we as a population, are living longer. Why do I mention this? Simple.  People with learning disabilities are living longer and are needing more specialised care.  The population of people with learning disabilities is ever increasing and is not going to diminish any time soon. So why are they excluded as a group almost in society? We forever see articles and media focusing on the ageing population and how elderly people may feel segregated and need care and help from those around them.  Why do we never see those with learning disabilities in the media like this? Why do we never see many people with learning disabilities in the spotlight? Perhaps those with learning disabilities are not aware. But maybe it is those around them who may not fight as much for them as for their elderly grandparents.  It has been, and may always be, a common societal view that the elderly are frail and need care and respect. We think of teenagers differently, we think of middle aged men differently.  It is these stereotypes that need fighting on a daily basis.

As a side note, I never experienced any negativity on my placement.  The nurses were very skilled, they were lovely and so very supportive.  They applauded me for doing learning disability nursing, however there was 2 nurses that even admitted if they could go back they would do adult as they like the hospital setting and many of those patients were being resettled into the community. In my placement I couldn't fault the nurses for this.  I personally would like to do community care and manage my own caseload. I would like to go on to do district nursing so I am able to do that extra training in catheter care, wound care etc.  I am not fully settled on that as I am leaving my mind wide open for the experiences I am yet to have in my nursing degree. 

It has been pointed out to me that there is a blog on the Mencap website of another student learning disability nurse facing negativity and opposition.  As I am unaware of where she is based this is difficult to comment on.  On the other hand, I can give my experience. 

On my placement I was able to give medication.  Once you qualify, it is almost expected of you to do this. This is why some universities have maths and english exams before they will even interview you. Medication calculations are important.  I was able to do PEG feeds, I was able to clean and dress the site. I was able to do body mapping charts. I gave injections. I was able to enemas. I completed case notes. All of this can be considered clinical care. Not one of my peers faced any opposition or comments in this, from other student nurses on other branches or people on placement.  Learning disability nurses are becoming more recognised and valued for their skills. 

It is becoming apparent that slowly but surely, it is being recognised that people with learning disabilities need that specialised care.  We need learning disability nurses to fight for those people with learning disabilities. We need people with awareness to make this known.  And I say we as a learning disability student nurse, we as people with learning disabilities, we as health care professionals and most of all, we as people.  I have always seen learning disability nursing as an amalgamation of all 4 branches.  In learning disabilities, you can work with pregnant women and their families, you can work with the newborn they just had that has been noted may have a learning disability.  You may work with children and assisting them in assessment and development.  You can work with teenagers, struggling with regular teenage problems or just trying to explain the process of puberty.  You may work those trying to move away from home and seeking help and support. You may work with those wanting to have a family. You may work with those going through significant trauma in their lives.  You may work with the elderly learning disability population.  You may work with those needing palliative care. You may work with those going through a bereavement.

See where I am going....? 

Learning disability nursing is not and will not be stuck to one area. You are working with people. People change, people develop. And most of all, people are people. Nothing is guaranteed.  Nothing is set in stone.  People with learning disabilities may just go through all the phases in life that the rest of the population go through.  It is all dependent on them, their needs, their assessment, their decisions and their wants.  So please never let someone tell you you cannot.  Learning disability nurses can do clinical skills. We can take blood, we can do I.V's, we can do B.P's, we can do dressings. All it needs is a bit of training.  Nursing is a career that you are always learning and are always adapting.  So if you want to do whatever it is within learning disability nursing, why can't you? Do well at university. Qualify. Find a nice job and a nice, supportive employer. Go on training courses. Never stop learning. And never stop fighting for and raising awareness of people with learning disabilities. Because odds are, they don't have the voice or the platform to do so. You do. 

And so placement begins...

So I have completed my first week of placement and it has gone so quick!

I had a mad dash into town to go and buy some shoes and I've been wearing them in around the house. I did want some trainers as they're usually a lot more comfortable but needles can easily go through them.

And it is in our portfolios to wear black sensible smart shoes for placement. 

Ironic thing is a lot of learning disability is in the community so I don't even know if I will be wearing them much! 

I rang up my placement again on the Friday before hand just to ensure I had everything right in my mind about how to get there, where to park, if they charge for parking and if I'm needed to wear uniform. 

I have to wear mine so at least I'm getting my money's worth! We had to pay £160 for our uniform so it's always good when you can wear it. 

For our off duty the staff have been really flexible and so helpful as they know students can live anywhere and may not be in close proximity to the hospital. They have asked us what we prefer to work and if we want to do nights etc.  It does state that by NMC guidelines we have to do so many nights each year of the course.  In first year we have to do at least 3. So I am aiming to do that this placement.  That way I can see what happens at night and enable me to hopefully get some work done!  It also means that if I don't get chance to next placement or the one after, that I am covered! 

In my placement I am actually in a hospital so I am really enjoying that. Of all the years I've worked with learning disabilities I have never yet worked in a hospital. It has always been in the community which is what I love to do. But this placement has certainly opened my eyes.

My very first day we had an emergency situation so that was certainly interesting. I have dealt with challenging behaviour, done my first set of observations independently and unobserved. I then recorded this using a NEWS chart. I have done my first bm (blood sugar test) and given my first few insulin injections. I have also been to the dentist this week with a patient and I have had the chance to speak to many nurses who are more than happy to help.  Ive also done my first set of administering drugs under observation and I have learnt a lot! 

It has been exciting and exhilarating having done so much in one week.

My task for the weekend is to learn about the drugs we administer in this ward and how each one works etc. 

I am also aiming to learn about a few others things as we have new patients coming in all the time.  

It has been a whirlwind of a week and my mentor has been really helpful. I have managed to observe an ECG (electrocardiogram) being done, I have been able to get to know the patients and to understand how a learning disability hospital setting operates. It is definitely the most rewarding aspect of nursing, being able to converse with your patients and respond.  Especially if their communication skills are limited. This is where it counts in getting to know your patients.

My advice for the week? 

Be enthusiastic and get involved wherever you can. Most places you will go on placement will have had students before. And if the patients don't mind, observe every chance you get. Everything on placement will help you learn, no matter how small you think it may be.  And all that will help throughout university and into your future career. 

1 more sleep..

So I have one more sleep until university begins. 

Funny isn't it from how when we are children we count down in sleeps and this continues on into adulthood!

But i have had some panicky moments over the weekend thinking "What am I doing?!" and "Will it all be okay?" "Will I cope financially?" "Will i get on okay with everyone?" "Will I pass?" 

All common questions that I believe probably go through everyone's mind when they start university, never mind nursing  After leaving work after having been in a full time role for 5 years it is going to be a little shock to the system I think, even if I have been to university before!

It is somewhat surreal knowing that tomorrow I begin university and I learn to become a nurse. After all the waiting, the applying, more waiting, the preparation, it's finally here.  I am so glad we have social media as well as i have managed to find classmates and meet up with a few people to attend occupational health and enrolment with. I think this has helped settled people a little and realise that everyone will be feeling exactly the same at some point or another.  The girls i have met have been lovely and the age range is varied.  The youngest is 18 and I think the oldest so far is in her forties!  So proof that no matter your age or experience you can succeed in getting into university if you apply yourself right.  

So in preparing for tomorrow I have been out this week and bought a new school bag 

Nothing too exciting, but I went for practical! I wanted a bag I know I can carry my books, my notes, lunch, water bottle and anything else in there. So its a 35L bag, so I am hoping that is plenty of room.  I didn't want a shoulder bag as I will be walking to university and I know in the long run I need to look after my back, especially in this line of work.  

I have also been messaging family and friends for any tips and any help they want to throw my way! So luckily I have an amazing family who are buying me some books so I have them to hand.  I have only asked for three which are fundamental for the three years of the course.  (I have found this out from asking others on social media from the same university I am attending) I have also bought some new highlighters, note pads, lever arch files and various other bits and bobs.  Hopefully this week I'll find out what else may be needed. But i'm sure another post on my organisation will follow.  

My partner is currently building us a desk and shelves in the study. So hopefully I can get some photographs up of that when it is complete.  He didn't want to buy a desk, they weren't big enough or wide enough or sturdy enough.  This is what happens when you live with someone who is a mechanical engineer apparently! At least he is practical!

As well as the desk building and bag buying, I have also printed off my timetable that is available on our student portal.  I have been reading through past exam papers that I have found and I have looked at what books I need from the library.  This last one is well worth doing if you can.  I have found one book which I need and all 10 copies are on loan.  So it is obviously a popular book! I have reserved this so hopefully I can have this soon. Mainly because we have an exam on our timetable already and I want to be prepared.  

So instead of counting down the days, it has now come to that point where we have gotten into hours.  When I was posting in May it felt so far away and that it would never come round.  But sure enough here it is and it feels like this summer has flown by.  

This time in three years i'll be waiting on my NMC registration and my PIN coming through. But first, a lot of hard work and dedication ensues! 

Ignorance is not bliss.

So only a few more weeks to go until induction.
I've been trying to get my blog out there and make and more people aware of the learning disability branch of nursing. Especially when I am still seeing articles of health care professionals (hcp's) not understanding or even trying to, those with a learning disability. It has to be one of the most annoying things that those who are meant to be trained and work following the 6 c's of nursing ignoring all that?
In the past week I've had 2 very recently qualified adult nurses talk about how l.d is all community and how we don't do anything clinical and how we can't do iv's and we can't take blood and we can't do x, y and z.
It shows that even the most recently trained of nurses can still be ignorant. I have been told communicating isn't hard and how l.d is not a hard subject.
It does take a lot for me to not bite people's heads off at such things! In the years I've worked with people with l.d and the hcp's that liaise with them I've seen appalling communication! Talking to me and not the individual, pretending to understand then looking to me for clarification, just simply nodding and agreeing, hoping that the individual may stop talking. Constantly asking other hcp's for help when the person may be showing a behaviour that may challenge.
The list can go on and on.
Yet it is the carers and the health care professionals that work with the individual on a frequent basis that will know most about that person. And there are many conditions that people with learning disabilities have that many people have not heard of. All of this needs to be publicised more and to give those with a learning disability a bigger voice. There is only so much the parents or carers can do. They need the likes of learning disability nurses to assist them, to enable them to look after the individual to their best ability. They want the public to know more, the doctors, the nurses, the psychologists, the speech and language team, everyone needs to be made more aware.
Learning disabilities are not going to go away. They won't diminish and they certainly will not stop happening.
If you're scared there's not going to be a job at the end of the degree, don't be.
People are living longer, they're living fuller and sometimes riskier lives. People are having children later on in life, people may experience medical trauma. All of the above and more can contribute as to why someone may have a learning disability. And these people need qualified knowledgeable professionals to help and assist in their care.
Learning disability nurses can deal with newborn babies, premature, and inutero.  They can deal with children and adults. Learning disabilities do not discriminate with age. They can affect anyone. So in being a learning disability nurse you are experiencing a wide age range. A variety of people. And that makes you just as qualified as any other branch.

What To Do Before Becoming A Student Nurse

• Brush up on your math skills as much as possible..drug calculations etc. There are some good websites out there to help, and BBC Bitesize is good for the basics if you haven’t touched on that in a while.

• Following on from this…familiarise yourself with Anatomy & Physiology. There will be exams on this! And this will help loads in learning little bits at a time during your free time. When else will you have this many months of preparation for a single topic where nothing else is also hanging over your head?

• Enjoy your free time as much as possible. Nursing degrees are in university attendance a lot longer than some other degrees. The summer before you start may be your last one with a lot of free time. The following summers you may spend revising, working and / or on placement. Make the most of seeing people and having days where you know you can enjoy the sunshine. It sucks having to be sat in, or even in your garden surrounded by books while everyone is off to Alton Towers or a BBQ..but it definitely pays to work hard!

• Get some stationary and get yourself organised - This includes a USB and / or portable hard drive to back up all of your work. (And me..personally i backup, my backup. As mentioned previously., me and technology sometimes have little fallings out!) Get some lever arch files to organise your notes. And a wall calendar i have always found helps immensely for keeping track of deadlines. And not forgetting, pens pens and more pens. And a pen clip if you’re anything like me. I have lost pens from my tunic pocket at work more often than enough. Bending over making beds, doing personal care etc. My pens have met untimely ends in toilets, bins, soiled laundry and well..you get the picture.

• Socialise! Both online and offline! Make yourself known on twitter etc. I have won a book through this and had tweets published, and it always helps to know your stuff on all things in your chosen field as well as others and all NHS info. Health care is constantly changing and being updated, so it pays to have the most up to date knowledge when it comes to assignments and helping your patients. Just please remember confidentiality. There is nothing worse than working so hard to get where you are to be kicked off your course or have your PIN withdrawn for some daft comment you have made about how bad your day was or how drunk you were the night before.

• In relation to the above…housekeeping. As you are going to be on placement and trained through the NHS, you are now looked at very differently from ‘ordinary students’. Thus, look at your online presence. Can people see you in ridiculous photos on social networking sites? Have you made any stroppy comments about anything that can bring yourself or others into disrepute? Worth thinking about. I have had friends delete all photos from websites, change privacy settings and even their online name so people cannot link them. Nothing worse than having a patient / client etc saying “I see you had a great night last night, bit drunk were we?” Or “That photo of you flashing your bum was hilarious..hope to see more ;) ” This can and will happen, so be aware!

• Research. This is so important. Research your university course you want to apply for, as well as the universities you apply to. Research what field of nursing you apply for and how you can progress. Is there a speciality you’re interested in? Research it! You may not have a definitive idea of how or where you want your career to progress in, but even a vague one is better than nothing. And if you’re ever asked..it may help to know (!)

• Get excited!!! This is a great opportunity and you are about to embark on what is the rest of your life. Never forget the privileged position you are in and why you started in the first place. After all, nursing is an amazing career and will have many ups and downs. Remembering why you are there and how you got to be there can help to keep you grounded and a little more sane when you have those busy insane days where it feels like nothing has gone right.

I’m sure i’ll end up adding more to this once i start. But this is a list from all my research and talking to student nurses etc. I am very lucky in that my place of work sees a lot of placement students. And they are more than happy to answer all my questions that i bug them with! But i will repay the favour when i’m in the same position (fingers crossed everything goes according to plan that is!)


If you can think of anything to add to this then please feel free.


Hope this has helped somewhat and best of luck for the future!

Why Learning Disability Nursing?

I suppose when most people ask me why learning disability nursing, i always reply “Why not?” 

It isn’t something most people think of when they think of nursing. Or a field that people may think needs specialised nurses. But the reality is that as we live longer, as we progress in medicine, as we find new cures and new medications, as we advance as we species, there will be new diseases, new learning disabilities and new immunities. 

And there are many, many people that have learning disabilities. It may be mild, they may be very high functioning in that they lead a reasonably independent life. Or it may be that they have such profound learning disabilities that the individual needs care with every aspect of their daily life. And for that reason, i want to help shape the care of the future for those with learning disabilities.

                                             

It is important to recognise the difference between learning disabilities and learning difficulties.

A learning difficulty doesn’t affect general intelligence (IQ) whereas a learning disability does.

Examples of learning difficulties may be dyslexia, dyspraxia or ADHD.

Learning disabilities on the other hand do affect IQ. And generally to be identified as having a learning disability, three criteria need to be met. These are; early onset (presenting before aged 18 years) ; intellectual impairment and social or adaptive dysfunction.

(Please see BILD for more information)

I recently posted that the reason for me going into learning disabilities is to make a difference. To be more than just an advocate, but to show people that those with learning disabilities need to be included, not secluded. And this is enforced in my mind every day.

I work with adults with learning disabilities, and i have done for the past 4 years. i originally started out as a support worker for adults with learning disabilities. This was after i went out to America to work in a special needs camp. Hands down the best summer of my life!

Well worth doing if you ever have the chance. I met some amazing people, it helped shape me as a person and cemented my career goals and aspirations for working with people who need that care and support.

Anyway, i digress.

Working as a support worker i was able to see how those with learning disabilities function day to day. How they integrate within their local community. How they achieve the most monumental of feats due to support, education and assistance.

I then started to be interested in the ‘what happens next?’

Its okay for people to see the day to day functioning, but what happens when someone with a learning disability is admitted to hospital? How do health professionals monitor health? Especially in those with communication difficulties?

I then began working in end of life care, to gain insight into the more clinical side of care. To see what is needed for people in such vulnerable positions. This was eye opening. I worked with people in their own homes who chose to return there from a hospice or hospital setting. And i loved it. Not many people can work with those who need such terminal care, and some may say it takes a special kind of person. But i, myself, would have remained doing that work for a lot longer than i did. But i needed to progress in my career!

So then onwards to working in a day centre facility with adults with learning disabilities. Some have been attending for years, some months and some only weeks. Some are making the transition from child services to adult services. This again, has been another way for me to see yet another side of the care and support that adults with learning disabilities receive. It is a fascinating job and it is utterly amazing the work the staff do. Everything is monitored from weight, hearing, eyesight, communication, to completing goals and tasks to enable someone to write their own name, to choose their lunch independently, to being able to go to zumba classes or even scuba diving!

The work that goes on in a day centre is massively undervalued. When i have worked in supported living (which i still do), i have met staff that will say they dont know what the staff in day centres do. Or why are they so nosey ringing up all the time? Or why do they get paid loads for doing nothing? The list goes on. But what some of these people fail to realise is that all those involved in the care of an individual need to work together. They need to utilise their abilities to communicate and do so! And by doing so it improves the individual’s quality of life, their care and their task learning.

So from here i now go to university (again) in September.

I get to learn more about the care of those with a learning disability and hopefully get to make a difference to someone, even if it is merely helping them put a shoe on. It is the littlest of things that can sometimes make the biggest of differences to a person.

After all, isn’t that what nursing is about?

Nurses Week

So it’s just been nurses week ..May 6th to May 12th…and i am fortunate enough to know a few nurses (family and family friends).

So all the thanks for the job they do as well as helping me through my application went out to them last week!
Honestly do not know where i’d be without their guidance, help and support. I keep waking up every day with a smile on my face that i am lucky enough to get onto a nursing course that i have been dreaming of first time round.
Now i’m not sure how many of you reading will know the history of nurses, but i am sure you have all heard of Florence Nightingale. There is more than enough information out there about her and her amazing work. And if it wasn’t for that incredible woman, who knows how the education of nurses would have turned out. Luckily enough it has turned out from being a nursing training scheme that she established, to later on nursing diplomas and now to nursing degrees. Nursing has long been a profession that has been overlooked and sometimes ridculed for the ‘bum-wiping’ and the ‘talking to patients’. It is a shame that some people do not and may never see the hard work that goes into becoming a nurse, maintaining that education and role as well as the hard work that goes into looking after patients. Now, for anyone that has ever worked in health care, i believe this is no news to you. But for those who haven’t, talking to a patient and carrying out personal care are 2 basic needs of any person that needs to be met. If that was you, would you like to be left to fend for yourself when you know you cant?
There are many many nurses out there, some more famous than others, who have helped to shape the health care system into what it is today. There are many nurses out there who have set an example, who have mentored students, who have spoken at conferences amongst many other things. And it is these nurses who may go unrecognised nationally for their contributions, that need to be thought of and need to thanked.
I am not going to give you a massive historical blurb about nursing. I’m sure you can find that out if you dont know already!
But what i do want to get across is that nursing is a profession that is not because ‘you are a failed doctor’ or because you weren’t clever enough (yes these are comments nurses STILL get today) it is a profession because you care. Because you want to have the patient contact, because you want to make a difference, because you want to help look after people and to ensure that their care is person centered to them.
It is a vocation, a profession, an education and above all, it is part of who you are as a nurse. Nursing doesn’t define you. You define nursing. By going into work every day, whether it is full time, part time or even on placement as a student nurse, you are leading by example. You are shaping the future of nursing. Every day. And that should make you proud to call yourself a nurse.