John Turnbull is the Universityof Northampton’s Subject Lead for Learning Disability (LD) nursing. As part of MENCAP’s Learning Disability Week (18 – 24 June), in which the organisation aims to spread the word about how to address the problems people with an LD face when accessing healthcare, John talks about why he loves this branch of nursing so much and what the future nurse can get out of joining him and his peers.
I become a LD nurse quite by accident.
Back in the early 80’s I was studying for a degree in English Literature, about as far and away from nursing as you can get. I had some spare time on my hands and wanted to do something productive and helpful.
A friend of mine worked in respite care for children with an LD and asked if I wanted to volunteer at a local support centre.
He must have sold the idea perfectly. I had no idea what would happen and I half expected to go along, help out and then go back to my books But, as soon as I walked into the centre, I knew instantly I wanted to work with this group of people. So, how could I make such a life altering decision to change my career so quickly? The reason is simple: the atmosphere in that room, created by people with LD and those helping them, was electric.
Supportive, positive and friendly, I was greeted not with a series of problems but saw immediately how a real, huge difference could be made to people’s lives. I felt at home and really welcome.
Then and now
The world and LD nursing have changed considerably between my first days on the wards and today. For a start, you aren’t likely to see an LD nurse actually on the wards. It has been said that we are ‘facility independent practitioners’, as much at home in the community as we are in supported living or independent nursing homes. This is reflected in the wide range of excellent nursing placements we have at University of Northampton.
From special educational needs schools, to traditional residential placements, community teams, intensive support team (where students get used to dealing with very challenging behaviour), St. Andrew’s Healthcare (a national and European leader in highly specialised areas), commissioning and independent practitioners (such as the Camphill Village Trust) we are very well served in Northampton and the wider county.
The style of teaching nursing has had a sea change as well. From a largely apprenticeship model we now have full, 3-year nursing degrees delivering a more academic and evidence based qualification.
The whole attitude toward people with an LD and how to support them has also revolutionised. They have greater visibility now and a clearer voice about what they want from healthcare, including us in LD nursing, hence the importance of Mencap’s awareness week.
So, why train to be an LD nurse?
The thing about working in LD nursing is you can never be just a bystander, people with a Learning Disability will actively want to engage with and talk to you and you feel drawn to them. I have always felt that this uniquely trusting relationship really brings out the best in a nurse, making you not only a better communicator but more compassionate and more patient.
It certainly did with me because I started making enquiries about how to train to work with this group of people almost immediately after my first stint volunteering. It just felt right, that
I wanted to do this.
That doesn’t mean working with LD people is always plain sailing. Nurses from other fields are often used to being told what a patient’s diagnosis is is and working with medical teams to treat them, but people with LD can have very complex needs and behaviour that can be difficult to understand. Therefore, we train LD nurses to do something different: sometimes it’s about taking a breather before you make any decision.
It’s vitally important LD nurses don’t make immediate assumptions and to imagine themselves in their shoes before even attempting to treat them, reflect on what they are seeing an
evaluate how to treat people from there. We teach our nurses many different forms of assessment and observation, to help them come to a more person-centred conclusions about that behaviour and how best to help the patient. They will even be helped to develop their own communication styles that will help them get to know patients and treat them effectively.
Inspiring, Creative, Supporting, Partnering, Collaborating.
These are the words that I’d use to sum up LD nursing. Our philosophy is to always see the patient as an individual and take their history and their abilities into account and then
help from there. This is also very much part of us teaching nurses to ‘be brilliant’, the initiative that runs through everything we do in our nursing courses at University of Northampton.
‘Being Brilliant’ focuses on ways of thinking and behaving that allows us to be the best version of ourselves. We develop a culture where all students and staff aspire to be the best that they can be, the principles are simple and focus on small changes in behaviour that can have a big impact.
It’s about applying and learning from the things you come across and not being afraid to do this. We have an advantage in LD nursing in that we teach smaller cohorts, so we really get to know our students. By getting to know you quicker and better, we know sooner how best to support you and to help you get the best out of nursing.
I think I speak for the whole LD team here when I say that, if what I’ve written has made you feel what I felt during my early voluntary placements, we’re looking forward to getting to
know you too.