Understanding and caring for people with learning disability

With a recruitment campaign for Learning Disability nurses under way, Patricia McLaughlin, a Community Nurse in this field, tells Jane Bell why she loves the job

Patricia McLaughlin: 'Much of my work seeks to promote positive physical and mental health'

What range of learning disability conditions do you work with and with what age range?

I work with children and adults who have a learning disability. People with a learning disability have a wide range of abilities and needs.

They may find it more difficult to learn new skills or live independently depending on the degree of their learning disability.

It is known that learning disability can be caused by infections or trauma before, during or after birth, or other factors including genetics and is usually present from an early age.

I work with people with a range of conditions, such as Down's Syndrome, Autism and Fragile X. However, the majority of people I work with do not have a recognised cause of their learning disability.

Is learning disability nursing today regarded primarily as a health issue or is it approached more as a social model of care?

Many people perceive nursing generally as having a reactive role in relation to health deficits and indeed many people with learning disabilities have unmet physical and mental health needs to which we respond.

However nurses for people with learning disability adopt a much wider definition of health, one that recognises that social, physical and emotional factors all influence overall health and well being.

Therefore much of my work seeks to promote positive physical and mental health.

This involves providing training for people with learning disabilities and their carers in areas such as diet and exercise, personal and social development, assertiveness and self-esteem.

How have attitudes to people with learning disability changed in the 25 years since you began working in the field?

Thankfully, over the past 25 years attitudes to people with a learning disability have changed dramatically with their rights as citizens becoming enshrined in legislation.

Another significant development has been the move towards social inclusion with all people with a learning disability now living in their own homes rather than the longstay hospital where many lived in the past.

With increased life expectancy what issues arise?

The majority of people with learning disability can now expect to live to over 60 years of age and will experience many of the health problems of people ageing.

Some people with genetic conditions such as Down's Syndrome will have greater health needs as they grow older, including the increased possibility of respiratory disease, epilepsy and Alzheimer's disease.

Increased life expectancy has also meant that many people with learning disability now out-live their parents who are often their main carers.

For some of these people the loss of a parent can be quickly followed by the loss of their home.

What is your nursing background?

I trained as a mental health nurse in the early 1970s. Following a career break to have my family I returned to nursing in 1982. During my time as a nurse in Gransha Hospital I had the opportunity to nurse people who had a learning disability in addition to their mental illness.

On my return to nursing I successfully applied for a staff nurse position in Stradreagh Hospital (now Lakeview), which was and is a learning disability hospital.

After qualifying as a Registered Nurse Learning Disability, I completed a Diploma in Community Nursing in the early 1990s, followed by a BSc (Hons) Professional Development in Nursing in 1997, and now work as a specialist Community Nurse for people with learning disabilities in the Western Health and Social Care Trust.

What do you love about the job? What are the challenging aspects?

The most rewarding aspects of my job are the variety and range of nursing interventions I am involved with. For example in a typical day, working as part of a multi-disciplinary team, I can liaise with a number of other professionals, including GPs, consultant psychiatrist, social workers, day care workers and teachers.

I see clients in their home, school, day care and residential facilities. I advise on issues such as behaviour management, medication, epilepsy and mental health. I regularly carry out health promotion activities on a one-to-one or group basis.

At times my role can be challenging; covering a large rural area, and the lack of clarity among some professionals and members of the public about the remit of the specialist Community Nurse for people with learning disability. However these challenges are far outweighed by the many positive and enjoyable aspects of my role.

How much autonomy do you have and what support systems are in place?

I feel I have a large degree of autonomy. I work within a defined geographical area and have nursing responsibility for a caseload of approximately 40 people. I prescribe, deliver and evaluate nursing care based on the assessed needs of my clients and manage my own diary accordingly.

What type of person do you need to be to give the best to the job and get the best from it?

I feel it is essential to be a caring and empathic person for any area of nursing. Also a nurse for people with learning disabilities needs to be a good listener, take time to communicate effectively using a number of alternative strategies and be creative and resourceful in their approach to clients.

However, the most important attribute is the ability to understand and value people with learning disability as unique individuals and not be blinded by a label.