Nursing: Learning disabilities

The fast-growing area of learning disability nursing offers rewarding and challenging work.

“Working with people who have learning disabilities is very exciting and rewarding,” says Jim Blair, member of the Royal College of Nursing’s Learning Disability (LD) committee and senior lecturer in the subject at both Kingston University and St George’s, University of London, “and even the tiny successes can mean an awful lot. “But as far as I’m concerned, one of our key roles, as the very people who understand the health complexities involved, is to challenge rigorously the health inequalities that people with such disabilities currently face in our society.”

While Blair, who entered nursing in his mid-twenties, believes that TV scriptwriters are helping to change public attitudes to LD, he says that far more awareness is required. “EastEnders has a child character who has Down’s Syndrome and the fact that she is regularly shown on camera is a huge departure from a decade or so ago, when nobody with such a disability would actually be seen. “Yet after more than two decades of specialising in LD, I have found that it is actually other health professionals who can be bad at dealing with clients with a learning disability, or even listening to the very people who know them inside out; their families.”

He says that he recognises that people have a fear of saying the wrong thing to someone who has autism, for example, but with the right training a nurse can help transform that person’s quality of life. “That’s where we as specialist nurses come in.” Blair’s point is reinforced by Ann Norman, who advises on the LD sector for the Royal College of Nursing and who believes that awareness of what learning disability means needs to be raised among general nurses as well as the public as a whole. “As children, we are all taught to be very sensitive when it comes to dealing with blind people, for example, but that level of empathy doesn’t always extend to the people in our society who have been born with learning problems,” she says. She gives the example of a woman with Down’s coming for a cervical smear at her GP, and requiring extra reassurance. “Nurses need to be made aware of the issues involved so that care can be improved,” she says.

There are estimated to be around 25,000 learning disability nurses up and down the country, yet this fast-growing specialism – which occasionally overlaps with mental health nursing – remains the Cinderella of the profession in Norman’s view. She says that as many as 2 per cent of the population have a learning disability such as Down’s, Asperger Syndrome or autism; defined by the RCN as anyone with “impairment of intelligence and adaptive function,” yet the quality of the care is, in her opinion, “still very variable”.

Whether based in the community or in hospitals, it is typically the LD nurse who acts as a broker with other health professionals and delivers the often complex nursing needs of the client. These nurses deal with people of all ages. “Very premature babies may be born with learning disabilities, but also people with Down’s Syndrome, for example, are now living far longer and require standard older age nursing as well as specialist treatment,” says Norman. When it comes to accessing criminal justice, LD nurses are once again on hand to help. “LD nurses generally have phenomenal communication skills and a growing number of them want to exercise that talent in helping their clients get access to justice,” she says. “Being a learning disability nurse really does transform lives.”