Community Learning Disability Nursing – How do I explain?

My name is Amy Willis; I qualified as Learning Disability Nurse and Social Worker in 2018. Upon qualifying, I worked within a nursing care home, supporting people with complex physical health needs, and I then secured a post within a community learning disability team as a Community Learning Disability nurse working in Barnsley; both experiences have provided me with a vast amount of knowledge, experience, expertise, and skills.

Many people ask me what my role as a community learning disability nurse is, to which my response is “how do I explain?” or “where do I start” as the role involves a so many differing skills and competencies. So, where do I start… in clinical terms, my role is focused on providing a range of support and intervention; from accessible information and resources to ensuring individual’s health needs are being met. As a community learning disability nurse, I am an advocate, a health facilitator, a therapist, and an all-round expert practitioner. From palliative care, mental health support, crisis intervention, to high quality compassionate care, the list goes on.

As a community nurse I have a great network of people I work alongside, this ensures we achieve the right outcomes for the people and the families we support. We provide specialist nursing intervention by adopting a person-centred approach to promote optimal health and wellbeing. We strive to tackle health inequalities and we empower individuals to have independence, choice, and control to ensure that ultimately, they lead a meaningful life within the community. The needs of the people who I support is diverse. This includes people with physical and mental health needs, sensory impairments, behaviours that challenge and forensic support needs, and I help to meet their needs by working with a diverse range of partner agencies.

As an example of a positive piece of work, I have recently supported a 24-year-old gentleman who was referred by his General Practitioner (GP/Doctor) to receive the covid-19 vaccination. As this man was frightened of needles, we were asked to consider whether he might need some type of therapeutic holds to administer the vaccine.

Firstly, we held a multi-disciplinary meeting (MDT) with the service user, his family, service provider and relevant professionals to determine the various options available to administer the vaccine(s). This included consideration of the environment, reviewing who would be involved, the potential use of medication, provision of sensory items and the potential use of communication aids (i.e. story boards). We utilised the mental capacity act and best interest decision making processes and we considered the use of therapeutic holds alongside the persons likes, dislikes, ultimately deciding what would be the least restrictive option for them.

Through careful planning, the multi-disciplinary team decided it would be in the gentleman’s best interests and the least restrictive option, to administer the vaccine through the window of the gentleman’s car. To achieve this, it would require a confident professional to administer the vaccine and a plan of action with a step-by-step process to make it clear who and what was involved. As a result, a plan was agreed, and staff members who knew the individual well, supported him in the car. The plan was deployed thoughtfully, and the approach was decisive. We limited communication with him so as to not cause any distress, we provided medication to help relax him prior to administration of the vaccine, and as a means of recognising how well he was doing; as well as a distraction technique, it was agreed that he would go for his favourite food after the vaccine was administered.

By following the above plan, the gentleman was able to receive both doses of the covid-19 vaccines successfully and without the use of therapeutic holds. By considering the individual’s likes, dislikes, involvement of people who know the individual well, adopting the least restrictive practice and adopting a person-centred, approach, the overall experience was a success.

To summarise, working within a community learning disability nursing team, every day is a new day and often, you don’t end up having the day you thought you had planned. I get to work with people within a Multi-Disciplinary Team (MDT) who are passionate and want to improve and help people to live full, happy, and healthy lives. A community learning disability nurses’ role is varied, it’s full of surprises, it’s rewarding, fun and most importantly, it allows me to the opportunity to change people’s lives. I enjoy learning disability nursing despite the challenges and complexity it brings, if I can help make the smallest difference to someone’s life, then I know I have done my job right!