Read about Holly’s experience as a Community Learning Disability Nurse to discover what it’s really like to work for us.

How did you get into your current role?

I started working with individuals who have a learning disability in what would seem an unorthodox way!

I was too late to organise a work experience placement for myself whilst in Year 10 at secondary school.

The school organised a placement at a special needs school, to which I explained that I did not want to attend this placement as ‘it was not my thing’. However, the school said it was this placement or no placement and fail! So, I attended the two-week placement at the school, and I have never looked back since. I fell in love with the role of supporting those with a learning disability and the unique outlooks of the individuals and the creative ways to support them.

Following my placement, I became a support worker alongside my studies in health and social care in both residential and day service settings. I then furthered my career as a trainee nursing associate. This only heightened my passion for supporting individuals with LD access equal health opportunities. I requested to complete the Registered Nursing Degree Apprenticeship in Learning Disability, following an amazing placement with the Kirklees LD Team, I applied for a job and found myself lined up to be a part of the team before I qualified.

What qualifications and training have you gained/completed?

My time working for Sense UK in residential and day services gave me a thorough introduction holistic support and care planning. I was lucky enough to be offered various training opportunities for both mandatory learning and bespoke learning for individuals with complex needs ranging from feeding via a tube to Epilepsy management and many more in between.

My Degree in Health and Social care allowed me to explore the intricate equilibrium that those with additional needs must navigate to access appropriate health care. I chose to write a dissertation on a physical heath need and the mental health implications of this which outcomes can still be applied today.

I was part of the pilot scheme of the Trainee Nursing Associate course in Manchester which allowed me to experience four areas of the NHS – Acute Medicine, Specialist medicine, Surgery and Community Nursing. I also attended university to complete a Nursing foundation degree which introduced me to view the nursing process as a holistic approach. I was privileged to be offered training that achieved my competencies in catheter insertion, insulin management, Medications administration, ECG, NG management, venepuncture, IM injections and many more.

Following a year and experience of COVID within a district nursing team, I decided to follow a specialist dream to become a Registered Learning Disability Nurse. My foundation degree allowed me to join second year. I experienced a number of enlightening placements from community teams, residential to behavioural assessment units. My course allowed me to further understand my Registered Nursing role with bespoke evidence-based education specialising in learning disability approaches.

Have you overcome any challenges along the way?

I have pursued a career in learning disability support for many years. I wish I had the knowledge that specific learning disability nursing was an option whilst at school. When I was choosing my options at university, I was never considered to aspire to high grades, and I felt my dyslexia unfairly placed me in the educational system, whereby I’d spent a lot of my time at primary school in ‘special educational needs classes and my secondary school in the lowest education sets.

I have had ongoing support from teachers who recognised my determination and dedicated parents that I am proud to say is the reason why I am in the position that I am in today. You could say I was a late bloomer education wise! I find academia a pleasure in my older years, graduating with a 1:1 in both my degrees and a distinction in my foundation nursing course. However, this did not come naturally to me and as a kid at school with a passion for learning, certainly made me a target for those who didn’t share my passion. (I was also a goth which didn’t help at the time! My fashion has since levelled out!)

My experience as a trainee nursing associate was in the hustle and bustling hospital of Manchester Royal Infirmary was amazing. However, at the time, I am confident that I did not recognise some of the struggles I experienced in myself. I now promote openly and honestly about some of the struggles experienced during reflection when being introduced to the diverse world of nursing. I was exposed to a number of really challenging situations in placement wards such as Cardiac ICU, Emergency Surgical Trauma Unit, District Nursing and Stroke Ward. I took all experiences with the greatest of enthusiasm and achieved a clear pass in all my placements.

Coming from a sleepy home town in Lincolnshire, I did not think I accounted for the toll that would take on my mental health when considering the highly emotive situations for both the patient, their families and the decisions that were made on a day-to-day basis. I was always thoroughly supported on my wards. Now that I have a few more years and experiences under my belt, I am now very aware that I perhaps was not coping as well as I thought I was. This is why I incorporate an emphasis on supervisions and open discussions about experiences that may be interpreted as ‘everyday nursing duties’ but should be recognised as individuals with a nursing role becoming immersed into someone’s story which may extremely emotional and challenging for all involved. My ethos is, ‘Never underestimate the power of reflective practice’.

What do you actually do in your job? How would you explain it to someone who doesn’t know anything about it?

I always find this question difficult to encapsulate! Community Learning Disability nursing is as holistic as it gets! Referral reasons can be received for health needs ranging from physical health access, behavioural support needs, community safety, dementia assessments, mental health support and providing accessible information for informed decision making around a number of areas of everyday life and positive risk taking.

However, a referral reason may not always be what it is considered on paper. Once a community learning disability nurse has completed their initial holistic nursing assessment, a variation of different unmet health and social care needs may be considered, and reasonable adjustments require exploring to promote the most equal access to opportunities to improve quality of life for that individual.

Supporting the patient themselves is only part of Community Learning Disability Nursing. Support to the patient’s family, support network and or paid staff team are also considered as part of the LD nursing responsibility to ensure guidance and recommendation are implemented effectively and efficiently.

Community Learning Disability nursing teams are in place to support those who may not have a voice, to advocate for themselves in the most accessible way. ‘Outside the box’ thinking and creative approaches are a daily consideration for not only the learning disability nurse, but the communication across the multidisciplinary team that surround the patient as well.

What’s the best thing about your job? What gives you the most job satisfaction?

I thrive on meeting my patients and working out ways to support them to access their own decision making for their own health. I feel confident when armed with the right evidence-based practice that provide resources which help reach agreed goals with the service user. I feel a sense of fulfilment when working alongside other teams who are involved with the patient and working in tandem to achieve planned outcomes.

I continue to learn from my patients and their unique interests, passions and perspectives, I gain a sense of alliance when supporting patients overcome their challenges and a sense of adrenaline when celebrating their achievements.

I work in a team that share my passion for supporting individuals with a learning disability, it feels like I am surrounded by a family who share the same goal. Despite current challenges in health and social care, the team that I am part of stand strong to support one another as passionately as they support their patients. I am lucky to be surrounded by an array of experience, knowledge and compassion.

What do you find most challenging about it?

There are a number of challenges facing health and social care within a broad spectrum. I cannot deny that these challenges have not gone unnoticed. Funding reductions, waiting lists, staffing across the wider MDT all contribute to the ongoing challenges that all health and social care teams are experiencing. It becomes incredibly frustrating when golden standard care is expected of a society that does not match this within their funding (from my experience).

Despite societal troubles faced as a wider political issue, the team that I am a part of continue to provide the highest standard of care within our capacity and bespoke pathways are in place to ensure all patients are waiting well whilst accessing our service.

Managing family expectations and changing work force attitude and values can be challenging when supporting individuals who present in a complex way, either physically and or in a behavioural presentation. Over the span of nursing intervention, they can get to know a family / support network and build interprofessional rapports with them. This can be challenging when expecting families/staff to carry out recommendations, when you consider the level of carer/role pressure on an individual and sometimes add to that pressure within your recommendation can feel defeatist, often nursing intervention is supporting someone to access what’s considered an undesirable experience in their lifetime e.g. hospital interventions, low mental health, behavioural challenges and at times, safeguarding issues.

 This is why, at most, little victories are required to be celebrated as learning disability nursing can often be considered as ‘the long game’ and with dedication, determination and passion (from all those involved!) often prevails to a healthier outcome than the ones in the beginning.

What would you like to do next? Do you have plans to undertake additional training etc?

I still feel that I am ‘finding my feet’ as the role of a learning disability nurse is ever changing and no one patient is the same.

I am currently pursuing a course in positive behavioural support planning within the team, and I always keep my eye out for additional external training as part of the Florence Nightingale Foundation Trust who supported me through a leadership and management course when I was a nursing associate.

If I were to change my role from a community learning disability nurse, I’d like to pursue a role within learning disability hospital / GP practice liaison. However, I plan to continue my path within the community learning disability team as each day teaches me valuable knowledge and understanding about the nursing process as a standard and bespoke approaches for those with a learning disability.

What would you say to someone else to encourage them into your chosen career? Do you have any advice for them?

Learning disability nursing may be a role you never thought you’d fall in love with. It is a niche career that isn’t widely advertised throughout school. [I believe when I took my ‘career test’ in my latter schooling days, I was advised to become a baker… That’s not a good idea for anyone!]

It’s a role like no other, you are guided by the nursing process as your foundation and the rest is creative, innovative and bold thinking to explore the best possible outcomes to support those with a learning disability.

Learning disability nursing will not only teach you about nursing someone else, but the experiences that you face within your career will teach you about yourself and those who surround you both personally and professionally as well. To me, learning disability nursing is not just a job, it’s like joining an immersive community.