Three passionate RNLDs launch a new resource for learning disability nurses

Anthony Green, Tracy March and Sean Ledington are three RNLDs behind an exciting new project to raise awareness of learning disability nursing and to encourage more would-be student nurses to take up this branch of nursing.

Anthony, Tracy and Sean have been involved in learning disability nursing for several years, and all are (or soon-to-be) qualified learning disability nurses or RNLDs for short. They have recently launched a new online resource for all learning disability nurses, whether student, qualified or potential student researching the career path and it's called LearningDisabilityNurse.com.

In this interview we're going find out more about the role of a Learning Disability Nurse, how you become one and where that career can take you.

Can you give us a little background on your interest in learning disability nursing and why you decided to become an RNLD?

My name is Anthony Green and I am a 3rd year Learning Disability Nursing Student studying at Bangor University in North Wales. I recently won the Fiona Law innovation award at the NNLDN (National Network for Learning Disability Nurses) conference held in Bangor this year.

The reason I have chosen to study for qualification as a Learning Disability Nurse is mainly down to my experiences as a support worker for the past 10 years and having grown up with an uncle who was Down’s Syndrome, who basically showed me every day that life is there for living.

I feel that if I can make a difference and an improvement to people’s life’s no matter how small, then I will have helped somebody less fortunate than myself in terms of options open to them.

This is also the only job I have had in my 25 years of working where I wake up every morning with a smile on my face because I love going to work and that is worth its weight in gold. It is a privilege and a pleasure to be involved with people with learning disabilities and I can’t wait to qualify and start making a difference.

My name is Tracy March I am a 45 year old single mother of 2 girls aged 15 and 21. At present I am in my 3rd and final year of study as a Learning disability nurse at Nottingham University.

Before I started my nursing course I had worked for the previous 5 and half years in Health and Social care predominantly with adults with learning disabilities. My final job was as a support worker within a Community Learning Disability Team and it was whilst in this role that I was encouraged by my peers to do my nursing.

I am passionate about those with learning disabilities having the same treatment as everyone else and hope to find a career in health facilitation. Learning disability nurses wear many hats and have to gain many skills, we see our patients as a whole holistic package and it is this that spurs me on to qualify and hopefully make a difference to those I will meet in the future.

My name is Sean Ledington; I qualified as a RNLD in late 2011 at Wolverhampton University. I currently work part time as a Parent Advocate for parents with a learning disability and spend the rest of my time busy setting up a new charity called ‘Person Driven Services’.

The charity will aim to fill the gaps that exist with health and social care at present and will be co-run at all levels by people with a learning disability.I am passionate about learning disability nursing but feel that it needs to market itself better. It really needs to start showcasing what it does great and the varied career options it can offer.

I came into learning disability nursing as a mature student after spending most of my career in sports and fitness and running my own business. The decision to come into nursing came about after a knee operation went wrong and I stopped breathing on the operating table; this made me take stock of my life and make a complete career change.

It was the best decision I ever made.

For anyone who is considering a career in nursing but isn’t very familiar with learning disability nursing, can you tell us more about the role of an RNLD?

The registered learning disability nurse (RNLD) has a vital part to play in meeting the health and social care needs of people with learning disabilities. Life expectancy continues to be drastically shorter when compared with the general population; epilepsy for example is 20 times more common for people with a learning disability than the general population.

As a group, people with learning disabilities encounter substantial health inequalities and are one of the most vulnerable.

The role of the RNLD will include:

Assessments of health and social care needs

Planning, implementing and evaluating programmes of careInter-professional and multidisciplinary co-ordination of person’s wellbeing

Using the Nursing process to maintain, improve and promote health and wellbeing

Ensuring equality of service, access and outcomes within health and social care settings

To empower community inclusion including housing, employment and social activities

To advocate, educate, support and empower people with a learning disability, there family or carers from cradle to grave

To promote the rights, inclusion, choices and independence of people with a learning disability and to have a philosophy that is person centred.

What kinds of jobs do learning disability nurses carry out and what potential career progression is available?

A newly qualified learning disability nurse can start as a Band 5 Staff Nurse within the NHS but most newly qualified nurses start their career in a private sector, residential, forensic or community-based setting as a Staff Nurse or Deputy Manager/Team Leader.

This is due to most NHS RNLD jobs being at the band 6/7 level. There are also growing opportunities for newly qualified nurses to work in children’s respite centres and adult dementia units.

The demand for newly qualified nurses within in the private hospital environment is very strong with fantastic career development available.

After approximately two years' post-qualification experience, a learning disability nurse can aim for promotion, and/or further specialist study with the possibility of moving on to Community Learning Disability Nurse or Hospital Acute Liaison Nurse.

With further training in specialist skills, management, or the development of teaching skills, it is possible to progress into area management of a company/charity, specialist activities (such as epilepsy nursing), residential home management, domiciliary care management, care co-ordination, research or nurse education.

With the number of NHS jobs shrinking there are increasing career opportunities outside the public sector or for practitioners in social services, voluntary organisations, residential nursing homes, private health & social care organisations, and in health services overseas.

A growing area for nurses is working for HM Prison Service, in settings such as specialist secure units for offenders with disabilities.

Can you give us an overview of your own experience in your learning disability nursing course, and how the academic / skills-based course material is delivered?

There is a combination of academic and practice placement-based learning opportunities, with both elements of the course being compulsory. During each part of the course, students will be expected to attend a range of practice placements as well as attending more formal teaching and learning opportunities such as lecturers, seminars and tutorials.

The first year / common foundation consists of all of the branches studying together: adult, child, mental health and learning disability. The material studied covers the foundations for social sciences for nursing, foundations in evidence based practice, biological sciences applied to nursing, nursing concepts and skills for practice.

This part of the course involves assignments, written and practical exams. The majority of the learning is presented through lectures with some web based studies and practical lessons.

During the 3 years of the course, students undertake a variety of placements in hospitals, community and/or residential settings. They begin by observing professionals at work and are expected to participate in the delivery of nursing care from very early on in the course, under supervision, in order to develop their own skills and competences.

There are also a variety of course work assignments to be completed while undertaking a placement. Students are supervised by a personal tutor, who is also a registered nurse and who provides mentorship supervision whilst on placements.

Theoretical and practical work is assessed through assignments, examination, and portfolio development. Placements are also assessed, with an emphasis on the development of practical skills and competence.

The actual programme is 50% theory in university and 50% practice at various placement settings.Student Nurses are viewed as adult learners, and are therefore expected to take increasing responsibility for their own learning and development.

This is matched to the current view that learning is a lifelong activity. It is also matched to the occupational requirement of professional autonomy and flexibility, responsive to changing health care needs, and is supported by the vision of nursing education expressed in “Creating the Potential” (NAW,2000). The programme is therefore planned to guide students towards these goals throughout its delivery.

With this perspective students are considered to be active participants in their learning rather than mere passive recipients of given knowledge.

Can you give us some examples of the types of placement you could expect to go on as a student LD nurse?

LD / ID student nurses experience a full range of care delivery and support across all age ranges: this is arranged and scheduled locally dependent on services in the locale and the curriculum requirements.

It is essential LD / ID nurses gain experience in environments where people who have a learning disability work, learn, live, get better and have fun.

We have given examples below of our own placements to give a flavour of possible placements and to show the variety of placements between geographical areas. We would recommend students speak to their university about potential placement areas when they are about to apply for a nursing course.

You’re involved with a project in conjunction with the Positive Choices Learning Disability Team to raise awareness of learning disability nursing as a career.

Tell us more about this and how you will achieve your aim?

We were all finalists for the Fiona Law award in 2011 at the National Network of Learning Disability Nurses (NNLDN) conference in Bangor after entering a competition whilst attending Positive Choices, the national conference for student learning disability nurses.

Finalists were given the opportunity to come up with the ultimate marketing campaign to increase the number of people considering becoming a Learning Disability Nurse.

Our findings had to be ready for presentation at the Positive Choices Conference at Napier University, Edinburgh, March 2012. The group quickly realised that to truly increase awareness of Learning Disability Nursing then they had to increase the project from the original poster idea to a total social media campaign.

This would include a website with the domain name of learningdisabilitynurse.com, Facebook, Twitter, You Tube, Flickr and Linkedin pages. All of these, with the poster, and social media blogging will aim to help raise awareness of Learning/ Intellectual Disability Nursing across the four countries of the UK.

Since the team first met in August 2011 we have designed the framework for the poster, set up the social media pages and produced a draft version of the website. The team have also gathered the support of leading individuals and organisations associated with Learning Disability Nursing and have been given space in Learning Disability Practice to highlight their work and plan to get further work published over the next twelve months.

Two of the team (Anthony and Sean) attended the Modernising Learning Disability Nursing (MLDN) event at Leeds in November 2011 and gave an overview of their work and plans; following this the group have been able to gain financial sponsorship to enable them to produce a professionally designed website and to start work on setting up a nationwide Learning Disability Nursing Awareness event by recruiting a network of learning disability nursing champions.

The team are now in the process of setting up as a voluntary organisation and have put in place a constitution, marketing plan and mission statement. learningdisabilitynurse.com and the associated social media sites will continue into the long term with the aim of being the number one website for anyone involved or thinking of becoming involved in learning disabilities.

We also see it becoming a portal for all things regarding learning disability. Partnerships with organisations such as your own will help move the project forward.

Do you think there are enough places offered on LD branch nursing courses by universities? Would you like to see greater availability?

We feel with the well reported increasing numbers of people with a learning disability each year and organisations having to take onboard the Equality Act and become more socially inclusive, the need for learning disability nurses as never been greater.

Universities can only offer places that they have been commissioned for. We hope the exciting Modernising Learning Disability Nursing project headed by Hazel Powell and the recent Task and Finish report by Bob Gates will increase the number of LD Nursing places being commissioned.

Our project is to ensure people considering taking up a student nurse place comes onto our website and social media sites so they can make an informed choice. This not only improves the quality of potential entrants but will help reduce attrition rates because some LD students leave the course after the first year as they do not fully understand the role of the RNLD when applying.

We would love to see a greater availability of student learning disability nursing places across the whole of the UK which is planned to meet the staffing requirements of each area accordingly.

There are some areas of the UK that have high numbers of people with a learning disability but have no local university offering nurse training courses.

If more people do take up learning disability nursing as a career, do you think greater funding needs to be in place to ensure public sector LD nurse jobs are available for newly qualified RNLDs?

There is no doubt that there needs to be extra RNLD’s within the public sector and the RCN have asked for a RNLD to be in post at every mainstream hospital.

The current economic climate means extra funding would be very hard to attain. What we have to do is show hospitals what we can do to improve outcomes within their organisation, that our skills are useful in other areas such as acquired brain injuries, epilepsy, dementia etc.

Don’t forget there are still over 6000 RNLD’s within the public sector, with many reaching retirement age in the near future. Many of these posts are band 6/7 and are a barrier to NQ nurses. One solution to this issue could be an extended preceptor ship so newly qualified LD nurses can be mentored over a few years and move up the bands accordingly.

Do you think stronger links with the private sector would open up new job opportunities for learning disability nurses that aren’t currently available?

The project team was invited to a recent RCN event in Leeds which aimed to strengthen links with the independent sector and identify what the RCN could offer to support the third sector and to showcase excellent and innovative practice within independent sector services.

The Modernising Learning Disability leads from all four countries of the UK were also able to explain to the private sector how the project would be of benefit to their organisation.The team feels greater links with the private sector can only be a positive for LD nursing.

Private companies should have a greater say in the education framework of student nurses so they gain the skills required for their organization. Greater links may also open up more placement areas for student nurses, especially when public sector placements are becoming limited in some areas of the UK.

Students benefit from a wider range of working environments and they are also able to showcase their skills to potential employers.

What are your thoughts on the variable standards of preceptorships offered to NQ nurses? Would you like to see a uniform standard introduced by the NMC?

The more concerning problem at the moment is the lack of preceptorships available for NQ nurses, many LD nurses work in the private sector where preceptorships are less common than in the Public sector as the private sector usually offer in house company induction training.

This varies between each company as there is no agreed standard for the private sector to follow. We would like to see a preceptorship that is influenced and/or introduced by the NMC that is universally adhered to and recognised by both the public and the private sector.

Check out the new online resource about learning disability nursing created by Anthony, Tracy and Sean - LearningDisabilityNurse.com