Forget ‘limitations’, learning disability nurses think about potential
Date 17 June 2024
UON academics and their students have been thinking about this and the following quote about what LD Nurses do: “'LD nurses don't just think outside the box...they think about what's in the box, on the top, bottom, and sides of the box, what's holding the box up, the colour of the box, and even the light that's shining on and out the box! LD nurses even know that the box doesn't exist.”
In this blog, Senior Lecturer in Learning Disability Nursing, Emma Gooding, talks about what she thinks this quote means and how this is applied to what UON students learn.
This week is Mencap’s Learning Disability Awareness Week and the theme is ‘Do you see me?’, which is all about people who have an ‘LD’ being seen, heard, and valued.
In Learning Disability Nursing, aside from the important health-based teaching students receive, such as physiology and anatomy, we are actual, real nurses, even if you don’t see us on hospital wards. We deal with clinical, health issues, but we are about much more: enablement, we’re person-centred, we innovate and are creative (sometimes with few resources!), we dissent if we need to (but remain within the bounds of the law) and we enable people.
A key activity during the three-year degree in Learning Disability Nursing at the University of Northampton is debate. This is especially helpful when we ask our students to grapple with the sometimes complex and challenging areas of medical and care ethics.
One such debate we had recently was about a quote that says learning disability nurses don’t just think outside of the box (the ‘box’ being where we put people who have an ‘LD’ into, that contains what we think they can do), but also within the box, and everywhere else on and around it and (here’s a revolutionary concept!) that there might not even be a ‘box’.
Or maybe…there are lots of boxes, and LD nurses need to do all of the thinking and doing for all ‘boxes’ at some or all the time, for the people they work with and advocate for, their families, carers and other professionals.
Sound tiring?! Well, it is…but if you’re a learning disability nurse, that’s only in the best, most rewarding, and enjoyable of ways. So let’s think about this ‘box’ of what some people might think contains ‘limitations’, or disabilities. We think very differently about the ‘box’.
When we’re teaching our students, we simply don’t think about whether the people we work with and advocate for have ‘limitations’ – we only think about their potential. This could be in all sorts of areas and that’s what we have discussions about as it could be their health. We, obviously, have a focus on helping them maintain and improve health, but these potentials can also be about their independence and learning life skills. We are their champions and advocate voices for people who might not otherwise have one.
We have students who don’t come from the UK and have different, but totally valid, ways of seeing the world and doing things. So we approach an issue from all these angles which makes a rich learning experience. This is what our students need because, when they’re on placement and especially after they have graduated, they will meet and work with different people and different situations, such as people who are traumatised, who cannot physically talk, or their families and carers.
Imagine an everyday occurrence up and down the country (although what I’ll write now is based on a recent, real-world example we have discussed) – going to the dentist. For the patient who doesn’t have a learning disability, this is straightforward. They know what the problem is, can make an appointment, walk through the dental surgery door on the day, wait in the waiting room, have the appointment, then go home afterwards and follow the dentist’s advice or care plan.
Now imagine that you live in a world that’s very different to the person above. Someone for whom certain clothing materials or LED lights or music piped through speakers can make them feel terribly uncomfortable – someone who isn’t able to talk, or even walk through a door like you or I would. How do they get through all this and then also endure painful, but necessary, dental treatment?
Communication is the name of the game with learning disability nursing – not just verbal communication, but looking out for the individual cues or signs (imperceptible to other, untrained people) that someone with an ‘LD’ is in distress or unhappy. We educate our students to observe everything, to really understand the people they are the voice for so they spot these signs, which will be individual and unique for that person.
So, what do learning disability nurses do with this ‘box’ or ‘boxes’? Well, we don’t see a box because you can’t put people who have a learning disability into one. The box doesn’t exist.
We see people who are enabled – not disabled – people who live, laugh, love and work outside of the boxes other people might put them in.
Emma has worked as a nurse for 26 years in a variety of clinical areas- working with adults, children and their families in a variety of settings - residential care inpatient wards, secure settings, community teams and clinical commissioning for NHS services.
Emma joined the University of Northampton in 2020 to start a new phase in my career by developing the learning disability nurses of the future.