I am writing in response to the email published in issue 302 of RCN Bulletin (April) titled “End of LD nursing?”
Firstly, I am very sorry to hear that a fellow learning disability nurse has had experiences that led her to feeling that there is no future for learning disability nursing and that learning disability nurse training should be combined with mental health nurse training. I would like to state that the majority of learning disability nurses I talk to do not share this view.
Secondly, I am disappointed that the RCN Bulletin has published this email with no reply. The RCN is the union for many learning disability nurses, and is there to represent us individually and as a collective. I am concerned that blindly publishing this will lead to student learning disability nurses questioning their career choice, non-learning disability nurses thinking this must be true, and any learning disability nurses that are feeling the same having these views confirmed.
The future of learning disability nursing seems to have always been a contentious issue. The General Nursing Council (the RCN’s predecessors) argued from the 1920s whether we were actually doing nursing as we were not curing sickness (although midwifery was not questioned!) The Jay report in 1979 again questioned the future of the profession. In fact, I don't think there has ever been a time when the future of learning disability nurses has not been questioned, but we are still here. In my view the reason it has continuously been questioned is we have been kept behind closed doors, along with people with learning disabilities themselves and the outside world has never had to be that concerned about what we do. But things are changing.
Mental health nurses’ work is generally focused on the recovery model, helping people return to their optimal level of functioning. As learning disability nurses, we nurse the person’s disability in learning using an enabling model where we are helping people gain new skills and do things they have never done before. We do this by creating enabling environments that mitigate the effects of the persons’ disability and teaching the person new skills with highly specialised health interventions. We are skilled in assessing and meeting the needs of this complex group of people who, without the right support, may be unable to communicate their needs themselves and, without our support, health needs get overshadowed and attributed to being part of their disability (diagnostic overshadowing).
There are many pressures in learning disability nursing at present. There was a 23 per cent reduction in the number of learning disability nurses employed by the NHS between 2008 and 2011. Many learning disability nurses are approaching retirement age and the numbers of new students and registrants has been continuously declining, leading to learning disability nursing not being financially viable for many universities. There are also the universal challenges of changes to commissioning, and how our services will be commissioned if people do not understand what we do.
But we are getting better at speaking up about this. Strengthening the Commitment was published last year and sets out the strategy for the profession. We are getting better at being more visible and describing what we do. The work of the RCN Learning Disability Nursing Forum has been strongly supporting this work.
I am sure the nurse that wrote the email is not alone in her views. But we need to support nurses who feel like this to see that there is a clear and strong role for learning disability nursing. We need to acknowledge the difficulties that there are and support the strategic work that is underway to address this. I feel that the RCN Bulletin, by blindly publishing this email, has acted in a way that doesn't support the work that is happening.
May I suggest that there is a focus on learning disability nursing in a future edition of RCN Bulletin to address this?