Item 19: A word for dyslexia
Resolution submitted by the RCN West Midlands Regional Board
That this meeting of RCN Congress calls on RCN Council to lobby employers to recognise and provide for the needs of nurses with dyslexia and similar conditions
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Sue Warner, a Worcestershire member and representative of the West Midlands regional board, proposed the item by calling on Congress to demonstrate its support for nurses and student nurses with dyslexia and similar conditions such as dyscalculia.
Sue explained that in the light of retirement and attrition rates among nurses, it was imperative that there are sufficient nurses working to provide safe levels of patient care. In this context, and with one in ten nurses admitting to having dyslexia, it was important that this group of staff were supported and empowered by employing organisations to nurse to their full potential, free from discrimination. Dignity for patients could only be provided if dignity was accorded to all staff, Sue maintained.
Dyslexic student nurse Susan Tivy-Ward, a first time Congress visitor and speaker, said it was common practice for nurses with dyslexia to 'check, double check and check again' in carrying out important patient-focused tasks such as keeping records and administering drugs. She added: 'Sometimes these nurses can be seen as slow, rather than safe, effective practitioners.' She urged fellow members to support the resolution.
Nurse educator Sue McBean, a mother of a teenager with dyslexia, set out the higher education institutions' practical measures of support put in place for students with dyslexia that could easily be adapted to the clinical area, such as extra time for written work and the opportunity to clarify tasks to be undertaken following instructions. She said: 'Any task involved with words takes longer and people with dyslexia are concerned to be perfect and that can result in a fear of failure.'
Lecturer Fraser Westwood called for guidance from professional bodies on the level of support it was appropriate for education providers to offer students with dyslexia because the current lack of clarity was not fair to nurses, patients or education staff. He said: 'I still have reservations about some of the students that I see and how we deal with this. The bottom line has to be patient safety.'
Geoff Earl has two daughters with dyslexia and spoke about how their confidence has increased thanks to the personal and practical support for their condition that they had received at school. He said: 'A confident nurse will usually also be a competent nurse.'
Nurse educator Alison Twycross sounded a note of caution, asking what constitutes a reasonable adjustment to accommodate the needs of nurses with dyslexia. She called on Congress to vote against the resolution but urged RCN Council to carry on its work to highlight the issues involved.
First-time speaker Chrissie Newton, a recently-qualified nurse who has dyslexia and dyscalculia, said her nurse training had become much easier once her conditions had been diagnosed, but she felt she was regarded as 'the slow nurse' now she was registered and wanted to see support offered beyond the pre-registration training stage.
Lynn Pollard, who also has dyslexia, spoke about her NHS trust, saying it had introduced computer-based learning which was not always easy to undertake because of this format. Finally, Billy Drysdale urged the RCN to use the Knowledge and Skills Framework as the driver for embedding support for nurses with dyslexia into learning and development practice.
Results
For 230 (87.79%)
Against 32 (12.21%)
Abstain 6
PASSED
Background
Dyslexia is a learning difficulty that manifests primarily as a difficulty with written language. In its framework for understanding dyslexia (2004), the Department for Children, Schools and Families (DCSF) defines dyslexia as: 'A specific difficulty, typically characterised by an unusual balance of skills. Dyslexia affects information processing (receiving, holding, retrieving and structuring information) and the speed of processing information. It therefore has an impact on skills such as reading, writing, using symbols and carrying out calculations.'
Dyscalculia is a lesser known condition that is similar to, and potentially related to, dyslexia and relates to arithmetic difficulties. In its national numeracy strategy (2001) the DCSF defines dyscalculia as: 'A condition that affects the ability to acquire arithmetical skills. Dyscalculic learners may have difficulty understanding simple number concepts, lack of an intuitive grasp of numbers and have problems learning number facts and procedures.'
For nurses with dyslexia and similar conditions - regardless of whether or not the conditions is admitted, recognised or diagnosed - the potential impact on professional learning and development, career opportunities, actual and perceived competence (for example, in the context of record keeping or administering medicine), and fitness to practice is considerable. The legal duties imposed on employers by the Disability Discrimination Act 2005, the Health and Safety at Work Act 1974, and other legislation, requires employers to ensure fairness, equality and safety in employment, and in the provision of services.
A review of literature into dyslexia in nursing practice (2007), commissioned by the RCN Practice Education Forum, found that just under 10% of the nursing population admit to having dyslexia. The review revealed there was limited research on nurses with dyslexia or disabled health care professionals in general, particularly in relation to fitness to practise. Nonetheless, concerns remain about the effect of being dyslexic on competence and fitness to practice, and also in relation to the risk of discrimination against dyslexic nurses.
In its 2007 review recommendations the RCN called for the introduction of a national standard of anti-discriminatory practice across the NHS and independent sector, urging employers to embrace a social disability model (modifying the environment to support the individual). Additionally, the RCN recommended the introduction of a strategy to address issues of training, dyslexia screening and assessment, together with reasonable adjustments and accommodations in the clinical. Finally, the RCN advised that employers should promote greater awareness of the effects of dyslexia among staff, and provide appropriate support to minimise problems before they occur.
References and further reading
Dale C and Aitken F (2007) A review of the literature into dyslexia in nursing practice: final report, London: RCN Practice Education Forum.
Department for Children, Schools and Families (2001) Guidance to support pupils with dyslexia and dyscalculia, London: DCSF.
Department for Children, Schools and Families (2004) Delivering skills for life: the national strategy for improving adult literacy and numeracy skills. A framework for understanding dyslexia, London: DCSF.