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Exploring mental health issues in people with an intellectual disability
Mental health concerns are prevalent in regard to those with intellectual disability. There are many reasons for this, some of which may relate to the causation of the person’s intellectual impairment. Other extraneous factors, such as the number of significant life events, may also result in compromised mental health. For many people, however, mental health problems may go untreated, which may relate to difficulties in diagnosis or in ascribing the signs and symptoms to other causes. With increasing numbers of people with an intellectual disability making use of regular community health services, and the reported unfavourable nature of such services, mental health problems may not be addressed. Registered intellectual disability nurses have a crucial role to play in ensuring that the mental health concerns of people with an intellectual disability are identified and addressed in an expeditious manner to achieve maximum well-being. Mental health concerns in people with intellectual disabilities can be difficult to identify due to various factors, including the person’s physical health, behaviour and cognition, and formal and informal carers’ skill deficits and attitudes. Knowledgeable and skilled health professionals must be present in the daily lives of people with an intellectual disability to identify and explore emerging mental health issues, make referrals, implement interventions and monitor outcomes. Registered intellectual disability nurses play a vital role in ensuring that the mental health of people with an intellectual disability is addressed and maximised. This article explores such mental health concerns and, drawing on a brief case study, describes the role of nurses.
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Management of indwelling urinary catheters for people with learning disabilities
The insertion of an indwelling urethral catheter is a considered, invasive intervention that places the patient in a position of increased vulnerability. It requires the nurse to have the knowledge, skills and understanding to prepare and perform the procedure while supporting the patient. Such a procedure may evoke a range of emotions and responses in a person with a learning disability. It is important that nurses address the needs of the individual and tailor the care to their needs in a sensitive and respectful manner.
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Percutaneous endoscopic gastrostomy feeding: clinical knowledge and skills for learning disability nurses
People with learning disabilities may require percutaneous endoscopic gastrostomy (PEG) tube feeding to maintain their nutritional status when they have a congenital deformity or severe infection that makes eating and drinking difficult. In addition, people with learning disabilities may have severe dysphagia or medical or surgical conditions throughout their life that make it difficult for them to eat and drink and put them at risk of aspiration and choking. To manage this increasingly common clinical situation learning disability nurses must have the knowledge and skills required to manage patients with a PEG tube safely and effectively.
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Insertion and care of nasogastric tubes in adults with intellectual disabilities
Many adults with intellectual disabilities require nutritional support as feeding problems are prevalent in this population. While many types of nutritional support are available, enteral feeding tubes, such as nasogastric (NG) tubes, are considered safe and effective. NG tube feeding is a common clinical procedure carried out to maintain patients’ nutritional needs when they have swallowing difficulties or cannot tolerate oral feeding. Insertion of an NG tube provides adequate nutrition and improves positive health outcomes and quality of life, but being fed through an NG tube may alter patients’ perceptions of feeding and mealtimes.Healthcare professionals, including intellectual disability nurses, should not underestimate the social aspect of mealtimes or the physical and psychological effects of NG tube feeding in patients with intellectual disabilities. Demonstrating competence and compassion with regard to insertion and care of an NG tube and applying best practice to ensure patient safety and well-being are critical to supporting patients with intellectual disabilities.
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Implementing cultural safety to enhance the care of mental health service users
Culture plays an important role at every level of healthcare and in every healthcare encounter. Cultural factors significantly affect the interactions between mental health nurses and service users, the experience of mental health service users and ultimately their health-related outcomes. The concept of cultural safety originates from the work of Maori nurse leaders in New Zealand. It builds on concepts such as transcultural nursing, intercultural competence, cultural congruence and cultural competence, enabling a deeper exploration of the underlying issues of inequality affecting people from minority groups. Implementing cultural safety in mental health nursing practice can enhance the quality of care by promoting culturally sensitive communication and prompting nurses to better accommodate the needs of service users.This article discusses the concept and benefits of cultural safety in the context of mental health nursing and explains how mental health nurses can use cultural safety to enhance the experience and health-related outcomes of service users with diverse cultural backgrounds.
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Supporting people who are experiencing domestic abuse
Supporting the health, well-being and safety of people who are experiencing domestic abuse can be a life-saving intervention and is an important part of the mental health nurse’s role. This article details best practice in safely assessing and supporting these people, and outlines the associated indicators and the potential effects that domestic abuse can have on health. The article also details the actions that mental health nurses can take to improve the care of victims, and explains the importance of effective communication skills, risk management and record-keeping.
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Inhaler and nebuliser technique for people with a learning disability
Healthcare professionals who support people who require an inhaler or nebuliser need to know how to use the devices, monitor and assess patients’ inhaler techniques effectively. Often, people have inadequate inhaler techniques, which can lead to poor management of their respiratory condition, increased signs and symptoms, reduced quality of life and increased use of primary/secondary care services and treatment costs. This article explains how to use inhalers and nebulisers appropriately and considers some of the challenges for children and adults with a learning disability. It also describes some devices and assessment tools, and explores assessment/review methods to help ensure people use their inhalers/nebulisers successfully.
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RCN Bulletin 394: Winter 2021
Inside the long COVID special issue we explore the latest research and clinical pathways, how to support colleagues who have long COVID, your workplace rights and the psychological impact of long COVID. PLUS: bereavement support, celebrating nursing support workers, a victory for safer staffing, meet RCN Nurse of the Year Nicola Bailey, and making your job description work for you.
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RCN Bulletin 396: Summer 2022
Read about RCN Congress 2022, using genomics in nursing, our fightback against unfair fines for overseas nurses, five ways to beat compassion fatigue, flexible working and care home placements.
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RCN Bulletin 398: Winter 2022
Get the latest news on RCN strike action across the UK, find out what happens on a picket line, plus how to spot symptoms of carbon monoxide poisoning, how to tackle microaggressions, five ways to manage the menopause, and meet our RCN Nurse of the Year 2022.
