On Our Mind
Nottinghamshire Healthcare NHS Foundation Trust provides integrated healthcare services including intellectual disability, mental health, community health, forensic and offender healthcare services across Nottinghamshire, Leicestershire, Lincolnshire and South Yorkshire.
Our On Our Minds blog shares lived experiences from colleagues at the Trust and patients who use or have used our services on a variety of topics from a wide range of services.
A day in the life of a Community Learning Disability Nurse
Rebecca Sams is a learning disability nurse in the Community Intellectual and Development Disabilities team (Nottingham City). Rebecca is extremely passionate about her work, ensuring patients, their family and/or carers are communicated with effectively and that patients feel safe, happy and empowered to make their own choices to achieve their goals.
With a nursing career spanning 30 years, she hopes by sharing more about her role she will inspire the next generation to work with and support some of the most vulnerable people in our society.
It's another busy day in the life of a community learning disability nurse working within a multi-agency multi-disciplinary team, says Rebecca. My main responsibilities are to provide effective individualised assessment and treatment to adults with learning disabilities within the Nottingham city area. The patient is at the centre of each assessment and treatment plan, and as their nurse I work collaboratively within the team to ensure their needs are validated, and they are empowered along their journey with the community intellectual disabilities team.
Key to this role is to communicate effectively with the patient, their family and or carers, to ensure that all team members are aware of any changes to an individual patients' presentation and any updates to their care planning process. When completing nursing assessment and treatment interventions it is my responsibility to ensure that these are not only individualised to the person in a format that they understand but are also evidence based.
Most importantly for me is to support a patient to feel safe and happy and celebrate achievements that they make towards meeting their goals.
Community learning disability nurses demonstrate integrity, honesty and compassion whilst delivering the highest quality of care to the benefit of individuals, carers, families, communities and peers.
On my caseload I am supporting an individual who has recently been diagnosed with metastatic cancer. I have supported this person for 18 years, when they have been referred to the service for specialist assessment and treatment for their physical health needs. In 2020 when they were first diagnosed with lung cancer, I supported them to understand their oncologist treatment plan and developed a person-centred approach and easy read information to aid their understanding which included the importance of having chemotherapy.
This intervention also supported the person's wife who has a learning disability to understand her husband's treatment, and how she and their staff team may need to support him more as he attended chemotherapy sessions.
This information was shared with the oncology team, with the patient's consent, to support their understanding of how to make important reasonable adjustments to future patients who have a learning disability supporting the team to improve the quality of the service that they can deliver to patients with an intellectual disability.
This intervention was also shared with my team to support learning with my peers and share best practice.
Each individual referred to community learning disability is unique and evidence-based practice states that they should receive holistic, personalised care which acknowledges and is tailored to the needs of the patient. This can be demonstrated when delivering end of life care to an adult with a learning disability. As part of their palliative care, it is important for the person to express their individual ideas and choices of how they wish to spend their final months of their life and how they wish to be supported. This information is compiled within an easy read 'End of life Plan' for the individual. In listening to and validating the patients experience in their end-of-life care has improved their patient journey.
Community learning disability nurses have a pivotal role model in inspiring both their peers and professional colleagues. One of my passions in this field of nursing is delivering relationships and sex education to individuals and groups. I have completed courses with the family planning association and written my degree thesis in this subject area.
I have also collaborated with a group of adults with learning disabilities and our Speech and Language Therapy department to create an easy read guide to relationships and sex for Nottinghamshire Healthcare, which was shortlisted at The National Leaning Disability Nursing Awards 2024. The team are continuing to work collaboratively on their next project assessing the capacity of adults with learning disabilities to engage in sexual relationships. This is in response to a quality improvement project I have been developing to support clinicians in delivering their assessments and improving the process for our service users.
I have undertaken a course in teaching mindfulness-based practice for depression for adults. This has led to a new service developing in Nottingham of teaching to the multi-agency disciplinary team and discovering how this can be adapted to adults with a learning disability.
It's also a pleasure to have students spend their placements within our team. I enjoy supporting each student in their career pathway and see our roles as a two-way process in education. My nursing career started thirty years ago, and I try very hard to share my passion for this branch of nursing to the next generation of students and colleagues.
I have always strived to effectively promote the role of the learning disability nurse and support adults with intellectual disabilities to lead happy, healthy and fulfilled lives. This is not a simple task when often faced with the challenge of adversity and misunderstanding. Each day I look forward to continuing my commitment to delivering high quality interventions that are person centred and share innovative learning disability practice to inspire others.
What brings a warm smile to my face every day of nursing is being able to support adults with learning disabilities along their journey of life. They often arrive on my caseload feeling very unsafe and unhappy and I always reassure them that we will go on a journey together to a place where they will feel happy and safe again.
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