Hazel Powell

People sit round in some kind of collaborative group session

A Framework for Mental Health Nursing in Wales

A policy document celebrating and improving the country’s mental health nursing profession

Supporting students to care for people with learning disabilities

NHS Education for Scotland is working with higher education institutions and other partners to contribute to recommendations outlined in Strengthening the Commitment, the UK-wide review of learning disability nursing. This article focuses on the recommendation to help undergraduates in adult, mental health and children’s nursing to develop core knowledge and skills necessary to work safely and appropriately with people with learning disabilities in general health services. Traditional ways to help students gain experience of caring for people with learning disabilities have tended to depend on the commitment of individual lecturers, and consequently have been inconsistent. This article describes how the ‘Thinking Space’ approach was used to support lecturers and other professionals in enabling students to achieve required outcomes regarding learning disability care, and to meet the requirements of the review’s recommendation.

Enhancing pre-registration education in epilepsy care

This article outlines an approach to enhancing the educational development and delivery of teaching about epilepsy care in pre-registration learning disability nursing programmes in Scotland. It describes how the involvement of epilepsy specialist learning disability nurses in the three-year programme has strengthened links between practice and education, and ensured that students’ learning outcomes are evidence based and up to date. The approach could be adopted in other fields of nursing and areas of clinical expertise.

Increasing the workforce in remote and rural areas

This article describes a pilot scheme launched to address workforce needs in remote and rural areas of Scotland, in which three universities collaborated in the delivery of a pre-registration learning disability nurse education programme. The article includes findings from an interim evaluation of the scheme and makes recommendations for improvement. This article will be of interest to academics, learning disability nurses, commissioners and workforce planners throughout the UK who want to devise flexible and sustainable models of pre-registration nurse education in all fields of nursing.

Encouraging learning disability nursing research

Every area of health care is increasingly under-pinned by the principle of evidence-based practice. As health professionals, we are expected to base our interventions on a sound research base, evaluate the effectiveness of our interventions and contribute to the evidence base of our profession by carrying out research (Burton and Chapman 2004).

developing mentorship through collaboration

Learning disability nursing in Scotland can be considered to be facing some difficult times. A recent report looking at workforce planning (Scottish Executive 2004) showed that the proportion of learning disability nurses leaving the profession is relatively high, while the rate of newly qualified nurses joining it is relatively low. Kuhl (2005) argues that one cause is the difficulty that newly qualified nurses face in adapting to the culture that they find themselves working in. This can result in disillusionment, frustration for the nurse and retention difficulties for the NHS. Kuhl (2005) suggests that mentoring offers a way to help training and newly qualified staff learn about, and deal with, the realities of the environment they work in.

health promotion: how to spread the word

The need to meet the healthcare needs of people with a learning disability is increasingly being highlighted. Reports such as the Health of the Nation Strategy for People with Learning Disabilities (Department of Health (DH) 1995) emphasised the need for health promotion, surveillance and care among this population. Nearly 10 years on and inadequate health care for people with a learning disability continues to be a serious issue.

health screening

Government reports and practice documents have increasingly emphasised the need for primary healthcare teams and learning disability teams to work in tandem to provide good quality health care for people with learning disability. This culminated in two major reports. In England, the Valuing People White Paper (Department of Health 2001) identifies primary care services as the first point of contact for most people with a learning disability. It is also the point where important decisions about the person’s welfare and health are made.

the impact of control and restraint training on nursing students

The aggression of people with learning disabilities presents a difficult challenge to service providers (Black et al 1997). Aggression towards self, others or property has negative consequences for the client, carers and family, including risk of physical injury (Spreat et al 1986), high levels of stress for families and staff (Quine and Pahl 1985) and the breakdown of residential placements (Borthwick-Duffy et al 1987). Staff working with people with learning disabilities are at significantly greater risk of being assaulted during their working lives (McKenzie et al 2000), with greater prevalence in inpatient units (Harris 1993).

The challenge of achieving enduring change

The settings in which interventions for people with challenging behaviour take place can vary greatly according to the nature of the behaviour and the skills and needs of the carers.

A time to reflect

There are many definitions of reflective practice, but most authors agree it consists of learning about and developing practice through the analysis of events. This article explores the individual, professional and organisational issues arising from implementing reflective practice. It includes an example from practice in a learning disability service to highlight some of these key issues.

A change for the better

A common reason for referrals being made to health staff working in learning disability services is challenging behaviour (McKenzie et al 1999). A wide range of behaviours is considered to be challenging, ranging from aggressive and destructive behaviour through to passivity and withdrawal. Behaviour can also be challenging for a variety of reasons, which may reflect features of individuals and environments.