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Tapping into the wisdom of learning disabilities nurses

The RCN wants all acute hospitals to have 24-hour access to a learning disabilities liaison nurse, who can help develop policies and procedures for patients with learning disabilities and are experts at dispelling the anxiety felt by such patients when they enter hospital

The RCN wants all acute hospitals to have 24-hour access to a learning disabilities liaison nurse, who can help develop policies and procedures for patients with learning disabilities and are experts at dispelling the anxiety felt by such patients when they enter hospital


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People with learning disabilities who come into hospital often feel scared and anxious. They can struggle to communicate with staff, and may have physical and mental health needs that are not fully understood by some of those looking after them.

A learning disabilities liaison nurse can make this time easier for everyone – which is why the RCN has been calling for all acute hospitals to have 24-hour access to such nurses by 2020-21.

Learning disabilities nurse Amanda McKie, a matron at Calderdale and Huddersfield NHS Foundation Trust in West Yorkshire, works with staff at the trust’s two acute hospitals to ensure the 500 people with learning disabilities who are inpatients each year – and those attending for outpatient appointments or diagnostics – get the best possible care and experience.

Best outcomes

‘Learning disability nurses have such diverse skills and abilities,’ she says. ‘Working in secondary care supporting people with a learning disability enables us to use these skills to get the best outcomes for patients.’

While she works office hours from Monday to Friday, the unpredictable nature of the job can mean Ms McKie is still in A&E at 8pm helping with a patient who needs emergency care.

Elective patients are less of a challenge as their visits can be planned for – in some cases, she will arrange for them to have a familiarisation trip first to meet the staff who will care for them, so the environment is less alien when they come in for a procedure. But it can still be scary, so if a nervous youngster is undergoing a CT scan, Ms McKie is there to provide encouragement and reassurance.

Levels of need

Patients have varying levels of disability and health needs, and will often have parents or carers with them who can provide her with valuable information. If she knows it is difficult to give a patient a general anaesthetic, for example, it can be worth doing other procedures at the same time where possible.

Her role also involves helping the trust develop policies and procedures that affect those with learning disabilities, such as around end of life care, as well as training and educating staff.

Many will have had little training regarding patients with learning disabilities in their undergraduate education, and staff in some specialities seldom have contact with such patients.

Relaxed and reassured

But Ms McKie says they are all keen to provide excellent care. ‘I have seen staff get sweets and magazines for patients with their own money – anything to help them feel relaxed and reassured in hospital,’ she says.

Ms McKie says other trusts use different models of nurse input – in some, nurses employed by the local learning disabilities trust will help in the acute hospital. But she says knowledge of the hospital system and other staff can be important in making things happen.

‘After nine and a half years in this job, a lot of it is about relationships,’ she says. ‘Every hospital should have a specialist learning disability nurse to ensure individuals get the best possible care.’


Alison Moore is a freelance health journalist

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