Case Study: Community Learning Disability Nurse - Charlotte

What do you do?

I'm a community nurse within a multidisciplinary team. We are responsible for a caseload of people with learning disabilities, ranging from mild to profound learning disability. As I am the only full-time nurse in the team, I carry a large caseload.

It's a health facilitator role, co-ordinating health care needs for our clients.

We cover epilepsy, health promotion, sex education, monitoring of mental health, giving depot injections (injections that are absorbed slowly, over a period of time, into the bloodstream), educating and training staff, and liaising with hospitals and primary care agencies.

What is your background?

I did A levels and a pre-hospital course at college. I then went on to do my general nurse training, but within the first 18 months of my training, I had a learning disability placement and changed over to learning disability nursing. Five years ago, I became a qualified learning disability nurse.

What characteristics do you need to be successful in your job?

I think, first of all, you need to have very good communication skills because you're liaising with lots of people, such as clients, carers and families, as well as other professions and agencies.

Also, you need a warm approach, and you need the skills and the ability to work independently, using your own initiative, but also within a multidisciplinary team.

What other jobs could you do using the skills from this job?

Because most clients with learning disabilities also have additional mental health needs, you could transfer your skills over to work within a mental health unit or dual diagnosis unit, where people have a mild learning disability and, for example, offending behaviour.

What changes will there be in the future?

There is the possibility that community nurses may take on a care management role within the social care framework, so that we'll be adding more scope to our jobs. Whether that will be a positive or a negative thing, I don't know.

There is a plan for our Trust to merge with a neighbouring one, which I think will bring a lot of benefits. We'll be gaining more knowledge and other services with the merger, and meeting other nurses, as there aren't that many around here.

Finally, there is a plan for all case notes to be on computer, so there won't be any case files for us to carry around or write in.

What are the biggest challenges in your job?

The biggest challenge is prioritising when we have new referrals come in and, as a lead nurse in this locality, I'm responsible for delegating and allocating cases.

Also, having to work with clients and their families can be quite challenging at times and also, even though we're not a crisis intervention team, at times we do have crisis situations with regards to mental health, which we have to act on quite quickly and then prioritise the rest of our work.

Are there many opportunities to enter this career?

Within learning disabilities, there are posts available. However, because of the low number of learning disability nurses, the community posts are hard to find.

People tend to stay within these posts for a long time, but you do get promoted quite quickly because there aren't so many nurses available.

I've been qualified for five years and I'm already a G grade, which may not have been possible if I had stayed in general nursing.

What do you like about your job?

I like the fact that it's nine to five, Monday to Friday, with weekends and bank holidays off.

I also like working with the client group, particularly mild learning disabilities. It's very rewarding.

And, I like educating and joint working with primary care agencies, and liaising with GPs and educating them about learning disabilities.

Another thing that I quite like is the fact that, as a community nurse, you don't have to wear a uniform, so you don't feel that you've got people looking at you and you can feel more relaxed when you're with clients; they don't feel intimidated by any sign of authority.

What do you dislike about your job?

Within community nursing, there's nothing that I dislike about the job.

What are your ambitions?

I plan to start a Master's in mental health this year. If I achieve this, this will give me scope to work outside of learning disabilities, if I choose to in the future.

What advice would you give to someone interested in your career?

I think, first of all, it would be an idea for them to get a part-time job within a learning disability setting, to get used to working with people with a learning disability, and also to apply to nurse training within learning disabilities.

I think they need to have computer skills because we are writing reports and correspondence, and doing a lot of note-taking and attending meetings.

You need to be quite an outgoing person to be able to chair meetings and talk to people on the telephone that you don't know.

Also, within a community nursing post, it is essential that you drive because you are driving around a lot of the time to make visits. You are also driving clients around, so driving is an essential part of the job description.

A day in the life

9:00 am - 9:30 am

Check message book and emails and respond where necessary, for example, liaise with primary care agencies, carers, clients and families.

9:30 am - 12:30 pm

Make two client home visits.

12:30 pm - 1:00 pm

Have lunch.

1:00 pm - 2:00 pm

Write case notes for the morning's visits. Write letters and make phone calls relating to the visits if appropriate.

2:00 pm - 4:00 pm

Make two client home visits.

4:00 pm - 5:00 pm

Write case notes for the afternoon's visits. Write letters and make phone calls relating to the visits if appropriate. Plan visits for the rest of the week.

Please be aware that days may vary from those planned, depending on clients' needs.

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