Learning Disability: Nursing

Running head: LEARNING DISABILITY: NURSING
LEARNING DISABILITY: NURSING
Name of the student
Name of the university
Author note

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LEARNING DISABILITY: NURSING
Introduction:
Learning disability is a condition of reduced intellectual ability associated with
difficulty in everyday activities like social activity, daily household work, earning money by
employment. The people with a learning disability are found to take longer time than others
to learn and need assistance to take up new skills, interact with others and understand any
complicated situation or information. There are three types of learning disability, mild
learning disability, moderate learning disability and profound/severe learning disability. The
mild learning disability is difficult to identify as the individual can perform most of the task
with other normal individuals, though they find difficulty in works like form filling. People
with a profound learning disability need assistance in almost all the daily works like
communicating, moving. To write a reflective essay on learning disability relevance to
nursing approaches, I choose the Gibbs cyclic model of reflective writing (Alfonso and
Flanagan 2018).
Description:
In my reflective writing, I will be reflecting on my experiences I gained on the child
department of a well-known hospital, where I was placed as a learning disability nurse. The
duties of a learning disability nurse is not a cakewalk for me, as the duties come with lots of
challenges. The people with the problem need special care. According to the report of the
official site of the United Kingdom government approximately, 286,00 children suffer from
learning disability, where the percentage of moderate learning disability is severe learning
disabilities are 89% and 24% respectively (mentalhealth.org.uk, 2020). In my yea of nursing,
I observed that the case of learning disability is prevalence in economically low-income

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families. The children with a severe learning disability need assistance in learning new
things, as well as performing daily works (Zarkowska and Clements 2018). One of the
biggest challenges of being a learning disability nurse is voicing the need of the patients and
forming a bond with them as they are unable to express themselves. One boy, admitted with a
severe learning disability and tendency to harm others, admitted to the hospital. He was
throwing things nearby him to other people, screaming and trying to bite anyone closer to
him. He was so aggressive that the threw a flower vas to his father, who came to admit him
in hospital. I was terrified of seeing his violent behaviour and hesitated to go to him, taking
up the charge of his treatment. However, with time, I started interacting with him. He
became calm, expressive and his condition improved with time. At the initial stage, he was
not a stage that the health care provider can start his treatment, but with time, patience and
care, he became approachable to treatment. Another 17 years old girl admitted to the hospital
had a problem expressing herself. She has the problem of understanding words, writing and
calculating. However, she was not agreed to undergo any treatment to resolve her problems
(Stafford 2018). I questioned her parents and got to know that she was bullied, physically and
mentally abused in the school during her early school days and obtain a severe fear towards
any learning activity. I discussed the problem with my team, deciding a holistic approach of
treatment along with medication for her (Parkin et al. 2020).
Feelings:
Becoming a learning disability nurse was a dream for me since my childhood, as one
on of my close relative is working as a registered nurse for learning disability for more than
thirty years. Seeing her helping the patients of learning disability patients, motivated me to
take up the course of becoming a learning disability nurse. I understand the challenges of
being learning disable nurse in the time of my practical days. The patients come for the
treatment are hard to handle as they were unable to express their needs. It was quite a

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challenge for me to understand the behaviour, analyze and do the needful for my patients.
Some cases of learning disability came with aggression and even harder to handle. The senior
nurses sometimes failed to convince the patient that they are not the treatment is for their
benefit only. During the year of my junior nursing, I assisted the senior nurses, and my
experiences helped me a lot to perform my duty smoothly. To help the patients, my
colleagues and me designed an intervention for the boy with aggression and learning
disability (Sridevi et al. 2015). However, we need to apply intervention more rapidly to calm
the patients, where we failed. The patients' aggression scared my team, which can become a
serious obstacle in our nursing career. To overcome the obstacle, we need to handle more
such cases, to understand and rectify our errors during treatment.
Evaluation:
The experience of being a learning disability nurse in the child department had both
good and bad memories. The experience helped me to enhance my understanding of my role
as a nurse (Gunasekara et al. 2014). My duty was to examine the level of learning disability
of the child, teaching them skills that can help them to perform their daily needs, maintain
their wellbeing and helping with the activities that they fail to perform by themselves. I used
to design a care plan according to the major issues of the patients and monitor the
improvement result. In my senior years, when I became a team leader, responsibility
increases (Ellis 2018). I was responsible for coordinating the health care plan with the other
social welfare professionals, organizing visits to the home of the patients to measure the
improvement, planning activities for the patience and coordinate with the service users
(Cohen et al. 2015). I gained a profound knowledge about the test, result evaluation, analysis
by assisting the testing process. As a learning disability nurse, my team and I was responsible
for organizing awareness camp in our locality about learning disability (Tomaschewski-
Barlem et al. 2018). Patient admitted in the hospital were unable to communicate, rising the

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problem of understanding their problems and needs. Before the admission of the patients, I
was responsible for making a list about the likes, dislikes, fears and used sign language of the
patient. This list helps the nurse and the team to bond with the patient easily., I think we
violated a rule by ignoring the decision of an adult individual, in the case of the treatment of
the girl. According to The Mental Capacity Act 2005, any person over the age of 16 years has
the right to make his/her decision (Legislation.gov.uk, 2020). The girl admitted with learning
disability and trauma of being bullied was mentally unable to make her decision, but she was
an adult. Treating the patient without her permission is a serious violation of the law that was
done by the team and me. The incident proves that the decision-making capacity of the team
needs more modification, clarity, experience and improvement. This incident also violates
The Disability Act 2006, which protect the rights and needs of a disabled person
(Services.dhhs.vic.gov.au, 2020). This is a law as well as social approach to make the life of a
disabled person easier by protecting his/her rights. We as a team also failed in the platform of
teamwork as the treatment of the aggressive boy needed interference of other health care
provider outside the team, this failure can be a result of low of group cohesiveness (Butts and
Rich 2019).
Analysis:
The primary difference of a learning disability nurse with the other nurse is the
approach of treatment. The patient care plan for learning disabled people includes the medical
approach with the holistic approach for the overall wellbeing of the patient. In our learning
days, we taught to make eye contact, listen to the patient to improve the non-verbal, and
verbal communication with the patients (Benbenishty and Hannink 2015). The skill helped
me to improve my communication with the patient. According to the MENCAP, the most
common problem faced by the health care provider during the treatment of learning disable
patient is communication (Mencap, 2020). As a nurse, I also fill the same. At the initial years

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of my learning, it was tough and even frustrating for me to understand non-verbal
communication (Kourkouta and Papathanasiou 2014). The problem, though solved by the
service user who advocates as the communicator between the health care provider and the
patient. The service providers use unique techniques to communicate with the learning
disability patients, including visuals. As a nurse of learning disability people, I feel that I
need to adapt the skill to serve my patients more efficiently. The Code by nursing and
midwives council, at 2015 states that all the nurses and midwives are up to the committing
some professional standards set by the MNC before registering themselves with the nursing
and midwives council (Nmc.org.uk, 2020). The professional standards have different
domains that are professional value, communication and interpersonal skills, nursing practice,
decision-making, leadership, management and teamwork (Grossman and Valiga 2016). I
analyzed during various case studies that the standards are very much relevant to the practice
of the nursing profession. Some skills should be incorporated as a quality marker of a nurse.
The skills are good communication skill, care, commitment, courage and competence.
Action Plan:
The experiences I gained during my work period encouraged me to develop some
action plans for the future. The focus of the action plan is to improve my professional skills to
enhance the care level of my patients. I aimed to focus more on solving the problem of the
patient than focusing on my role in the team when dealing with critical patients. As a team
leader, I shall be more proactive when serving an anxious child, to reduce the potential loss or
harm of anyone else. I shall not depend on other team members to perform their duty
accurately; instead, I will take charge to invigilate if everyone is doing their duty mindfully. I
shall enrol myself in a course to understand the non-verbal communication skill of a patient,
to avoid any in-between service provider’s interference during the treatment (Modi et al.
2016). I shall change my approach of treatment by including modern techniques to improve

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communication level, anxiety and the treatment plan. I shall perform wide research on the
patient’s case history, environment, economic status, specific methods and treatment plans
after taking up any case in my hand. The research will also include the personal details of the
patients, including his/her likes, dislikes, phobia or any other personal traits. The decision
making skill of a team leader is a very important aspect of ensuring the success of the team as
well as the wellbeing of the patient. I shall try to fill up the gap between decision-making
skill and leadership quality for the better performance of the team. I shall continue my
learning process during my working years, including performing regular reflective works
using the Gibbs model. I shall be very careful to maintain all the rules and regulation formed
by the nursing and midwives council, UK. I shall regularly visit the official website of the
nursing and midwives council as well as the national library to keep myself updated about the
new rules and regulation implemented by the NMC. I also want to enrol myself under a
course by the national health services to get elaborate knowledge about my profession, as
well as a higher degree (nhs.uk, 2020).
Conclusion:
The experience I gained created the niche of my professional standard, polishing the
qualities needed to be a perfect nurse. I am a more responsible and sensible person now. I
can deal with all the challenging situation with confidence in the future and can handle
similar challenges easily. The experience gave me insight into the importance of patients care
more elaborately. I understood that it is not always possible to follow up all the rules and
regulations of the council. However, I need to ensure the wellbeing and need of the patient
with maintaining the rules and regulations, as much as possible. A strong team bonding,
evaluation power, courage and decision making skills are factors serving for the best interest
of the patient. The reflective writing following the Gibbs reflective model helped me to
understand the incident more vigorously, with giving me a scope to analyze the case I

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handled as a nurse. The steps I followed in the reflective writing strengthen the theoretical
and practical knowledge I acquired, giving me a clear understanding of my action plans in
future.

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References:
Alfonso, V.C. and Flanagan, D.P., 2018. Essentials of specific learning disability
identification. John Wiley & Sons.
Benbenishty, J.S. and Hannink, J.R., 2015. Non-verbal communication to restore patient–
provider trust. Intensive care medicine, 41(7), pp.1359-1360.
Butts, J.B. and Rich, K.L., 2019. Nursing ethics. Jones & Bartlett Learning.
Cohen, D.J., Davis, M., Balasubramanian, B.A., Gunn, R., Hall, J., deGruy, F.V., Peek, C.J.,
Green, L.A., Stange, K.C., Pallares, C. and Levy, S., 2015. Integrating behavioral health and
primary care: consulting, coordinating and collaborating among professionals. The Journal of
the American Board of Family Medicine, 28(Supplement 1), pp.S21-S31.
Ellis, P., 2018. Leadership, management and team working in nursing. Learning Matters.
Grossman, S. and Valiga, T.M., 2016. The new leadership challenge: Creating the future of
nursing. FA Davis.
Gunasekara, I., Pentland, T., Rodgers, T. and Patterson, S., 2014. What makes an excellent
mental health nurse? A pragmatic inquiry initiated and conducted by people with lived
experience of service use. International Journal of Mental Health Nursing, 23(2), pp.101-
109.
Kourkouta, L. and Papathanasiou, I.V., 2014. Communication in nursing practice. Materia
socio-medica, 26(1), p.65.
Legislation.gov.uk (2020). Mental Capacity Act 2005. [online] Legislation.gov.uk. Available at:
http://www.legislation.gov.uk/ukpga/2005/9/contents [Accessed 2 Mar. 2020].
Mencap (2020). Learning Disability - Autism - Down's Syndrome. [online] Mencap. Available at:
https://www.mencap.org.uk/homepage [Accessed 2 Mar. 2020].

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mentalhealth.org.uk (2020). Learning disability statistics: children. [online] Mental Health
Foundation. Available at: https://www.mentalhealth.org.uk/learning-disabilities/help-
information/learning-disability-statistics-/187687 [Accessed 2 Mar. 2020].
Modi, J.N., Chhatwal, J., Gupta, P. and Singh, T., 2016. Teaching and assessing
communication skills in medical undergraduate training. Indian pediatrics, 53(6), pp.497-
504.
nhs.uk (2020). The NHS website. [online] nhs.uk. Available at: https://www.nhs.uk/ [Accessed 2 Mar.
2020].
Nmc.org.uk (2020). [online] Nmc.org.uk. Available at:
https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf
[Accessed 2 Mar. 2020].
Parkin, E., Kennedy, S., Long, R., Hubble, S. and Powell, A., 2020. Learning Disability-
policy and services.
Services.dhhs.vic.gov.au (2020). Disability Act 2006 - DHHS Services. [online]
Services.dhhs.vic.gov.au. Available at: https://services.dhhs.vic.gov.au/disability-act-2006 [Accessed
2 Mar. 2020].
Sridevi, G., George, A.G., Sriveni, D. and Rangaswami, K., 2015. Learning disability and
behavior problems among school going children. Journal of Disability Studies, 1(1), pp.4-9.
Stafford, A., 2018. Integration of Theory and Feasibility in Learning Disability Identification:
Examining Criteria Effects in the Integrated Assessment and Intervention Model.
Tomaschewski-Barlem, J.G., Lunardi, V.L., Barlem, E.L.D., Silveira, R.S., Ramos, A.M. and
Santos, J.M., 2018. Actions of nurses in the exercise of patient advocacy: an integrative
review. Texto contexto-enferm, 27(2), p.e0730014.
Zarkowska, E. and Clements, J., 2018. Problem behaviour and people with severe learning
disabilities: The STAR approach. Routledge.

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