Written by Ann H
Disclaimer: this is a personal blog by a BuDS member. The views expressed are personal and don’t necessarily represent those of BuDS or our Trustees.
Background
It was the summer of 1975. I had left school and was waiting to go the local technical college to do my A Levels. I was bored and lonely. I lived in an isolated vicarage, in a rural location. I had no friends in the village as I had not gone to the local school. There were few bus services. To make matters worse my grandma who lived with us, had had a fall and was now permanently in a long stay Care of the Elderly unit.
My long-term plans were sorted as long as I got the required exam results. At that time to get into a London Teaching Hospital, you needed to apply years in advance. I had secured a place to do general training at Guy’s in August 1977. I was born there, and mum did her training there, so there was an important family link.
My mum was responsible for nurse education in Chesterfield, and a colleague of hers suggested I did voluntary work at Whittington Hall, a local learning disability hospital. I jumped at the chance, just to get out of the house. I went for an interview with the Volunteer co-ordinator, was shown around and agreed to do two days a week. I loved my time there. I was allocated to the Therapies department, where a range of activities took place – ranging from painting to crafts such as rug making, making cushions, woodwork, and finally an industrial area, where paid jobs were undertaken, such as putting tops on containers. I loved spending time with the residents, getting to know them and all their little quirks.
I loved my days there and before long I was working five days a week. I also found out that on a Monday evening staff from all the local hospitals could play badminton at the hospital. I asked if I could join, and before long I was playing badminton as well. Sometimes we would play more than once a week.
During my last week at the hospital before I started at Tech, the Senior Nurse of the unit asked to see me. She asked if I had thought of applying to doing learning disability training. To be honest at that time I didn’t know there was one, but I left there on my last day determined that that was what I was going to do. My parents were horrified. At that time learning disability nursing was not seen as a good career; it had a very bad reputation. The thought that I was thinking of chucking up a place at Guys to do learning disability was too much! Arguments ensued, eventually we compromised. I would do my General training, and then do a shortened Learning disability course afterwards. My parents hoped that once I got to Guys, I would love the general side, and learning disability would be forgotten.
My ‘A’ Level course work started at Tech. I continued to volunteer during holidays, and my Monday night badminton. One of the modules I was involved at Tech required us to do a day a week voluntary work. I immediately asked if I could continue at Whittington Hall. Not only was that agreed, but my best friend also wanted to come as well. She subsequently did her training, and has since became a very active advocate for fighting abusive environments both within health and non-health settings.
Life As a Student Nurse
In August 1977, I started my General training at Guys. I hated it! I did not enjoy the fast-paced environments, my few shifts on ITU with ventilated patients terrified me, I felt I was a machine watcher, not spending time with people. My favourite placement was care of the elderly, as I felt I was able to really get to know people. Much to my parents frustration, my love for learning disability did not go, if anything it got stronger. At the appropriate time on my course, I applied to Whittington Hall to do my training. I had an interview which was tough, as I would be doing a shortened course, and so needed to work hard, often on my own, to do it. I was thrilled to get a place, and I started in March 1981. I worked on a Care of the Elderly ward between finishing at Guys and starting my new course.
Because I was doing a shortened course, I was constantly moved between student groups. It meant I did not make any friends, as I was only in each group for a short time. I was also used as a guinea pig for placements. The new placements had to be introduced to reflect the new care philosophy of care reflected in a White Paper – ‘Better Services for the Mentally Handicapped’, which advocated more community-based services. I loved my time on the course. There was no conflict of interest with my mum who retired just as I started. However, I did have a conflict with my friend. Although we both started our nurse training in 1977, my friend qualified and had become a community nurse as I started my learning disability training. I ended up on placement with her. It was very funny when she was introduced to me, how we both kept straight faces, I don’t know! We were very professional when we had to be but had great fun in between.
I enjoyed my training very much, although I was made aware of situations I had not seen as a volunteer, such as safeguarding incidents, general poor practice, and challenging behaviour. Challenging behaviour was not managed well, and students on the challenging behaviour unit was told to dive behind the sofa if a resident blew! The theory of challenging behaviour was not well covered in the course. It was done by a series of tapes, by a professor, who had the most awful presentation style. Other students complained and the sessions were abandoned. Because I was keen to get my head around challenging behaviour, I would go in my lunch break and listen to the tapes. Years later when I was doing my Masters in Learning Disability, the same professor was my course Tutor. He was so different in real life, very engaging. He told the story that he was at a conference when a lady came up to him and thanked him for his tapes. He felt quite pleased until she continued telling him that she went to bed with him every night as his tapes cured her insomnia!
By the time I had completed my training, I was fully aware of why historically, learning disability had such a bad reputation, although I felt it was not now justified. But more importantly, I was hooked. I knew where I wanted to spend the rest of my working life.
Oxfordshire and Buckinghamshire
I got married in 1982 and moved to Oxfordshire. Although I tried to find employment in learning disability, I struggled and I got a job in a Community Hospital. I worked there for 18 months. It was alright, but I wasn’t really happy and wanted to get back into learning disability. I saw an advertisement in the paper for community learning disability nurses in Wycombe. I applied although was convinced I wouldn’t get it as the grade was for a Sisters post, and I hadn’t any experience in Learning disability post qualification. I thought it might give me a lead in the future. To my utter amazement I got the job. I had a very happy four years, I think probably the happiest from a work point of view. Initially it was difficult, we had no management structure, just three community nurses. We started trying to develop the service. I loved working with the clients and their families. However, it made me aware of many issues which people with learning disabilities and their families face. We were asked if one of the community nurses would like to go into the nurse training school to give talks to adult nurses. I leapt at the chance. I went into the School of Nursing 3 or 4 times a year and talked to the students. I loved doing that.
In 1988, I was out and about on visits and everywhere I went, I was told that the lady who ran the school of nursing wanted to see me. I wondered what I had done wrong! When I met her, she told me that there was a new learning disability nursing course starting in Aylesbury, and she thought I ought to apply for a Tutors post. I applied and got the job.
Nurse Education
The course I was going to be involved with had not been approved at that point, so I got involved with my first ENB (English Nursing Board) Validation. The course was finally approved, and gradually more tutors were appointed. I had to go on a Teaching Training Course to get my PGCE (Post Graduate Certificate in Education). During the 28 years I was involved in nurse education, I saw a huge number of changes both in philosophy of care of people with a learning disability as well as numerous changes in nursing curricula. I enjoyed working with students, and have an almost permanent Visiting Lecturer contract, even though I retired in 2016.
In the early 1990s I undertook a Masters in Learning Disability (Community Care). It was open for all people involved in learning disability. It was a great opportunity to share experiences with other professionals. The research I did for my dissertation has highlighted to me a major issue which still exists – that of the health inequalities of people with learning disabilities.
One of the aspects I loved doing was placement visits, to support student nurses within these placements. Many of the placements I also visited as a community nurse, and it was lovely when service users remembered me.
I also became an External Examiner for a couple of Institutions. I found that a very rewarding experience. I was able to visit students in different services. It also meant I met learning disability nurses to discuss current issues with. Unfortunately, there are not many learning disability nurses compared to adult nurses, so any chance to meet was important. Now I have found a Facebook page for learning disability nurses, which is great.
One of the achievements I am proud of, although I was not successful – as silly as that sounds – is that following from the Michaels Report – ‘Healthcare for All’, a recommendation made was that all health professionals should have training in learning disability. This is something which has only just been implemented in the last couple of years. However, the East of England Strategic Health Authority asked universities to tender to provide training for their staff. I was asked by my boss to put forward a tender. As usual it was a last second thing! I had never put a tender together, and I had no idea what I was doing. Google came in very handy! I was on holiday at the time, luckily, I was staying with my friend – yes, the one I had the fun placement with when I was a student. We spent a day at a spa, putting the tender together and coming up with the training plan. One thing neither of us had had any experience at was costing. The tender was submitted, and I got to the interview stage. The interview was very daunting, meeting very senior people. A few days later I was told I had not been successful, but I was told that the ideas I had were excellent, and what let it down was that my costings were way out.
Before I retired, I started working for the Nursing and Midwifery Council, validating and approving learning disability nurse training programmes. This was a role I enjoyed, seeing the innovative programmes that were being developed. It was also a role I could continue when I had retired, and I did. I gave up this role when the NMC changed their regulations about Validations and Approvals when instead of a ‘Visitor’, as we were called, for each branch of nursing attending a Validation or Approval, only one ‘Visitor’ Validated or Approved all branches. I was not happy as I could not say what should be in a mental health programme for example, and decided it was time to pack it in.
Post Retirement.
Looking back now at how my journey into learning disability nursing started, I am still as passionate as I was in my youth. I am now able to invest some of that enthusiasm working at BuDS. There are so many issues which I believe impact the lives of people with learning disabilities – Health Inequalities, lack of understanding of communication and other needs by Health Professionals, hate and mate crimes, and abuse, to name a few. I don’t believe I could have gone into a better nursing career, and just to think, if I hadn’t done that voluntary work, I might have spent many years working unhappily as a general nurse!