Assessment scenario You are working in a Community Learning Disability service and have been allocated to carry out an initial assessment following a referral from a GP. Rachel is 27 years old and has Down’s Syndrome and an associated learning disability. She lives at home with her mother Ann (age 68), who is her main carer. Rachel also has an older sister, Beth, who lives with her husband and their two children nearby. Rachel and Beth’s father died 3 years ago. Rachel attended a mainstream primary school, and secondary education at a specialist school before going on to complete vocational courses at college. For the past 6 years she has been attending a local day service for three days a week. At the day service she enjoys participating in varied activities including voluntary work in the café. Rachel has a number of friends at the day service, and she enjoys her time there. Rachel has congenital heart disease, and she had surgery in childhood. She requires regular medication and 6-monthly reviews by the cardiology team. Rachel has always been very anxious about hospital appointments, and this has worsened since her father’s death. At her last hospital appointment Rachel became agitated as there was a significant delay. She was crying and shouting in the waiting room, and Ann and her had to leave before being seen. The nurse contacted Rachel’s GP and suggested that they refer her to the Learning Disability team. When you visit Rachel at home, she tells you that she doesn’t understand why she has to keep going to the hospital, and that she just wants to go to the centre and see her friends. Ann tells you that she is concerned about Rachel going to the day service as she is vulnerable to infections, and that she would rather she stays at home and helps her around the house. Ann also expresses concern about what may happen to Rachel if she is no longer able to care for her.
The purpose is to make sure that you understand the role of the learning disability nurse in the contemporary healthcare environment and to consider some elements of what might be expected of you when you qualify as a registered nurse. The essay will assess the following learning outcomes:
1. explore how professional standards of practice and behaviour influence the role of the learning disability nurse in contemporary nursing practice
2. explain the importance of key legal, regulatory and governance requirements, policies and ethical frameworks including any mandatory reporting duties relevant to learning disability nursing practice
3. discuss the provision and promotion of non-discriminatory, person-centred, and sensitive care for people with a learning disability
4. describe a range of skills and strategies required to communicate effectively in learning disability nursing The purpose of the action plan is to for you to demonstrate how you respond to feedback and that you can use this to make improvements to your work
