International placements for learning disability student nurses hosted by Laura Stafford (@lauldn4), 3rd year Student Nurse at Teesside University @teesuniSOHSC and Paula Hopes (@paulahopes1) Senior Lecturer and RNLD at University of South Wales (@USWnurs_mid) on 31/10/17.

A reflection on the past:

Laura was one of my students when I worked at Teesside University and we were lucky enough to have the fantastic opportunity of travelling to Battambang hospital in Cambodia with 16 student nurses and an adult nurse lecturer Graham Jones. This was organised through a charity with strong affiliations in the North East of England, Transform Health Care Cambodia, Graham is one of the Charity Directors.  In my excitement about this opportunity and posting on Twitter I was asked to host a chat on my return. I put this out to the students who were on the trip and Laura and I met at the end of September to pull together the pre-chat info, our bio’s and some prospective questions. As ever the support from @weldnurses was fantastic and Laura and I spoke on Tuesday night to talk about how we felt pre and post chat. Laura is based in Alnwick and I live in West wales, so thank goodness for technology!

The fright night:

The conversation went everywhere and with it being Hallowe’en there were lots of spooky suggestions and horrific humour. The chat flew by, as always, but having the co-host role, I felt that I got to have a new experience, between host and participant. Laura did a wonderful job of keeping things together and really must be credited with the hard work. So pleased to see the support from our colleagues who came out with us as well as the community that is #weldns. There were student nurses from child, adult and learning disability nursing represented on the chat. We had students from Teesside and University of South Wales involved as well as other universities in the UK, some who have plans to travel abroad on placement @zoeeuk (India) and some who have recently returned @minionkevins (Belarus). The experiences of qualified staff and other lecturers were brought in @NicBraid who has volunteered in Romania and @Cathy_55555 who visited Nairobi during her nurse training. Some people joined the chat and expressed a desire to have this incredible opportunity. 

Laura opened up and started with question 1) What are the benefits of international placements for learning disability student nurses?

Many agreed that the importance of understanding other cultures and beliefs should be an opportunity everyone experiences. Bringing in new perspectives of nursing and especially for us in relation to disability. Great to hear from others who feel that the values base in learning disability nursing supports us to act as excellent role models to other professional groups.An idea emerged from @salsa442 @NicBraid and @Ross_6479 around dancing and nursing across the nations. Combining Sally’s ‘dancemum’ commitments with knocking something off her ‘bucket list’ like Nic did.

The importance of recognising the cultural differences in the classroom and what we gain when we have students bringing with them a different perspective was highlighted by @chris_dlamini. This is of particular interest and relevance to me, I teach on post-reg M.Sc modules with international students, I feel that I have a new appreciation for their circumstances and the issues they bring from practice.

Question 2) Why is it important for students from all fields of nursing to share this experience?

The importance of shared emotions, shared knowledge and shared impact was explored. Not to forget the role of the MDT as some participants have experienced working alongside other professional groups as part of field trips or study tours.  As @dmarsden49 recognised, what better experience could there be to reinforce inter-professional learning? @Vickyneeson highlighted the way we learned from each other in Cambodia and pooled our experiences. Sharing learning together and breaking down barriers was highlighted by @florenceella the recognition of us #ldns as a professional group and nurses first was briefly discussed.

My favourite question of the night: question 3) How can learning disability students benefit from working in environments where the client group is not recognised?

There was lots of interest and mutual appreciation in relation to this, some possible barriers also highlighted: frustration and suffocation from the social and economic hurdles balanced with being able to see the benefit LD nurses bring to society and the potential differences we can make. A lovely tweet from @marydunningTU recognised that students can ‘illuminate hope’ in these situations as well as recognise that they can influence and be effective role models, humanising care. A number of tweeters recognised the difference one person can make, and the difference may only be in one persons life but this is a start and so meaningful to those people. The importance of recognising the group of individuals is a good start.

A look to the future:

There were also questions posed to us as hosts and it was great to see so much enthusiasm across the night.

1) What be your biggest learning/key message (curtesy of: @Hazelpowell11)

2) What could we learn/ do better regarding the family approach? (@Hazelpowell11)

3) How have we shared our learning since returning? (@nicbraid)

4) Some discussion focused on the issues in the UK and the needs of people with learning disabilities, do we really have it right/better?

The need for academics to promote and teach about the potential for growth and development through international placement was highlighted. @chris_dlamini told us about his research plans, the need to work alongside nurses born abroad and understanding cultural perspectives on nursing, tying in with a very important point raised by nurse consultant @jimgblair. The implications for nurses, student nurses, opportunities to travel abroad and Brexit, I’m sure many of us agree that this would make a great future chat! As Jim said: ‘how do @weldnurses think brexit will impact on people with learning disabilities and their families? Are there any positives to Brexit?’We look forward to hearing more at Positive choices this year, a dickie bird tells us that James Ridley will be presenting on his experience in India. 

One thing I learnt on Hallowe’en was how fearless we can be as a professional group, exploring areas of the world where people have no idea who we are and what we do. We were welcomed with open arms in Cambodia and got to do some work that we would not traditionally be involved in in the UK. I learnt about culture, respect, death, dignity, communication and use of language, I’m sure I learnt much more that I haven’t made myself aware of yet.

Many thanks to all involved, Paula 

Laura (@Lauldn4) here. Rather than repeating what Paula (@PaulaHopes1) has written above, I thought I'd add a few thoughts which summarise the chat for me. Paula mentioned holding a joint twitter chat about our trip once we had returned to the UK, which I was keen to do. I've previously 'lurked' on some past chats so I had an insight how useful and important they are; especially as a student nurse, as they're a great tool for sharing ideas and experiences with others. During the build-up to Hallowe’en, I had lots of support from both Paula and Ross (@Ross_6479), who helped to reduce some of the pre-chat anxieties I had been feeling. Throughout the chat a number of questions were put to us. The pace of the chat was so fast that I couldn't give these my full attention, so I'd like to answer a few of these now; and perhaps they will be featured in another #weldns chat in the future because it is always interesting to other people's views. 

What is your biggest learning/key message (courtesy of: @Hazelpowell11) 

For me, the thing I took the most from our trip is an even greater appreciation of our own NHS. As someone who has only ever known our own healthcare system, I've never really thought about how our lives would be without it. I always thought I've been massively grateful for our hospitals and services, but since returning to placement in the UK I have - on more than one occasion - had to take a moment to be thankful for what we have. 

What could we learn/ do better regarding the family approach? (@Hazelpowell11) 

Something that I really took from the trip was seeing first-hand how involved families were in the patients' care. The families often took on the role of the healthcare assistant for the ward and it wasn't uncommon to see a family member cooking a meal for everyone. As LD nurses, our fundamental values are centred around holistic, person-centred care for our service users; and I believe the Cambodian people's approach of caring for the spiritual needs – as well as the physical – of their loved ones, even from the hospital bed, is very holistic in and of itself.

I found it really positive to hear from some students who are planning to participate in future international placements (@zoeeuk), and it was interesting to see that many contributors to the chat had already travelled abroad (@minionkevins, @NicBraid, @Cathy_55555), so I'm really glad that they chose to share their thoughts with us on the night. As question 3 suggested, we often travel to countries where the role of the learning disability nurse isn't recognised, and our client group may not receive the same level of support as they do in the UK. It's exciting to know that LD nurses and students are sharing their brilliant skills and knowledge across the globe, being a 'voice for the unheard' (@Cathy_55555). 

I'd like to thank everyone who gave up an hour of their Hallowe'en to get involved in the chat. It was a fantastic experience and I enjoyed every second. Laura