#WeLDNs - Tuesday 3rd December 2019 8:30pm (GMT Standard Time) Knowledge and skills for community LD nursing

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Hosted by WeLDnurses using #WeLDNs

This chat is guest hosted by @NorthwayRuth @AngieHack10

This year we have been celebrating 100 years of learning disability nursing. However, it may surprise you to know that community learning disability nurses have been in existence for almost half of that time. The first community learning disability nurses took up their posts in the early 1970s at a time when the majority of health service provision for people with learning disabilities was focused on long stay hospitals.

Of course, this role has undergone many changes since that time. In the early days it was often focused on maintaining / creating links with families for those in the institutions and then with supporting resettlement.  Subsequent changes in policies and service provision have led to further evolution of the role and community learning disability nurses are now working in a wide range of settings and roles. Many work in the context of inter-agency and/ or interdisciplinary teams some having a generic role whilst others have a more focused area of specialism such as epilepsy or behavioural support. 

Alongside such changes in practice the educational provision to support the development of community learning disability nurses has changed from the early days of the (then) British Institute of Mental Handicap 6 week course, through the ENB 805/806 courses to the current system of the specialist practitioner qualification (SPQ). However, SPQ courses with the learning disability specialism within them are few and opportunities for learning disability nurses to gain their SPQ can be limited. 

Currently further changes to the nature and structure of community learning disability teams are being discussed. Alongside this the NMC are about to commence their review of the post-registration educational standards. It is timely, therefore, to consider what are the specialist knowledge and skills required by community learning disability nurses now and in the future in order to ensure that, as a profession, we are appropriately equipped to fulfil our role. The Queen’s Nursing Institute (QNI) and the Queen’s Nursing Institute (Scotland) are therefore working on the development of voluntary standards for practice and education for community learning disability nurses. This project is due to run until September 2020 when the standards will be launched.





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 #WeLDNs transcript

 
@StaceyReesRNLD
03 December 2019 20:30
RT @WeLDnurses: Five minutes to go before tonights chat, thats just enough time to eat seven mince pies before we get going #WeLDNs
@WeLDnurses
03 December 2019 20:30
Good evening everyone! You know the drill by now, give us a wave and let us know you're hanging out tonight! #WeLDNs
@StaceyReesRNLD
03 December 2019 20:31
@WeLDnurses Hello y’all ?????????????? #WeLDNs
@LucyAnn_Spencer
03 December 2019 20:31
@WeLDnurses Hi everyone. Lucy here from #NorthWales. #WeLDNs
@LiamFreeman1991
03 December 2019 20:31
@WeLDnurses ???? #WeLDNs
@dmarsden49
03 December 2019 20:31
@WeLDnurses Evening all! #weldns https://t.co/2Ey6uC4sGy
@samabdulla
03 December 2019 20:32
@WeLDnurses Evening #Weldns
@carlyannedavies
03 December 2019 20:32
@WeLDnurses Hi all @WeLDnurses #WeLDNs
@BoranSue
03 December 2019 20:32
RT @WeLDnurses: Five minutes to go before tonights chat, thats just enough time to eat seven mince pies before we get going #WeLDNs
@NorthwayRuth
03 December 2019 20:32
Good evening everyone - looking forward to this evening's chat. Who is joining in this evening? #weldns
@CommunityLd
03 December 2019 20:33
@WeLDnurses Glenn in County Durham #weldns
@StaceyReesRNLD
03 December 2019 20:33
RT @NorthwayRuth: Good evening everyone - looking forward to this evening's chat. Who is joining in this evening? #weldns
@WeLDnurses
03 December 2019 20:33
Don't forget to add #weldns onto your tweets so we can all see them! https://twitter.com/AngieHack10/status/1201962603456737281
@NorthwayRuth
03 December 2019 20:34
@carlyannedavies @WeLDnurses Hello Carly #WeLDNs
@NorthwayRuth
03 December 2019 20:34
@CommunityLd @WeLDnurses Hello Glenn #WeLDNS
@dmarsden49
03 December 2019 20:34
Thanks for hosting this #weldns chat with @qni & @AngieHack10 on Community Nursing in learning disabilities. https://twitter.com/NorthwayRuth/status/1201962516202610688
@AngieHack10
03 December 2019 20:35
@WeLDnurses Good evening #WeLDNs looking forward to chatting with you this evening!
@WeLDnurses
03 December 2019 20:36
Good to see everyone! Tonights chat is brought to you by @NorthwayRuth, @AngieHack10 and the @TheQNI to talk standards of education for community learning disability nurses (CLDN) #WeLDNs
@DonnamarieTho14
03 December 2019 20:37
RT @WeLDnurses: Five minutes to go before tonights chat, thats just enough time to eat seven mince pies before we get going #WeLDNs
@WeLDnurses
03 December 2019 20:37
So lets get going! Starting off with considering the role of a CLDN, what does the role look like now? #WeLDNs
@extremeNWales
03 December 2019 20:38
If you are a fan of North Wales please follow us :-) RT @LucyAnn_Spencer: @WeLDnurses Hi everyone. Lucy here from #NorthWales. #WeLDNs
@LiamFreeman1991
03 December 2019 20:39
@WeLDnurses What I have learnt, is they have to have many skills to understand the referrals, plan a intervention suitable for service user and use the team's skills when they are stuck on caseload #WeLDNs
@NorthwayRuth
03 December 2019 20:39
@WeLDnurses For me it seems that the role now is very varied and constantly evolving #WeLDNS
@samabdulla
03 December 2019 20:39
@WeLDnurses In my experience, the only way to describe it is varied. Kids, adults, physical health, mental health, skills teaching, liaison... #weldns
@NorthwayRuth
03 December 2019 20:40
@LiamFreeman1991 @WeLDnurses So are the referrals very varied? #WeLDNS
@CommunityLd
03 December 2019 20:40
@WeLDnurses 10 years ago I started as a community care co-ordinator in an integrated team. I then moved into forensics. Role is evolving to become more specialised and pathways lead #weldns
@WeLDnurses
03 December 2019 20:41
Does this mean the role is very different than the first CLDNs? #WeLDNs https://twitter.com/NorthwayRuth/status/1201964259963527168
@ross_6479_RNLD
03 December 2019 20:41
@WeLDnurses Good evening all #waves from up north #Weldns
@StaceyReesRNLD
03 December 2019 20:41
@LiamFreeman1991 @WeLDnurses I would say CLDN has a coordination role across many different settings and professionals #weldns
@StaceyReesRNLD
03 December 2019 20:41
RT @NorthwayRuth: @WeLDnurses For me it seems that the role now is very varied and constantly evolving #WeLDNS
@HabitualJoshing
03 December 2019 20:41
I supposed ‘varied’ seems to be a recurrent term. I think community nursing really follows the nursing process and often provides very specialised assessment and intervention #WeLDNs
@LucyAnn_Spencer
03 December 2019 20:41
@WeLDnurses my first placement was within a Community LD team. I found it to be very varied, lots of different skills needed. #WeLDNs
@NorthwayRuth
03 December 2019 20:42
@samabdulla @WeLDnurses Also it seems that there can be a lot of the role focused on supporting others to support people with learning disabilities through (for example) providing education #WeLDNs
@WeLDnurses
03 December 2019 20:42
@CommunityLd Do you think there is still a "general" CLDN role? #weldns
@theLDphysio
03 December 2019 20:42
@WeLDnurses Lurking a learning as ever, a physio imposter in Nottingham #weldns https://t.co/n7iOHrsndU
@LiamFreeman1991
03 December 2019 20:42
@WeLDnurses Yes, they are from discharge from hospital, physical health, sex and relationships, communication, behaviours that challenge, day to day living #WeLDNs
@CommunityLd
03 December 2019 20:42
@WeLDnurses Yes there is still within teams but depends on locality setup #weldns
@StaceyReesRNLD
03 December 2019 20:42
@WeLDnurses I would also say varied, with a lack of clarity amongst CLNDs themselves and wider professionals #weldns
@WeLDnurses
03 December 2019 20:43
@chris_dlamini @NorthwayRuth @AngieHack10 @TheQNI Don't forget your hashtags Chris! #weldns
@dmarsden49
03 December 2019 20:43
@WeLDnurses So I was hearing from @SABP_CTPLD_EAST about prescribing, in reach to local hospitals, collaboration across all sectors, and currently reflecting on the implementation of the Moulster and Griffiths model recently. #weldns
@NorthwayRuth
03 December 2019 20:43
@LucyAnn_Spencer @WeLDnurses Were there any specific skills and knowledge that you felt nurses demonstrated when working in the community? #WeLDNS
@LiamFreeman1991
03 December 2019 20:43
@StaceyReesRNLD @WeLDnurses They are key to making referrals to the right professionals such as OT, psychology, psychiatric and social worker #WeLDNs
@StaceyReesRNLD
03 December 2019 20:43
@WeLDnurses I would also say varied, with a lack of clarity amongst CLDNs themselves and wider professionals #weldns
@chris_dlamini
03 December 2019 20:43
@WeLDnurses Hello #weldns. Lurking from Hertfordshire tonight. Very cold where l'm at! https://t.co/Mca0hJFdPf
@WeLDnurses
03 December 2019 20:44
Unsurprisingly the word of the day is varied, in roles, in set up of teams, in patient groups... So, enough looking back. What might the role of CLDN look like? #weldns
@hayleyldnurse
03 December 2019 20:44
RT @WeLDnurses: So lets get going! Starting off with considering the role of a CLDN, what does the role look like now? #WeLDNs
@NorthwayRuth
03 December 2019 20:44
@HabitualJoshing Do you think that the nursing process is followed differently in a community setting or is it similar / the same as when working in a residential service? #WeLDNS
@StaceyReesRNLD
03 December 2019 20:44
@CommunityLd @WeLDnurses Totally agree with you Glenn and teams within the same healthboards also have varied roles #weldns
@SueMarsden6
03 December 2019 20:44
#weLdns https://twitter.com/suemarsden6/status/1201965463149973504
@dmarsden49
03 December 2019 20:45
@chris_dlamini @WeLDnurses Hertfordshire, that's not your usual hangout, is it? #weldns
@CommunityLd
03 December 2019 20:45
@WeLDnurses It’s now very much needs led and episodic care #weldns
@SueMarsden6
03 December 2019 20:45
@WeLDnurses #WeLDNs ??
@HabitualJoshing
03 December 2019 20:45
@WeLDnurses I suppose we have moved away from alway remaining involved to more time-limited interventions, often based on clinical pathways with demonstrable outcome measures #weldns
@WeLDnurses
03 December 2019 20:45
RT @CommunityLd: @WeLDnurses It’s now very much needs led and episodic care #weldns
@CommunityLd
03 December 2019 20:46
@StaceyReesRNLD @WeLDnurses A lot of sub speciality teams eg health facilitation, in-reach etc #weldns
@StaceyReesRNLD
03 December 2019 20:46
RT @CommunityLd: @StaceyReesRNLD @WeLDnurses A lot of sub speciality teams eg health facilitation, in-reach etc #weldns
@WeLDnurses
03 December 2019 20:46
@CommunityLd Is tha a positive? #WeLDNs
@NorthwayRuth
03 December 2019 20:46
@StaceyReesRNLD @WeLDnurses Do you think this lack of clarity is down to organisational issues or a lack of clarity on the part of individual nurses? What might be done to reduce this lack of clarity?#WeLDNS
@SueMarsden6
03 December 2019 20:46
@CommunityLd @WeLDnurses #weLDNs our service has recognised that episodic care doesn’t always meet needs and some people need a named nurse/professional for the long haul
@WeLDnurses
03 December 2019 20:46
Something that can be built on? #WeLDNs https://twitter.com/HabitualJoshing/status/1201965789135409152
@StaceyReesRNLD
03 December 2019 20:46
@SueMarsden6 @WeLDnurses Yes agreed. They key constant between services #weldns
@WeLDnurses
03 December 2019 20:47
Don'f forget those Hashtags! #WeLDNs https://twitter.com/hayleyldnurse/status/1201966141347946496
@Shaun_LDNurse
03 December 2019 20:47
@WeLDnurses Despite me feeling it’s the #LDNurses bread-and-butter, I’ve not really had much hands-on experience (besides contact with individual community #LDNurses). My impression is varied, but increasingly restricted (to its’ detriment). #WeLDNs
@ermate
03 December 2019 20:47
@WeLDnurses I personally would love to see community nurses have some commissioning opportunities via the use of personal health care budgets. Would be absolutely fantastic... #weldns
@NorthwayRuth
03 December 2019 20:47
@SueMarsden6 @CommunityLd @WeLDnurses An important point - so is there an important monitoring and support role #WeLDNS
@CommunityLd
03 December 2019 20:47
@WeLDnurses Not necessarily, as those with no ‘health’ or ‘care’ needs in the borderline learning disability range can be excluded from service. There is a need to define a health errr need ?? #weldns
@HabitualJoshing
03 December 2019 20:48
@NorthwayRuth I think sometimes the process can be less complicated; the role of the CLDN is often removed from having to do the day-to-day support as one might in residential care. Therefore, I think the assessment and intervention process can be much clearer and timely #weldns
@Its_Me_Alie
03 December 2019 20:48
@WeLDnurses Good evening from Preston #weldns
@chris_dlamini
03 December 2019 20:48
@dmarsden49 @WeLDnurses No. Visiting the university. I am a Northener geographically #weldns
@NorthwayRuth
03 December 2019 20:48
RT @SueMarsden6: #weLdns https://twitter.com/suemarsden6/status/1201965463149973504
@hayleyldnurse
03 December 2019 20:48
@WeLDnurses Oops #WeLDNs
@LucyAnn_Spencer
03 December 2019 20:48
@NorthwayRuth @WeLDnurses there was a lot of close #MDT working. There was also a lot of teaching work and skills building, transition planning, PBS work, assessments. No day was the same. #WeLDNs
@CommunityLd
03 December 2019 20:48
@SueMarsden6 @WeLDnurses Totally agree but under resourced services have to manage capacity. If no active care then difficult to justify these days #weldns
@NorthwayRuth
03 December 2019 20:48
@SueMarsden6 A good description #WeLDNs
@WeLDnurses
03 December 2019 20:49
So thinking about our dream CLDN. What would you say would be the key areas of skill and knowledge they would need? #WeLDNs
@NorthwayRuth
03 December 2019 20:50
@CommunityLd @SueMarsden6 @WeLDnurses It is a difficult balance isn't it - stretched resources mean that on going support may not be possible but a lack of on going support can sometimes lead to crises that could have been avoided #WeLDNs
@WeLDnurses
03 December 2019 20:50
#WeLDNs https://twitter.com/SueMarsden6/status/1201966721839620097
@samabdulla
03 December 2019 20:50
RT @WeLDnurses: So thinking about our dream CLDN. What would you say would be the key areas of skill and knowledge they would need? #WeLDNs
@hayleyldnurse
03 December 2019 20:51
@WeLDnurses @CommunityLd My team currently works in episodes of care, meaning each person has an identified health need to access the service. I don’t think there is a ‘general’ role, however lots of individuals would benefit from long term CLDN oversight due to complex and changing presentation #WeLDNs
@LiamFreeman1991
03 December 2019 20:51
RT @WeLDnurses: So thinking about our dream CLDN. What would you say would be the key areas of skill and knowledge they would need? #WeLDNs
@StaceyReesRNLD
03 December 2019 20:51
@NorthwayRuth @WeLDnurses Probably both? Clear processes are needed - pathways will support this. Consistency, accountability, and competency. #weLDNs
@SueMarsden6
03 December 2019 20:51
@WeLDnurses #weLDNs ... sorry hopeless at hashtags
@samabdulla
03 December 2019 20:51
The skills of the “generalist” CLDN are always going to be huge, knowing enough about most things, but need to develop additional specialist CLDTs and resource properly #weldns https://twitter.com/weldnurses/status/1201966805775982598
@ross_6479_RNLD
03 December 2019 20:52
@LucyAnn_Spencer @NorthwayRuth @WeLDnurses Yes, this is certainly my experience, whilst the framework of the offering may remain the same, the work is so varied and can often start with one goal but migrate into others, holism is a big factor for me in community ime #WeLDNs
@CommunityLd
03 December 2019 20:52
@NorthwayRuth @SueMarsden6 @WeLDnurses @DeclanMunnelly will tell you I used to hold onto patients far to long and got wrong off management for it haha #weldns
@NorthwayRuth
03 December 2019 20:52
@HabitualJoshing I suppose that this then brings the challenge of implementation where we may only have an indirect input as we are not always the ones delivering the interventions? #WeLDNs
@WeLDnurses
03 December 2019 20:52
@SueMarsden6 We've got you #WeLDNs
@CommunityLd
03 December 2019 20:52
@hayleyldnurse @WeLDnurses Absolutely there is a need for early intervention or different tiers of service #weldns
@StaceyReesRNLD
03 December 2019 20:53
@NorthwayRuth @WeLDnurses In ?????????????? we know over the next 5-10 yrs we will have +++ CNLDs retiring. Succession planning. Dev. posts. Nurse ed pre & post reg #weldns
@SueMarsden6
03 December 2019 20:53
@WeLDnurses #weLDNs mental capacity act, autism, behaviour, confidence and competence to support and challenge. The ability to look up any novel genetic condition and grasps it’s fundamentals immediately!
@HabitualJoshing
03 December 2019 20:53
@WeLDnurses I think whereas other fields may seperate out things like physical and mental health, CLDNs need a good knowledge and level of skill in both. It’s a great example of LDNs working holistically #weldns
@dmarsden49
03 December 2019 20:53
@WeLDnurses The Community Nurse role is truly holistic, it exposes you to the plethora of complex issues that are problematic for a person to live a perceived normal life & get to negotiate & navigate the systems set up to mitigate those issues with the individual & carers. #weldns
@WeLDnurses
03 December 2019 20:54
RT @SueMarsden6: @WeLDnurses #weLDNs mental capacity act, autism, behaviour, confidence and competence to support and challenge. The abilit…
@hayleyldnurse
03 December 2019 20:54
@CommunityLd @WeLDnurses Different tiers of service is a really interesting idea, these tiers would need to be so fluid & seamless in order to be responsive #WeLDNs
@LucyAnn_Spencer
03 December 2019 20:54
@WeLDnurses #communication and the ability to change communication style frequently. From being able to communicate with a person with a #learningdisability to communicating with family, and different families will require different styles. Also communicating with professionals. #WeLDNs
@ross_6479_RNLD
03 December 2019 20:55
@WeLDnurses Approaching care with the person at the centre, good strong MDT links with clear referral pathways, needs led and quality of life focussed. Working in unison with other health & social care providers to ensure care is provided by most appropriate and suited. #WeLDNs
@Shaun_LDNurse
03 December 2019 20:55
@WeLDnurses The notion of variety makes me feel a little uneasy, especially without oversight as it can lead to inconsistency. Whatever #Community #LDNursing looks like it needs to be agreeded upon, consistent, and we’ll understood. #WeLDNs
@NorthwayRuth
03 December 2019 20:55
@HabitualJoshing @WeLDnurses An important point - the relationship between physical and mental health is so important as one impacts on the other. Similarly if social care needs are not met then this can impact on health #WeLDNs
@StaceyReesRNLD
03 December 2019 20:55
@WeLDnurses Do you think these should remain the same? However, what we do & how we do things should be explored? #weldns
@CommunityLd
03 December 2019 20:56
@WeLDnurses All community nurses need a specialism in one and knowledge of rest in following Autism Positive behaviour support Personality disorder Mental health Complex health needs #weldns
@HabitualJoshing
03 December 2019 20:56
@NorthwayRuth That’s true; I think a skill needed by CLDNs is to be able to negotiate and manage expectation. We often work hard to ensure those delivering the interventions are equally onboard, so there’s a big practice education and leadership role #weldns
@NorthwayRuth
03 December 2019 20:56
@dmarsden49 @WeLDnurses I think that the 'navigator' role is an important one that is not always recognised and which requires a range of skills and knowledge #WeLDNs
@AngieHack10
03 December 2019 20:56
@CommunityLd @WeLDnurses #WeLDNs How do you think community LD nurses can influence the avoidance of individuals slipping through the net who do not have clearly defined health care needs ?
@CommunityLd
03 December 2019 20:56
@hayleyldnurse @WeLDnurses Yeah I’m thinking specialist tertiary teams that are hubs of CLDT #WELDNS
@WeLDnurses
03 December 2019 20:56
losing perhaps a notion of jack of all trades, do we finally become a master of one? #weldns https://twitter.com/CommunityLd/status/1201968377251663872
@LucyAnn_Spencer
03 December 2019 20:56
@ross_6479_RNLD @NorthwayRuth @WeLDnurses I agree. I found it extremely person centered. There was also a balance of working with the family and care providers too and a lot of support to them as well as the person with a learning disability. #weLDNs
@ChrisHutchRNLD
03 December 2019 20:56
RT @HazelPowell11: This question always promotes much discussion but not easy to answer. Tonight's #WeLDNs chat will contribute to how we c…
@StaceyReesRNLD
03 December 2019 20:57
@WeLDnurses Working in partnership with social care (fundamental) and other health professionals #WeLDNs
@SueMarsden6
03 December 2019 20:57
@CommunityLd @NorthwayRuth @WeLDnurses @DeclanMunnelly #weLDNs yeah me too probably... but when a family I know cry because they know they don’t have to tell their story again and that I just “know” what is going on... it’s worth it.
@WeLDnurses
03 December 2019 20:57
RT @StaceyReesRNLD: @WeLDnurses Working in partnership with social care (fundamental) and other health professionals #WeLDNs
@NorthwayRuth
03 December 2019 20:57
@HabitualJoshing I agree - our role in providing this leadership and support is essential #WeLDNs
@CommunityLd
03 December 2019 20:58
@WeLDnurses I think it’s the ‘Jack of all trades’ which has kept our specialist reputation down! Which other profession can advocate knowledge in all of them areas? #weldns
@HabitualJoshing
03 December 2019 20:58
@NorthwayRuth @WeLDnurses That’s a good point; I think all too often LDNs are often responding to a person’s social care needs, which can then have such a significant impact on their wellbeing #weldns
@StaceyReesRNLD
03 December 2019 20:59
@WeLDnurses Coordination, collaboration & education is key in all areas of the role #weldns
@NorthwayRuth
03 December 2019 21:00
@LucyAnn_Spencer @ross_6479_RNLD @WeLDnurses I think that this is a key element of the role and a lot of skill can be required in balancing the needs of the individual with learning disabilities and those of the family - at times there can be some tension in this #WeLDNs
@WeLDnurses
03 December 2019 21:00
Currently, how to we mark the differences in skills expected of those who might hold a specialist practionner qualification, against those of your standard post registration nurse? #WeLDNs
@CommunityLd
03 December 2019 21:00
@AngieHack10 @WeLDnurses By having an access service which has a clear remit to holistically assess needs (both health and care) to ensure person doesn’t be dismissed. Perhaps extending inclusion criteria beyond IQ? #weldns
@chris_dlamini
03 December 2019 21:00
@dmarsden49 @WeLDnurses Will do. #weldns
@theLDphysio
03 December 2019 21:00
@WeLDnurses Perhaps knowledge of preventative healthcare including healthy lifestyles and exercise benefits? #weldns I know some of this is already being done but can't forget about physical health alongside mental health
@ross_6479_RNLD
03 December 2019 21:00
@HabitualJoshing @NorthwayRuth @WeLDnurses This is where I think the ability to break down barriers and think of creative solutions is a great skill of the LDN, were often faced with ‘it can’t be done’ and regularly come up with a way that it can, it’s here we need the skill to bring people on that journey #WeLDNs
@LiamFreeman1991
03 December 2019 21:01
@StaceyReesRNLD @WeLDnurses I haven't noticed on placement, that when social workers get involved, they are immediately saying the individual needs a PBS straight away, while can then lead to CHC check list being done #WeLDNs (but that is not all of them)
@CommunityLd
03 December 2019 21:01
@AngieHack10 @WeLDnurses I battled hard to ensure autistic adults without ld game under the forensic service #weldns
@NorthwayRuth
03 December 2019 21:01
@theLDphysio @WeLDnurses I think that ideally we would be able to focus more on prevention and the promotion of healthy lifestyles but do resource constraints make this difficult? #WeLDNs
@hayleyldnurse
03 December 2019 21:02
Understanding of MCA & MHA & how this works in practice.Knowledge of the Human Rights Act & how to advocate these. Being non-judgemental, inclusive & being able to holistically asses health needs. Skills & coping strategies for: IT,time management, resilience & autonomy #WeLDNs https://twitter.com/WeLDnurses/status/1201966805775982598
@Shaun_LDNurse
03 December 2019 21:02
@WeLDnurses Lots of comments on what ideally would be needed, but not necessarily on what’s already missing and to the detriment of the people we support (e.g. physical health assessment etc.) A comprehensive scoping exercise is needed to establish this. #WeLDNs
@ross_6479_RNLD
03 December 2019 21:02
@HabitualJoshing @NorthwayRuth @WeLDnurses Another great skill that is useful here is being able to generate and articulate the evidence base to support what we are proposing and how it will benefit the individual and their wellbeing and quality of life #WeLDNs
@dmarsden49
03 December 2019 21:02
@NorthwayRuth @StaceyReesRNLD @WeLDnurses When I became a Community Nurse - granted 20 years ago!- there was an expectation that I'd undertake a specialist qualification giving me the #SCLD registration with @nmcnews This enabled understanding of the role to be deeper than a series of ascribed tasks and roles #weldns
@CommunityLd
03 December 2019 21:03
@ElizabethFair74 @WeLDnurses Why not is more the question? But to answer people with learning disabilities are presenting with more complex needs. We need that expertise in community services to prevent hospital admissions #weldns
@theLDphysio
03 December 2019 21:03
@NorthwayRuth @WeLDnurses Yes they do, but super ideal CLDN will be able to overcome all obstacles in this eutopian futuristic land #weldns
@samabdulla
03 December 2019 21:03
@Shaun_LDNurse @WeLDnurses Thy very much depends where you are, Scottish CLDNs do a health Ax with every referral and then annually from there, along with annual GP meeting, cancer screening information as standard... #weldns
@SueMarsden6
03 December 2019 21:03
#weLDNs a specialist should be able to lead and teach, to develop the practice of others, to demonstrate development of that specialist interest. https://twitter.com/weldnurses/status/1201969465300340736
@NorthwayRuth
03 December 2019 21:04
@theLDphysio @WeLDnurses Am liking your thinking! #WeLDNs
@HabitualJoshing
03 December 2019 21:04
@ross_6479_RNLD @NorthwayRuth @WeLDnurses That’s a really great point. I often found you would end up creating things that already existed elsewhere just because it things that worked wouldn’t be shared. This can be a benefit of pathway working #weldns
@ross_6479_RNLD
03 December 2019 21:05
@Shaun_LDNurse @WeLDnurses We do this too, forms part of our nursing assessment, we have also recently implanted a health check clinic where we support GPs to complete health checks with those who would struggle to access primary care #WeLDNs
@LucyAnn_Spencer
03 December 2019 21:05
@LiamFreeman1991 @StaceyReesRNLD @WeLDnurses I found that there were a lot of CHC funding battles going on. #WeLDNs.
@Llinda_P
03 December 2019 21:05
@WeLDnurses I worked in a CTLD for 25 years and the role continued to evolve and change over time. Tea and sympathy visits were replaced by more targeted interventions #WeLDNs
@SueMarsden6
03 December 2019 21:05
@CommunityLd @WeLDnurses #weLDNs yes totally agree. There’s a pay off though, because appropriate long term management cuts down on crises, and reduce duplication and repetition. A confident family is less likely to need repeat I think.
@NorthwayRuth
03 December 2019 21:06
@Shaun_LDNurse @WeLDnurses I like your idea of a scoping exercise - how do you think it would be best to identify the gaps in current provision? Would we also need to scope the knowledge and skills required and hence whether there are any educational needs? #WeLDNs
@HabitualJoshing
03 December 2019 21:06
@dmarsden49 @NorthwayRuth @StaceyReesRNLD @WeLDnurses @nmcnews I’m not sure (at least from where I practiced) that that expectation is there anymore. But then I do think the focus of ld nurse training is increasingly community-orientated #weldns
@theLDphysio
03 December 2019 21:06
@WeLDnurses Ooo, also an ability to kick GPs up the proverbial for not providing annual health screening (around 50% in 2018). If you're not too busy #weldns
@CommunityLd
03 December 2019 21:06
@SueMarsden6 @WeLDnurses Or a confident support team #weldns
@LiamFreeman1991
03 December 2019 21:06
@LucyAnn_Spencer @StaceyReesRNLD @WeLDnurses #WeLDNs
@samabdulla
03 December 2019 21:07
@NorthwayRuth @Shaun_LDNurse @WeLDnurses Would we be able to account for regional difference? #weldns
@Shaun_LDNurse
03 December 2019 21:07
@samabdulla @WeLDnurses That’s all fine and well, but to refer back to some of my previous tweets, the variability can (and does) lead to inconsistencies in role. Something which say other professions (e.g. physio) in #CLDT have tried to move away. #WeLDNs
@StaceyReesRNLD
03 December 2019 21:07
@AngieHack10 @CommunityLd @WeLDnurses This is why CLDNs should be working in partnership with social care and other professionals to ensure health needs are met #weldns
@NorthwayRuth
03 December 2019 21:07
@ross_6479_RNLD @HabitualJoshing @WeLDnurses I agree - I think that the 'can do' attitude is a key skill. I am regularly impressed by the creativity demonstrated by CNLDs when seeking to get the best for those they support #WeLDNs
@Llinda_P
03 December 2019 21:07
@NorthwayRuth @LucyAnn_Spencer @WeLDnurses Assessment, teamworking, education, flexibility #WeLDNs
@CommunityLd
03 December 2019 21:08
@ElizabethFair74 @WeLDnurses Maybe specialism is not best description. Detailed Knowledge maybe? But there should be more post registration opportunities to develop skills. More Advanced Nurse posts #weldns
@theLDphysio
03 December 2019 21:08
@NorthwayRuth @WeLDnurses @Shaun_LDNurse When it comes to LD and education, you guys are streets ahead, believe me. Although we can always learn to learn a little more. Scoping exercise would be interesting #weldns
@CommunityLd
03 December 2019 21:08
@StaceyReesRNLD @AngieHack10 @WeLDnurses There is some good examples of integrated care in North East #weldns
@StaceyReesRNLD
03 December 2019 21:09
@HabitualJoshing @ross_6479_RNLD @NorthwayRuth @WeLDnurses So important to ensure that research or #EBP isn’t the elephant in the room in comm teams. It’s a key part of the role #weldns
@CommunityLd
03 December 2019 21:09
@WeLDnurses There’s a need to start this in pre Reg! #weldns
@NorthwayRuth
03 December 2019 21:10
@CommunityLd @ElizabethFair74 @WeLDnurses Do we have any figures for how many ANP posts there are in community learning disability nursing? #WeLDNS
@HabitualJoshing
03 December 2019 21:10
@StaceyReesRNLD @ross_6479_RNLD @NorthwayRuth @WeLDnurses I think that’s a lesson to learn for all LDN roles; I think most job descriptions include statements on adding the evidence base but it’s often seen as an add on #weldns
@WeLDnurses
03 December 2019 21:10
Anyone? #weldns https://twitter.com/NorthwayRuth/status/1201971944452689920
@ross_6479_RNLD
03 December 2019 21:10
@Shaun_LDNurse @samabdulla @WeLDnurses I agree consistency is key, I think that always putting the individual at the centre and striving to meet their needs consistently will prevent unmet needs and repeat referrals, often stringent restraints on what can be delivered is what results in people reaching crisis #WeLDNs
@NorthwayRuth
03 December 2019 21:11
@CommunityLd @ElizabethFair74 @WeLDnurses Do you think that the current SPQ qualification provides some of this detailed knowledge and (if not) what needs to be included in the future? #WeLDNs
@WeLDnurses
03 December 2019 21:11
#WeLDNs https://twitter.com/AngieHack10/status/1201972037461446658
@CommunityLd
03 December 2019 21:11
@NorthwayRuth @ElizabethFair74 @WeLDnurses Not that I am aware. But at the RCN LD forum we are going to try and map where ld nurses are working #weldns
@AWolke
03 December 2019 21:11
Interestingly read all the views on what LD nurses do and also what may be options! Let’s remember we are not the be all and end all in who should support people with LD and we should not take the roles of others as generic services have a responsibility #WeLDNs
@Shaun_LDNurse
03 December 2019 21:11
@samabdulla @NorthwayRuth @WeLDnurses Possibly around some local variations (as in able to identify why certain decisions have been made) but I don’t think it detracts from the fact, although we support individuals, that the aggregate often experience similar challenges when it comes to health and well-being. #WeLDNs
@samabdulla
03 December 2019 21:12
@WeLDnurses Could the NMC give us this? #weldns
@dmarsden49
03 December 2019 21:12
@NorthwayRuth @CommunityLd @ElizabethFair74 @WeLDnurses Do we have any figures on how many are on the registered with the NMC as SCLD or SPLD? #weldns
@NorthwayRuth
03 December 2019 21:12
@samabdulla @Shaun_LDNurse @WeLDnurses I think that wold be a challenge given that health and social care policies are devolved and hence the context in which community LDNs are working will vary #WeLDNS
@CommunityLd
03 December 2019 21:12
@ElizabethFair74 @WeLDnurses There are quite a few roles on community. Just need more #weldns
@AngieHack10
03 December 2019 21:13
@CommunityLd @StaceyReesRNLD @WeLDnurses Brilliant, but Community LDNurses need to consider how they can influence commissioning of services across the UK for parity? #WeLDNs
@dmarsden49
03 December 2019 21:14
@samabdulla @WeLDnurses It's not on the register currently https://www.nmc.org.uk/registration/staying-on-the-register/your-statement-of-entry/registration-and-qualification-codes/ #weldns
@NorthwayRuth
03 December 2019 21:14
@HabitualJoshing @dmarsden49 @StaceyReesRNLD @WeLDnurses @nmcnews An interesting point - have changes in pre registration education meant that some of what used to be introduced in the SPQ is now part of pre reg education and is this likely to increase with the new pre reg standards? What does this mean for post reg education? #WeLDNs
@samabdulla
03 December 2019 21:15
@Shaun_LDNurse @NorthwayRuth @WeLDnurses That information already exists, and nobody here would dare deny it, I suppose my question was more linked to larger regional differences. Legislation, social policy, health board policy rather than very local #weldns
@dmarsden49
03 December 2019 21:15
@samabdulla @WeLDnurses Although @thercn was doing some work on credentialing for ALNP #weldns https://www.rcn.org.uk/professional-development/professional-services/credentialing
@CommunityLd
03 December 2019 21:15
@AngieHack10 @StaceyReesRNLD @WeLDnurses Need more Ld nurses working in commissioning. I’ve been to speak to my local health scrutiny board to ensure they know about learning disability nursing and need to ensure it’s prioritised in commissioning services #weldns
@Shaun_LDNurse
03 December 2019 21:16
@NorthwayRuth @WeLDnurses I’m not sure how it would be done exactly (the particulars) albeit do have an impression how it could be accomplished... If I were to begin, I’d be here all night though. ?? #WeLDNs
@StaceyReesRNLD
03 December 2019 21:16
@NorthwayRuth @HabitualJoshing @dmarsden49 @WeLDnurses @nmcnews Such an important point especially with the development of the new curriculum #weldns
@CommunityLd
03 December 2019 21:17
@AngieHack10 @StaceyReesRNLD @WeLDnurses CNLD also need to be supported by flexible commissioning frameworks that allow truly bespoke services to be developed #weldns
@NorthwayRuth
03 December 2019 21:17
@Shaun_LDNurse @WeLDnurses Perhaps something for later discussion! #WeLDNs
@AWolke
03 December 2019 21:17
@AngieHack10 @StaceyReesRNLD @CommunityLd @WeLDnurses In a perfect world I may agree with joint services sadly from experience it only led to health staff covering the shortages in Social care staff and therefore not being able to provide health related support! #weldns we must ensure our profession has real health related focus
@WeLDnurses
03 December 2019 21:18
How do you think we can push for HEIs to better support specialist learning disability qualification for post registration study? #WeLDNS
@AngieHack10
03 December 2019 21:18
@dmarsden49 @WeLDnurses I agree Daniel, CLD Nursing evidences ‘true’ patient centred and holistic care. These unique skills need to be recognised! #WeLDNs
@HabitualJoshing
03 December 2019 21:18
@NorthwayRuth @dmarsden49 @StaceyReesRNLD @WeLDnurses @nmcnews I think it would have some significant implications. I think it would be interesting to find out how many CLDNs have the SPQ? And how many have obtained this recently? #WeLDNs
@CommunityLd
03 December 2019 21:18
@AWolke @AngieHack10 @StaceyReesRNLD @WeLDnurses Totally agree Tony. Big issue is not enough learning disability nurses to go around #weldns
@SueMarsden6
03 December 2019 21:18
@WeLDnurses #weLDNs ... no idea but I’m really interested in it as an alternative career pathway which keeps you in clinical practice but recognises expertise.
@Shaun_LDNurse
03 December 2019 21:19
@samabdulla @NorthwayRuth @WeLDnurses Hmmm true, but we need to consider to what extent those policy differences affect the role - are they fundamental and alter the character, or merely a a variation and more to do with priorities. #WeLDNs
@dmarsden49
03 December 2019 21:20
@AngieHack10 @WeLDnurses What happens in other fields Angie? Are specialist community qualifications retained? #weldns
@hayleyldnurse
03 December 2019 21:20
@WeLDnurses Is this Advanced Nurse Practitioner or are there different versions? #WeLDNs
@theLDphysio
03 December 2019 21:20
@WeLDnurses Let me know how you guys got a separate qualification course in the first place! we're lucky if we get an hour lecture tops if at all. #weldns #notjealous OK maybe. A bit.
@samabdulla
03 December 2019 21:20
HEIs are businesses and we need to be able demonstrate value for this, create a market, and there is the drive to create the programme. #weldns https://twitter.com/weldnurses/status/1201973894845997056
@dmarsden49
03 December 2019 21:21
@HabitualJoshing @NorthwayRuth @StaceyReesRNLD @WeLDnurses @nmcnews Is that data available somewhere @nmcnews? #weldns
@AWolke
03 December 2019 21:21
@CommunityLd @AngieHack10 @StaceyReesRNLD @WeLDnurses Is that because we have tried to be too varied and lost focus? I am not sure we have sold the nursing aspect enough! I also feel that social care providers etc should be encouraged to employ LD nurses as nurses and have it clearly identified in their JD and their CPD #weldns
@CommunityLd
03 December 2019 21:21
@WeLDnurses Give us some money to develop them!! I’m hopefully, developing a post registration course in neurorehabilitation nursing. Need same for ld #weldns
@HabitualJoshing
03 December 2019 21:21
@WeLDnurses In my mind, do we have evidence of how it benefits practitioners in the community, over and above their current training? If we can articulate that we can make a strong argument for it. #weldns
@NorthwayRuth
03 December 2019 21:21
@WeLDnurses I think one of the challenges for HEIs is that courses for CLDNs attract relatively small numbers of students and then viability and sustainability are questioned. May need to look at how courses are delivered to ensure flexibility and access for wider geographical areas #WeLDNs
@dmarsden49
03 December 2019 21:22
@SueMarsden6 @WeLDnurses Isn't that Advanced Nurse Practitioner and Nurse Consultant? #weldns
@Shaun_LDNurse
03 December 2019 21:22
@ross_6479_RNLD @samabdulla @WeLDnurses Good point. Does the role and scope of community #LDNurses shape services, or services restrict the overall scope or role of #LDNurses. #WeLDNs
@hayleyldnurse
03 December 2019 21:22
@WeLDnurses Distance learning courses so that nurses can complete the course at a location and time that suits them. Nurses from across the country could complete this at the same time = shared learning & a full cohort (hopefully!) #WeLDNs
@NorthwayRuth
03 December 2019 21:22
@HabitualJoshing @WeLDnurses A good point - perhaps within this we also need to consider whether changes in pre reg mean that we need to change the post reg offer #WeLDNS
@samabdulla
03 December 2019 21:22
@NorthwayRuth @WeLDnurses Is the answer in developing a suite of modules, which would also be fit for non CLDNs also? An option of post ref pathways #weldns
@LucyAnn_Spencer
03 December 2019 21:23
@NorthwayRuth @WeLDnurses I agree, it can be difficult to fill a course at undergrad level. #WeLDNs
@SueMarsden6
03 December 2019 21:23
@dmarsden49 @WeLDnurses #weLDNs good point. ANP strikes me as being more hands on, and nurse consultant more oversight, but that’s just my view. Quite frankly there aren’t enough of either/both...
@Shaun_LDNurse
03 December 2019 21:23
@NorthwayRuth @WeLDnurses Hopefully one soon @WeLDnurses. No time like the present. #WeLDNs Always happy to share my details with anyone who wants to chat away from twitter too.
@Ash_S_RNLD
03 December 2019 21:24
@WeLDnurses I have to agree no day is the same. I work across the ages ranges, short term interventions, long term input, palliative care planning, chronic health care and support, liaison, education and training for services and patients and carers, plus all the other stuff... #weldns
@StaceyReesRNLD
03 December 2019 21:24
@AWolke @CommunityLd @AngieHack10 @WeLDnurses Iwe’ve had 2b varied to meet the needs of ppl. Maybe it’s about CLDNs working with social care for optimum health outcomes #weldns
@AngieHack10
03 December 2019 21:25
@dmarsden49 @WeLDnurses Apologies, lost contact as on train! Yes, for example, District Nursing Specialist Practitioner Qualifications, General Practice Nursing. Currently, there are only 4 Community LD Nursing SPQs approved by the NMC in the UK. #WeLDNs
@NorthwayRuth
03 December 2019 21:25
@Ash_S_RNLD @WeLDnurses I think that what you have identified very well there is the extent of the knowledge and skills that CLDNs may require - this has key implications for the educational preparation we offer #WeLDNS
@WeLDnurses
03 December 2019 21:25
Sweet christmas that went fast! With just five minutes to go there is a lot of food for thought here... #WeLDNs
@SueMarsden6
03 December 2019 21:26
@theLDphysio @WeLDnurses #weLDNs do you not think that in most registered professions the clinical skill set is more easily transferable? The LD nursing role is, in my opinion, massively different from an RGN role.
@StaceyReesRNLD
03 December 2019 21:26
@WeLDnurses Coordinators, influencers, collaborators and educators #weldns
@WeLDnurses
03 December 2019 21:26
What would be the final thing you want people to take away from tonights chat? #WeLDNs
@ross_6479_RNLD
03 December 2019 21:26
@WeLDnurses 5 mins already!!!! Wow! #weldns
@ross_6479_RNLD
03 December 2019 21:26
RT @WeLDnurses: What would be the final thing you want people to take away from tonights chat? #WeLDNs
@BoranSue
03 December 2019 21:27
@HabitualJoshing @WeLDnurses #weldns We have to articulate the specialist role that this is. Current pre ref training is fantastic but to take the service forward needs leadership and confidence and SPQ is essential in this and other areas of specialist practice. Need to grow this body of evidence.
@AWolke
03 December 2019 21:27
@StaceyReesRNLD @CommunityLd @AngieHack10 @WeLDnurses Interesting point haven’t we tried that! We do not, sorry in my opinion, need to be as varied as we have become! We need to smarter and support and ensure other clinicians/nurses can meet the needs of people with LD otherwise they will always be seen as LD people #weldns
@SueMarsden6
03 December 2019 21:27
@AWolke @CommunityLd @AngieHack10 @StaceyReesRNLD @WeLDnurses #weLDNs excellent point, couldn’t agree more.
@NorthwayRuth
03 December 2019 21:27
@WeLDnurses I agree - a lot to think about and digest! #WeLDNs
@CommunityLd
03 December 2019 21:27
@WeLDnurses That if we want to address health inequalities and stop people been detained in ATUs longer than necessary, if at all, there is a need for massive expansion of CLDT #weldns
@dmarsden49
03 December 2019 21:27
@AngieHack10 @WeLDnurses Is that courses? Where are they? #weldns
@HabitualJoshing
03 December 2019 21:28
@NorthwayRuth @WeLDnurses There are good examples in other disciplines (sensory integration in OT) where certain institutions have really monopolised training. I think a particularly savvy HEI could do the same here and offer distance learning or flexible options to a greater number of people #weldns
@dmarsden49
03 December 2019 21:28
@BoranSue @HabitualJoshing @WeLDnurses Agreed! #weldns
@SueMarsden6
03 December 2019 21:28
@AngieHack10 @dmarsden49 @WeLDnurses #weLDNs I’d like to know more about an SPQ.
@LiamFreeman1991
03 December 2019 21:28
RT @WeLDnurses: What would be the final thing you want people to take away from tonights chat? #WeLDNs
@StaceyReesRNLD
03 December 2019 21:29
@AngieHack10 @dmarsden49 @WeLDnurses Really? Would be great to map those courses with the new @nmcnews standards for pre-reg nursing #weldns
@AWolke
03 December 2019 21:29
@CommunityLd @WeLDnurses Agreed, but also a massive expansion of education and support to ensure that there are meaningful activities, daily lives, for people in the community and that they are not just seen as the TC cohort! #weldns we cannot do that alone!
@SueMarsden6
03 December 2019 21:29
#weLDNS what kind of expression is that?! https://twitter.com/weldnurses/status/1201975851744714754
@WeLDnurses
03 December 2019 21:29
Thanks so much for joining us tonight and thanks to @NorthwayRuth and @AngieHack10 for the chat topic. #WeLDNs
@NorthwayRuth
03 December 2019 21:29
@BoranSue @HabitualJoshing @WeLDnurses A good point and one which needs to be taken into account when developing new standards at a post reg level. Should a key post reg focus be the development of leadership and influencing skills and knowledge in a community setting? #WeLDNs
@StaceyReesRNLD
03 December 2019 21:29
@SueMarsden6 @AngieHack10 @dmarsden49 @WeLDnurses Yes me too Sue #weldns
@Shaun_LDNurse
03 December 2019 21:29
@WeLDnurses We’re a long way from consistent, solid and sustainable. The work continues. #WeLDNs




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