Learning disability nurse: is the title fit for purpose?
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Learning disability nurse: is the title fit for purpose?

Jonathan Beebee RCN professional lead, Learning disabilities and neuroscience nursing

Jonathan Beebee asks whether the profession needs a more contemporary title to reflect changes in practice

The formal title ‘registered nurse in learning disabilities’ has been in use since the 1990s. Over the century that we have been practising, our title has changed every 30 years or so and reflected the values and practices of the time. This has sometimes meant the use of language in our titles that would now be considered culturally unacceptable, including being labelled as ‘mental deficiency’, ‘mental subnormality’ and ‘mental handicap’ nurses.

Learning Disability Practice. 27, 1, 16-17. doi: 10.7748/ldp.27.1.16.s7

Published: 08 February 2024

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Picture credit: iStock

Despite the improvement with our current title, it can sometimes produce barriers. An autistic person who does not have learning disabilities may not want to see a learning disability nurse, for example.

Also, since the term learning disabilities was first used there has been confusion among the public on what it actually means. It is often confused with ‘learning difficulties’ and primarily understood as a challenge with educational attainment.

Some would argue that the term ‘learning disability’ is now dated because it reflects a societal value placed on academic achievement, which is a social construct and explains little about a person.

Meanwhile there has been a growing acceptance and interest in the concept of neurodiversity, which does not need ‘treatment’ or ‘intervention’. However, some people’s lives may be so affected by their neurodiversity, or how society responds to it, that they may require help and support from healthcare professionals, including learning disability nurses. In some instances these services are referred to as neurodisability services.

In view of this, perhaps ‘registered nurse in neurodisability’ would be a more contemporary term for our profession to consider using.

‘Registered nurse in neurodisability’ appears to fit with contemporary practice. The term is aligned with the growing awareness and acceptance of neurodiversity and neurodivergence. The use of disability in this title reflects the fact that not everyone with neurodivergence needs support, health services need to be finite, and our skills are needed by those whose neurodivergence – or society’s response to it – has a disabling effect on their lives.

A learning disability is a neurodisability. Yet the term also serves to broaden our offer to people who experience autism, stroke, dementia, cerebral palsy, epilepsies, motor neurone disease or attention deficit hyperactivity disorder. These are all roles in which learning disability nurses currently work.

Conceptualising neurodisability

Could someone who is considering the study of nursing conceptualise a neurodisability nurse role compared with a learning disability nurse? Would acute hospital services be less likely to question the nursing skills of a neurodisability nurse, given that learning disability nurses are often perceived as less capable than other registered nurses?

Some learning disability nurses in acute hospital settings have had to prove their worth and ability to undertake the role.

We often hear about learning disability nurses being denied interviews due to misconceptions about our ability to administer medications or carry out other nursing interventions.

Learning disability nurses work with individuals with differing and complex needs in settings such as prisons, dementia services, stroke services, epilepsy services, acquired brain injury services, children’s services, mental health services and primary and secondary care.

Addressing needs

There remains a huge need for learning disability nurses to enable primary and secondary care services to effectively meet the needs of people with learning disabilities, and to provide specialist learning disability nursing interventions in addressing health and social care needs.

Yet learning disability nurses also work in other settings where they are not solely supporting people with learning disabilities.

Also of concern is that the number of learning disability nurses has been declining for some time. In 2016, the RCN reported a 40% decline since 2009 in the number of learning disability nurses employed by the NHS in England.

Similarly, there has been a reduction in the number of learning disability nursing students, leading to some universities closing their courses for this field of nursing.

Would a change in our professional title support the attraction to and retention of nurses in our field of nursing? Could it strengthen our position in the wider nursing family?

Or would a change of title pose any risks to people with learning disabilities, who are known to have more complex needs and higher morbidity, such as by potentially ‘losing their voice’ to other people with neurodisabilities who are more able to advocate for themselves?

I do not necessarily have the answers to these questions, but I do think it is about time we started the debate.

For full article go to rcni.com/ to be published on 2 Feb

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