A Profile of Learning Disability Nurses

Author(s): Owen Barr and Kader Parahoo
Document Type: Article
Year: 1994
Title of Publication: Nursing Standard
Publisher: RCN Publishing Company
Volume: 8: 42
Pages: 35-39
Subject Area(s): Health services, Social Care, Disability
Client Group(s) : Disabled, Employees

Abbreviations: NI - Northern Ireland, CNMH - Community Nursing Mental Handicap, UK - United Kingdom, RNMH - Registered Nurse Mental Handicap

Background to the Research

  • Community nursing services for people with learning disabilities in NI developed slowly beginning in the 1970s. In the early 1990s, with the general move from hospital provision to community nursing in the UK, the growth of these services accelerated. At this time the nature of the service changed to a more specialist service based on individual needs. These rapid developments altered the structure and organisation of service and changed the role of the professionals involved. This in turn had implications for service providers and users.
  • This research examined the structure and process of the CNMH service in NI. The aim of the research was to provide a profile of the nurses within the service and a description of their practices. This data generated an overview of the direction in which the service was moving and contributed to the debate on the role of the CNMH staff.
  • This paper reports only the data on the profiles of CNMHs and the similarities and differences between the four health and social services boards.

Research Approach

  • Data were collected through a postal questionnaire distributed to all 50 CNMH staff in NI in 1992. A total of 36 questionnaires were returned (response rate 70%).

Main Findings

  • Almost 95% of the respondents were under the age of 50 years.
  • Almost two thirds of CNMHs had less then five years experience as a CNMH and 36% had less than three years.
  • 80% or respondents had grade G posts and this varied from 43% in Board A to 100% in Board C.
  • There were no CNMH staff at grades D or F. Grade H posts were noted in Boards A and B - these nurses worked as team leaders of community nursing teams. Grade E posts were noted in Boards A and D.
  • All respondents possessed the RNMH qualification and two thirds had a post-basic qualification in relation to community nursing.
  • Almost a quarter were Registered General Nurses and 11% held a teacher practitioner certificate.
  • Few had a specialist qualification. One CNMH had a certificate in health education, two had completed further study in family therapy and one in the care of the violent and potentially violent, and one held a qualification in behaviour therapy.
  • There was no significant variation in qualifications across Boards or according to gender.
  • The average size of their caseload was 43 with marked variations between Boards.
  • Frequency of visits needs to be taken into account in an analysis of caseload. Monthly visits were the most common in all four Boards. 90% of clients in Board B and 85% of clients in Board C were visited at least once every three months, while the figures for Boards A and D were 52% and 51% respectively.
  • Authors commented that as services continue to develop the body of experience and knowledge will be further enhanced. They anticipated that it would be worth monitoring whether the changing grade mix of CNMH services has any impact on the recruitment and retention of younger staff.
  • This study reported a male to female ratio of almost 1:3 in CNMH services. This indicated an increase in the number of male CNMH staff in NI since the DHSS Study in 1986 which showed that all CNMH staff were female.
  • The data on caseloads suggested that staff in NI had considerably higher caseloads than their colleagues in the rest of the UK (average caseload of 42.7 people in NI compared to 24.1 in the rest of UK). The recommended figure for a manageable caseload was 30 in 1985.
  • The authors pointed out the need for specialisation in the role of the RNMH and the importance of clinical specialisation. Although more than half the respondents had multiple qualifications there was a near absence of clinical specialist training.
  • They suggest that the lack of specialist courses, limited funding, and poor career advice may explain why well-qualified CNMH staff had little specialist training.
  • The authors recommend that a structure be put in place which would provide a range of educational opportunities to maintain and improve specialist knowledge and competencies.

 

Home | About ORB | Contact


Disclaimer: © ORB 2001Friday, 03-Dec-2004 11:05