Nurse Education in Practice (2005) 5, 6162

Nurse Education in Practice

www.elsevierhealth.com/journals/nepr

GUEST EDITORIAL

Some lessons from learning disability practice

Those of us who work in learning disability services are used to working in partnership with the users of our services. People with learning disabilities are now involved at all levels of policy development in the UK from national government strategy to local implementation groups. The latest Government White paper on learning disability services in England makes such involvement compulsory and ensures the involvement of people with learning disabilities at the highest level through the Valuing People Support Group (DoH, 2001). Partnership boards now manage local services in England and must include people who directly use services as well as managers from Social Services, the NHS and the voluntary sector. Such involvement creates signicant challenges for everyone involved because there are very complex issues, including decisions about large budgets that need to be faced by varied groups that include people with learning disabilities. Challenges include the fact that participants have different speeds at which they understand the spoken word and varying reading abilities. Some people for example cannot read at all, and others read only a few words. One way of managing such meetings is to encourage the use of red cards. These cards are held by all participants and are raised by the individual when they do not understand something that is being said. The speaker must then stop and explain what they are saying so that everyone understands. Red cards are usually raised when jargon or abbreviations are used but sometimes to slow the speaker down a little. This can be very helpful for people with learning disabilities but it is also interesting to see how often non-disabled participants use the cards because they do not understand what is going on. This begs the question about the assumptions made about the understanding of many participants in regular meetings. Agen1471-5953/$ - see front matter 2005 Published by Elsevier Ltd. doi:10.1016/j.nepr.2005.01.002

das and minutes of meetings are written in a format that is accessible, this means that they are in everyday non-technical language and that text is accompanied by illustrations. Involvement of people with learning disabilities is important because without it practitioners are less likely to be able to tailor services to what people want or need. However, it also has a signicant benet for many of the people themselves who have the opportunity to learn and develop in a way that many others take for granted. Policy and implementation meetings seem a mysterious world to people who have not had the chance to be involved. Involvement leads to the development of skills as well as condence and knowledge. This has led to important lessons about the way in which complex issues can be shared among people with very different intellectual skills. These are largely about the process of learning in which people can get to the same point at various speeds, or using different methods of communication. Lessons have been learned about the way in which communication takes place, put simply it is possible to transmit highly complex issues and ideas in a way that makes it possible for everyone to understand. This whole issue relates rmly to the way in which nurse educators work with students. If, as is certainly my view, nursing is fundamentally about communication in all its many forms, then nurses have a particular responsibility to transmit ideas in ways that are easily understandable. Lessons from learning disability services can be instructive for processes within nurse education because whilst the differences may not be quite so extreme, nurse educators are still dealing with very different skills, backgrounds and levels of condence. How, for example, would the introduction of red cards in classes with student nurses help both lecturers and students to make themselves

62 clear, avoid using unnecessary jargon, and simplify complex ideas? How many more students, as well as practitioners and lecturers would better understand curriculum development and quality meetings if attention were paid to the accessibility of agendas and minutes of meetings? However, the question needs to be asked about whether there is an intention to share ideas or whether the opposite is the case. Are nurses in the business of restricting debates, rather than sharing them with as wider an audience as possible? Nurse Education in Practice, together with other nursing journals, has a responsibility to publish papers that are academically sound and rigorous in both argument and method, and also accessible to a wide audience. Simplicity of process should not be confused with avoidance of complex issues (or that awful phrase of dumming down). The approach demands a great deal from people on an intellectual level because great care has to be taken in the way those messages are given as well as received, the message itself remains complex. Nor should it be avoided because of the fear that if lots of people know something then it is not as

Guest editorial important as if only a very few know about it. Such elitism should have no place in nurse education or practice. Language ought to be clear and simple and the simplicity of the language will then help with the complexity of the message. It is hoped that Nurse Education in Practice will continue to ensure that papers are accessible to all, without compromising on the rigour that is essential for the development of nursing practice, education and research.

Reference
DoH, 2001. Valuing People: A New Strategy for Learning Disability for the 21st Century. Department of Health, London. For more information about Valuing People there is an excellent website www.valuingpeople.gov.uk/ index.htm.

Duncan Mitchell Professorial Fellow School of Nursing University of Salford Eccles M30 ONN, UK E-mail address: d.Mitchell9@salford.ac.uk

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