SWAH nurse shares insights into their job

This week we talk to Emer Ferguson, Acute Liaison Nurse Learning Disability, Emergency Department.

Passionate about supporting people with a learning disability, Emer discusses 'laying the foundation' for improved services to meet people's need at the busy hospital.

What motivated you to pursue a career at the SWAH?

I have worked for the Western Trust for 23 years in various different roles as a Registered Nurse Learning Disability (RNLD), ranging from a staff nurse role in the former Stradreagh Hospital to Community Nurse Learning Disability (CNLD) in both Omagh and Fermanagh.

I had taken up a CNLD post in 2005, and remained in post until this new role of acute liaison nurse learning disability became available in the SWAH in 2020.

At that time, we were navigating the changing face of community nursing in the midst of the pandemic, and I felt that I had the knowledge, skills and expertise of the needs of learning disability population to introduce this role to the SWAH.

Could you share a significant challenge you've faced in your role and how you overcame it to provide quality healthcare services?

The greatest challenge this role brought was that this a new service not only to the Western Trust, but to Northern Ireland, so trying to embed this service where none had been before was a challenge in itself.

The focus of the role was on the provision of additional support before, during and at the point of discharge for people with learning disabilities and their family, education and support for health professionals in acute care.

I was in a good position as this service had already been established in Altnagelvin Hospital, Londonderry, and I was able to draw on the experience of my colleague, Clionagh McElhinney.

I have identified many areas where my skills and experience have been challenged through this role and would say that it is a constant learning curve.

These challenges have been overcome by being present in my role and introducing resources and support where there was none previously.

The multi-disciplinary team within the SWAH have also been a great resource for me to learn from them in a supportive environment.

This role comprises four key elements: clinical patient care; education and practice development; strategic organisational development, and a bridge between acute and community services.

This role is a work in progress, and I am always happy to receive feedback regarding this service to continue to improve.

How do you believe your role contributes to the well-being and recovery of patients within our community?

People with learning disabilities often face barriers to accessing services; these can be due to a lack of reasonable adjustments, lack of knowledge of learning disabilities from staff, a lack of resources, and health inequalities.

Part of this role is to work to identify these barriers and to work with acute care staff to address these and improve access to services.

This role is constantly evolving, and it is hoped that having the continuity of care for adults with learning disability that enhances their acute care journey to ensure they receive positive outcomes. The role also contributes to safe onward care planning and liaising with community professionals to ensure safe discharge.

This role serves as a link between multi-disciplinary teams across community and acute care.

This collaboration between teams helps to support people with learning disabilities, their families and carers on discharge, with more comprehensive planning.

It is hoped that this planning will help to reduce risk of re-admission, ensuring that each person’s needs are being met in the most appropriate ,way and that community care providers have the most recent information based on assessed need.

Can you highlight a particular patient interaction or medical achievement that you are particularly proud of, and why?

I am proud of all the interactions that have enabled a person with a learning disability to have a more positive experience whilst attending the SWAH.

One of the most notable achievements, to date, has been the opening of the learning disability sensory room in the Emergency Department.

This was a collaborative piece of work with the Emergency Department and Adult Learning Disability team, and is proving to be a great resource at the hospital.

How do you ensure the delivery of compassionate and effective care in your specific healthcare discipline?

Learning disability nursing has its roots in person-centred care – which means that the person is at the centre of their journey, and it is our job to empower and support a person on their journey through acute care, however that presents.

For people with learning disabilities, accessing care can be difficult for many reasons, and it is in this role that we can demonstrate compassionate support.

This is where person-centred care becomes most critical as this is more than just a one-size-fits-all approach, and becomes particularly required in settings where individuals face heightened stress.

This role also has a remit for educating – we offer Learning Disability awareness training sessions to all acute care staff, sharing our expert knowledge and helping teams to identify where they can improve their service for people with learning disabilities.

What aspect of your work do you find most rewarding, and how does it resonate with your personal values and mission?

My favourite part of this role and all the roles I have had, has always been the patient interaction.

I love working with people with learning disabilities and celebrating their wins, helping to empower them and learning from them.

As a learning disability nurse, this is the essence of my role and my motivation to continue to change the landscape of care provision.

I truly believe, regardless of who we are and the role we play in society, that we all should be valued the same.

Part of my conviction in my role is to enable and to empower people who may require it, to receive the same access and positive outcomes to care as those of us who are able to advocate for ourselves.

How do you manage the demands of your job, and what strategies do you employ to ensure exceptional healthcare service delivery?

I have the support of a lovely learning disability nursing team behind me who are always there to be my cheerleaders, and a shoulder to cry on – when required!

It has been a pleasant discovery that the teams in the SWAH also have been so supportive and receptive to my role, and they have a willingness to work together to achieve better outcomes.

I use a number of strategies to ensure exceptional healthcare service delivery.

First and foremost, patient and carer feedback is vital to shaping the continued development of the service, as too is staff feedback.

Feedback can be used to review and reassess practice and aid in the development of our goal to ensure we keep delivering to the highest standard.

Personally, I use reflection on my practice to keep myself focused on the tasks in hand and ensure I have full awareness of what is working well, and if there are areas for further development or special focus.

Have there been any mentors or colleagues who have significantly influenced your practice, and in what way?

My colleague and friend Glenda Frazer – we have worked together since 2007 – Glenda is so passionate about people with learning disabilities and learning disability nursing, and always strives to inspire those who work alongside her to meet their potential.

At the time of applying for this job, Glenda was my line manager, and supported me to see how I could make a difference in this role.

What are your aspirations for the future, and how do you envision the evolution of your role within the SWAH?

This is such a new role within Northern Ireland and it is still very much in a ‘laying the foundations’ phase.

Myself and my colleague, Sinead, in Altnagelvin Hospital, will continue to work together to raise awareness of the unique needs of the learning disability population when accessing acute services.

How do you believe your efforts contribute to the overall excellence and advancement of healthcare services in our local community?

I have completed two years in post and have achieved lots through the introduction of this service to the SWAH.

I have seen the benefits to people with learning disability accessing services, to staff here in the SWAH providing care, and also the benefits for multi-disciplinary team work in the onward planning for discharge back to community.

I hope that we, as an Acute Liaison Nurse Learning Disability service, can continue to deliver and improve access to, delivery of and satisfaction with acute care.