An Insight into Learning Disability Nursing



This is an upcoming in-conversation session focusing on learning disability nursing, hosted by cardiovascular nurse, Michaela Nuttall, and with guest Chloe, a third year learning disability nursing student. Michaela will facilitate a lively and engaging dialogue with Chloe, covering topics ranging from the passion for LD nursing, the nomination for Student Nurse of the Year, and the need for proper resources for making reasonable adjustments when caring for people with learning disabilities. This session will serve as a great opportunity for medical professionals to learn more about LD nursing and to seek advice from an experienced nurse.
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LWN founder Michaela is joined by guest speaker Chloe Hawkins for this 'In Conversation' webinar to discuss Learning Disability Nursing.

(Apologies for the sound quality due to poor reception, however we feel that the webinar includes some great information to be shared)

About Chloe:

“Hello my name is Chloe, I am a final year Learning Disability Nursing student from the North East. Prior to starting my nurse training, I was a team manager for a supported living service for adults with learning disabilities, and prior to that, I started my career as a support worker for people with learning disabilities. I have had experience in many specialist areas and have had the privilege of working with people of all ages, from newborns to end-of-life care. Since starting my nurse training I have been a Nurse Ambassador for the ‘NextGenNurse’ project and chaired the Future LD nurses group, I have also been fortunate enough to be one of the student editors for the Nursing Times (2021-2022) and have been shortlisted for ‘student nurse of the year, learning disabilities in the student nursing times awards 2023. I have undertaken a range of extra CPD courses and training to enhance my knowledge and patient care.”

Learning objectives

Learning Objectives: 1. Describe the concept of reasonable adjustments and their purpose in nursing. 2. Recognise different types of reasonable adjustments to ensure equitable health care for individuals with learning disabilities. 3. Explain the importance of learning disability awareness in nursing education. 4. Identify the relevant resources and training available to help nurses develop a better understanding of learning disabilities and end of life care. 5. Engage in an open discussion to share real-life experiences and to help build empathy towards individuals with learning disabilities.
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Computer generated transcript

The following transcript was generated automatically from the content and has not been checked or corrected manually.

So welcome everybody to another of our learners nurses sessions. And this one is one of our in conversation ones. Now, for anybody that's new on that, I've not done an in conversation one before. This is where we just have an informal chat with someone that we think is really interesting and about a topic that we think is really interesting. So there's no slides. You just kick off your shoes or unless you're still at work and you can't kick off your shoes. Sometimes we know people listening rather than watch. So this is a time to, to just learn a little bit more about Chloe what Chloe does and learning disability, nursing. So before we start the usual, the usual bits, um my name's Michaela Nut. All. I'm a cardiovascular nurse and I am the founder at LA with nurses and I'm just gonna put it right out there. We've just heard today Chloe, I didn't tell you, we've just learn that we've been shortlisted for an award. So we know we've been shortlisted and um yes, so one of the nursing awards. So it's just out there now, which is fantastic. Um So for everybody here at the end of our session, there's the opportunity to do the evaluations you're already on medal. Now, you go through the system. I click the button at the end of our session that gives you straight into doing your evaluation. Of course, you get your certificate and there's that space on medal where you can do your own er, reflection. So Chloe, can I ask you to? So, so Chloe, I've known for quite a while now. Um, and I'm gonna tell you a bit, we're gonna unpack Chloe as we go on. But Chloe, can I tell you, ask you to say a little bit more about er, on where you're from? Hi, everyone. So my name is Chloe. I'm currently a third year learning disability nursing student and I'm studying no North University. Um, I do have a little bit of a tech delay at the moment. There's a bit of delay between me and Michaela. So if I look a bit blank, that's why we've said we'll be fine. Oh, Adrianne is here. I can see and actually Zoe's just said she can hear you as well. Chloe. So it's really good. It's really good. Fantastic. Fantastic. Now your name is that, is that, is it like all your mates that are in there? Is that what it is? Which is really, really good. So everyone from UNI, oh, so, so you guys who we all know Chloe then is, is, is know that she is an amazing young nurse and, um, and hi, hides her under a bus a lot. So I'm gonna try and tease out from her some of the things that we are gonna go through tonight and some of the things we know, but I'm gonna start off the conversation by Cody. Why? Tell me why, why, why LD? Nursing? Why, why LD nursing? It's a big question. Um, so I started my sort of career in learning disabilities, working as a support worker for adults with learning disabilities. And prior to that, um, obviously I'd done my sort of a levels and health and social care and I worked in a day service for adults with learning disabilities and I loved it. So, um as soon as I started working, I worked as a support worker and then from that, I managed a support living service and that's when I started to work with, um some of the community nurses who really sort of pushed me to, you know, turn what I was doing as a team manager into of nursing and really shaped my career. Um But honestly, it's just the best job, the best career ever. Um And I know we're all bias, there's not many of us there. I think what we lack for you, you guys certainly do. And I've been fortunate to, to know, as I said, Chloe for quite some time now because Chloe for those of you that don't know and for people that are watching because Chloe, this goes out available to any nurse to wall anybody to watch now. So, um and, and for me, it's not just about nurses who are learning disability nurses. It's about all nurses knowing a bit more about LD as well is where and I know that's a big passion of yours, but I was fortunate enough to help set up in the back office function way the future LD Nurses, which you are, we would have you, you helped drag that along with an absolute founding chair and still still pushing it through and, and through that engagement, I have to say I the passion for nurses in LD is overwhelming often, you know, we get a bit sort of and I'm a, I'm not an EL D nurse, I'm a cardiovascular nurse and we get a bit cynical and tired and old, but I never seem to get that from EL D nurses. I would say the the passion still comes through. So can you give us um about, about um well, I wanna say um tell me about your shortlisted because I know that's very exciting. Tell me about your latest, your your latest thing. Your No. So I was very fortunate to be nominated by my lectures at university um for Student Nurse of the year in their Student Nursing Times Awards and obviously in the category of learning disability, nursing. Um So I went for my interview at the start of the month and I'm a shortlist, so I'm on the finals. Um, so I don't find out until the end of the month, but, I mean, it's a fantastic achievement even to be sort of nominated and recognized. But, you know, being a fine list, you know, I'm so proud and especially to represent the Northeast as well, you know, and the university, you know, the amazing work that the partnerships that we have in the northeast are great. Absolutely. We're all in the, we're all in the Chloe Camp Carol's and Zoe's here. Zoe's one of our, one of the support team here. She does amazing stuff with us and she's pretty, yeah. Oh, it's a day of celebrations, isn't it? But I'm gonna make it more, a little bit more serious, a little bit more serious now. So, um, and I want you to think about, um, um, so for a lot of us who are generalist nurses, that's why I was a generalist nurse. We, we got absolutely nothing in my training and continue to have nothing for, um, people with learning disabilities and what I'd love to know two things. One, what is your thoughts on that? And two, how do you think, how do you think we can help rectify whatever your thoughts are? Um, I think it's really important, um, that on the curriculum there is learning disability awareness and particularly sort of set sessions along making reasonable adjustments to access equitable health care that would be echoed by a lot of learning disability, nurses and mental health nurses as well. Um, from conversations I've had with people who are currently studying adult nursing, they feel the same as they would like more. Um, I know that obviously the curriculum changes were all guided by the N MC. But, you know, within that there is real scope to make sure that that education's done. Um, obviously specializing in learning disabilities, that's the main focus of our curriculum. Um, but, you know, I think in terms of sort of future education, um, I know that, you know, work gets done and, you know, the amazing work that gets done across higher education across the country. But, you know, there's still that massive push to then reach people who are in practice as well, not just the nurses coming through. And I think that's where a lot of, you know, the things like the mcgowan training, mandatory training for learning disabilities and autism. We must because I think they, people with learning disabilities need to access to and, and if we have that awareness then is going to support them as well. Yeah, absolutely. So, so for somebody like me who, um, and a lot of nurses like me, um, that don't get, um, that, you know, that, that, that our training was so, so long ago, I have to say so long ago. Um, where can I go to do, you know, anywhere I can go to is there where do I go? So there's loads of fantastic resources online that you can access for free and the national Learning Disability nurse website, um which is set up by people across the country and like consultant nurses and head of learn disability nursing. And you know that that's a really fantastic resource. It has all everything that you need in one place and obviously the nice guidance I know sometimes it can be a bit lengthy to tra through. Um But you know, it's there for a reason and even each hospital trust should have our own policies are a fantastic resource to tap into. There's not many of them, but you know, the work that they do is fantastic. Um But as well, like I say, online training, um and speaking with learning disability nurses, um you know, I think for all we sometimes sit and feel like we preach to people, you know, it's providing that education that people might not otherwise have. You know, and people with learning disabilities often, sadly, have lower life expectancies and have avoidable deaths given that education means that we can reduce that. Yeah, absolutely. So I didn't tell you sorry when people are listening to this afterwards, they can't see the chat. So we almost have to read the question out. Sorry. All right. So yes. So Lee Baker said I teach health care assistants, apprentices. Would those resources be be appropriate for them too? Yeah, absolutely. Um, any sort of resources and training that's going to give people that confidence and that knowledge to make sure that reasonable adjustments are made, to make sure that they've got learning disability awareness. It's really beneficial. But like I said, these websites are really useful. Um, absolutely as well. So that's brilliant. Um, oh, and we've got another one coming. So, are there any resources that discuss end of life care? Yes. Sorry. There's a bit of a delay in terms of end of life called the Palliative Care Network for people with learning disabilities. And you can find them online on Twitter and they have some great resources. Um And it just means that it gives people that support and guidance to maybe have those difficult conversations in a way that's appropriate, you know, like you or I, you might not be the type of person that wants to discuss death or dying, but it's then giving you those resources and that sort of confidence to do that. I think that's a great question from Z actually. Do everybody keep the questions coming in because this is this will, this is a new conversation and your questions will help us. We, that Zoe's already said she's going to look up. Um So you've mentioned reasonable adjustments a couple of times now. Um And I, and, and I suspect for some people, you know, exactly what reasonable adjustments is, are and how it should happen and what it is. But imagine you're talking to a load of nurses that have never, um, or maybe not used to thinking about reasonable adjustments or don't quite understand or know what they are. Can you spend a bit of time just unpacking and exploring reasonable adjustments for us? Um, so reasonable adjustments are something that any health care professional can make. To be totally honest. Sometimes people make reasonable adjustments without even realizing it. We just give it a fancy name so that could be given people longer appointments and side rooms um pre visits and because disabilities are protected under the Equality Act, that means that reasonable adjustments are too. So health care professionals and foundation trust should be making reasonable adjustments in line with law. And I know that sounds a bit scary and it, you know, but it's people's rights and to make sure that they have equitable health care, small changes that we can make, make a massive difference to the health and well being of our patients. So creative um scenes and car parks, you know, appointments that have taking the span of a week because the person has had to come do some desensitization work, particularly around blood testing. Um You know, there's a lot of work that goes into that particularly for people who have phobias and in making those reasonable adjustments, like longer appointments, letting them come into the practice early, really help and again, like access to um easy read material we're making sure that that person gets the best health care that they can. Um, like I say, a lot of the time people make adjustments without even realizing what they're doing, but just making sure that actually if somebody comes in and they have a hospital passport, um, some of you might be familiar with hospital passport, but they usually an, a four little booklet highlights what the person's needs are. Um, any sort of current medication or sort of like social history and any reasonable adjustments that they might need. Um So I've worked with people who have maybe needed extra staff on a particular day, um or their carers to come into hospital with them and just making sure that there's accommodations for that and there's enough room, you know, so you're not crammed in a tiny side room somewhere and even the lights making sure that it's not too bright for someone. I know you can't always facilitate that in terms of bigger areas, but if it's something that can be done and something that can be adjusted. Um iii I love the passport, I have to say the hospital passport. So um I used that before now with my daughter who and, and this is good. So she doesn't have a learning disability, but she has a physical health disability that can't be seen. And often some of the issues she has is over stimuli over, you know, it's, it's something called postural tachycardia syndrome and the wrong lights, the wrong smells, the wrong she, her brain becomes overloaded and she can't talk properly. You know, she becomes really brain foggy and I found AAA lot of time in, in some places they just don't understand that physical side. So I use the hospital, you know, I use the passport to say you've got to make this is this is your reasonable adjustments for that disability there. So, and it, and actually people go, I get that, I, because they understand the hospital, if anybody hasn't used the passport yet, I would absolutely recommend it goes there. Now, Alicia main cap is a fantastic resource for resources and guidance as well. So I'm gonna go back now to career part if that's right on on how does somebody become a learning disability nurse? Because until I got really involved in it, I didn't, I didn't know a lot about it. So, so tell me the different routes. Oh, so um so my route, obviously I've been through university, applied through UAs. Um and I've done the three year undergraduate program that typically is probably the most popular. Um but I could be wrong ship. And so the hospital trust that that individual works for would support them to go through their training and that's quite popular in the northeast at the moment. Um And it means that that person would then have that, you know, they would work and train at the same time and we also offer, um, in the northeast we have like the master's programs. So for people who have already had a degree, um, with the right level of experience, um, would be able to do a two year program. Um, and I know further and it was online, I think I seen it on Twitter and in Devon they were doing, um, a really sort of fantastic initiative to get, um, learn disability nurses and I would have to double check sort of the ins and outs. But again, that sounded like an apprentice program. And so like I said, there's lots of routes, but I think the most popular tends to be the undergrad program. And I think as well, a lot of people don't realize that you can be, um, you can be a learning disability nurse. So even because that's when you're into it. So what would you recommend people do? Thinking about young people, schools? What I, what I noticed when I, when I, when I spoke to all, all the elder nurses, I know is that actually you've all been, you've all been exposed to LD in your world, whether that's a family member, a workplace, you know, it, it's there. Um, yeah, so, and there's a lot of people I think who could also become elder nurses that have not necessarily been exposed to it in the same way. But would they have the same passion? I don't know. But what would you to say about people who have never thought about elder nursing as a career. I think it's something that, um, is really a rewarding career path. I mean, obviously all field of nursing, all, obviously I'm biased. Um, but, you know, I think I've done a lot of work with the nextgen nurse project and spoke to a lot of 14 to 16 year old around career options. Some of them have never even heard of learning disability nurses. I'm sure that actually people know what we do and know that this is a career path and you know, there's so many jobs that you can go into as a learning disability nurse. Um that it just really opens up doors and I think in terms of looking at it as a career research, it try and, you know, people could organize sort of shadow placement days or work experience because I think it's such, I think once you're in the job, you realize how lovely it is. And I think if you've never had those experiences, it really gives people the chance to see if they like it and try it. And I know that um I think it's on youtube Health Education, England and NHS England have a fantastic um video about learning disability nursing. And it showcases some of the roles and it's only about a two minute clip, but it's a lovely video of people wanted to sort of have a look at that after and be preached. It's something that's really good to just give people that flavor of actually what learning disability nurses do because it's so diverse. And what about, so, could it be say, um, you've got nurses who have trained as traditional tradition? I'm like a really old fashioned traditional nurse and I did the old three year course and I came out with not even a diploma at the end of mine. You know. So, um, but if you've got a, you've got an adult nurse or a child's nurse and they wanted to go into el D nursing, is, is that an option? Can they sort of move, add it on? Is there a, one of them starting at the beginning of year three again? Would that, um, can that be done? Yeah. Um, I'm not too sure about how it works in terms of sort of transferring your skill set and, um, I know that, um, people are certainly transferred between fields in their degree. Um, and I know that some people obviously do, do the master's programs to sort of top up. Um, so, you know, as long as there's sort of that passion and that sort of the skill set, um, you know, then I think it would be something that people can sort of look into depending on the trust and the location as well. So I'm not 100% sure on of that. Ok. That was just a thought and, and do so. So, you said, depending on the trust. So it's also, there's not all, it's not available everywhere at LD to become an LD nurse. Is that the bit? So there are some, some universities that might provide adult nursing, regular nursing as it were, but they may not do LD nursing. Is that right? Yeah. Yeah. So there are some universities that don't offer learning disability nursing courses and obviously in the northeast we're quite lucky. Um, but I know there are other areas that, that don't offer it and sometimes it is because of sort of uptake. And again, if people don't know that it's a career option, they might think. Oh, I'd love to do that but it might not be available near them. Um, but again, yeah, in terms of hospital trust as well, you know, in a main stream sort of acute hospital, there might not be many. Um, obviously there's always learn disability liaison, post or community nurse and post, but it just depends on the trust and, you know, and again, if you worked in the community you could sort of dip into, you know, supporting each patient. Yeah, in different localities. So I, so I'm, I'm, I'm hearing there's, there's a potentially lots of different routes but it's not the same all over because of what's available and what isn't available and actually the more people demand it, the more the supply will go up. So there is something out there, isn't it about and we always need more nurses, whatever type of nurses we are, we always need more. But I want to, I want to bring it back now to you if that's all right. Clary for a bit. And, and if we've got, so let's imagine we've got other student nurses that might be listening. I know we've got some with us now. But let's imagine there's ones that are going to listen to this, um, on a, on a catch up on demand or, um, we might turn this into a podcast, who knows. Um, I know that you're involved with us, some of the bits and Bobs as well. And I, I want you, I wouldn't mind if you could share particularly some of your shared decision making stuff, some of those bits where, um, on, on what you, what, what you've been doing. But also, um, I was thinking as well often as nurses, we're not very good at putting ourselves forwards. We're not very good at saying actually I'm really quite good at this or I might try this or I feel, you know, it's all that imposters inro that often comes through. So almost, I'd like you to also think about what sort of advice would you give to other nurses or whether qualified or student nurses, um, to just go for things and give it a go. Is that all right? So I'm gonna, if you don't pick all of that, this will be a mouthful. Um So I'm a member of the NHS England um Learning Disability Shared Professional Decision Making Council. Now don't make me say that again. Um So it's, it's a group and set up um n and other professionals across the country, the group was set up was to really support of the provision of learning disability services and to sort of push for learning disability awareness. Um So, in terms of, you know, reaching the younger generations to think about learning disability nursing as a career option, recruitment and retention, informing policy and practice. And I think as a student member, being able to see those sort of inner workings really important and placement at the moment, I'm working in the very area you're discussing and this is the experiences that people are having at the moment. So it's really good in terms of, you know, you've got your ear to the ground, you can see what's going on, but you can also inform um you know, other clinicians and the council members of what's going on. Um So as part of that as well, um I also am a member of the chief nursing officers, um student nurse and student midwife, shared decision making council um to represent learning disability, nursing students want um the way that students are supported nationally and from that, um obviously, there's some really great messages sort of cascaded down from what's been going on. Um But as well in terms of student provision. Um So through this, I've also um I'm supporting the development of a student specific area on the learning disability nurse website. Um which means that students will have somewhere to go with all their resources, all of the things that they might find interesting or useful, but not just for learning disability, nursing students, for all nursing students because we want it to be an area that students can access if they don't know and it's ok if they don't know. Um It gives them that chance to educate themselves and get that extra knowledge. Um So from that, obviously, there's a lot of work going on and sort of behind the scenes and stuff like that, so very busy and, and um I think in terms of, I am the world's worst person for saying what I do. Um And I think now obviously I'm coming to the end of my degree and I think I've got to the point now where you start saying things and then go, oh, I do know what I'm talking about and I think it's, you know, sometimes it can be difficult but just to try and have that confidence in yourself and your abilities. Um you know, and actually be it your field of um you know, expert in that area, you know, your program length. Um you know, you work with people day in day out and you've got that most up to date sort of rich knowledge and So, you know, I'm definitely, you know, just pat yourselves on the back a little bit more as well and, you know, and just celebrate what people do because I think, like you said, we'll very much just get on with it and don't tell people. But I'm very lucky that I've got a lot of people who say these things for me. Exactly. But that's, and that's the thing is, it is really hard to put yourself out there. And, um, and to say, actually this is good and, and, and I wonder if it's even so, um, I wanna say, I, I, I'm gonna say, is it even harder if you're, because how does it, ok, I'm gonna come at this now from a, and you don't even know that, you know, we, we sort of said how we might shape this conversation. But if I think back to my nurse training, which was a long time ago, there was just, we just did our general, that was it general nurse training. Now, I think, you know, it's split and so we, we have adults and Children and, and, and LD. Um, and, and I'm guessing that you've got a huge class or, you know, there's a huge cohort and your LD group will be quite small in amongst all of that. And is there almost a, and you can, oh, my gosh, I'm gonna ask you questions and you might wanna, is there almost like this an assumed hierarchy type thing or does that not happen? You know, because I know, you know, difference between specialist nurses, non special nurses care, primary care, all of that is it? Yeah. And so there was a bit of a delay. So I think I've caught all of your questions. There's not a hierarchy as such but we are a very small cohort and there is a very, there's not a divide because obviously we all work together. But I think what we like, I, like I said before, what we lack for in numbers, we're like the ones that are sort of speaking up and going well if they had a learning disability and uh you can. Um but like I say, I'm assuming it's the same across the board. Um but yeah, compared to sort of some of like the adult nursing cohort who have hundreds and our cohort is very small in comparison. And I'm sorry to put in terms of national in terms of sort of registered nurses, I think. No, that's fine. Um You know, any questions that anybody's got as well, just pop them in the chart. I don't mind. Um you know, in terms of, of adult list. And I think off the top of my head on the N MC register, there's something like over 500,000 and there's only 16.5 1000 learning disability nurses. And when you look at sort of in terms of like a population and people with learning disabilities make up roughly about 1% of the population. I'm not going to try and work it out because my maths is terrible. But there's a massive divide and in terms of nurses to people that need us. Yeah. So I'm, I'm gonna invite people now if they haven't already wanted to thought about it. Pop some questions in but I wanna just pull it back in our last couple of minutes. Um is to think about. So I'm a, I'm a um so we've got one coming before I ask. So wants to know, are there pediatric LD nurses? Yes. Um So again, I, I probably should have mentioned this before. We are such a privileged privileged field of nurse because of ages. So we work with Children end of life care and so we can go into children's services, we can go into adult services and I've recently just done a short placement in maternity. So, newborns, you know, um we have a really diverse skill set and that's not to say that we're better than anybody else. But, you know, we have that train and we have those sort of clinical placement experiences that allow us to work into a sort of specific field in terms of, of, of adults. Wow. And so so um so what I was going to add in then is around the physical health side. So, you know, my, my biggie is heart attacks and angina and all of that sort of stuff. Um, so, um, how does that, so how does the physical health side weave into the LD nursing side or do you, and this is going to sound really like, do you, do you get, do you do LD nurses check blood pressures as well? Do we advise on stopping smoking? Is that something? Yeah, absolutely. Um, so it depends on each person's role, um, you know, as with any nurse, but the sort of new N MC future nurse standards means that all fields of nursing have to complete the same amount of deficiencies and set skills by the point of registration. So that includes all of your physical health stuff. And there may be areas that we don't particularly do so much of um you know, so things may be met by simulation or going into spoke placements in different areas. Um But we certainly do a lot of physical health monitoring and we do a lot of sort of medication reviews in terms of people who may be on um antipsychotic medication. So there's a, a big push and you might have heard of it, it's called the Stop Stop and over medication of people with a learning disability and, or autism. So it's called ST and for pediatrics as well and it just promotes that actually does this person need to be on this medication? We need to reduce the amount of um psychotropic medication that people are on. Um because unfortunately in the past that has been, um, sort of an issue. So we do a lot of, um, things particularly around medication. Um, but it honestly, it depends on the area that the person works in. Um, I worked with one nurse who was going through extra, like top up training to be able to do bloods so that they could have a calm, relaxed clinic that takes the burden off, um, you know, increasing demand in sort of GP practices as well. Because if I think of our phlebotomy services where I am, you get your appointment and you literally, you're in your card, he's off your arm, you're done and you're out and you're sorted and the next one in and then I was thinking, how do they slide in? You know, let's give you half an hour. Let's iii I it needs to happen. But how does that fit in? You know, it's such a, I'm loving the thought of that extra skill set. Um Before I go on to Adrian's point, I was gonna ask about um and this is why I'm joining the dots now on different people that we've done these different sessions on um how is pill swallowing for people with LD, you know, with the swallowing medication? Is that, is that challenging? Because it's challenging in people without LD? Anyway? So is it challenging? Yeah. So there's a higher percentage of people with learning disabilities who may have additional swallowing problems who may have dysphasia. So a difficulty with their swallow. So a lot of people that we work with, obviously dependent on the individual may use liquid medication or they may have patches and obviously we don't want anybody to choke. So it's all on a case by case basis. Um But again, it would just be making those adjustments. We know that sometimes liquid medication may be more expensive than say a tablet. But if you could get it, you know, there's a cost for everything. But if that person can't physically swallow a tablet, they can't swallow a tablet. And it's about, I think a lot of nurses, you know, we are very much, you know, we're all patient advocates and it having that ability to be firm and say, actually this is what they need. Um So it is something that, you know, we, we encounter quite a lot. So, and the reason why I ask, is it not long ago we did a session on pill swallowing with the amazing Alice and um who I met last year at a conference who was doing pill swallowing because actually a lot of people have a problem pill swallowing. Um even with these, you know, with, with issues with dysphasia or not, there's still, you know, worries about it when I choke all of that. And she runs a fantastic, very simple pill swallowing program. So maybe if anybody want to watch that, we've got it on I think it's on demand our, our pill swallowing one. And also it's, it's really honestly, I, I remember when she did it, it was incredible. It's changed even the way I swallow pills now. Um And it's so, you know, it, it's a wonderful session. So I would definitely recommend and I'm putting people together now, definitely recommend. We think about that. You think about looking at that one. So before I let us go, um and I'm going to, I'm going to let Chloe think about her take away messages that she wants people who are on the session or maybe catching up. I'm just going to read out what Adrian, right? And a is an amazing, amazing LD nurse. Um So, um and he said he thinks North University program has developed a batch of super nurses with access to a variety of placements outside of LD nursing. And I think that sounds, that sounds unbelievably fantastic because that's really integrating as well, isn't it? And that means that a lot of um a lot of people will get exposed to more elderly students, which is, which is really what's needed to be able to really get some better integration. So Chloe, I'm gonna give it back to you before we wrap up to say, give us your takeaway messages. Oh I feel a bit put on this spot. OK. So I think take home messages. I mean, I could sit and talk about this all day and probably bore people to sleep. But I think the take home messages is, you know, if you're not learning disability, know and just be mindful of making sure that you can adapt your practice. And like I say, it can be a lot of things that you do already and making sure that you're aware of policy. So things like the Equality Act, the Mental Capacity Act, um which they're not always easy things to get your head round book and, and you know, hopefully you'll be able to get some support from them as well. Um But I just think, yeah, take home messages, just give everything a try and make sure that, you know, you think about the patients with learning disabilities as well. Brilliant. And actually, we've just got somebody who's posted in. So I'm gonna read this one out before we, before we close. And so Natalie has said really interesting. Thank you. I've looked after patients with LD on acute general wards and come across the hospital passports and also the issues surrounding consent forms for patients uh having operations and, and thinking about the Mental Capacity Act. So really echoing everything that we've just been talking about here and LD isn't just the LD nursing is, is I think the bit, isn't it? It's for everybody. Um And, and for there. Well, that sounds dumb. That was very quick. Thank you so much Chloe for um agreeing to come and do this. Thank you to everyone who's joined us and anyone who will join us on the, on the on demand. Um I'm going to pop this at the feedback button now. It's really quick and sorted away. It's gone. So of course, we use uh Med. Med is a wonderful organization and it's absolutely free to use for healthcare professionals. So I sound like I'm on commission. I'm not, I just love it because it's totally free. And so you can all use it um in, in your own organization if you want to as well. Chloe, you're getting lots of, thank you. I hope I suspect you might know some of them and Adrianne. All right then. So I'm gonna click the stop going live button. Chloe and um yeah, we will. Um.