From student nurse to clinical director - my career pathway

In writing this blog I was asked to think about three things, how I came into nursing , my career journey to date and what was better/worse then and now.

Sounds easy…. ?

My nursing journey started almost thirty years ago and shockingly looking back was an accident rather than a well thought out plan.

As a child I had a friend Rachel who lived a few doors down, she had cerebral Palsy and what I now think was a very mild learning disability, although that was not necessarily how she was treated. I can remember from about the age of 11 recognising the struggles she would face to be accepted. I wanted her to join Girl Guides with me and she was not allowed, I think people thought it would be too rough, we were the girl guides not the karate club and anyway I used to tip her out of her wheelchair onto the grass so we could play and she never came to any harm!

My decision was made I was going to be a “special school teacher”, however after submitting my application to university I was informed that from my year of entry there would no longer be courses specifically for “special education” so there were two options standard teacher training or, they helpfully sent me some other disability related options. On the list was “ Mental Handicap Nursing” a new programme where the teaching was mostly university based to see if that added value to nurses (the programme only ran for two cohorts until they decided there was no added value in nurses having a university education!).

So started my nursing journey, I trained at Monyhull Hospital an old expansive institution in South Birmingham. It was a tough three years. There were some great people and I learned so much  but it is impossible to pretend that things were not difficult. As students we were learning that community care was definitely on the horizon and yet the thinking on most of the wards was anything but progressive.

I have prided myself on a career full of positive experiences and opportunities but it could have never really started, I found myself in trouble on more than one occasion for breaking the rules, the time that most easily springs to mind was when I refused to blend the main course with the dessert for speed of feeding.

The staff, with a few very noteable exceptions were as institutionalised as the service users and my training became an endurance test to the finish line.

On qualifying I breathed a sigh of relief and took a very short term job with the children’s team I had been on placement with to complete a resettlement project and from there took my first “proper” job in Maidstone. Working in a residential service for men with challenging behaviour.

It was here that I had the opportunity to put into practice the best bits of my nurse training, to begin to develop a sense of what a good service looks like and to appreciate the benefits of life in the community.

Over the next three years I completed further academic study and moved to work in a number of different homes within what was then Maidstone Priority Care Trust. It was probably one of the most rewarding times of my career. The service users ensured that my training continued and reminded me why I had chosen this career.

In 1996 I was managing a residential service and although not looking for a new job personal circumstances, my dad had just died and I was about to get married made me look for jobs in the community where regular office hours would give me weekends to focus on my family.

I have Steve (Hardy) to thank for pointing out an opportunity in Oxleas and joined the Trust in 1996 as a community learning disability nurse in the Bexley team.

Community Nursing bought a new and different set of challenges but also a new enjoyment, my clinical skills developed more rapidly than before and the close MDT working was a real privilege. When I look back and answer the question about what was better then it is impossible to think that anything from my training was “better” it is the days as a community nurse in Bexley that will always be my reference point for the “good old days”.

In 2004 I became Oxleas first nurse of the year and later the RCN learning disability nurse of the year. This was for my work with parents with a learning disability. At the time I was mildly embarrassed by the fuss but with hindsight recognise the springboard that I was then given to develop my work across a wider platform than Oxleas and begin to be part of networks beyond the trust.

This certainly made me less worried about change and gave me an appetite for further extending my career, the timing was good in the previous years I had had three children all of whom were now at school and so I decided to give my career a renewed focus.

Since then I feel change has been the norm. I have had roles in Greenwich and Bromley as Nurse Manager, led on establishing Atlas as a new inpatient service, became a consultant nurse and then Clinical Director before taking on a reactively unusual role as both Clinical Director and Associate Service Director.

I believe that change is good with every new role I have had I have learned something new about me, about people with learning disabilities and about how we can develop services.

Improving the health and lives of people with a learning disability has been at the heart of all of the decisions I have made and I know the same is true of all of my colleagues.

The NHS has changed so much in that time and I remain in awe of the fantastic work that our teams do to improve the lives of people with a learning disability even when times are tough. 

I know that all of my colleagues will do a great job in ensuring that there is a bright future for learning disability nursing, this will be challenging and we will need to be creative in embracing new roles and opportunities such as exploring apprenticeships, working in new environments and developing roles in diverse settings.

Society also needs to play catch up in acknowledging the contribution of people with learning disabilities to their communities and I hope that over the next decade we will see greater inclusion and equity.

Current initiatives such as Transforming Care and LeDeR need to provide a legacy of improvements that are realistic and sustainable and there needs to be parity when looking at the resources required to provide safe and effective services.

Am I glad I became an accidental learning disability nurse – absolutely I can't imagine any other career path that would have been more rewarding or bought me in contact with so many amazing people (service users and colleagues).

Lorraine Regan, RNLD