Chris Davis was previously the PBS Project Manager for the Learning Disabilities Managed Care Network (LD MCN) which covers NHS Borders, Fife, Forth Valley and Lothian. Now a Clinical Educator in Adult Acute Mental Health Nursing with NHS Lothian Chris talks about the challenges of adapting the LD MCN service to cope with the COVID-19 pandemic.
The challenges presented by the COVID-19 pandemic are well known and widespread, across all industries and areas of our lives. As an inpatient nurse working with adults with learning disabilities life initially seemed to change very little for me, while some of my friends and family were removed from their offices and started working from home. I got up at the same time, travelled to work as normal and after getting to grips with PPE just tried to make the days as meaningful and structured as they could be for the individuals I work with.
I have also been working part-time with the LD MCN since July 2019 as the Positive Behaviour Support (PBS) Project Manager. Although I have no yardstick to measure against, looking back at the first eight months they now seem relatively simple. The LD MCN covers the South East of Scotland and aims to provide useful information to people with learning disabilities. We direct people to resources that will help assist services to meet the needs of individuals with learning disabilities, ensuring these services can provide the best quality care. I came into post the same week a course developed by a university was not progressed. This left me with the task of finding and organising the implementation of a Positive Behaviour Support course at university level or similar using a pre-agreed budget. Not an easy start! I spent many a long day trawling the internet and phoning others to ascertain what was available and what was realistically achievable.
The team are almost all part-time and although we are seconded from many other areas which makes meeting up a challenge in itself, the level of support and camaraderie I felt was fantastic. I was welcomed and felt like a part of the team quickly. During every conversation with more experienced practitioners, I was offered wisdom and advice which were eagerly received. This advice helped hugely as I tried to navigate the first few months of regional work. After a discussion in August 2019 with Jayne Crow our Clinical Lead, an opportunity arose to work with the University of Glasgow in supporting the development of a Post Graduate Certificate in PBS. After a huge amount of work and organisation, the course began in January 2020. For me, this was the first time I had been able to work outside of my inpatient role within the NHS Lothian Learning Disability Service. The biggest challenge for me was working without a team as in my inpatient role I am used to getting immediate team feedback which helps guide my next decision. Sometimes I felt that I was forging ahead and making progress however this could be quickly undone by a change of circumstance in a single area. Any change meant another round of calls to ensure all parties involved were kept up to date and in agreement.
Then in March 2020 after a discussion with the Network Manager and Clinical Nurse Manager, I returned full-time to my inpatient role. This was done in anticipation of the coming challenges related to COVID-19; staffing wards and providing care to the individuals in our service. This abrupt pause to the work that was happening in the LD MCN was difficult to accept as we had begun mapping out the direction of travel and were already looking at the next piece of training implementation to support a course at the University of Glasgow. The momentum which was beginning to gather around the group of candidates and the members of the PBS steering group felt really positive. We were working towards linking in with a National Community of Practice and this felt like part of a larger change in care delivery. Making connections with key individuals over a variety of areas and working out how these people and organisations fitted into the wider picture of health care delivery in Scotland wasn’t something I wanted to put on hold. As a nurse, I would always list communication as a strength however twinning this with politics encouraged me to relearn this as a new skill. I have found that so many challenges are made easier by the fact that everyone I have met and spoken to shares the same motivation; to ensure that good information and practice are shared for the benefit of the individuals we work with.
Before the pandemic I had to adapt to regional working, now the challenge is to remobilise the LD MCN with current rules and restrictions in place. This has called for some creative thinking. As a bit of a technophobe, I would always prefer meeting people face to face, especially when I am meeting people for the first time. Arranging meetings and training online was a bit of a daunting prospect and very much a step into the unknown. The unknown of being an organiser getting up to speed with online platforms and the unknown surrounding the training and how it would be received by those it was aimed at. I owe a huge debt of gratitude to the individuals who were working remotely during the time I was back in inpatients. They have been able to offer me technical assistance, tips and a supportive ear when needed. Especially Karen Lee the LD MCN Project administrator who I’m sure has been on the end of the phone to me more times than she cares to remember.
My experience in an inpatient setting during the beginning of the pandemic taught me that staff have to be focused on the here and now. The thought of engaging in training or taking on new work far from the front of their mind. Meeting key individuals and gathering momentum must have been impacted. So, as I began the phone calls and Microsoft Teams meetings to get myself back up to speed, I was relieved to find that the last few months had been spent meeting virtually to address these challenges.
Looking at how we offer or direct people to training that is both meaningful and functional has resulted in migrating some of our courses online, including a Support Workers Course which the LD MCN has run in person for several years. This has been led by the Learning and Development Co-ordinator Susan Gowland. As we move through 2021, we hope to continue adding to these online resources. By coordinating some PBS training and identifying other areas for development we can ensure that no obstacle stops us from mapping out a health promoting future for the people in our care.