Technorati href="http://www.technorProfile Thinking Nurse: January 2005

Thinking Nurse

This blog will reflect my interests in learning disabilities, nursing, nursing theory, philosophy and politics and my general interests in the arts and literature. (Nursing is an art as well as a science!) Philosophy and nursing have been intrinsically linked since the days of Socrates, his mother was a midwife, and taught him everything he knew!

Saturday, January 29, 2005

Link Between Cannabis and Psychosis

Linking on the title of this posting will take you to the site of 'Rethink' a leading mental health charity. They are highly concerned about the growing amount of evidence that links cannabis to the triggering of psychosis.

I have always been suspicious of this government's policies on drugs and alcohol. They are liberalising access to both, and young people are binge drinking and smoking away. As a result our hospitals and mental institutions are facing crisis.

Time for some real thought...

Tuesday, January 25, 2005

Neurodiversity - A Human Right

A key human right is the right to think differently from the majority of other people. By this I do not just mean the right to hold different political or religious beliefs, although this is important. I think there is a right to actually think in different ways, we should embrace ‘neurodiversity’ as a concept.

People who have been labelled as ‘autistic’ ‘schizophrenic’ ‘manic depressive’ and ‘learning disabled’ have all made significant contributions to human knowledge, culture and society, often achieving things that ‘neurotypical’ people could not. This is not to idealise these conditions, they are often associated with physical and mental suffering, but the huge social stigma and discrimination that go with these conditions are something that it is possible for nurses, and other human beings to challenge.

Have a look at this website:

Monday, January 24, 2005

'Positive Choices' Conference - Nottingham April 1st

I have just learned that I will be one of the 450 student nurses attending this potentially historic conference.

Speakers at the conference will include influential figures in the learning disability field such as Bob Gates and Ruth Northway, as well as some students who I have not yet heard of, but suspect are likely to become leading figures in learning disabilities in the future.

I will of course post a full report of the conference here, as soon as I have recovered and got onto a working PC.

Sunday, January 23, 2005

Gassing Of Aloisia V: Hitler's Mentally Ill Relative

This news report (linked in the title of this piece) about the gassing of a close relative of Adolf Hitler, because she was mentally ill, reminded me of one of the great untold stories about the holocaust, the fact that among the first victims of the holocaust were tens of thousands of people with mental disabilities.

We would like to think that such slaughter was carried out by fanatical jackbooted Nazi soldiers. The reality however is much more chilling, and should never be forgotten by nurses who work with mentally ill or learning disabled people today. The programme to wipe out mental illness and people with learning disabilities was largely implemented by the Psychiatrists, Doctors and Nurses who staffed the mental institutions of the time. It was people like us, sensitive caring health professionals, who selected the patients, herded them onto buses, and watched them die.

This is a hard thing for nurses to believe - but it is true. It is a stark warning about what can happen when we start listening to eugenicist arguments, that some human beings are more valuable than others. But such attitudes still exist today. The World Bank promotes 'Disability Adjusted Life Years' as a method for third world countries to select which patients should receive treatment - the elderly, the disabled and thus those least likely to work and create profit are the ones who miss out on treatments as a result of such policies.

In our own country, people with learning disabilities are far more likely to suffer from, and have their lives considerably shortened by easily preventable illnesses. The Disability Rights Commission is currently investigating why these people seem to be so grieviously short-changed by healthcare services.

Eugenics is still here, in our NHS, in our own values and attitudes, just under the surface, it is a reflection of the 'Devil take the hindmost' ethic incipient in any society based on competition rather than cooperation.

T4, short for the address Tiergarten 4, was a Nazi work group of psychiatrists and physicians. During World War II, they were in charge of the killing of more than 100,000 people with disabilities.

Life with a disability often has been perceived as not worth living. As recently as 1983, fifteen US states had laws that required the sterilization of people with disabilities.

(Image from : disabilities2.html)

Wednesday, January 19, 2005

Learning Disability Nursing Links

If you look to the lower right of this blog, (underneath 'archives') you will see that I have started a list of links to a rather eclectic mix of sites and articles that I think might be of interest or use to learning disability nurses.

It includes links to sites about various thinkers and theorists whose writings might influence our practice, prominent organisations in the learning disability and nursing fields, and to blogs by nurses or other interesting people.

If you know of any sites you think ought to be included, if you find any dead links, or indeed if you want me to link to your own website or blog, please leave a comment here.

Please also feel free to post links to this blog if you feel it might be of interest or use to users of your own website.

Wednesday, January 12, 2005

Tregaskis - Constructions Of Disability - Book Review

Claire Tregaskis - Constructions of Disability: Researching the Interface between Disabled and Non-Disabled People, Routledge 2004.

It is rare that I get so excited about a piece of research, but here is one that I found thought provoking, inspiring and challenging. It is an interesting and innovative book that I feel should be read particularly by learning disability nurses, other professionals who work with disabled people, and also by anyone interested in disability or sport and leisure.

I have previously pointed out the interstitial nature of nurses' work - occupying the 'grey areas' the places that no other profession seems to go. One of these interstitial loci, is at the interface between disabled and non-disabled people. When two (or more!) world views collide there is inevitably conflict, and stress and also the opportunity for creativity and synthesis, this book is the example of such creativity and synthesis.

Nurses and other professions interested in the issues that arise when confronting issues of 'integration', or 'community presence and participation' will find this book speaks directly to their questions.

Tregaskis has produced a brilliant piece of qualitative and experiential research. She spent months as a researcher and participant in a leisure centre, looking at ways that disabled and non-disabled people interacted, drawing enormously on her own personal experience and impressions. The beauty of qualitative research is that it addresses the worlds of feelings and human meanings as much as it does the world of hard fact. Tregaskis has lived in and described these worlds in a way that opens them up to the reader, a chance for horizons to meet and for knowledge and meaning to be exchanged.

Tregaskis explores the various identities she assumed, and had thrust upon her at the centre in a groundbreaking way. This use of multiple identities allows her to "reflect as fully as possible the complexity of my fieldwork identities and relationships" (p8) In one chapter (p121 - 127) she directly confronts her own role as an oppressor in certain contexts within the centre, with an impressive level of honesty and introspection that would be a good example for nurses in their own reflection on practice, nurses also finding themselves as agents and colluders in the interstitial spaces between oppressor and oppressed. In a situation where Freire would argue that to fail to take a stand alongside the powerless is to side with the powerful, nurses need to pay heed to Socrates' injunction to 'know thyself'.

Practitioners with an interest in Learning Disability will be particularly interested in the ways that people with learning disabilities were included, and excluded in the centre, particularly by the experience of people in segregated groups organised by professional carers, with the chilling "supposed need for surveillance of disabled people by disability service staff' (p115) that typified the participation of a number of centre users. Her writing on the experience of people with learning disabilities is a direct challenge to all practitioners in this field to look at how their practice impacts on the lives of the people we are meant to be 'empowering'.

While Tregaskis is strongly influenced by the Social Model, she has gone well beyond the 'simple binary oppositions' that cruder versions of this model advocate, she is interested in finding points of common interest between people with disabilities and non-disabled people, as a basis for forming 'alliances for change' (p91).

She explores the way sport, and her presence in the centre offered her "a time and space in which I could reclaim and celebrate my body" (p95) She explores the idea of 'the communicative body', the notion that "our bodies are a key emotional outlet through which we can begin to make connection between our experiences" (p100).

Tregaskis has a great deal of expertise through her experience as a countryside access officer, explaining that access is about far more than doors, ramps and toilets, and suggests a multiplicity of ways that sports centres, and other institutions can be made more accessible to people with disabilities, that should be studied by anyone who wants to accomplish more than token gestures toward accessibility and inclusion.

The book is also interesting for it's critique of Wolfensbergers' theories of 'normalisation' and 'social role valorisation', she challenges the implicit value judgement contained in Wolfensbergers' conservatism corollary that "disabled people should do all they can to fit in with the mainstream and avoid doing anything that would draw attention to their difference" (p98)

She also points out that although she, as a well-educated researcher, and the centre manager (a black man) both had very valued social roles, they still both experienced discrimination and oppression.

Her conclusion is that "true inclusion will only be achieved when as a society we begin to systematically build all social provision around the premise of the equal valuing of difference." She advocates that "we challenge the assumption that impairment automatically results in devalued social status. Instead we need to follow the lead of the disabled peoples' movement in encouraging more disabled people to acknowledge and celebrate their own difference from the norm." (p152)

One question for discussion arising from this book is whether we as Learning Disability Nurses can/should/do encourage our clients to 'acknowledge and celebrate their difference from the norm', and what are the consequences for us and our clients of taking such a position? This blog seems as good a place for such a discussion as any, so I invite readers, whether they are nurses, disabled people or simply interested parties to make their contribution to the discussion here.

I would be very interested in any comments on this issue, and hope that this excellent book launches a discussion which helps us all clarify our ideas and hone our practice.

Cost of the War in Iraq
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