Overcoming phobias, one step at a time
A learning disabilities nurse has broken down barriers and built a relationship based on trust and compassion, to help a patient overcome a severe needle phobia.
Natty is 19 and has a learning disability. She developed a needle phobia in her teens. Needle phobia can impact the person with the learning disability and their family. It can make having a blood test anxiety provoking for everyone involved.
Once, Natty's phobia had been manageable through interventions on the paediatric ward.
"Each blood test became more traumatic explains Natty's mum, Hayley. Where we had once been able to coax Natty into having a blood test and distracted her with cuddles, toys and even Entonox, we found that as she got older, every attempt became more distressing for her."
Natty was referred into the adult learning disability service when she turned 18. Zahra Harper was Natty's learning disability nurse. She works within the Trust adult learning disability service.
"Evidence suggests that people with a learning disability can be at a greater risk of health inequalities. This includes barriers to health investigations, such as blood tests. This can lead to people's health not being monitored."
Breaking down barriers
When Zahra met Natty, they had a chat to produce a person-centred care plan. The plan would be about how she could best support Natty to have her blood taken at the GP surgery.
"I visited Natty to work closely with her and to help understand her fears and past experiences with needles.
"I suggested that together we create a step-by-step desensitisation plan to help her have a positive blood test. The visual guide was to help Natty get a better understanding of how a blood test would be taken. It was broken down into easy-to-read steps with pictures. Natty even modelled in the photos!"
Zahra also took resource packs, including an imitation needle, to her meetings with Natty.
"I started to bring props to my meetings with Natty, like imitation needles and cream. This was to give her the opportunity to see and hold the things the nurse at her GP surgery would use,"
adds Zahra.
"I took photos of the GP surgery, the equipment that would be used and the nurse's room to prepare Natty. By taking away the element of surprise, we helped to prepare Natty for what was going to happen at her blood test."
Working with Natty's personal assistant, Helen, Zahra was able to break down each step. Together, they worked on practicing what was going to happen at the GP surgery until Natty felt comfortable enough to move onto the next step.
"The plan was tailored to Natty's specific needs. We even included a hot chocolate treat at the end!
"Natty engaged in the decision-making throughout. This gave her a sense of control and confidence. The plan was flexible, evolving with her comfort level.
"The plan is regularly reviewed and updated dependent on the person's needs. We always ensure the person is involved as much as possible in each step of the plan.
"By supporting and empowering people with learning disabilities to create and use these plans, it is hoped that we can help reduce health inequalities."
Zahra adds:
"If one step on the plan felt like too much, or was a bit overwhelming, we would stay there and practice it for a bit longer. Then when Natty was ready, we moved onto the next step."
It was Natty who decided when she was ready to book a real blood test after weeks of hard work.
Zahra worked with the GP surgery to make the appointment and set out reasonable adjustments for the day of the blood test.
On the day of the appointment, Natty was prepared and happy to go ahead with her blood test.
Natty says after the blood test that she "felt less frightened and proud."
During 14 November to 20 December the Trust celebrated UK Disability History Month. It is a time to reflect on the experiences of people living with a disability or long-term condition. It is a time to renew our promise of building an inclusive workplace. You can read more about it here.