Care of a woman with Down's syndrome using the Neuman Systems Model

Learning disability nursing needs theory and practice experience

It has been suggested that few social service managers have the experience to appreciate the value of community learning disability nurses (CLDNs) (Messant and Caan, 2000). According to Messant and Caan, due to the broad spectrum of health and social needs required by the population, ‘activity and outcomes are difficult to quantify and aggregate’. These observations are made in relation to the current climate of some social service departments taking over the management of CLDNs. They also follow in the wake of joint investment plans being realized where social care teams and community nurses are working together. This has led, in some cases, to the operational role and clinical skills of CLDNs being either ignored or diluted or CLDNs being recommended to adopt a quasi-care management function rather than a ‘hands-on’ approach (Greig, 1999).

Should children with Down's syndrome have cosmetic surgery?

This article explores the rise in the uptake of cosmetic surgery for children with Down's syndrome. The pursuit of such surgical intervention is often a response to society's discriminatory attitude towards Down's syndrome and difference. Such an action raises many ethical concerns, e.g. should a child be subjected to cosmetic surgery when he/she does not understand what is happening to him/her? Much time, effort and resources are needed to work with children with Down's syndrome to ensure their full and active development through childhood. There have been changes in challenging discriminatory attitudes towards people with a disability in society. This, however, is the result of the public coming into contact and building relationships with people with disabilities in the wider community and not cosmetic surgery.