An exploration of the role of the Social Model of Disability in Irish Intellectual Disability Nursing: The nursing perspective

by E. Hartnett, P. Gallagher, Dublin City University

0
4781

This article is an overview of a research study carried out in completion of a Masters of Science Degree, Disabilities Studies, in University College Dublin (2004). To begin with, the term ‘social model of disability’ is clarified. This is followed by background information and methods employed for the study. Finally the study results are discussed.

The National Disability Authority (2004), a body which plays a vital role in monitoring quality and standards in disability service provision in Ireland, emphasises that it is committed to a social model of disability. The National Disability Authority (2002, p.7) describes this social model as one which:
places a person’s impairment in the context of the social and environmental factors which create disabling barriers to their participation in society. This contrasts with more medical and individual concepts of disability which equate a person’s impairment with their disability, without placing it in context. For example, employing the social model of disability would mean that a wheelchair user cannot get in to a building because of the planning and design of the building or the attitudes of the owner, rather than being unable to climb steps.

It is exclusion from society, as opposed to an impairment, that disables the person according to the social model (Richardson, 2000). Many changes took place in Irish disability legislation and policy in the 1990s that were consistent with the social model. During that decade people with disabilities in Ireland challenged the medical model with its perception of people with disabilities as objects of pity in need of handouts and charity from the state. Society was being challenged to take responsibility for the role it plays in oppressing people with disabilities. The social model advocates society addressing these responsibilities. It also advocates challenging the fact that, traditionally, professionals held much control over the lives of people with disabilities. Northway (1997) highlights the importance of professionals being aware of the social model and of the potential that professionals have to oppress people with disabilities.

STUDY SAMPLE PARTICIPANTS STAFFING GRADE

Participants organisation Staff nurseCNM1**CNM2Other
Religious (no nursing school)X
Voluntary (no nursing school)XXX
Health board (no nursing school)X
Health Board (with nursing school)X
Diploma student nurseX
Nurse lecturerX
An Bord AltranaisX
Department of HealthX
National Council*X
*National Council for the Professional Development of Nursing and Midwifery
** CNM1= Clinical Nurse Manager level one.
Note: Eleven 11 Xs are shown in this grid because one participant fitted into two categories, the details of this overlap have not been included to preserve the anonymity of the participant.

Registered Intellectual Disability Nurses (RNID) are a group of Irish professionals involved in the provision of services to people with an intellectual disability. A review of the literature revealed a scarcity of information in relation to the role that the social model plays in Irish intellectual disability nursing. This study aimed to shed some light on this research gap. The stated aim of the study was to explore the role of the social model of disability in Irish intellectual disability nursing from the nursing perspective. The objectives were to explore:

  • Awareness and use of the social model.
  • How the social model could enhance Irish intellectual disability nursing.
  • Limitations of the social model for Irish intellectual disability nursing.

The sample included ten RNIDs working on the frontline, in management, in education, with the Department of Health, with An Bord Altranais and with the National Council for the Professional Development of Nursing and Midwifery. Frontline and management participants were working in organisations run by religious orders, voluntary bodies and health boards. Table One illustrates the sample participants. In order to gain a deep understanding of each participant’s perspective on the study’s focus of inquiry, in-depth interviewing was employed. Data were analysed using Glaser and Strauss’s (1967) constant comparative analysis.

In relation to the first objective, the results revealed that although the term ‘the social model’ was not one that the majority of participants used, evidence of aspects of the social model were very apparent from participants’ descriptions of their work practices and outlook in disability. Participants emphasised upholding the rights of people with intellectual disability and treating adults with intellectual disability as adults and not children. Participants also emphasised considering the person before their impairment and changing environments to fit the person instead of expecting the person to fit the environment. Participants emphasised that RNIDs look at health in a holistic way and promote well-being and ability in all dimensions of the person’s life. This description of meeting health needs would appear to have much in common with the social model and its focus on ability and opportunity, as opposed to impairment and dependency, as associated with the medical model of disability.

Participants described the following limitations of the social model for intellectual disability nursing. This model may conflict with service providers’ philosophy; the nurse’s duty to care may limit the amount of service user empowerment they can promote in certain situations; adhering to a contract of employment may mean the nurse cannot truly advocate for the service user. Two participants described the social model as being unrealistic and ignoring the reality of impairment.

Despite these limitations, participants also spoke of how the social model could contribute to intellectual disability nursing. These contributions included promoting self worth and sense of identity for people with an intellectual disability, promoting inclusion and disability awareness, an opportunity to improve on how services were delivered in the past, and providing a bigger and better picture than within the limits of the medical model.

Role confusion was an issue spoken of by study participants. Commitment to the social model or aspects of this model could support Irish intellectual disability nursing in clarifying the role of the RNID by offering a clear language, underlying values and principles and a network of support that accompanies the social model. Through networking with the organisations that are committed to the social model (including the National Disability Authority), RNIDs could contribute to sharing resources, experience and knowledge, promoting quality service provision with an emphasis on what service users want.

From this study it would appear that the social model has much to offer Irish intellectual disability nursing and further research on a larger scale could contribute valuable information in relation to this focus of inquiry.