title: A narrative review of acute care nurses' experiences nursing patients with intellectual disability: underprepared, communication barriers and ambiguity about the role of caregivers.
abstract: OBJECTIVE
  To describe how nurses experience caring for people with intellectual disability in an acute care setting.
  
  
  BACKGROUND
  Recent advances in the care of people with intellectual disability in hospital are primarily based upon the experiences of people with intellectual disability and their caregivers. Little is known about the experiences of registered nurses caring for people with intellectual disability, yet the experiences of nurses in delivering care largely determine the quality of care experienced by people with intellectual disability and their caregivers.
  
  
  METHODS
  A narrative literature review using electronic database searches was conducted using variants of the terms disability, nursing and acute care.
  
  
  RESULTS
  Through our reading of the recent literature describing the experiences of nurses caring for people with intellectual disability in an acute care setting, we have identified three themes: (1) nurses feel underprepared when caring for patients with intellectual disability, (2) nurses experience challenges when communicating with people with intellectual disability and (3) nurses have ambiguous expectations of paid and unpaid caregivers.
  
  
  CONCLUSIONS
  The enablers of and barriers to the delivery of nursing care in acute care settings need to be made explicit and researchers and nurses need to collaborate in the development, implementation and evaluation of care delivery strategies.
  
  
  CONCLUSIONS
  Nurses need to be adequately prepared to care for people with intellectual disability. Preparation should include dealing with the complexities of communicating with people with intellectual disability and practical experience of doing so in clinical and educational environments that ensure the safety and dignity of nurses and people with intellectual disability. Nurses need supportive strategies for developing therapeutic relationships with a range of informal and formal caregivers.
authors.affiliation: School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Lewis
authors.affiliation: School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Gaffney
authors.affiliation: School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Richmond, NSW, Australia.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Wilson
mesh_terms: D017028:Caregivers; D003144:Communication Barriers; D006801:Humans; D008607:Intellectual Disability / Q000451:nursing*; D009723:Nurse-Patient Relations; D011787:Quality of Health Care
keywords: acute care; experiences of care; intellectual disability; professional communication; registered nurse; therapeutic relationships