Background: Nursing in the field of intellectual and developmental disability (IDD) has evolved over the last decade. With this evolution new challenges related to this field of nursing practice have surfaced. The field of IDD nursing is complex and considered out of the realm of common nursing practice. Given the complexity and uniqueness of this area of nursing practice, nurses face challenges when supporting this population. The purpose of this commentary is to highlight current challenges faced by nurses working in the field of IDD in the USA in order to generate conversation and solutions. Methods: A review of literature and clinical practice experience was conducted. Articles were analyzed for content related to nursing practice in the field of IDD. Textbook references were incorporated to substantiate key points. Additionally, the author's 24 years of clinical practice and nursing administrative experience were included. Results: Nurses face varied challenges in the field of IDD: lack of education regarding this population, healthcare complexity of this population, role ambiguity, varied practice settings, nursing model of care controversy, and caseload distribution and acuity. Conclusion: Nurses working with the IDD population face challenges that may be distinctive to this field of nursing. Educational preparation for nurses, physicians, and health care professionals is minimal. The multifaceted needs of persons with IDD and diverse practice settings nurses encounter create a fragmented system that is difficult to navigate. Evidence-based interventions to guide IDD nursing practice are lacking. Standardization of care principles and role clarification for the IDD nurse across settings are varied. The IDD field requires a synthesized approach to healthcare management that currently does not appear to exist across settings. An increase in nursing research for this population and area of practice should occur. Nursing and medical programs must seek ways to include or expand content specific to the health intricacies of this population.
