Should I tell my nursing school about my disorder?

  1. 0
    Hi, I am currently in nursing school with two semesters left (not counting the one I am currently in). I have been diagnosed with Narcolepsy about 4 years ago (before I even started nursing school). I have noticed that due to my disorder, I have been late to clinicals a couple of times (because it is so early and I have such a difficult time waking up). I set my alarm 2 hours before I even have to leave. Yes, I have medication to perk me back up when I am feeling really sleepy. This disorder is also covered by the ADA (American Disabilities Act). The other day, during the post-conference at clinical, I was resting my head against the headrest of the chair, still listening and rocking the chair back and forth, but closing my eyes because I was way sleepy. I noticed the clinical instructor making a point to watch me rest my eyes. I noticed it when I would open them up every couple of seconds. I wasn't falling asleep, but had a strong desire to just shut my eyes. So, after that, I am wondering if I should let my school know that I have this disorder. At first, I was worried that they may inhibit me from doing certain things, but since I have been at their school for almost 2 years, they would be able to look back at my track record and see that I've been doing extremely well, including my grades. So, should I tell my school about my disorder?

    Thank you all!
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  4. 34 Comments so far...

  5. 2
    You should find out if you can practice as a nurse with this disorder. It is about patient safety. How did this not get attention during your entrance physical?
  6. 2
    We had to fill out paperwork extensively upon being admitted and were REQUIRED to disclose any disorders that could be covered by the ADA at that time, at which time they did a thorough evaluation as to whether the individual is capable of performing the basic functions of a nurse with their disability. The ADA protects people as long as it is physically possible to safely meet job requirements with or without accomodation. Falling asleep from narcoleptic symptoms cannot really be accomodated in most types of nursing. I am curious - did your school not do this kind of evaluation or did you cover it up?

    Bottom line is yes, you need to tell them as soon as possible. If you were not honest in the beginning and were given the chance to be, I don't think it is going to go well for you. And if you weren't given the chance but this is a problem that is not adequately treated (and from your description, its not), I also don't think that it is going to go well. I hope I am wrong for your sake, but going by your post alone, it seems rather ominous. Nurses who fall asleep on the job get fired. Students who do the same probably suffer the equivalent fate I think. Talk to them and see if there is a workable solution.
    SlumberingCub and bradleau like this.
  7. 1
    Have a discussion with your physician.
    2ndyearstudent likes this.
  8. 1
    You have a responsibility to manage this disorder. The school won't excuse behaviour like lateness or falling asleep in meetings ... you have to be able to do these things to be a nurse! Let alone stay awake long enough to take care of your patients.

    I know what a difficult disorder it is but it's time to see your neurologist and get it under control.
    bradleau likes this.
  9. 0
    Quote from HeartsOpenWide
    You should find out if you can practice as a nurse with this disorder. It is about patient safety. How did this not get attention during your entrance physical?
    Yes, I can practice as a nurse with this disorder and it's not as extreme as some may think. I have never fallen asleep except when I am in bed at night or while taking a nap. I have medication that assists me in staying alert.
  10. 0
    Quote from RN2BDFW
    We had to fill out paperwork extensively upon being admitted and were REQUIRED to disclose any disorders that could be covered by the ADA at that time, at which time they did a thorough evaluation as to whether the individual is capable of performing the basic functions of a nurse with their disability. The ADA protects people as long as it is physically possible to safely meet job requirements with or without accomodation. Falling asleep from narcoleptic symptoms cannot really be accomodated in most types of nursing. I am curious - did your school not do this kind of evaluation or did you cover it up?

    Bottom line is yes, you need to tell them as soon as possible. If you were not honest in the beginning and were given the chance to be, I don't think it is going to go well for you. And if you weren't given the chance but this is a problem that is not adequately treated (and from your description, its not), I also don't think that it is going to go well. I hope I am wrong for your sake, but going by your post alone, it seems rather ominous. Nurses who fall asleep on the job get fired. Students who do the same probably suffer the equivalent fate I think. Talk to them and see if there is a workable solution.

    I think most people, when hearing the word "Narcolepsy" automatically assume that all narcoleptics fall asleep unexpectedly. That is not the case for me. Mine is more classified as "Excessive Daytime Sleepiness" as I have never fallen asleep and I also have medication that I take to keep me from getting sleepy. There was no "physical entrance" exam of the like when I entered nursing school, so there was nothing to disclose.
  11. 0
    Quote from coast2coast
    You have a responsibility to manage this disorder. The school won't excuse behaviour like lateness or falling asleep in meetings ... you have to be able to do these things to be a nurse! Let alone stay awake long enough to take care of your patients.

    I know what a difficult disorder it is but it's time to see your neurologist and get it under control.
    Narcolepsy, or Excessive Daytime Sleepiness, is harder to "get under control" then most would think. I did not "fall asleep" during the meeting, I only shut my eyes to rest them. I was still swiveling my chair back and forth as to show that I was not asleep. All of us at the end of clinicals are extremely exhausted. Like I said in my other responses, I do have medication I take to defeat my sleepiness. Currently, my clinical instructor doesn't allow us to take lunch, so our days are an hour shorter. With this disorder, I could really use a break. How would diabetics do without eating prior to getting their insulin injection or to prevent hypoglycemia? I bet they get coverage to have a break so to eat. Any ideas?
  12. 1
    Quote from Harmony4All
    Narcolepsy, or Excessive Daytime Sleepiness, is harder to "get under control" then most would think. I did not "fall asleep" during the meeting, I only shut my eyes to rest them. I was still swiveling my chair back and forth as to show that I was not asleep. All of us at the end of clinicals are extremely exhausted. Like I said in my other responses, I do have medication I take to defeat my sleepiness. Currently, my clinical instructor doesn't allow us to take lunch, so our days are an hour shorter. With this disorder, I could really use a break. How would diabetics do without eating prior to getting their insulin injection or to prevent hypoglycemia? I bet they get coverage to have a break so to eat. Any ideas?


    I know exactly how hard it is to control ... I also know how quickly the closed eyes spiral out of control. If you are at the point where you feel the need to close your eyes, well, you aren't managing. If you weren't sleepy then you were just being rude? I don't think that's the situation here though.

    Here's what I do: Sleep hygiene. Go to bed at the same time every night. Don't do anything in bed besides sleep. No caffeine after about 4 pm (yes hours and hours before bed). Get up at the same time every morning, even if I don't have to. Take provigil religiously. I have to take it every single day at around the same time, no skipping doses. Don't drink alcohol cause it makes me a hot mess w/ the provigil.

    Realistically, you aren't going to get a nap time break in the hospital. Yea it feels good (great) but it's not realistic to your setting right now. So don't get into the habit of taking afternoon naps when your job/school won't support it. It just messes with your brain and causes you pain. It takes awhile but you CAN train yourself off of the daytime napping (helps the nighttime sleep too).

    You are training for a job in which you assume responsibility for people's lives. You cannot be falling asleep on the job. Period.

    If you get in trouble for sleepiness, and tell your school that you are narcoleptic, you know what's going to happen? They'll hit the roof. Not because you are narcoleptic, but because it's uncontrolled and they therefore can't trust you with patient care. For your own sake you have to get ahead of the problem.
    Harmony4All likes this.
  13. 0
    Quote from coast2coast
    I know exactly how hard it is to control ... I also know how quickly the closed eyes spiral out of control. If you are at the point where you feel the need to close your eyes, well, you aren't managing. If you weren't sleepy then you were just being rude? I don't think that's the situation here though.

    Here's what I do: Sleep hygiene. Go to bed at the same time every night. Don't do anything in bed besides sleep. No caffeine after about 4 pm (yes hours and hours before bed). Get up at the same time every morning, even if I don't have to. Take provigil religiously. I have to take it every single day at around the same time, no skipping doses. Don't drink alcohol cause it makes me a hot mess w/ the provigil.

    Realistically, you aren't going to get a nap time break in the hospital. Yea it feels good (great) but it's not realistic to your setting right now. So don't get into the habit of taking afternoon naps when your job/school won't support it. It just messes with your brain and causes you pain. It takes awhile but you CAN train yourself off of the daytime napping (helps the nighttime sleep too).

    You are training for a job in which you assume responsibility for people's lives. You cannot be falling asleep on the job. Period.

    If you get in trouble for sleepiness, and tell your school that you are narcoleptic, you know what's going to happen? They'll hit the roof. Not because you are narcoleptic, but because it's uncontrolled and they therefore can't trust you with patient care. For your own sake you have to get ahead of the problem.
    Thank you Coast2Coast,
    I completely understand how the "closed eyes" can quickly spring out of control. I'll also take your advice on training myself not to take naps. The issue I have is that I only have two clinical days. Those days I get up at 4am. There is no way I am going to wake up at 4am all the other days, especially since I do all my studying and homework in the evenings after my children are in bed. So, that's going to be rather difficult (having a consistent sleep hygiene), and that's also why I have such difficulties with clinicals that are so early. I am a night owl and always have been. A night shift would be my ideal shift once I get my license. It's just these early morning clinicals that are rather difficult to work through.

    How long have you had Narcolepsy?

    In addition, I don't take Provigil every morning, I have been advised to only take it when I need it. I metabolize medications extremely fast, which means 50 mg is all I need to give me about 4-5 hours of "awake", I then have to take another 50 mg just before that one wears off. If I take a higher dose, then I feel as though I am "floating" or "dreaming". So, thae 50 mg has been working for me. At times, if I can't wait for the medicine to kick in, I will grab a soda that gives me a quick boost until the Provigil kicks in (but the soda is extremely short-lived). I also have learned that if I take the Provigil around the time I have eaten, the medicine has no effect on me. So, it's a bit tricky. It's best if I take it on an empty stomach. The 50 mg may appear to be extremely small, but between my dr and I, we have been trying different meds and dosages for about 3 years when we discovered that I am extremely sensitive to medication, hence metabolizing them rather quickly, and finding out the 50 mg is my dose (100 mg pill split in half).

    So, you don't think my nursing school should know about my disorder, as long as it's managed?

    Thank you again!!!


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