Nurses With Disabilities: Getting What You Need So You Can Give Your Best

From first-hand experience in negotiating the curves of life with a disability, a nurse-manager shares a few of the practical lessons learned when a chronic medical condition clashes with the realities of her high-profile, high-stress job. Nurses Announcements Archive Article

Nurses With Disabilities: Getting What You Need So You Can Give Your Best

It was the nightmare every long-term care nurse manager dreads: the exit interview with a state survey team that has just inspected every inch of the building and every piece of nursing documentation produced over the past year.....and found it badly wanting.

I tried to keep what I hoped was a neutral expression on my face as the lead surveyor read off the sixteen citations they had levied against my assisted-living facility. Two of them were classified as serious......and six of them were my fault. In the vernacular of the day, (stuff) just got real, and I was faced with the knowledge that I could no longer hide my inattention to detail, my inability to focus when there was too much going on around me, my impatience with the mundane and the routine. And until I came clean with the reasons why these were issues for me, I was in danger of losing the best nursing job I've ever had.

As many readers know, I have a mental health diagnosis that makes playing well with others extraordinarily difficult at times. I am also very good at what I do when my head is 100% in the game, even though I can be loud, sloppy, anxious, profane, and witchy by turns. However, while my immediate supervisor---who is arguably the most decent man on the planet---knows about my "nonconformity", I was terrified that Corporate would find out and then chop off my head.

Who would have guessed that NOT disclosing my illness would have handed them the axe? Our new director of clinical operations is not only smart, but intuitive, and she urged me to 'fess up so that we could problem-solve. That was how I wound up not only admitting to having a disorder that affects my ability to function on the job, but winning the accommodations I need to perform at my best....and probably saving my behind in the bargain.

"I was wondering about that," she said, smiling. "Your work habits are definitely consistent with your diagnosis." Dang, I thought, this woman is GOOD!

Now we all know that there are unscrupulous employers who actually look for reasons to get rid of people. I've worked for companies like that in the past, but when I ran across it I always kept my resume polished. Sometimes, however, you've just got to take a chance and ask for help. Here are a few suggestions for getting what you need so you can give the job your best, even when you aren't feeling your best.

Have a solution in mind before you bring your boss a problem

He will appreciate your foresight, and may even be willing to meet you halfway if you don't waste his time. For example, if mornings are hard on your arthritic joints and it takes you three hours to be fully functional, offer to switch to evenings or a hybrid shift like 11A-7P. You'll probably get extra points for explaining why this would also be an advantage to the company, e.g., they get you during your most productive hours and you're covering parts of two shifts.

Avoid invoking the Americans with Disabilities Act unless you absolutely have to

Employers really don't enjoy feeling threatened, and frankly, if you hold the ADA over their heads to try to bully them into complying with an agenda, they'll probably find some way to make life so miserable for you that you'll end up quitting.

NEVER use your disability as an excuse for poor performance!

This is a guaranteed career-killer, and deservedly so. There's a big difference between acknowledging a physical or mental condition that makes work more of a challenge for you than the average person, and blaming the condition for everything that goes wrong in your life. Disabled or not, you still have to take responsibility for what you do, and your employer has a right to expect you to perform to the best of your abilities.

Blessed are the flexible, for they will not be bent out of shape

Sometimes an employer is unable to accommodate requests for a private office, more work space, different hours etc. At my workplace, there isn't even a broom closet that could be converted into a separate office for me, even though a good portion of my discomfort is due to the fact that the office I share with my floor supervisors is like Grand Central Station.

Being easily distracted and struggling with short-term memory loss makes it all but impossible for me to stay on task in this environment.To make matters worse, I lose my place in a process when I'm repeatedly interrupted and then I can't remember where I left off. So I'll be spending a part of each workday shut up in the private dining room or an alcove when they're not in use, protected by my fellow managers so I can complete those soporific audits I'm supposed to do.

Use your strengths to remind your company of why they hired you in the first place

You probably have at least one special talent that makes you the best in a given job skill; don't be afraid to show it off! My own boss told me recently that while I'm not so hot at the routine (read: boring) stuff, there's no one in the entire company who's better than I am at handling a crisis. I've rescued other buildings from stop-placement determinations, administrator walk-outs, narcotic diversions, and other disasters---that's why they offered me the position I turned down last year, which is now held by the woman who's working with me to put my own department back together. But our regional manager knows that if one of the properties is having an emergency, he can give me a call and I'm all over it.

Working in a fast-paced healthcare environment isn't easy for anyone, let alone those of us with disabilities. But with the right kind of assistance and mutual respect between the nurse and the employer, anything---and everything---is possible.

Long Term Care Columnist / Guide

I'm a Registered Nurse and writer who, in better times, has enjoyed a busy and varied career which includes stints as a Med/Surg floor nurse, a director of nursing, a nurse consultant, and an assistant administrator. And when I'm not working as a nurse, I'm writing about nursing right here at allnurses.com and putting together the chapters for a future book about---what else?---nursing.

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Specializes in nursing education.

I love that your supervisors are willing to work with you for accomodations. I love how they acknowledged your gifts and abilities! This is really inspiring. Thanks for sharing this, Viva!!

Specializes in ..

What a moving and informative article. It's easy to see the disability of a person who uses a wheelchair, or holds a white cane. Employers, friend, and strangers are usually very helpful and accommodating to the needs of the physically challenged. Yes, those who suffer mental illnesses can be limited, as well, but there are no visual cues that alert others that they have a mental illness. Manifestations of mental illness are often seen as personality 'faults', so others not only fail to accommodate, they worsen the problem by responding inappropriately.

I've had conversations with people who deal with colleagues or co-workers who have bi-polar disorder, schizophrenia, or depression. Because of privacy, employees aren't aware of their co-worker's condition so they respond inappropriately to the odd behaviors and personalities of the sufferer--thus making the situation and the stress of the sufferer much worse. So, how can we differentiate between co-workers who might have a mental illness and someone who is just contrary or difficult? How do we know who we should be thoughtful of and gentle with, because they may be depressed, have bi-polar disorder, etc? Well, it doesn't matter. No, It doesn't matter if they are mentally ill, or if they are 'odd' or if they are 'difficult'... be thoughtful and considerate of everyone. Just like your mother taught you... be kind, always, to everyone you interact with--some may have a painful mental illness and need the extra compassion and support--just like the person in the wheelchair needs the extra assistance negotiating the curb or doorway. And, virtually always, when people are 'difficult' it's not because they are difficult, it's because they are dealing with a difficulty... maybe a mental illness, a personal problem, a family issue, or are scarred from personal experiences. So, be kind. Respond with gentleness. Be sensitive. Don't take comments personally. You don't have to be someone's best friend, just don't make their life worse.

But I had a manager once who was oh so kind and understanding when I explained to her that I was late for work one day (the only day in three years) due to an episode of my panic attacks. I was 90 minutes late. While this condition is 99% under control with meds and has never been a concern at the workplace I find it an irritant as opposed to a major health problem most of the time. Good old Miss Management, as I said, was verbally very understanding, shared her own 'anxiety' situations with me and all was well.

Or so I thought until 2 months later there arrived a letter from our nursing governing body that she had reported me to them as being mentally incompetent to practice as a nurse due to my disorder. Nothing ever came of it and the governing body was not interested in following up. She presented so much conjecture, opinions, conflicting facts, and outright falsehoods that the 'report' was ignored.

Oddly she was investigated for supplying a false report to the nursing body.

Not always good to be forthcoming!

Specializes in CCRN, ED, Unit Manager.

Great article. This one was actually thought provoking.

Specializes in LTC, assisted living, med-surg, psych.
But I had a manager once who was oh so kind and understanding when I explained to her that I was late for work one day (the only day in three years) due to an episode of my panic attacks. I was 90 minutes late. While this condition is 99% under control with meds and has never been a concern at the workplace I find it an irritant as opposed to a major health problem most of the time. Good old Miss Management, as I said, was verbally very understanding, shared her own 'anxiety' situations with me and all was well.

Or so I thought until 2 months later there arrived a letter from our nursing governing body that she had reported me to them as being mentally incompetent to practice as a nurse due to my disorder. Nothing ever came of it and the governing body was not interested in following up. She presented so much conjecture, opinions, conflicting facts, and outright falsehoods that the 'report' was ignored.

Oddly she was investigated for supplying a false report to the nursing body.

Not always good to be forthcoming!

I'm sorry this happened to you, even though it all turned out OK.

With the cat out of the bag, I know I'm going to be under a microscope for a while, if not for the rest of the time I work for this company. But at this stage of my life and career, I'd rather have closer oversight than be pushed out the door. Times are tight for unemployed nurses, especially for those of us who are 50-and-then-some, and most especially for those of us with health issues. There is no way that I could pass an employer's physical or supply a medication list without somebody figuring out that I am being treated for bipolar disorder. I really have no desire to try.

That's why I disclosed. Every other time I've run into difficulties on the job, I left rather than face the truth about why I was having those problems. I'm done running. If it eventually costs me my job, it won't be because I failed to fight for it; and frankly, I'm pretty sure I would have been fired anyway if I hadn't explained why I'm brilliant in some instances and inconsistent in others. As I stated above, sometimes you've just got to take a chance.

Specializes in Sleep medicine,Floor nursing, OR, Trauma.

Sending you mad props for your bold rawrness. Will write more later. Coma onset in 3......2.......

Specializes in Critical Care.
But I had a manager once who was oh so kind and understanding when I explained to her that I was late for work one day (the only day in three years) due to an episode of my panic attacks. I was 90 minutes late. While this condition is 99% under control with meds and has never been a concern at the workplace I find it an irritant as opposed to a major health problem most of the time. Good old Miss Management, as I said, was verbally very understanding, shared her own 'anxiety' situations with me and all was well.

Or so I thought until 2 months later there arrived a letter from our nursing governing body that she had reported me to them as being mentally incompetent to practice as a nurse due to my disorder. Nothing ever came of it and the governing body was not interested in following up. She presented so much conjecture, opinions, conflicting facts, and outright falsehoods that the 'report' was ignored.

Oddly she was investigated for supplying a false report to the nursing body.

Not always good to be forthcoming!

But did you keep your job in all this? Did she fire you or drive you to quit? Did she tell you she reported you or the Board tell you. Someone posted a nursing article about the Board and they seemed more determined to make our lives difficult and look for reasons to discipline nurses then to support us. Congrats that they supported you.

Specializes in FMF CORPSMAN USN, TRUAMA, CCRN.
But I had a manager once who was oh so kind and understanding when I explained to her that I was late for work one day (the only day in three years) due to an episode of my panic attacks. I was 90 minutes late. While this condition is 99% under control with meds and has never been a concern at the workplace I find it an irritant as opposed to a major health problem most of the time. Good old Miss Management, as I said, was verbally very understanding, shared her own 'anxiety' situations with me and all was well.

Or so I thought until 2 months later there arrived a letter from our nursing governing body that she had reported me to them as being mentally incompetent to practice as a nurse due to my disorder. Nothing ever came of it and the governing body was not interested in following up. She presented so much conjecture, opinions, conflicting facts, and outright falsehoods that the 'report' was ignored.

Oddly she was investigated for supplying a false report to the nursing body.

Not always good to be forthcoming!

I'd say that was more karma than anything. Seems appropriate to me.

Specializes in FMF CORPSMAN USN, TRUAMA, CCRN.
I'm sorry this happened to you, even though it all turned out OK.

With the cat out of the bag, I know I'm going to be under a microscope for a while, if not for the rest of the time I work for this company. But at this stage of my life and career, I'd rather have closer oversight than be pushed out the door. Times are tight for unemployed nurses, especially for those of us who are 50-and-then-some, and most especially for those of us with health issues. There is no way that I could pass an employer's physical or supply a medication list without somebody figuring out that I am being treated for bipolar disorder. I really have no desire to try.

That's why I disclosed. Every other time I've run into difficulties on the job, I left rather than face the truth about why I was having those problems. I'm done running. If it eventually costs me my job, it won't be because I failed to fight for it; and frankly, I'm pretty sure I would have been fired anyway if I hadn't explained why I'm brilliant in some instances and inconsistent in others. As I stated above, sometimes you've just got to take a chance.

This is one of the major obstacles I face a well, that and of course my age. Being 65, employers aren't known for laying out the Welcome Mat, regardless of how stellar your career might have been. Many of my friends have told me over the past couple of years that I should get off my butt and return to what I love doing. I do love Nursing and have said so many times here, but when it would come time for me to list my medications on my Employment Physical, and I had to ask for a separate sheet of paper, the proverbial cat would be out of the bag. There's no way I could pass the Physical anyway, and the first clue would be me, rolling into the room in the powerchair. The fact that they could never insure me, would likely give them pause to begin with. I have had a good run, I loved my job, and as I said in one of my post, it isn't really a job when you get up every day and love what you do for a living.

I can't help but wondering if the patient's suffered due to your issues? I appreciate your honesty but if patient's suffered due your lack of attention, I don't think you should be in this position.

Specializes in ICU.
I can't help but wondering if the patient's suffered due to your issues? I appreciate your honesty but if patient's suffered due your lack of attention I don't think you should be in this position.[/quote']

Ouch, I can't help but feel that that's a little harsh. There are plenty of us nurses who live with mental health disorders, and the vast majority of us would do something the instant we recognized any impact on our patients.

Viva- thanks for writing this! I'm so glad that your employer is working with you, they would be very unfortunate to lose a person like you!!