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Keys to Success for Nursing Students With Disabilities

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Specializes in Pediatrics, developmental disabilities. Has 38 years experience.

Can someone with learning disability become a nurse?

Nursing school can be a challenge for many nursing students and even more challenging if you have a disability. Following these important steps can make the journey easier.

Keys to Success for Nursing Students With Disabilities

The Girl Scout motto regarding "being prepared" is the best advice for nursing students with disabilities. In order to be prepared, you need to take action and do your homework- the sooner the better.

An important first step is to learn about your rights under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act. Visit the web sites listed below and pay careful attention to what is considered to be a disability as well as "reasonable accommodation". Also, remember that if you need reasonable accommodation, you are responsible for making the request.

Title II of the ADA covers state funded schools such as universities, community colleges and vocational schools. Title III of the ADA covers private colleges and vocational schools. If a school receives federal dollars regardless of whether it is private or public it is also covered by the regulations of Section 504 of the Rehabilitation Act requiring schools to make their programs accessible to qualified students with disabilities.

An additional part of doing your homework includes careful consideration of the pros, cons and timing of disclosure. You are only obligated to disclose if you request reasonable accommodation. Disclosure will allow you to request needed accommodations, but it can also potentially lead to stigma or being treated differently. The decision can be difficult and should be considered with care.

Visit the campus Office for Students with Disabilities as soon as possible. If you will be requesting accommodations such as a sign language interpreter, books on tape or a note taker, recognize that it may take time for the Office of Students with Disabilities to make needed arrangements. Make sure you have copies of up to date medical documentation regarding your disability

Purchase items you may need such as hearing aid batteries or medications. Research technology and equipment such as amplified or electronic stethoscopes, computer programs, audiobooks, and screen readers before classes begin.

Purchase your textbooks as soon as possible. Also, try to get copies of course syllabi before the start of classes. Organize a study notebook for each course and buy a calendar to record class times, clinical times, assignments and exam due dates.

Read all you can about other nursing students with a similar disability. Check your library for books related to nurses with disabilities. If you can't find a specific book you want, ask your librarian to order it. Do a library search for journal articles using the keywords "nursing student', disability" or use a specific disability keyword such as "hearing loss", "deaf", "learning disability", "mental illness", "missing limb", or "vision loss".

Get connected with a nurse or nursing student mentor with a similar disability and join online support groups. Visit the nursing laboratory and introduce yourself to the lab instructor. Find out if there is an organization for students with disabilities on campus. If so, consider joining. Also, learn about other resources for students (writing center, library, study areas, tutoring services, counseling center, health office). Information should be included on the college or university website.

Remind friends and family members that you are going to be very busy with school and will need their support and understanding. Being prepared is the best approach to being a nursing student with a disability. Remember that being a nursing student is challenging for many students with or without disabilities. Try to stay positive, eat healthy, exercise, make time for some fun and repeat often....

"I can do this!"

If you are a nursing student with a disability, what helped to facilitate your success? Can you add any additional suggestions?

Download

ADA Q & A: Section 504 & Postsecondary Education

Resources

AFB CareerConnect: For Job Seekers Who Are Blind or Visually Impaired - American Foundation for the Blind

Association of Medical Professionals with Hearing Losses

College Survival Skills | DO-IT

Exceptional Nurse | Welcome

Information and Technical Assistance on the Americans with Disabilities Act | ADA.gov

Pediatrics is my love and passion. I am a Pediatric Nurse Practitioner and have been practicing and teaching nursing for over 35 years. I am the founder of a nonprofit organization for nurses with disabilities, www.ExceptionalNurse.com, author of three books and numerous articles about nurses and nursing students with disabilities as well as other topics. In addition, I am an autism mom/warrior and dog lover!

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23 Comment(s)

Nurse Beth, MSN

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

Great information. I like how you talk about whether to disclose your learning disability or not.

llg, PhD, RN

Specializes in Nursing Professional Development. Has 43 years experience.

Great information. Perhaps in a future post, you can add some thoughts on 1 other issue that students with disabilities should consider: being realistic about career paths and job opportunities after graduation.

I have run into a couple of students who seem to have focused only on the process of getting their RN without thinking about about what happens after that. Employers are not obligated to provide unlimited accommodations, just reasonable ones. As someone who works with senior-level students and also hospital orientees, I have seen a few painful situations in which people who had managed to get through school with lots of accommodations being made for their disabilities discovered that they could not handle an actual job in their chosen field because of things that could not be changed.

For example, one student was passionate about becoming a nurse in an Emergency Department -- but needed the accommodation that she work in a quiet environment without a lot of distracting noise and light -- and needed a slow pace to give her time to process information thoroughly before having to make a decision. She had gotten extra time for all her exams, and only needed to take care of 1 patient at a time in school ... but no ED could accommodate her need for that slow pace and non-distracting work environment forever. I've encountered a couple of cases like that.

While many disabilities can be accommodated within the profession of nursing -- I myself have hearing and balance deficits -- we need to be realistic about what can and cannot realistically be accommodated in the workplace when we make our career plans.

Thanks for helping the students get on the right track!

llg

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 10 years experience.

Agreed don't just focus on what you need to get through school (and remember you can't just self-identify you must have been diagnosed by an outside professional whether a neuropsychologist, school psychologist, speech-language pathologist, learning consultant (LDT-C) or other qualified professional. Many colleges with schools of education/graduate schools of education have qualified grad students than can perform these assessments as part of their training.

You need to be realistic about employment opportunities. If you can only work 8-4 Mon-Fri in a slow paced environment nursing may not be the best career choice even if is your "dream" or "passion". If you have a cognitive processing disability that affects your executive functioning, critical thinking, application of knowledge, and require maximum modifications & accommodations this may not be reasonable outside the classroom setting. Not everyone can do anything you want.

My son has challenges and needs to make some decisions soon. I'm pushing for career interest testing in 8th grade now to plan for more success in the future

Donna Maheady

Specializes in Pediatrics, developmental disabilities. Has 38 years experience.

I couldn't agree with you more...all students and graduates (with and without disabilities) have to be realistic about considering where they are best suited to work.

In many ways, I see the journey to self-discovery in nursing to be the same for all.

Thanks so much for commenting....I will think about an article on these issues!

Donna Maheady

Specializes in Pediatrics, developmental disabilities. Has 38 years experience.

Nurse Beth said:
Great information. I like how you talk about whether to disclose your learning disability or not.

Thanks, Beth.... disclosure is a major issue to consider. For example, if you need extra time to take exams or a quiet space.... other students may show resentment. Anticipating potential issues and working on coping methods and rehearsed responses is part of the process.

Been there,done that, ASN, RN

Has 33 years experience.

Sunshine,. lollipops and rainbow aside.

How can anyone with a disability, perform nursing care for the disabled?

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 10 years experience.

Been there,done that said:
Sunshine,. lollipops and rainbow aside.

How can anyone with a disability, perform nursing care for the disabled?

I know an extremely competent PNP who happens to be a paraplegic due to a car accident. She has no cognitive issues and works in a combination out patient & long term care pediatric facility with many children of various disabilities aged 0-21. Her accident occurred during her BSN program. She graduated with honors as they were able to make reasonable accommodations.

Someone who needs to primarily type extended written passages due to dysgraphia could easily be accommodated in a setting with EMRs.

There is no absolute answer.

The type students llg is referring to should have received better counseling as needing maximum modifications and accommodations in school does not reasonably or realistically transfer to the work environment. Those students are not being set up for success in the real world.

It's not about just overcoming obstacles and reasonable accommodations it's also about realistic employment opportunities.

Been there,done that, ASN, RN

Has 33 years experience.

JustBeachyNurse said:
I know an extremely competent PNP who happens to be a paraplegic due to a car accident. She has no cognitive issues and works in a combination out patient & long term care pediatric facility with many children of various disabilities aged 0-21. Her accident occurred during her BSN program. She graduated with honors as they were able to make reasonable accommodations.

Someone who needs to primarily type extended written passages due to dysgraphia could easily be accommodated in a setting with EMRs.

There is no absolute answer.

The type students llg is referring to should have received better counseling as needing maximum modifications and accommodations in school does not reasonably or realistically transfer to the work environment. Those students are not being set up for success in the real world.

It's not about just overcoming obstacles and reasonable accommodations it's also about realistic employment opportunities.

If any disabled student can obtain their degree, more power to them.Most certainly agree that exceptions occur. However, nurses NEED to be physically able to perform the their duties and the ADL'S of their patient.

Unless, the nursing degree obtained qualifies the student for an office job.. it is useless.

Donna Maheady

Specializes in Pediatrics, developmental disabilities. Has 38 years experience.

Been there,done that said:
Sunshine,. lollipops and rainbow aside.

How can anyone with a disability, perform nursing care for the disabled?

Can you be more specific?

Is this an example of what you are asking?

A mental health nurse practitioner who happens to be deaf works with patients who are deaf in a mental health care setting. She is fluent in American Sign Language.

ixchel

Specializes in critical care.

Been there,done that said:
Sunshine,. lollipops and rainbow aside.

How can anyone with a disability, perform nursing care for the disabled?

I have a broken, anteriorly displaced spine and epilepsy. I care for them quite well, actually. 🙂

At work, I chose to disclose one and keep the other to myself. At school, I found out about both (spine first semester in the program, epilepsy the third) and without knowing at that time how impaired these diagnoses made me, I disclosed both.

Admittedly, I'm only impaired to the extent that I just need to be mindful and self-aware at all times. I keep up on exercises and meds, I keep with good body mechanics, I avoid seizure triggers.

The word "disability" includes a massive spectrum of impairment. At this time, I'm a very fortunate girl. But, I do have disabilities. I choose to remain functional on bad days, knowing the good ones still balance them out.

I agree, though, that realistic understanding and expectations are required. If my seizures become uncontrolled or my spine hinders my ability to remain physically active, I'll have some very tough decisions to make. I do worry that those who jump into nursing with higher levels of impairment may be setting themselves up for disappointment and struggle after graduation.

Yet another reason why nursing school really should teaching real world nursing. I get that there is a massive variety of opportunity out there, but so, so many jobs expect that coveted year of med/surg before they'll look at your resume.

When I learned about my spine, I had a clinical instructor try to talk me out of staying in the program. I hated her for it. Thinking back on it, her delivery could have been better, but there was an element of truth to it, and she was the only person who dared to share it. She was overall a jerk. If it had been anyone but her, I might have been convinced to not do nursing. Glad it was her, though. It's been worth it for me so far.

Jensmom7, BSN, RN

Specializes in Hospice. Has 36 years experience.

There's a saying, "Just because you CAN do something doesn't always mean you SHOULD."

I've seen people who have no disabilities wash out of Nursing because they can't keep up in the work environment and no longer have just one patient for a 4 hour clinical day.

If you need multiple accommodations just to make it through school (not talking about wheelchair access here, more on the order of multiple tries to pass an exam, access to someone for clarification during an exam, a quiet room to yourself to take an exam), you are going to be deeply disappointed when you discover that isn't the real world of Nursing.

I really wish we as a society would stop giving kids trophies just for showing up to a game, stop telling them that they can do anything they want because the rest of the world thinks they're as special as Mommy and Daddy do, and spend more time helping kids become the best people they can, realizing some dreams may not be doable once the cocoon of school and excessive special accommodations drops away.

I wanted to be a ballerina, and I have a wonderful natural arch (without curling my toes, even!) but I'm built more like a Reuben model than Twiggy, I can't spot during a turn to save my life, and the thought of going en pointe makes me vaguely queasy (friend was a ballerina and I saw her feet-ouch). So, I watch a lot of dance movies and dream a bit.

Was I devastated when I couldn't realize my dream? Nope. Life does go on.

CloverPark, RN

Has 5 years experience.

Great post... This hit very close to home, and unfortunately, it did not end well. I was diagnosed with ADHD as an adult. I always knew something was wrong with me, but never thought it was an actual condition with an actual name. Long story short, after getting some bad grades in elementary school and then in middle school, I went all out and and just worked my butt off to get better. I just tried my best to cope with it, but I realized c2that1lp I had to work twice has hard as my friends who I considered equally as smart as I was.G?jm

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 10 years experience.

Been there,done that said:
If any disabled student can obtain their degree, more power to them.Most certainly agree that exceptions occur. However, nurses NEED to be physically able to perform the their duties and the ADL'S of their patient.

Unless, the nursing degree obtained qualifies the student for an office job.. it is useless.

I get what you are saying. The PNP I know who was partially through her BSN program at time of injury, may not have been given the accommodations to succeed if she had not already proven clinical and academic competence. I know her after she completed her PNP and I never asked specifics on her undergrad clinical rotations and she never volunteered.

If a potential student, for example has no cognitive or learning disabilities but happens to have spastic diplegic or quadriplegic cerebral palsy their physical limitations would prevent success from completing the clinical and skills labs. If you cannot fully control your hand motions you cannot push pulls out of a card pack or open a medication bottle. Trying to force accommodations would be unrealistic as this person cannot have a 1:1 aide while working. This student needs to be redirected to a more appropriate career.

A student with a language comprehension disability who cannot comprehend the written or spoken word without modifications or accommodations would be better redirected as they may not have the ability to apply knowledge, comprehend physician prescriptions, verbal orders, written care plans, and other mandated skills.

I think if reasonable accommodations such as the PNP or other example above can be made its one thing.

However I agree with you that just because accommodations can be made in school, and some one has a dream or calling or burning desire to be a nurse doesn't mean they should. People who blindly encourage others to press on because if you dream you can achieve (just look at the NCLEX forum) does everyone a disservice. It's not mean & cruel...it's reality. A blind person cannot drive a school bus. Some people need a reality check. Having "compassion" and "desire" is not enough to become a nurse, you must be academically and clinically competent.

My child has incredible insight and empathy. His personality would make an excellent nurse. However it's not a realistic choice due to his learning issues and the obstacles put in his path through his education so far putting barriers in his way. In a few years he may recoup what was stolen from him but right now nursing would not be a good choice with the academic demands. For me to encourage him and not redirect him towards careers more appropriate would simply cruel and shortsighted.

Sure aim high. Dream big but be realistic. Wanting something is not enough.

I would have loved to be a concert pianist but my left hand cannot play independently of my right. I cannot play complex pieces no matter how much I want to, no matter how well I can read the music, no matter how much I practice. Luckily my son has an intrinsic musical talent and is now learning his third instrument with much success.

Quote
Agreed don't just focus on what you need to get through school (and remember you can't just self-identify you must have been diagnosed by an outside professional whether a neuropsychologist, school psychologist, speech-language pathologist, learning consultant (LDT-C) or other qualified professional. Many colleges with schools of education/graduate schools of education have qualified grad students than can perform these assessments as part of their training.

And I'll add that your college may have a lower bar than the national exam (NCLEX, ACT, SAT, GRE, MCAT, etc.). A month before graduation, I had to go get a full battery of testing done by a PhD for the state BON in order to get accommodations on the NCLEX. Don't assume what you had in high school or even what your college accepted is going to be enough. Contact your BON early.

Quote
... other students may show resentment.

To this one, I have to say, "who cares." Seriously, you resent my disability? I'd happily give it to you. I'd love not to need accommodations. (And guess what, in the work environment, I won't need anything more than a very rare hour or two for an appointment.)

Quote
How can anyone with a disability, perform nursing care for the disabled?

Because disabilities may not manifest in every situation.

CloverPark, RN

Has 5 years experience.

After trying to edit my last post and receiving errors when I tried to submit it, I'm just going to redo it. Disregard the last one.... I was a bit sleepy....

(Edited due to me falling asleep while typing the accidentally posting it..... Anyways!)

Great post... This hit very close to home, and unfortunately, it did not end well. I was diagnosed with ADHD as an adult. I always knew something was wrong with me, but never thought it was an actual condition with an actual name. Long story short, after getting some bad grades in elementary school and then in middle school, I went all out and and just worked my butt off to get better. I just tried my best to cope with it, but I realized that I had to work twice has hard as my friends who I considered equally as smart as I was. I actually wasn't diagnosed until I was already in nursing school. I was working as a tech (an AWESOME one by the way) at a large teaching hospital and it was my dream to work there as an RN. Well I got lucky and landed my dream job on my favorite unit. Things were going OK, but I definitely struggled with time management (don't we all in the beginning?). I felt comfortable around the nurse educator and felt I could trust her. In a moment of weakness, I disclosed my ADHD to her. She was very supportive and understanding, and actually made me feel so much better. I knew she had to notify the DON of this, but I felt more comfortable telling one person about this initially, because at that point, I still had not told hardly anyone about my secret and felt very awkward. I was 4 weeks into orientation. The usual orientation time was about 6 weeks, sometimes less, sometimes more. We had just had a meeting regarding my time management, in which the plan was to put me with a different preceptor who was super organized and probably had great tips to offer. The schedule was set up for the next week with my new preceptor.

Well, the very next day, I received a call from the director, stating that I could not return to work until we had a meeting.... We had JUST had a meeting the day before... What changed? Nothing happened at work after the meeting. In fact I finished the shift well. The weekend prior, the charge nurse told me I was doing a great job. The only thing I could think of was the ADHD disclosure.... But I figured that would be illegal for her to fire me over that (and YES, it was). We scheduled a meeting a few days later. When I showed up, she informed me that the meeting was to take place at HR.... Once there all these lies started spewing out of her. I was shocked, offended, and hurt. For example, she accused me of giving insulin late, when I knew that never happened, and even if it did my preceptor surely would have said something to me about it. That was one of many random accusations with no evidence to back it up. I defended myself well, proving her statements wrong, but after a few days, I was finally fired. I was never allowed to return during that time from the first meeting to the one at HR. The first meeting was the first time they addressed any improvement I needed to make, but yet they would not let me go back to even TRY to improve. I never made any med errors, was always on time, acted professionally, and got along very well with all my coworkers and patients.

I was devastated. I took legal action, got involved with the EEOC/ lawyered up.... and got a pathetic payout, because I could not afford to take things any further. I was offered a job back as a tech. But that was insulting.

I still trust that the nurse educator never meant for this to happen. She told me "everything was going to be OK," and was so kind and supportive. I actually had an event I attended r/t work which offered CEUs and she was helping facilitate it. I didn't realize it yet at the time, but when she asked me then if I had heard from the DON, there was a look of worry on her face, like she knew what was going happen.

I was traumatized for about a year after that happened. I finally got another job, nowhere near as nice, but at least I'm somewhat happy. Still.... that experience will haunt me forever....

Donna Maheady

Specializes in Pediatrics, developmental disabilities. Has 38 years experience.

TheFlash said:
After trying to edit my last post and receiving errors when I tried to submit it, I'm just going to redo it. Disregard the last one.... I was a bit sleepy....

I still trust that the nurse educator never meant for this to happen. She told me "everything was going to be OK," and was so kind and supportive. I actually had an event I attended r/t work which offered CEUs and she was helping facilitate it. I didn't realize it yet at the time, but when she asked me then if I had heard from the DON, there was a look of worry on her face, like she knew what was going happen.

I was traumatized for about a year after that happened. I finally got another job, nowhere near as nice, but at least I'm somewhat happy. Still.... that experience will haunt me forever....

So sorry to hear this happened to you. I have to think there is a lot more to this story...sad.

Been there,done that, ASN, RN

Has 33 years experience.

Donna Maheady said:
Can you be more specific?

Is this an example of what you are asking?

A mental health nurse practitioner who happens to be deaf works with patients who are deaf in a mental health care setting. She is fluent in American Sign Language.

Thought I was quite specific. I am old school. How does one obtain a nursing degree without learning how and applying hands on care?

Here's my problem with this. I have high functioning autism, formerly known as Aspergers Syndrome. Because of this, I am sensitive to loud noises and other external stimuli. On the opposite positive side, I'm extremely detail oriented and can spot things that other people miss because I am looking at the details that might get overlooked. I know the information in the lecture, but when the pictures in the book don't match the lab practicals, I get confused. I know the information and I passed all of my anatomy lecture exams with flying colors. The lab practicals on the other hand were timed with a loud buzzer and I could hear the ticking on the other side of the room. Because of this, I failed every practical given. My parents and friends have convinced me to abandon a career in nursing because of this, but I'm heartbroken. I want to help people and I'm good at it.

Technically it is illegal to discriminate against people based on disability but one would be hard pressed to find those on the Autism Spectrum working in the medical field. Does anyone have any ideas? I'm at a loss.

Donna Maheady

Specializes in Pediatrics, developmental disabilities. Has 38 years experience.

Sonusai said:

Technically it is illegal to discriminate against people based on disability but one would be hard pressed to find those on the Autism Spectrum working in the medical field. Does anyone have any ideas? I'm at a loss.

I think there are more health care professionals with ASD than you may think. Have you visited your college's office for students with disabilities? Joined a campus group of students with disabilities? Reached out to other nurses with autism?

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