Keys to Success for Nursing Students With Disabilities

[Donna Maheady]

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

[CloverPark, RN]

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, LPN]

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.

[Tumbler]

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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.

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... 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.)

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

Because disabilities may not manifest in every situation.

[CloverPark, RN]

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]

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]

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?

[Sonusai]

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]

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?

[Tumbler]

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Technically it is illegal to discriminate against people based on disability

Not technically, just downright illegal.

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but one would be hard pressed to find those on the Autism Spectrum working in the medical field.

People with all kinds of disabilities work in the medical field and as nurses. There's a whole board about it on AN.

The tough part about accommodations, especially if we had them in high school, is that in post-secondary ed, the purpose is to grant access only, i.e. give us an equal opportunity to try. Means we have the same opportunities to succeed OR fail that everyone else has, and sometimes, some of us fail, just like sometimes students without disabilities fail. The curriculum can't be modified for us. With proper documentation and accommodations, you may have been able to get lab tests without the ticking timer. However, the practicals (actual slides) not matching the pictures in the book may still have done you in. The only way to know for sure is to try again, but that means investing more time and money, and that's really a call no one can make for you.

Sadly, clinicals are full of noises and external stimuli. I don't know how that would ever be accommodated, although only the disabilities officer in your school would be able to tell you yes or no. Remember, we have to be able to DO everything the other students can.

Your family and friends talked you out of the profession. I assume that they love you and feel like they give good advice, but it's really up to you to decide whether or not you take it.

[MandieDandy]

Hi there! I have ADD, which I'm well aware is distinctly different; however, I too have trouble with noises. Ticking clock-ugh, kill me now, lol. I also have a lot of trouble with silence. Just a suggestion but what's worked WONDERFULLY for me is a white noise app on my iPhone. I have it on ALL the time, even in the OR. It's so quiet, most people can't even hear it. It may be worth a try???

[Sonusai]

That's a good idea, but I don't have a smart phone. Money is tight and I have a phone that is phone calls only, not even texting. Keeps my minutes down. I've never seen another nurse or medical professional with flapping hands or rocking but maybe that's just in my area. Do you know where I can find someone? Since this will be my third time taking Anatomy 1, it excludes me from the RN program in the community college I go to, and the LA County has a rule of taking a class maximum three times for credit. No CLEP classes allowed in the community college I go to, otherwise I would just take the exam and be done. I know the material but certain word differences like vesicles versus ventricle versus part confuse me. Secrete versus Excrete, etc.

[ComeTogether, LPN]

I have a few thoughts.

First - Just because a student needs accommodations for testing doesn't mean they'll need them in the work place. I struggle with testing due to the constant distraction of other students moving, coughing, writing, breathing etc. but I do just fine in normal environments. I don't get accommodations, but I'm also medicated.

Second - Good point about thinking long and hard about whether or not to disclose. I've chosen not to disclose my ADHD and LD due to the stigma and stereotypes that surround the diagnosis - something I intend on educating anyone and everyone who will listen about, but not yet.

Third - Those in glass houses..... no one is perfect and everyone has their own barriers. Some disabilities bring with them a unique set of abilities and insight that most people don't have, and that can be very valuable.