Learning Disabled Students

Multicollinearity, BSN, RN · Dec 7, 2006

I'm not sure what's scary. I meant that it's easier for a student to say they have a learning disability and that's why they have extra test time - to nosy fellow students, etc. It's easier for an instructor to say to try to preserve privacy. In reality - nobody gets accommodations without a verified letter from an MD or psychologist the specific diagnosis and details of the condition. The college has to make sure the documentation meets certain federal guidelines.

Do you understand that by definition learning disorders are specific problems with learning in individuals with normal or above normal intelligence? Other problems are comorbid.

dmarie (GA) · Dec 7, 2006

OK, I feel like I've somehow offended, so let me try once again.

I'm not a nosey student. I want my nursing degree, period. I'm 34 years old. I don't have time nor do I care about what goes on with other students. I'm working my butt off to obtain a degree. Whether a student is L.D., ADD, ADHD, or Batman in disguise is really none of my concern.

However, it was explained to me, by my clinical instructor, without any prompting on my part, that there existed a learning curve. Upon further observation, I noticed that she received extra time and help, along with a calculator, for tests. These special accomodations are given to students who are L.D. I later learned, from the student herself, without any solicitation on my part, that she has speech issues and ADD.

I don't have any issue with folks who learn in different ways. But this particular girl scares me. That's all. I never said she was less than intelligent, and I never said that people who are L.D. in general are less than intelligent.

This student might have other issues that are unknown or unnamed that may contribute to her clinical performance. But she IS labeled L.D. Her personal business is none of my concern.

Because this girl's performance scares me doesn't mean that all L.D. people, or people with any other issue, obstacle, or challenge, scare me as well. My point is simply this: Nursing is a unique profession that requires a certain degree of critical thinking, communication, and autonomy. It's not for everyone.

If you can't perform sufficiently on the tests, labs, or clinicals, then you shouldn't be allowed to progress through the program.

By saying that, I'm not personally attacking everyone who has an L.D., nor am I saying that people with L.D.'s aren't capable of performing sufficiently.

Sheri257 · Dec 7, 2006

This particular student also has serious trouble grasping basic drug calculations. She comes to me for help all the time. I'm always very nice and help her as much as I can, but I really, really, really worry about it. I don't care what setting she ends up working in ---- drug calculations are important!

I see your point here. Even if someone is learning disabled, they still have to function.

As I previously mentioned, all of the LD students in my class and others still have to pass the math tests without calculators. And the math tests only get tougher each semester and you have to pass those tests without calculators also. There are students, LD or otherwise, who have failed out of the program just because of the math tests alone.

If this person really isn't functional and can't do basic calculations then, the school isn't doing them any favors. I also think it was inappropriate for the instructor to assign the student to you. That's really the instructor's job.

:typing

Multicollinearity, BSN, RN · Dec 7, 2006

I do know that there is one LD that requires the use of calculators. I think it is called dyscalculia? I don't know more about it though.

BSNtobe2009 · Dec 7, 2006

This is why it is called a learning disability. Our traditional school systems have been around for so long, and it is not always the best way for all people to learn. Being able to fit into the college system has nothing to do with whether or not you will make a good nurse. Taking extra time to test in college does not mean a person will need extra time to think about what to do in a code situation. After the "learning process" of college many people with LD are great at finding ways to make accomadations for themselves at work, and in life. I totally agree that there needs to be some checks to make sure these LD nurses will be safe nurse, just like with all nurses. But getting extra time on a test, or having a book on tape is not a clear judgement of that.

The thing is, there is a difference between the MD making a compensation and the TEACHER making a compensation.

Dyslexia is a learning disability, however, it is a learning disability that can be overcome with therapy and acquiring additional skills to where you will be eventually indistinguishable from other students.

However, if you have anything that requires extra time, or you can't process thoughts quickly....the law may require schools to make reasonable accomodations for you, but the vast majority of healthcare professions are EXEMPT from making accomodations, depending on the setting.

In a hospital, or a doctor's office, an emergency can occur with any patient at any time. However, if you worked, let's say for an insurance company and worked mostly by phone, I would support a company having to make FURTHER accomodations than a hospital, because you are not responsible for direct care of a patient.

LydiaNN · Dec 7, 2006

The thing is, there is a difference between the MD making a compensation and the TEACHER making a compensation.
Dyslexia is a learning disability, however, it is a learning disability that can be overcome with therapy and acquiring additional skills to where you will be eventually indistinguishable from other students.
However, if you have anything that requires extra time, or you can't process thoughts quickly....the law may require schools to make reasonable accomodations for you, but the vast majority of healthcare professions are EXEMPT from making accomodations, depending on the setting.
In a hospital, or a doctor's office, an emergency can occur with any patient at any time. However, if you worked, let's say for an insurance company and worked mostly by phone, I would support a company having to make FURTHER accomodations than a hospital, because you are not responsible for direct care of a patient.

Actually, all employers are required to make reasonable accommodations. However, depending on the requirements of the job, what is reasonable will vary considerably. Obviously what is reasonable in an office won't fly within a hospital. Basically, the person has to be able to perform the essential functions of the job. Med calculations are an essential job function, so an employer wouldn't be required to make an accommodation for that, because to do so would be a modification, not an accommodation.

Multicollinearity, BSN, RN · Dec 7, 2006

I guess my take-home message for this thread is: unless you have a PhD in clinical psychology and you have done qualititative and quantitative testing on the student with the LD, you really don't know what the student can or cannot do. Everything else is irresponsible speculation. If the student cannot perform the job of a nurse - then he or she will fail out. Students do fail out of nursing school for many reasons. Also, as the previous thread I linked here shows, there are many nurses will learning disabilities who function well in the hospital setting. I don't need to understand how they do it (compensate) to know that those with more education and knowledge of such disabilities say they can do the job - and they do it!

I also think that there is a misconception that because a student requires more exam time that he or she might freeze in a clinical emergency - as if to say "stop, I need 1.5 more seconds to act!" Those with learning disabilities will tell you it doesn't work that way. The academic setting of written recall with newly aquired material is entirely different than the actual real work world. This is what the experts say. This is what students with LD's say. They know more than I do about it - so I won't pontificate on the internet about who should be a nurse or not despite what real experts say.

slou! · Dec 7, 2006

Wow, I have a learning disability and I am shocked at peoples attitude's of those with learning disabilities!

Especially because the term "learning disability" is SO broad. There are so many different kinds of learning disabilities.

I have dyslexia. I have gotten extra time on tests. I'm sorry if that offends anyone, but it takes me longer to process words and I have trouble reading. If the test was orally, then I would be fine. I agree with the person who said you either know the material or you don't. I don't think the extra 10-15 minutes I get would really make a difference if I didn't know the material. If I know the material it comes to me. I don't spend the extra time trying to remember the material, I do that before the test when I'm studying. I spend the extra 10-15 minutes because it takes me longer to read!

I am not a nurse or a nursing student (I am a pre-nursing student), but I know that I have no problems with critical thinking. It's not that it takes longer for me to THINK, but it takes longer for me to READ. Yes I know there is reading involved with nursing, but I have been challenging this my whole life and I will continue to do so. I maintained A's and B's in high school, and after 1 semester in college so far, all A's. It is challenging but I am so determined to do this and not be defined by a learning disability.

I have struggled with this for ever, and people's attitudes never seem to change. I have been told I was a "slacker and perhaps I should flip burgers if I do not want to read or write" :rolleyes:

Sheri257 · Dec 7, 2006

Actually, all employers are required to make reasonable accommodations. However, depending on the requirements of the job, what is reasonable will vary considerably. Obviously what is reasonable in an office won't fly within a hospital. Basically, the person has to be able to perform the essential functions of the job. Med calculations are an essential job function, so an employer wouldn't be required to make an accommodation for that, because to do so would be a modification, not an accommodation.

This is exactly what we were taught about the Americans with Disabilities Act during the legal module of our program. You do still have to be able perform the essential functions of the job. If you're blind, for example, and can't do the job because of that then, no employer is obligated to hire you or provide accomodations.

And, those accomodations have to be reasonable. If, for example, a hearing impaired nurse wants the hospital to buy specialized auditory enhanced stethoscopes, the government doesn't expect a rural hospital to do that as much as a big city hospital that has more financial resources ... because those accomodations aren't necessarily reasonable for a rural hospital with limited resources.

:typing

BSNtobe2009 · Dec 7, 2006

Wow, I have a learning disability and I am shocked at peoples attitude's of those with learning disabilities!
Especially because the term "learning disability" is SO broad. There are so many different kinds of learning disabilities.
I have dyslexia. I have gotten extra time on tests. I'm sorry if that offends anyone, but it takes me longer to process words and I have trouble reading. If the test was orally, then I would be fine. I agree with the person who said you either know the material or you don't. I don't think the extra 10-15 minutes I get would really make a difference if I didn't know the material. If I know the material it comes to me. I don't spend the extra time trying to remember the material, I do that before the test when I'm studying. I spend the extra 10-15 minutes because it takes me longer to read!
I am not a nurse or a nursing student (I am a pre-nursing student), but I know that I have no problems with critical thinking. It's not that it takes longer for me to THINK, but it takes longer for me to READ. Yes I know there is reading involved with nursing, but I have been challenging this my whole life and I will continue to do so. I maintained A's and B's in high school, and after 1 semester in college so far, all A's. It is challenging but I am so determined to do this and not be defined by a learning disability.
I have struggled with this for ever, and people's attitudes never seem to change. I have been told I was a "slacker and perhaps I should flip burgers if I do not want to read or write"

Now, that is where I would readily defend anyone with a learning disability....they are not slackers and it would greatly anger me to hear someone describe them as such.

However, let me present you with a scenerio.

In an emergency setting, products may have to be grabbed quickly. I have read many, many times where those WITHOUT learning disabilities have miscalculated meds, took the wrong med that was the wrong dosage or something completely different, but the name was very similar.

If someone has dyslexia and it takes longer for them to read, in a life or death emergency, where it is hard enough to do not slip and make a mistake...how would you feel if you made a grave medication error because your learning disability caused you to misread a medication or give the wrong dosage? Is the patient supposed to understand the disaiblity regardless of the damage it caused? Is the BON supposed to say, "Oh well, we can't suspend her license due to a med error because she has dyslexia, and she is doing the best she can?"

Would you agree that the PROBABILITY of someone with dyslexia is greater for a med or order error than someone who doesn't?

I'm not saying that people with dyslexia shouldn't be allowed to be nurses, I am just using it as an example of how in the healthcare field, sometimes making accomodations isn't enough to protect the patient.

Multicollinearity, BSN, RN · Dec 8, 2006

If someone has dyslexia and it takes longer for them to read, in a life or death emergency, where it is hard enough to do not slip and make a mistake...how would you feel if you made a grave medication error because your learning disability caused you to misread a medication or give the wrong dosage? Is the patient supposed to understand the disaiblity regardless of the damage it caused? Is the BON supposed to say, "Oh well, we can't suspend her license due to a med error because she has dyslexia, and she is doing the best she can?"
Would you agree that the PROBABILITY of someone with dyslexia is greater for a med or order error than someone who doesn't?

I just asked my best friend about this scenerio. She has dyslexia, and she works in hospice. She said that she would take about 3 seconds to block off the name of the drug with her finger, in chunks, to double check the drug name and dose. She said she does this sort of thing all the time and nobody knows she is dyslexic. I asked her if a patient could die in those three seconds. She said "well...new grads are slow...we don't keep them on orientation until they are as fast as a veteran nurse." Then she snorted that she walks really fast so maybe those seconds could be made up. These variables are just too hard to quantify in reality. Some nurses without any kind of LD are just slower than others, some think more slowly, etc.

Obviously it depends upon the severity of the dyslexia. I bet that there are some cases of dyslexia that are so severe that the person couldn't work in any field requiring reading, let alone critical care. But that's not the average dyslexic. Shades of gray.

Multicollinearity, BSN, RN · Dec 8, 2006

Would you agree that the PROBABILITY of someone with dyslexia is greater for a med or order error than someone who doesn't?

Actually, no I would not agree. If the nurse understands his or her LD and understands which strategies she needs to do, double checking for example, or something called chunking...then no. Thing is, nurses without LD's may not double check as much because they have no reason to. LD nurses (and employees in any field for that matter) tend to want to never make mistakes and do something that could be blamed on the LD. They tend to be extra careful -. especially knowing the attitudes evidenced in this very thread.

On the other hand, if a nurse has an undiagnosed LD, or one that she or he ignores and doesn't understand or compensate properly for...yes dangerous.