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

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.

Specializes in LTC, assisted living, med-surg, psych.

I didn't realize it when I posted this article, but this week, coincidentally, is Mental Illness Awareness Week. Amid all the pink ribbons, football cleats, and T-shirts commemorating Breast Cancer Awareness Month, this little-known but far more widespread public health concern is still being stuffed away, as it always does, in the closet of our national consciousness.

Please join with me in raising awareness about psychiatric disorders and de-stigmatizing the millions of Americans who suffer from these often-debilitating conditions.

Viva, thank you so much for your inspring and sincere post! I am an RN with more than just one disability. I was on unemployment for a full year before finding a great job with the flexible hours I desperately needed in order to be at my functional best along with a manager who is fully aware of my diagnosis'. I fully agree with every word about being honest about who you are so you can give your best... I searched high and low for a job and was consistently turned down for positions I was more than qualified for. I was told someone with "more" experience etc. got the job. I was SO distraught and discouraged. I was not going to settle for just any job to only be set up for failure. God works in mysterious ways. 2 weeks before unemplyment ran out. This wonderful job I now have came along just in the nick of time. I think the hardest part of it all was being honest with myself about my limitations and really finding things I AM good at and being grateful for them. My diasability is not something I've had all my life. Coming to terms with my new self and finding a good fit for me has been a very humbling journey. Again Viva, thank you for your post :yeah:

Amen Corpsman!!! Thank you

Specializes in FMF CORPSMAN USN, TRUAMA, CCRN.
Amen Corpsman!!! Thank you

I call em like I see em, Don't like people to take liberties thay aren't entitled to.

Having a disability (or two) does not necessarily render one unintelligent, non-compassionate, irresponsible or a host of other "stigmas" that may come along with the word disabled. This is when you really put your critical thinking skills to the test and figure it all out. We have to sometimes over compensate in some areas it's true. But those of us who own our shortcomings and or limitations and can still be very productive, efficient, positive and all around great nurses , or Nurse leaders inspite of it all, I applaud you! Things may not always run as smoothly, or come as easily as they would to other Nurses. As long as we maintain our ethics, never forget the pledge we took and do some checking and double checking if need be. That just means we have to work a little harder and rest a little more if need be. It all evens out.

"Never judge someone unless you have walked a mile in their shoes" :nurse:

I think you are missing my point, Viva took a bold move posting her shortcomings here.......it is a service to all. Viva is the one who post her short comings here not me. I don't have the details and not familiar with state law, but in my state have this number of issues could cause a place to loose their license. She is lucky her employer is not reporting to the Board of Nursing, which personally I don't think is indicated but not all employers are as generous or proactive as her employer. I don't need, don't want any more details not needed . But I am assuming Viva posted this to educate all on disabilities visible or not, in that light I have posted my comments since her premise is to educate that this situation could have had a very different outcome. I am not being critical but trying to add to her conversation. I am not a perfect person, but common sense tells me Viva did not get the support she needed to over come her situation and her employer suffered.

Mental Health is an illness, it sounds to me this incident is result on more than one bad day. It sounds like her illness was not in good control, shame on her employer for not noticing sooner, if someone had a visible issue it would have been dealt with ( someone with a weeping wound, chest pain, or vomiting) and been mandated to get medical attention.

Specializes in FMF CORPSMAN USN, TRUAMA, CCRN.
I think you are missing my point Viva took a bold move posting her shortcomings here.......it is a service to all. Viva is the one who post her short comings here not me. I don't have the details and not familiar with state law, but in my state[b'] have this number of issues could cause a place to loose their license. She is lucky her employer is not reporting to the Board of Nursing[/b], which personally I don't think is indicated but not all employers are as generous or proactive as her employer. I don't need, don't want any more details not needed . But I am assuming Viva posted this to educate all on disabilities visible or not, in that light I have posted my comments since her premise is to educate that this situation could have had a very different outcome. I am not being critical but trying to add to her conversation. I am not a perfect person, but common sense tells me Viva did not get the support she needed to over come her situation and her employer suffered.

Mental Health is an illness, it sounds to me this incident is result on more than one bad day. It sounds like her illness was not in good control, shame on her employer for not noticing sooner, if someone had a visible issue it would have been dealt with ( someone with a weeping wound, chest pain, or vomiting) and been mandated to get medical attention.

Actually, I think you are missing my point. Your profile doesn't list what your role is in Nursing. Are you familiar with exactly what can happen when the State Inspectors walk in a do a survey of your facility? They are usually there for the week, and the exit interview takes place on Friday afternoon, of course, I guess it kind of depends on how big your facility is, but rest assured they will leave no stone unturned. They pour over charts, they check personnel records for completeness, they check individual licenses, and they make sure the facilities individual city operating licenses are up to date; they insure fire codes are being met, absolutely everything is scrutinized. Then they pick a few of the staff to talk to and shadow to make certain they know what they are doing. Failing to meet standards on any one of these areas earns you a citation, and it isn’t exactly like the State calls ahead and tells you they are coming in for a visit. You look up from your work and they are there, and suddenly the inspection is underway. Sometimes if you are fortunate, you can surmise it is about time for an inspection and be somewhat prepared, but you are never 100% ready, you just have to stay on top of your game all of the time. I think that’s where Viva meant she was lacking her attention to detail, things simply slipped her mind. It’s easy enough to do. I’m certain you’ve heard the old saying, “It’s hard to remember that your objective was to drain the swamp, when you’re up to you’re a$$ in alligators.” Especially in an LTC, you can never be fully prepared. You are always going to have holes in MARs; you are liable to have a med cart unattended, if just for a second, it was still unattended. You might have the treatment cart unlocked; God knows there could be a thousand little things and for the Inspector to come away with only 16 is actually pretty damn good. For Viva to say she was responsible for six, likely meant she was covering her staff for those six, not that they were her own cross to bare. Yet you came down on her like she had personally set fire to the LTC and locked the doors while everyone else was still inside, not like this was a learning experience and she had an opportunity teach other about her disability. Her employer has nothing to report her to the BON for, these are not personal faults, as part of the survey, she now has to write a Plan of Corrections and submit it, which I am certain will be concise and direct. This clearly demonstrates you don’t have a working knowledge of State Inspections and you really shouldn’t have interceded where you didn’t know what you were talking about. Maybe her staff wasn’t as “on the ball” as they could have been, maybe she let a few things slide, and her attention to detail waned a bit, these things happen. Perhaps we could review your performance evaluation next?

Thank you Viva for sharing. Finding this article has been a bit of a miracle to me. Do you mind if I contact you privately ? I have bipolar disorder just recently diagnosed and for the most part I am functional but owe a lot of that to the fact that I work from home telephonically . My meds are still being tweaked and I find I can't function too well until 9 am. I made my boss aware and she seemed supportive but at the same time I was being heaped with more work because I have excellent time management skills. I stood my ground and asked for a decrease but I'm always fearful that my dx will lead to being fired instead of the real reason being that I was unfairly overloaded . I had even considered taking medical leave until medication symptoms smoothed out but again I'm afraid of the problems this would cause.

Specializes in LTC, assisted living, med-surg, psych.

I'm glad you found this helpful. You and I are wandering around in somewhat dangerous territory, but so are a great many other nurses with physical and mental disorders, and sometimes we simply have to throw down the gauntlet and say, "This is me---the same person you knew before the diagnosis. Take me as I am, or let me go so I can move on with my life." For me, that has included multiple med adjustments and a couple of breakthrough mood episodes; but my boss is accommodating, and he's even helped me structure my days and given me support in order to have fewer interruptions/distractions.

The way I look at it now---and as a director myself, I can see it from both sides---our employers can't possibly know what we need to do our best work if we never tell them. That's not on them.....it's up to us to make that happen. And yes, some employers won't get it, and we have to fight tooth-and-nails for everything, or find ourselves suddenly and mysteriously out of work. :mad: But honestly.....do we really want to work for employers who would discriminate against us based on a treatable medical condition?

Didn't think so. :yes: