Learning Disabilities in the Workplace

  1. 9

    I have been an RN for 11 years. I worked my way through nursing school with no accomodations even though I have struggled with Dyslexia since 4th grade. I don't feel it is something I should have to bring up or discuss unless my symptoms are being addressed. However, even though there is more research being conducted now on Dyslexia than ever before, I still hear inappropriate and ignorant things from otherwise educated peers.

    Learning Disabilities in the Workplace

    I'm writing this article because I feel like some back story is necessary to really understand the circumstances behind my feelings. It may look like I am searching for sympathy or advice, but really I just want to get anyone to start thinking and have a bit more understanding.

    I don't know if I'm being overly sensitive or not. I like to think I have thick skin when it comes to this issue since I've been teased and tormented most of my life while still managing to exceed everyone's expectations. First I was told I would never learn to read, then I was told I would never learn math, then I would never graduate high school, and finally, I was encouraged to pursue the restaurant industry or retail where I could work my way up in a company with no formal education.

    I graduated from high school a year early with honors, completed my ADN at 21, and finished my BSN with a 3.4 GPA. I was diagnosed with dyslexia in 4th grade when no one in my small town really knew what to do with me. I was smart, but I couldn't read. No real research or understanding existed on how to approach teaching someone like me in the early 90s. I have fought and struggled to teach myself every step of the way.

    You have to have a recent diagnosis within the past 5 years in order to be granted accommodations in college. I didn't even know what they were. I made it through high school on an individual study program where I could work on my own at my own pace. This way I didn't waste time hearing the teacher explain things in a way my mind didn't register. When nothing comes easy, you learn to adapt and find multiple creative ways to solve a problem.

    In nursing school, the NCLEX style questions took me longer to read than to answer. But I couldn't get extra time on exams because no one tests adults for dyslexia for less than several thousand dollars (especially in 2003). I read every paragraph of the assigned reading 3 times then summarized in a notebook what I had read to deal with the retention issues that came with my disability. Once I accepted I wouldn't get any help, my attitude was I wouldn't get any help as a nurse anyway, so I might as well get used to it now.... but then no one has ever held a gun to my patient's head and made me answer a patho question in under a minute or they will shoot them either.

    Throughout my career, I have never hidden the fact that I was dyslexic. Naturally, it isn't the first thing to come up in an interview. But if it came up in conversation or my symptoms happen to be showboating on a certain day I have always been up front. If you are confused by "symptoms", dyslexic individuals often have difficulty with word retrieval. I can explain everything going on to my patients and their families because I have rehearsed my responses and explanations so well. I may sound like I am speaking off the cuff, but I am really reciting a modified script tailored to their situation. Catch me in the hallway and ask me about my weekend and I won't be able to get out my boyfriend's name. I also have a stutter that is common with dyslexics, again nothing I say in front of families is unplanned. Even the delivery of my words and the speed at which I speak is different to keep them from catching this. But if I am really busy or tired, getting a sentence out in report can be hell. For this reason, I write all my reports and read them to the oncoming nurse so they can follow what I am saying.

    My biggest fear when I graduated was that I would make a patient error due to dyslexia. This has caused me to be among the most dedicated safety-conscience nurses I know. I take great pride in this. It is not uncommon for nurses to remove armbands in the pediatric population and place them on the bed or the crib because the patient won't stop pulling at it. I will not allow my patient to go without an armband and require my patient parent or another nurse to verify the MR # with me when I re-band a child... even if I have to do it 4 times in a shift. I have never taken unlabeled blood away from the bedside. If I forget a label, I leave the blood, go get the label, check it with the parent or another nurse, then label it and send it. I have made students throw away blood and explain to the parents they have to redraw it because they failed to label it when they have taken unlabeled blood from the bedside. They will probably hate me forever, but they will probably never do it again.

    Since pedi doses are so sensitive, I do every calculation twice, on two separate pieces of paper. If a drug is not in guardrails I have another nurse verify the dose, even if it isn't required. I refuse to sign off on a medication I have not actually walked into the room and looked at the band and the drug together with.

    I'm sure you're catching my theme that I have been hyper-vigilant through my career. I have caught near misses where everything was labeled perfect and the drug scanned, but I noticed the solution was the wrong color and found the pharmacy sent me the wrong concentration. I could go on forever.

    Today in new employee orientation, the Quality and Safety presenter was really trying to drive home how many medical errors happen in the US each year that could be prevented. She was giving us stats on near misses and her experiences with root-cause analysis. It was a fast-paced presentation you could tell she gave every week and had memorized and rehearsed well. She gave an example of when over a weekend there was a spike in near misses of patients nearly getting the wrong blood in her last hospital when she was working risk management. She explained a new employee had been on staff over the weekend, then exclaimed: "and it turned out he was dyslexic!"

    This was followed by "How could we have known we had hired someone with dyslexia? Where any of you asked if you were dyslexic in your applications? Did anyone ask if you were dyslexic in your interviews?" My jaw was on the floor as someone attempted to interject that the application does ask about disabilities. Before they could even finish she interrupted with "well good at least you could read it."

    These words were coming from a highly educated and experienced department head in a prestigious facility. I have had the parents of terminal cancer patients tell me it's my fault their baby died, and that didn't make me cry. In a room of over 80 people, I had to stand up and walk out as if I needed to use the bathroom so no one would see me cry. A quick peek at my past posts and comments will show you I make it no secret nursing has not been kind to me the last few years. I have had many reality checks and bumps in the road through my career.

    After taking 4 months off, moving home, doing some serious soul searching and prayer, and spending some much needed time with my family. I have put down roots near my family, changed my specialty, taken a new job, changed my major, and am trying to view my previous obstacles as opportunities for growth. This was a terrible way to spend my first day at the facility I hope to stay at the next 20 years.

    Please know, people with learning disabilities have varying degrees of severity just like any other disease, they can be the best employees because they see everything from a different perspective and solve problems a different way, they are adaptable because nothing has ever come "easy" or "natural" to them so they have always had to find a way to do things other people think are simple, they overwhelmingly and consistently have higher IQs and intelligence scores, they work well in groups as they easily identify each member's strengths but rarely want to lead the group; only guide it, they aren't stupid, and if you are presenting in a room of 80 people, you are likely to have around 16 dyslexics in the crowd (with or without a diagnosis) as it is estimated 1in 5 people suffer from some degree of dyslexia that most often goes undiagnosed and untreated their whole lives.

    I hope someone out there learned something from my story
    Last edit by Joe V on Jun 14
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    About GaryRay, BSN, RN

    Gary has been a Pediatric ICU Nurse for the last 11 years, she has recently made the transition to Adult Radiology and has been accepted into the MS in Project Management program at USC. She looks forward to this new chapter in her career.

    Joined: Jan '16; Posts: 153; Likes: 301
    Radiology; from US
    Specialty: 10 year(s) of experience in Pediatric ICU

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  3. by   tnbutterfly
    Thank you for sharing your story.

    For some encouragement for you and other nurses with disabilities, you might like to read the following book: "The Exceptional Nurse: tales from the trenches of truly resilient nurses working with disAbilities"

    The author has written several articles for allnurses.

    You can read an overview of the book in the allnurses Product Directory.
  4. by   Nature_walker
    I am also dyslexic. Everyone at work just thinks I'm a really really bad speller for the most part. They laugh because they know I taught English for years. No, I taught English for years to prove to myself that I could.

    Here's the thing, if I'm asked, I own it. It's just a part of what makes me me. My coworkers all have their own things that make them them, and that's kind of the cool thing about people.

    How the educator handled that presentation is crappy. I would have been mad as well. Those ignorant comments are why people don't understand. It's not like being around a dyslexic person is contagious. Seriously, I can't pass it off to you if you use the same computer that I was using today. I find that I'm like that OP, I check, check and check again due to my fears of making a mistake. I have made a med error, but it wasn't because I couldn't read it, it was that I was rushed through my checks. My extra checks are what I need to do so it doesn't happen again. I've seen non-dyslexic coworkers make errors too. It can happen to anyone.
  5. by   Donna Maheady
    I am so disappointed reading this! Just when i start thinking things are improving...BAM!

    Your article clearly identified all of the "safe guards" you integrate into your nursing practice.

    We all learn differently and have different strengths and weaknesses.

    Speechless...which is rare for me!
  6. by   Crystal-Wings
    As someone with asperger's syndrome and ADHD, nursing hasn't been kind to me either. That's why I stick with private duty nursing with peds. My patients don't judge me, and for the most part the parents on the cases I've had have been kind as well.
  7. by   GaryRay
    It really is nice to hear from other nurses with the same struggles. And ordinarily, I don't hide being dyslexic. I don't open a conversation with it any more than I open a conversation with "I have a poodle at home" but it comes up and I talk about it openly. I know it makes me a more careful nurse than many of my peers.

    But this situation really got under my skin. I felt like a senior leadership team member was grossly misinformed and advocating for discrimination against professionals with disabilities.

    You shouldn't have to limit your practice to avoid judgement anymore than I should have to explain having dyslexia doesn't mean I can't read.
  8. by   Amethya
    Thank you for doing this article. I don't have Dyslexia, but I do have a learning disability, which is ADD. I have learned to get over it and work around it, but sometimes I worry my ADD will prevent me from getting a good job or keeping one. Not only that, with dyscalculia, it makes things worse as well with math, and I have to double check my work to make sure I did the dose right. I want to be a real nurse, not just a CMA, but with what I have and adding the math issue, I get worried I will mess up, even now as a Medical Aide at a school. But this gives me some hope that maybe, just maybe I can become a nurse and it will be alright.
  9. by   GaryRay
    Quote from Amethya
    Thank you for doing this article. I don't have Dyslexia, but I do have a learning disability, which is ADD. I have learned to get over it and work around it, but sometimes I worry my ADD will prevent me from getting a good job or keeping one. Not only that, with dyscalculia, it makes things worse as well with math, and I have to double check my work to make sure I did the dose right. I want to be a real nurse, not just a CMA, but with what I have and adding the math issue, I get worried I will mess up, even now as a Medical Aide at a school. But this gives me some hope that maybe, just maybe I can become a nurse and it will be alright.
    I have ADD and Dyscalculia as well. (They tend to run together in a spectrum) This is why I do all my dosage calculations multiple times, I also have developed tools similar to the quick reference OB nurses use when they calculate gestation for common drugs I give and drip rates when we had to calculate titrations in nursing school.

    I do conscience sedation all day at work with drugs that have multiple doses in one syringe, and different concentrations between drugs. To keep from making an error in the procedure, I mark each syringe with a sharpie at the dosage intervals when I am prepping my drugs. You always find a way to adapt.

    Go to nursing school if you want to be a nurse! You will find a way to get through. I failed statistics 3 times! I ended up waiting too long to take it and had no choice but to take it online (RN-BSN transition program) I finally just broke down and took out a student loan for a tutor to come to my home and teach me the content 6 hours a week and got a B.

    I document on meditech with no spell check, I have to write all my notes on MSWord then cut and paste them into the chart! I've been doing it for so long I actually chart faster than my coworkers who don't have to take the extra steps to make sure their spelling is right.

    That's the point of this article. Disabilities require adaptation... in the end you become a stronger asset to the facility that the people who never had to struggle. You are going to be a great nurse.
  10. by   mejsp
    Wow! Thanks for this. I became sensitive to students with dyslexia when my boss had to go to the high school and explain to a teacher why his dyslexic son could not complete the crossword puzzle assignment. That boss was an attorney and well-informed about the school's obligation to accommodate his son's needs.

    I hope you return to the Quality and Safety presenter for an enlightening session. A favorite priest said one of the things he feared most was hurting people unintentionally with no sensitivity to how his comments had affected them. If and when you have the energy I hope you will help that presenter see things more clearly.