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Please don’t be afraid to state concerns related to patient safety, it’s a big part of being a RN. If you feel your comment was misinterpreted, contact the unit manager and clarify. If you like, paraphrase Clint Eastman’s “Dirty Harry” quote, “A man’s got to know his limitations....” or just think of it silently when you do so. You are so early in your career that these criticisms have extraordinary weight for you. (Check out nurse researcher Dr. Patricia Benner’s Theory “From Novice to Expert” to see where you are on a RN developmental timeline.) These are extraordinary times that demand a tremendous effort to meet patient needs but taking care of you now ensures you’ll be around to take care of others later. Be gentle with yourself and your expectations of what you can do. ‘Thank you for your care of COVID patients!

As a bedside nurse, becoming disabled can affect you beyond just physically and financially, but emotionally too. Be sure to grieve completely then move on. If it takes help, get it. After rehab it’s important to do all you can to improve working with what you have. Improving your physical abilities within those limits will not only help you become stronger and feel better, but will allow you to adapt to your challenges. Addressing any lingering emotional issues means less “baggage” in the background as you go after new options. Advancing your education/ certification may help you in finding employment and opportunities. For instance, as a NP you may find great use for your direct patient care skills. There are many examples of nurses who are or who have become dependent on assistive aids who work in direct care. Opportunities may be found in areas related to bedside care e.g. in case management in a facility or in a related industry such as health insurance. Pharmacological companies, prosthetics manufacturers and similar industries plus state and federal agencies now routinely hire nurses for advisory roles. Educational institutions have nursing positions in clinical research as well as in the healthcare education programs. Consider how your interests and background may suit you for a role that will expand your horizons, and possibly your potential income as well if you need to offset the costs of more education. If stamina-building aka “work-hardening” is an issue for you, one or more part-time positions may work better short-term. Your state’s vocational rehabilitation agency provide opportunities for you, if it’s not underfunded/ overloaded. In my experience, if agency lacks resources, and you need to gradually rebuild your ability to work regularly, volunteering your skills there as an advocate/ educator for the agency’s clientele has benefits beyond the obvious ones. The time you invest can be flexible and your communication skills and knowledge will be appreciated greatly in that setting. It took me a while to understand and to learn how to use the Americans with Disability Act (ADA) and the federal and state resources connected to it effectively. (BTW, July 2020 marks the 30th anniversary of the law.) In healthcare institutions, ADA and its enforcement are poorly understood but the situation is improving slowly as awareness grows. The use of adaptive devices like canes, WC, prosthetics, etc. may make us obvious, but patient acceptance is often better than that of colleagues and administrators! I would suggest also that you search online for national professional organizations for nurses with disabilities, such as NOND, and other websites/ articles concerned with how to best function as a nurse with a disability. This was another aspect it took me years to do, but the sense of community and advice you will gain is exceptional. Individuals with disabilities who aspire to be nurses need our support as well. Involvement in organizations and sites for healthcare providers needing adaptations in order to practice can range from very basic awareness to activism but you will have choices and support, something you may not feel you have now. Please do not let repeated refusals from administrators and recruiters to discourage you in your search for work. Prepare yourself mentally and physically to demonstrate that you can do the work, with reasonable accommodations if necessary, and be fully aware of how ADA applies in your unique situation. Nurses present new concepts to unreceptive audiences as an inevitable part of our practice. Keep that in mind as you search for employment and use your skills to overcome the resistance. It won’t be easy, but you’re already dealing with “not easy”. Search for and reach out to those of us in healthcare who know what you deal with daily. I think you’ll find There are diverse professionals ready and willing to assist you. My journey began when I was injured while working as an ED nurse. I do miss it, terribly so on some days. It’s been 20+ years. Eventually I made the transition to nursing education. I have a full-time, niche job I enjoy, retaining nursing students in their degree program. The accommodations of my multiple disabilities include adjustments in scheduling and specialized office equipment. On tough days it’s helpful to recall that now I have the encouragement of my division chair and many of the faculty, plus the support of the institution’s disability services coordinator. There is hope for you as well.

Nursing is a tremendously broad profession with many specialized areas. You mentioned you’re completing a BS degree in medical anthropology - a program that will dovetail with aspects of your nursing degree in many ways, enhancing your understanding of the nature of human experiences across the lifespan. You also spoke of becoming a nurse practitioner ultimately. Again, the insights you’ll be able to develop as a result of the knowledge from your current degree will enhance your nursing practice. Once licensed and working as a RN, you may find yourself interested in a specialty such as forensic nursing. You may find the combination of the two separate but complementary fields, nursing and medical anthropology, will lead to extraordinary opportunities as a NP you may not now envision. The broader the basis of learning and experiences you develop on your path to your goal in nursing, the greater the scope of potential practice areas you’ll encounter. Please don’t consider the time and effort you’ve invested in your BS, before considering nursing, to be a “waste”; try to look ahead and consider how you can mesh your unique background in your future practice. And please, don’t focus on the years it will take to achieve your goal. Aiming for the DNP (your best bet) may seem a distant ambition but once you are licensed as an RN you’ll discover the importance of the experiences of working as a nurse as you pursue higher qualification. That experience may include employer-sponsored aid with the cost of BSN/ graduate degree tuition as well as increased confidence in yourself as a nursing professional. Do your research, prepare yourself mentally, physically and financially for the challenge and go for it! Your potential in this field is not based on a GPA but on how you will use what you have learned.

The sad reality assessed and documented at the CC program where I work is that significant prerequisite course knowledge is lost to program applicants over time. The effect translates into students struggling in nursing courses and in program failures. There is a massive amount of pathophysiology involved in understanding the correct application of nursing diagnoses, development of care plans, and delivering nursing care. Nursing faculty, course durations, and course credit limits simply cannot include adequate time to integrate refresher sessions for prerequisite anatomy and physiology knowledge. It is the student’s responsibility to enter a nursing program prepared to learn nursing concepts. There are state boards of nursing that specify nursing education requirements, including course completions in the degree program overall, written into that state’s laws. Without those credits in the degree, a new graduate may not be able to establish eligibility for licensure. As you may have retained significant A&P knowledge through your experiences as an EMT, if your program is at the associate degree level, you may be able to challenge the requirement by successfully taking the A&P course final exams or a college level proficiency exam. BSN programs are often less receptive to such challenges, but there are exceptions. Don’t be discouraged if the nursing program permits the challenge but requires the equivalent of a “B” grade rather than a minimal pass to waive the requirement. If you can genuinely demonstrate the knowledge required, attempt the challenge. If not, accept that the requirement is important and retake the course(s). You’ll find you’ll be better prepared and will save study-time and reduce personal stress while studying nursing.

Please be aware, that your personal medical issues may result in several challenges in gaining admission to and completing a nursing program, beyond the difficulties in class that you acknowledge already. As the first reply noted, objectively reconsidering your desire to become a nurse, in light of all the challenges to be overcome, is a necessity. That said, if you are prepared to address those challenges, you may find a way to achieve your goal. Some greater obstacles beyond the problem of staying awake in class will require you to manage your symptoms in your clinical/ lab/ simulation experiences and testing or evaluations. Disability laws provide some protection by requiring reasonable accommodations of disability in academic settings. To ensure that you have the benefit of any accommodations possible, you’ll need to apply to your institution’s Disability Support Services office. The institution will need documentation of your medical conditions well in advance of the start of your nursing classes. The DSS office may be able to provide a number of classroom related accommodations, such as a scribe to take notes for you so you won’t miss content, up to extra time on exams. Unfortunately, accommodations for clinical experiences may not involve the DSS office. You must also make sure that when your medical documentation of fitness to participate in clinical studies I s submitted to the program with your application, as required by the institution and the nursing program’s policy, that the doctor understands the physical requirements of the program and by certifying your fitness, is willing to detail your limitations in a positive way. Based on that documentation, you may need to explore ways to meet the program’s outcomes with your nursing faculty and clinical instructors. Patient safety is a primary concern for faculty and instructors, so please be certain that your condition is stable and well-managed before any accommodations are explored. I hope these realistic insights into issues you must be prepared to address if you hope to gain admission to a nursing program and to complete it successfully do not discourage you. Although disabled nurses do find ways to practice nursing within personal limitations, a nursing program must be completed first. You may want to approach your goal by taking small manageable steps: e.g. attend a practical nurse program, become a LPN/ LVN, work a year or two, then enter a LPN-to-ADN program (possibly online), to reduce the number of semesters to a level of licensure and entry to a healthcare career. You’ll find lots of encouragement and examples of disabled individuals who became nurses, as well as helpful organization(s) and information online through a basic search for “disabled nursing students”. Educating yourself about the challenges and potential solutions will prepare you to address the inevitable concerns you’ll encounter in institutional and nursing program admissions and policies. If you have the heart for a career helping others, you will find a path, if not in nursing, in another of the many associated healthcare occupations. Keep your goal in mind and avoid focusing on a title if your objective is to share your gifts by helping others!