I am a NICU nurse and I’ve been a NICU nurse for 10 years. I have my certification and am good at my job, but left in 2019 due to work related PTSD which resulted in a panic disorder and depression.
I have been in therapy, have a doctor, have a medication manager, and have a career advisor. I am returning to work soon and would like to know what sort of reasonable accommodations I might request.
So far, all I have is that I be given level 2 assignments of grower feeders/NAS etc and no level 4 assignments.
Has this happened to anyone? What did you request as reasonable accommodation under the ADA?
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
12 minutes ago, may1787 said:
I guess I wasn’t expecting negative and snarky comments. I was able to find my answers through this, however, so I guess it worked.
I had to reread the replies several times to make sure I didn’t miss anything - I didn’t see a single negative comment, and definitely didn’t see a snarky comment. You asked for opinions, and they were given.
By negative I mean constantly saying I can’t have those accommodations when they don’t really know. I understand they are opinions coming from people without knowledge, I guess I wasn’t expected people without knowledge only coming here to break down their opinion and not fact. I was asking for factual answers.
I definitely empathize with your difficulties, may1787. PTSD in nursing is all too common, and managing panic disorder is incredibly difficult. This is especially true in the high stress environment of NICU nursing. I think you are on the right path, however. Don't let others discourage you from pursuing your passions and living your life to the fullest despite mental illness. As nurses, we need to support each other, ESPECIALLY the ones who need it the most.
Requesting ADA accommodations does not necessarily mean that you will require those accommodations throughout the length of your employment. Nor does it make you any lesser of a nurse. In fact, exposure to triggering stimuli that cause panic, such as being in a high stress environment, working in a NICU, and taking difficult patients, can actually decrease the amount and severity of panic that you experience. After requesting Level II only assignments for a period, perhaps you can work with your nurse manager/charge nurses to gradually lean back into more difficult assignments. This, along with medication management and psychotherapy/CBT, would likely help you tremendously. Best of luck to you!!
I definitely empathize with your difficulties, may1787. PTSD in nursing is all too common, and managing panic disorder is incredibly difficult. This is especially true in the high stress environment of NICU nursing. I think you are on the right path, however. Don't let others discourage you from pursuing your passions and living your life to the fullest despite mental illness. As nurses, we need to support each other, ESPECIALLY the ones who need it the most.
Requesting ADA accommodations does not necessarily mean that you will require those accommodations throughout the length of your employment. Nor does it make you any lesser of a nurse. In fact, exposure to triggering stimuli that cause panic, such as being in a high stress environment, working in a NICU, and taking difficult patients, can actually decrease the amount and severity of panic that you experience. After requesting Level II only assignments for a period, perhaps you can work with your nurse manager/charge nurses to gradually lean back into more difficult assignments. This, along with medication management and psychotherapy/CBT, would likely help you tremendously. Best of luck to you!!
Thank you so much Nursenate5! I was beginning to wonder if returning was for me, since my experience just on this thread felt very much like one of the things that lead to my burnout.
If NICU is too much of a high stress environment that you need ADA accommodations, maybe you need to find a low stress specialty for a while before moving back to the NICU.
I have been pulled to our Intermediate Nursery (mainly Grower/Feeders). That causes me more stress from sensory overload (alarms, continuous babies crying, and general noise from talking) than a very high acuity intubated heart kid on numerous drips.
If NICU is too much of a high stress environment that you need ADA accommodations, maybe you need to find a low stress specialty for a while before moving back to the NICU.
I have been pulled to our Intermediate Nursery (mainly Grower/Feeders). That causes me more stress from sensory overload (alarms, continuous babies crying, and general noise from talking) than a very high acuity intubated heart kid on numerous drips.
We have different issues then. I have more issues with level 3/4 than with level 1/2. That’s the thing about disability, it’s not black and white and everyone is unique.
since my experience just on this thread felt very much like one of the things that lead to my burnout.
Having a hard time piecing that one together but all righty. Best of luck to you, I hope you find a position that works for you.
edited to add: It was good to read from the perspective of someone (below) who has gotten reasonable accommodations for PTSD. Obviously every individual is different so no one is saying “This nurse got XYZ accommodations so that is what YOU are entitled to also.” But it was good to get a reading from someone who understands the system.
Specializes in Psych, Addictions, SOL (Student of Life).
On 10/26/2020 at 12:38 AM, may1787 said:
What do people think of these as reasonable accommodations to request?
-Have a support person for all meetings with a supervisor (not including charge RN)
-provide frequent positive reinforcement and constructive feedback
-provide feedback via email
-intermittent FMLA
-excusing from shift rotation
I don't think anyone here is being intentionally mean or snarky - but they are trying to be realistic.
When I read your list it does not seem that your requests are all that reasonable. I have had ereasonable accomodations due to a patient attacking and injuring me in the psych environment. This caused a new layer of PTSD to add to the continuing CPTSD I lready suffered.
I do not believe it is reasonable to have a support person at all meetings with a manger. Who pays this person and what is their role? Isn't this what a Union Rep is for?I am confused by this! It also appears though I might be reading it wrong that you want frequent positive reinforcement? How often is frequent? I personally woould rather know if I am falling short in some way than think everything was fine only to be let go without preceived warning. What if positive reinforcement is not warranted. Sometimes when I am not performing well I need a proverbial kick in the pants. Plus the definition of constructive feedback is nebulous. I have given what was clearly constructive feedback to peers I manage only to have them run to HR with accusations of being a bully (Managment found no fault with my behavior) when infact I was just trying to push someone outside their comfort zone to prove they could do it.
While an employer may like you well enough to give you a chance they do not want someone who needs a high level of support when situations go south which does happen in any ICU environment.
This is not a legal answer - only a ADA attorney can give you that. Just an opinion from someone who has been in nursing for close to 20 years. The only thing I find reasonable in your list and that I have used myself is intermittant FMLA which allows you time off w/o pay to attend Dr.s appointments, therapy without putting your job at risk.
If the NICU environment is too stressful for you it may be time to look for a less stressful specialty?
By negative I mean constantly saying I can’t have those accommodations when they don’t really know. I understand they are opinions coming from people without knowledge, I guess I wasn’t expected people without knowledge only coming here to break down their opinion and not fact. I was asking for factual answers.
It looks like you are consulting experts on ADA law outside of AllNurses, and that's as it should be. You say you are looking for facts, but per the TOS, legal advice is not allowed on this site. What we can do is give you opinions regarding the likelihood of your proposed accommodations being implemented. There is often a world of difference between what should ideally happen in a theoretical workplace, and what happens when you try to implement that in the real world.
First, I think you need to make every effort to apply for a job that matches what you can do rather than thinking about accommodations for a job you can't. So if you're applying to a level 2, then don't spend you time worrying about level 3 and 4. It's not relevant. Same with rotational schedule. If you can't rotate, apply for a position that does not rotate, and there's no need to consider ADA. Your follow up explains that you are doing this, but you got some of the answers you did because by initially listing no rotation and only level 2 patients, it sounded like you were asking for unreasonable accommodations.
Intermittent FMLA seems appropriate.
The other accommodations seem to be more about management style, and might be too nebulous to enforce. What constitutes a "meeting" with a supervisor? If it's a formal sit-down in your supervisor's office and you are in a union, your Weingarten rights allow you to have a union representative present, regardless of the ADA. Is a "meeting" any time a supervisor speaks to you? If your manager is trying to resolve an issue in a timely fashion, does s/he have to round up a "support person" to ask you what happened with Baby X or to get your side of the story if a parent complains? Who constitutes a "support" person? Are your colleagues going to be forced into that role or will your manager have to stop and find someone off the unit before talking to you?
What is "frequent positive reinforcement and constructive feedback"? That sounds like something good management would do with everyone. But how often is "frequent"? Is your employer is in violation of the ADA if your manager says something negative to you? Does all this feedback have to be through email? How often will you be checking it? Sometimes tone does not come through as well through email. My gut says that if people start to be afraid of what they say to you and how they say it, communication is going to suffer. We'd all like positive feedback, but sometimes negative feedback is necessary. Sometimes a correction needs to happen in the moment, not later with a support person in a meeting, not through an email you might read hours from now.
Maybe I'm overcomplicating things here. But as tone is difficult to ascertain, I'll say that your posts come across as looking for validation only, which isn't really reasonable when you ask for advice on a public message board. I haven't seen anything snarky, but you literally asked what we think of the accommodations, and then argued with anyone who said they might not be reasonable to implement.
It also appears though I might be reading it wrong that you want frequent positive reinforcement? How often is frequent? I personally would rather know if I am falling short in some way than think everything was fine only to be let go without perceived warning.
Thank you for posting a similar comment that I chose to delete that the OP took offense to.
hyppgr8 - You've said pretty much what I was thinking.
turtlesRcool - same re your response.
OP - no one is trying to negate that you have issues needing accommodations, but it's just that your ideas of what is reasonable is a bit unrealistic. And it upsets you that posters' responses don't line up with your wishes. To me, your asking for positive feedback sounds like you want folk to 'pat you on the back' and send 'way to go' emails. Sorry, it don't work that way in the real work world! Esp NOT in HC.
And just to say, all your wishes for feedback & support & meetings sounds reeeeally close to a PIP disciplinary action. You may be asking to set yourself up for something you didn't think about. Just a thought.
I ended up getting input from other individuals who work NICU (on another website) who have asked and received reasonable accommodations. All I have asked is considered reasonable and has reasoning according to the ADA and JAN (feel free to go to those websites if you actually desire to learn more and I would encourage many of you to do so based on some of the responses here) and have been easily accommodated by the NICU.
For those of you that have been kind, thank you. I greatly appreciate it.
JadedCPN, BSN, RN
1,476 Posts
I had to reread the replies several times to make sure I didn’t miss anything - I didn’t see a single negative comment, and definitely didn’t see a snarky comment. You asked for opinions, and they were given.