Students with Disabilities

You have been assigned a student who is a paraplegic and in a wheelchair to your clinical group. You wonder about her physical competency to perform required psychomotor tasks. Three students in your busy classroom need special testing accommodations due to diagnosed learning disabilities. Nurses Announcements Archive Article

Students requesting accommodations from a college or university must have a disability as defined by section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA). A disability can be a physical, psychological, and/or a learning impairment that substantially limits one or more major life activities.

Documentation of the disability should be from a qualified professional. Complete documentation includes a diagnosis of the specific disability, justification of the need for special accommodations, and the functional limitations the disability presents to the student's learning environment.

It is the responsibility of students with disabilities to seek available assistance at the college or university and to make their needs known. In other words, the individual with the disability must initiate the procedure. Each college or university receiving federal funds has a disability support service office with a specific process for students to follow. The students must obtain the evaluation at their own expense, and this can be costly. It is not the same as in high school where the state pays for the evaluation and teachers initiate the process.

An individual with a disability is not automatically entitled to any specific accommodation. According to the ADA, students who demonstrate learning, emotional, or physical disability are allowed "reasonable accommodations." Reasonable accommodations do not include accommodations that would fundamentally alter the essential performance standards in a program of study or present the institution with an "undue burden." A student with disabilities is subject to the same codes of conduct and disciplinary processes as other students.

Reasonable accommodations can consist of alternative testing locations and formats, the use of readers, computers, or scribes, priority seating in the classroom, and increased time for testing. These accommodations are determined on an individual basis. The most common accommodations in nursing school involve extra time for examinations (usually time-and-a-half) and exam administration in a separate classroom (with minimal distractions).

Once a student has been officially granted special accommodations, it is then his or her responsibility to contact the faculty to communicate the approved accommodations and how they can be implemented. Accommodations are not retroactively applied and cannot "undo" prior to failing grades. Students need to give their instructors enough time to contact the disability office on campus to make the alternate arrangements. In most instances, at least two or three weeks' prior notice is required.

It is the faculty's responsibility to diligently protect students' confidentiality at all times, according to the Family Educational Rights and Privacy Act ("FERPA"). The students' special accommodations or disability should never be discussed with other students and should only be mentioned to other instructors on a "need to know" basis.

I received testing accommodations in college at NYU. I am dyslexic and received extra time and a distraction free environment during tests. I deserved those accommodations based on my neurologist's findings. I was diagnosed with my disability at 7-8 years of age. My disability will never be gone or cured, but I had extensive remediation. (its actually discriminatory to me that I had to be reevaluated as an adult learner in college to keep those testing accommodations because people would actually try and exploit the system!) I can do everything that anyone else can do... I look the same as everyone else. I am articulate and intelligent. So when I say I'm dyslexic to people in school, professionally, or personally - they are shocked! I am happy to see their shock and educate them on what is my cross to bear over a lifetime. I am extremely creative and I think in pictures while others have an inner monolog (you just hear yourself in your head vs. I see myself in my head). For instance, you think about getting a glass of water when you're thirsty - I picture the whole walk to the kitchen, take out the glass, let the water run on your hand to feel when it gets cool, I hear the glass filling, I taste the water... now I'm thirsty... I am an advocate for my disability by being proud of it's part in making me - well me! When people have been bitter, I feel out the situation and decide if I walk away or change someone's mind about what it means to be learning disabled - beyond the old cliche - "we learn differently..." I tell them how I'm different and how having that special place and extra time to take my exams levels the playing field... I never have an advantage...

I read once it explained this way - everyone else is running on a track in their lane. Everyone learns to run on that track the same way. My lane has hurdles so I can't just run like the rest of you... I have to learn to jump. So in the end... I believe that's why so many famous people have this disability... It actually makes us stronger... or it gobbles others up and leaves them without a chance.

so here comes the question - with so many nursing errors that could be hazardous to a patient why do I think its safe for my dyslexic brain to be out there handling serious medical care? It is a valid question. I embrace it. Here is how.

I take my disability seriously. I know that some medications look or even sound alike. Its hard for any of us sometimes on a hectic day... so I check with pharmacy when I'm not sure about something. I check, check, check and recheck... I act when I suspect someone is starting to crash... I get early interventions started... I critically think... I am a team player... I time manage... I multitask... I am constantly looking up answers to my questions and my patients questions... I draw pictures to teach my patients... I check check check and recheck my orders! I complete my orders and clean up my space! I keep myself organized and I write things down! I check check check everything before I leave for the night!

I do everything that you do and I'm even more careful than you are, because I have to be... I am a hospital concerned with patient safety's dream nurse! So my answer is my dyslexic brain needs me to double check myself all the time... Shouldn't you be doing the same? Haven't I found the greatest place for my brain?

My answer is 100% yes!

Specializes in alzeheimers, skilled, assis. living.

I felt honored to read your message. You are a winner! I am a very troubled mom with 3 children (grown) one has schizophrenia. He has had it prob. around 14 was when we started seeing withdrawal signs and having loads of trouble in school. He is 28 now and still cannot get a start on life. He was isolating so much that we had him placed in an assisted living, hoping that being around ppl would help. However it has somewhat, but we had to put him in a small , run down facility because of the better places won't take you if you are not in your sixties range. He has been there about 8 months. They have no activities, he does now have a guy that takes him out a few hours a week. I just don't know what to do to help him. I have tried almost everything I know and he fails. I just don't know if another failure would help him. His worker is trying to get him a part time job at a furniture factory. I don't know. He is calling tonite saying he is sick, but I know it's just wanting to be home, makes me sad. I just keep praying and looking up and hoping there is someone that can help him, I sure can't.

Specializes in ICU, trauma, gerontology, wounds.

If you were treated this way, your educators were ill-informed, and may have even been violating the law. Two suggestions: speak to your educators directly, going up the chain of command to see that the behavior changes, or transfer to a better school of nursing.

Specializes in Gerontological, cardiac, med-surg, peds.
Teresag_CNS said:
If you were treated this way, your educators were ill-informed, and may have even been violating the law. Two suggestions: speak to your educators directly, going up the chain of command to see that the behavior changes, or transfer to a better school of nursing.

???? To which prior post are your referring? Thank you for your clarification....

Specializes in ICU, trauma, gerontology, wounds.

I was trying to reply to this quote by jsundownh:

"I had teachers in nursing school who made it as difficult as possible for me and other students because we had special testing areas. The tests were the same as everyone else's, but we got extra time on our test and in a quiet environment. The attitude was that we were getting something extra "an unfair advantage" that made me so mad."

Specializes in Cath Lab, OR, CPHN/SN, ER.

Thanks for posting this Vicky. I've learned more than I would like about FERPA, 504's and IDEA since starting work as a school nurse. If I were in a face to face classroom for my BSN, I'd probably be interested in doing a 504 due to my hearing loss just to maintain appropriate seating in the classroom.

I recall a resident at the same local hospital who was in a wheelchair. He did a wonderful job and I wish I knew what area he works in now. He was even on one of the morning shows.

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"The last people I thought I would have problems with were educators and nursing instructors."

I can well understand your pain. Let me tell you my story. I have been a nurse for 18 years+ and now realize why I always got evaluations from my managers/peers stating that "I could not see the forest for the trees, that I was too intense, " etc. What they and I did not know was that I have ADHD.

Most people think ADHD is just for kids, if they believe in it at all. I was finally diagnosed with it about 3 years ago, though I had long suspected it. Those comments that were made about me in my evaluations are because they and I at that time did not know that people with my condition look at things differently, prioritize things slightly differently than everyone else, etc. I once heard the thought process of an ADHDer characterized as "like having a ping pong ball erractically bouncing around in your brain without any control." That to me about sums it up, except that it is so many ideas which are bouncing around in my brain- the same ideas that are responsible for my creative and innovative ideas in the workplace and in the classroom . That did not make me a bad nurse, as a matter of fact, because of ADHD, I was more attentive to detail and I never had a patient die on my shift in all of those years, even when I worked in the ICUs, stepdown, tele, etc. (I also have to say, with regards to patients dying, that the credit also belongs to God as He and I had made a pact in the very beginning of my career, that no patients would ever die on my shift and I can testify that He has kept to his end of the bargain! :wink2:)

Anyway, with regards to school, I made A's all through my ADN, BSN, and Master's and am now going for another advanced degree with a 4.0 GPA so far. I rarely told my teachers or asked for assistance though i knew i was entitled to it. (Yes, it did bite me in the butt that I told some of them when I went to apply for a teaching job at the university where I received both my BSN and MAster's degrees and did not even get an interview! This was regardless of the fact that I had graduated with honors for both degrees and was 1 of only 2 students who had ever taken 5-6 courses at a time in the BSN and Master's program- usual load allowed was 1-2 only- ANd at the same time was working fulltime. But that is another story....)

I also cannot tell my managers, either at work or at the school where I am going to be teaching at, as I am sure that they would not have hired me if they knew. (Most people think that people with ADHD or ADD are stupid, lazy, don't llisten, etc. which is just not the case.) It is really sad to have to hide who I really am. (Though I sometimes reveal myself, such as speaking before thinking.) So yes, I can well understand why you were so hurt when your instructors did not "practice what they preach" as it were. This is one reason why I wanted to become a nurse educator, as I understand what students with disabilities often go through, not only in the academic arena, but also in the clinical arena as well. I also hope to be able to influence more nursing managers in the clinical environment that just because a nurse may act different maybe there is a reason for it, like the reason that I got the evaluations that I did. (I am working on my PhD thesis on that right now.)

Anhyway, I guess what I am trying to tell you is that you should use your disability to your advantage and teach others, whether in the workplace or in the academic arena, what attitude they should adopt and how best to teach you and others with your type of disability. I am sorry that your instructors (and most likely your employers in the future) haven't figured out that you are not trying to "gain an advantage" by asking for help. Never let anyone make you feel like you are using your disability as a "crutch." Always remember that you do have much to contribute, even though you have a different way of going about it. Finally, do not paint all instructors with the same brush as there are some of us out there who do understand and are trying to change this. :nurse:Take care.