S
tudents with disabilities are increasing in number at nursing schools throughout the world. Although they may initially encounter discrimination and other obstacles, students with hearing loss, vision loss, paralysis, learning disabilities, mental illness, chronic illness, limb differences and other disabilities have not only been admitted to nursing programs but have successfully completed them.If you are someone who loves helping others, nursing is one of the most rewarding careers you could consider. But if you are also a person with a disability, there is important “homework” to do before you make the decision to become a nurse. Nursing is a physically and emotionally demanding educational experience and profession. As you complete your homework, make a list of the pros and cons. Your decision shouldn’t be based on what you “think” a nurse does or what you viewed on a television program. The best way to find out what nurses do is to spend some time with nurses. Learn as much as possible about a nurse’s responsibilities and the technical skills that nurses and nursing students typically perform.
You can gather this information by talking to nurses and nursing students, observing nurses at work, volunteering in
the future nurses organization at their school or taking a health occupations course and joining a chapter of the Health Occupations Students of America.
Additional information about what is involved in nursing careers can be obtained from colleges, universities, technical schools, libraries, nursing journals, nursing associations and the Internet. Some helpful Internet sites to visit include:
■ The National Institutes of Health, http://science.-education.nih.gov/LifeWorks.nsf/feature/index.htm, to learn about careers in health sciences.
■ Discover Nursing, sponsored by Johnson & Johnson, to learn about careers in nursing (www.discovernursing.com).
■ ExceptionalNurse.com is a nonprofit resource network for nurses and nursing students with disabilities (www.
“Homework”
Begin networking with nurses, nursing students or other health care professionals who have a disability similar to yours. Ask these contacts about their experiences and about accommodations that helped them succeed. Find a nurse or student who can mentor you. Do a library search and read all you can about the experiences of other nursing students with disabilities.
Know your rights under the Americans with Disabilities Act and the Rehabilitation Act. Be knowledgeable about reasonable accommodations and the differences in legal protections for students with disabilities in high school and in college—i.e., the differences between IDEA, ADA and Section 504.
Keep abreast of new programs and developing technology, such as standing wheelchairs that will enhance mobility for nurses who use wheelchairs. Clear surgical face masks will allow a nurse to read lips when other members of the surgical team are wearing masks. (The development of clear face mask
products is being monitored closely by the AMPHL.) The University of Salford, in England, opened the first nursing program for students who are deaf.
Understanding Admissions Standards
Another important part of your homework is learning about the different educational options available to prospective nursing students and about how to navigate the nursing school admissions process.
There are several different types of nursing programs offered. Registered nurses (RNs) are educated in baccalaureate degree programs (Bachelor of Science in Nursing), two-year associate degree programs and three-year
hospital diploma programs (rare in the United States). Licensed practical nurses (LPNs) are educated in
technical schools and community colleges. In general, a BSN program is usually less
focused on technical skills.
Going to nursing school doesn’t have to be
an impossible dream just because you have
a disability. The key is knowing what will be
expected of you, knowing your options and
knowing your rights.
by Donna Carol Maheady, EdD, CPNP, RN,
and Susan E. Fleming, BSN, RN
Nursing
Students
Organizations:
The Association of Nurses in AIDS Care provides a newsletter for HIV+ nurses and students.
www.anacnet.org/programs_pubs-hivnurse.php
NOISE (Network for Overcoming Increased Silence Effectively) is a listserv and support forum for medical professionals and students with any degree of hearing loss. www.amphl.org/noise.html
The Postsecondary Education Programs Network (PEPNet) is the national collaboration of the four Regional Postsecondary Education Centers for Individuals who are Deaf and Hard of Hearing. PEPNet’s mission is to assist postsecondary educational institutions in attracting and effectively serving persons with hearing disabilities.
www.pepnet.org
Books:
Maheady, D. (2003). Nursing Students with Disabilities: Change the Course. (River Edge, N.J.: Exceptional Parent Press.) This book showcases the success stories of eight nursing students with various disabilities who graduated and are now practicing as nurses. www.eplibrary.com
Serdans, B. (2002). I’m Moving On. . .Are U?
(Philadelphia: Xlibris Corporation.)
The author is a nurse with dystonia, a movement disorder. This book shares her journey of living and practicing nursing with a disability. Available from
http://care4dystonia.org or Amazon.com.
Equipment and Technology:
A blood pressure gauge that can be used with one hand is available at www.Stethoscopes.com.
An amplified electronic stethoscope (E-Scope) for use by nurses with hearing loss is available from Cardionics, www.cardionics.com.
A “talking thermometer” that provides an audio announcement of temperature (along with a digital display) can be purchased at
www.sightconnection.com.
A pressure-sensitive stethoscope for people with hearing loss is available from Ultrascopes,
www.ultrascopes.com.
There are no universal standards for admission to nurs-ing programs, and requirements under state Nursnurs-ing Practice Acts can vary from state to state. Furthermore, admission decisions can differ from program to program and can be dramatically inconsistent. The same student can be rejected at one school and welcomed at another. Decisions will be made on a case-by-case basis.
Some nursing programs have technical or core perfor-mance standards. Examples may include critical thinking, interpersonal skills and communication, mobility, motor skills, hearing, visual and tactile skills. Other programs may have more specific standards, such as being able to lift 25 pounds, physical ability to perform CPR, hearing ability to understand normal speech without viewing the speaker’s face, and manual dexterity to draw up solutions in a syringe.
It is important to recognize that even though you may have a career goal of working in an area of nursing that does not require direct patient care—such as case management, research or teaching—you must still complete nursing courses that will require you to demonstrate a wide range of technical skills, including some that you may not plan to use after you graduate.
If you will need accommodations for your disability in nursing school—such as special equipment, a sign language interpreter, books on audiotape or someone to take notes for you—you will need to provide documentation from your physician, audiologist, psychologist or other health care professional.
Above all, be prepared, be prepared and be prepared. Anticipate a wide range of responses to your disability from administrators, faculty, other students and patients. To deny that you may meet with a negative attitude or response isn’t being fair to yourself or realistic. The important thing is to move forward with your head held high.
Rehearse Your Responses
Mentally rehearse responses to questions you may be asked during nursing school admissions interviews. Always focus on your positive attributes, previous accomplishments and life experiences. Be professional and enthusiastic. Practice interviewing by having someone role-play with you.
You may be asked about how you will perform technical skills with or without accommodations. Some skills you may
not be familiar with. Be honest in your responses. Keep the following examples of questions and answers in mind as you plan for interviews.
■ A student who uses a wheelchair might be asked, “How will you perform CPR?” Sample answer:“First, I will call for help, which is the first recommendation of the American Heart Association when working with adults. Then, I will get up out of my wheelchair. It’s not some-thing that I use all the time; in an emergency like CPR, I would not use the wheelchair.”
■ A student with one hand might be asked, “How will you give an injection?” Sample answer:“I have developed excellent compensatory abilities and can be creative when learning new skills. I learned to tie my shoes with one hand when I was four years old. When I am required to learn or demonstrate how to give an injection, I will seek extra assistance from the laboratory instructor and practice different methods.”
■ A student with low vision might be asked, “How will you read a medical chart?” Sample answer:“I will use an optical reading aid.”
■ A student with a back injury and lifting restrictions might be asked, “How will you make a bed or turn a patient in bed?”Sample answer:“I will ask a colleague/peer for help. In return, I will negotiate work that I can do to help my colleague/peer out.”
■ A student with hearing loss might be asked, “How will you hear a patient’s beeping monitor?”Sample answer:
“I’ve never worked in a hospital. I don’t know if I will be able to hear the monitors. I may need assistive technology that will activate my vibrating pager when a monitor beeps.”
■ A student with hearing loss may also be asked, “Will you be able to hear the sound of a needle penetrating a patient’s skin?” Answer:“No, I won’t be able to.” (You may be asked this type of question to see if you will respond honestly.)
These examples are not meant to be verbatim responses that applicants should use, unless the response is appropri-ate. They are included simply as examples of answers that are honest and show that the applicant has researched or thought about the topic.
Go For It!
The future promises to find more and more nurses with disabilities working successfully in this exciting and fulfilling profession. Nurses can practice in a wide variety of settings,
such as telephone triage, nursing education, home care, legal nurse consulting, case management, hospital nursing, school nursing, camp nursing, travel nursing, parish nursing, research and more. If you know in your heart that nursing is
a vital part of the health care team. Through your unique contributions and strengths, you will enrich patient care, share your gifts and experiences, and add greater harmony
to our profession. ■
Donna Carol Maheady, EdD, CPNP, RN,
is an adjunct assistant professor of nursing at Florida Atlantic University in Boca Raton and founder of www. ExceptionalNurse.com. Susan E. Fleming, BSN, RN,
is a staff nurse at Deaconess Medical Center in Spokane, Wash., and an adjunct clinical instructor at Washington State University Intercollegiate College of Nursing. She is currently pursuing a master’s degree at the University of Washington.
References
1. Bueche, M.N, and Haxton, D. (1983). “The Student with a Hearing Loss:
Coping Strategies.” Nurse Educator, Vol. 8, No. 4, pp. 7-11.
2. Chickadonz, G.H., Beach, E.K., and Fox, J.A. (1983). “Breaking Barriers:
Educating a Deaf Nursing Student.” Nursing Health Care, Vol. 4, No. 6,
pp. 327-333.
3. Creamer, B. (2003). “Wheelchair Fails to Deter Paraplegic from Nurse’s
Life.” The Honolulu Advertiser. Available at http://
the.honoluluadvertiser.com/article/2003/Dec/28/ln/ln10a.html. 4. Eliason, M. (1992). “Nursing Students with Learning Disabilities:
Appropriate Accommodations.” Journal of Nursing Education, Vol. 31,
No. 8, pp. 375-376.
5. Huyer, S. (2003). “The Gift of ADD.” Advance for Nurse Practitioners,
Vol. 11, No. 4, p. 92.
6. Kolanko, K. (2003). “A Collective Case Study of Nursing Students with
Learning Disabilities.” Nursing Education Perspectives, Vol. 24, No. 5,
pp. 251-256.
7. Maheady, D. (1999). “Jumping Through Hoops, Walking on Eggshells:
The Experiences of Nursing Students with Disabilities.” Journal of
Nursing Education, Vol. 38, No. 4, pp. 162-170.
8. Pischke-Winn, K., Andreoli, K., and Halstead, L. (2003). Students with
Disabilities: Nursing Education and Practice (Proceedings Manual). Rush University College of Nursing. Available at www.rushu.rush.edu/ nursing/studisable.html.
9. Americans with Disabilities Act (1990), Public Law, No. 101-336, 42 U.S.C. 12101.
10. Matt, S.B. (2003). “Reasonable Accommodation: What Does the Law
Really Require?” Journal of the Association of Medical Professionals
with Hearing Losses, Vol. 1, No. 3.
