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End the Disability Debate in Nursing: Quality Care is Fact - By Leslie Neal-Boylan

Misconceptions abound regarding the abilities of people with disabilities and this holds true in the nursing profession, as well. While nurses with experience and expertise are often denied jobs or lose their jobs because of a physical disability, research shows appropriate accommodations can be made to retain these highly skilled and much-needed health care professionals.

Four research studies involving registered nurses with self-identified physical and/or sensory disabilities reveal common themes about their work life experiences. The studies occurred over a period of five years (2007-2012) and included interviews and surveys of nurses with a variety of acquired and congenital disabilities. Nurses from all levels of nursing education (associate degree, bachelor’s degree, master’s degree, and doctoral degree) and from inpatient, outpatient, and community settings participated. In addition, one study compared the work life experiences of physicians and nurses with disabilities.

Leslie Neal-Boylan, PhD, APRNLeslie Neal-Boylan, PhD, APRNThese studies confirm the value of nurses lies not in whether they can lift 50 pounds, (often stipulated in nurse job descriptions), but in what they know. A nurse thinks critically and makes judgments that directly affect patient outcomes. A nurse is taught to question, consider, and ensure that doctors’ orders are appropriate for the patient because first and foremost, the nurse is a patient advocate. Patients and families rely on nurses to help them navigate the complex health care system, translate complicated medical jargon, and better understand the diagnosis and treatment plan.

Concerns have been raised about whether a nurse with a physical disability might impact patient care or safety; however, hospitals and healthcare agencies are being encouraged to acknowledge that with proper accommodations, nurses who have a disability can perform the necessary tasks involving direct and indirect patient care without jeopardizing patient safety.

For instance, a nurse who has trouble walking can monitor telemetry on a cardiac unit, work in a poison control center, manage a unit, or be in charge of quality improvement. A nurse with a hearing impairment can function effectively in just about any milieu as long as TDD devices are placed on telephones and people face the nurse when speaking.

Research also shows that nurses with disabilities know their limitations, and are likely to leave their position over the slightest concern about their ability to provide safe, high quality care. To date, there are no documented incidents of a patient injury caused by a nurse with a physical disability.

Furthermore, patients report little concern over being cared for by a nurse who has a disability. In fact, they feel the nurse is more likely to be empathetic. Patients want the people taking care of them to be competent and confident. They seem to understand that the knowledge nurses provide is their most important skill.

In the event that adequate accommodations are unavailable, other opportunities exist. The most recent research study found that if they are persistent, nurses can find jobs in which they can perform as nurses and be appreciated for what they bring to the job. Interestingly, most of the nurses interviewed for this study were employed by someone who was either a nurse who had a disability or a chronic illness, or by a non-nurse who had no preconceived notions about how much a nurse can lift or can do physically and was only interested in the nurse’s expertise. It is ironic that non-nurses would be more accepting of hiring and retaining nurses with disabilities than are health care providers or agencies. Nurses with disabilities have found satisfying positions in school nursing, informatics, case management, and as advice nurses, to name a few less typical nursing roles.

Studies of nurses with physical disabilities confirm what research has previously shown about people with disabilities: they often suffer discrimination despite the Americans with Disabilities Act, they are rarely given a chance to show what they can do, and people make inaccurate assumptions about their abilities. It is important that employers and colleagues look beyond disability to discover what skills truly make a person valuable to the organization.

Leslie Neal-Boylan, PhD, APRN, is associate dean and professor of the Quinnipiac University School of Nursing in Connecticut. She is the author of Nurses With Disabilities: Professional Issues and Job Retention (Springer Publishing), the first research-based book to confront workplace issues facing nurses with disabilities.

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