1. Maheady, Donna EdD, RN, CPNP

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"I lost my job because I have to use a cane and they said I was unable to return to full capacity according to the job description. I asked for another position and was told, 'We can't make a position for you.'"FIGURE

FIGURE. Nurses say t... - Click to enlarge in new windowFIGURE. Nurses say that support from employers and coworkers is key.

That statement comes not from a patient being treated with physical therapy, but from a fellow nurse who happens to be disabled. Many nurses have disabilities, including hearing or vision loss, mobility or dexterity limitations, multiple sclerosis, cerebral palsy, mental illness, amputations, and paralysis. Some have been injured from lifting heavy patients at work or receiving the brunt of a patient's violent outbreak, or through exposure to latex or glutaraldehyde. Their ages, disabilities, and work experiences may differ, but what remains constant is a passion to continue working in nursing. And given the critical shortage and the passage of the Americans with Disabilities Act (ADA) 14 years ago, it's difficult to understand why nurses report disability as a barrier to employment.


The March 2000 National Nurses Survey found that 9,438 RNs reported disability-illness as a reason for not working in the nursing profession. The 2003 Heldrich Work Trends Survey conducted by the State University of New Jersey-Rutgers, found that people with disabilities are underrepresented despite the desire and the ability to work. Barriers to work included lack of appropriate physical access, employers' reluctance to hire, and lack of transportation.


There are no studies documenting the exact number of nurses with disabilities-and some nurses fear termination if they disclose their disability to an employer. In states with programs that monitor a physical disability in the same manner as a drug addiction, nurses fear disclosure will result in the loss of their license.


However, there are disabled nurses who report successful accommodations and continued practice. For example, nurses with mobility limitations are successful case managers, telephone triage nurses, and consultants. And in some cases, patients may feel more comfortable being cared for by a nurse who offers personal experience regarding an illness or disability.


Nurses say that support from their employer and coworkers is the key to success. Technologic accommodations are also useful and include equipment such as amplified and electronic stethoscopes, amplified telephones, digital blood pressure machines and thermometers, and see-through masks (which facilitate lip reading, for example, for OR nurses who are deaf. Yet nurses' stations and medication rooms that can accommodate wheelchairs or scooters are still needed, as are appropriate and available parking spaces.


Patient safety is a main concern-for everyone. Yet when nurses feel comfortable disclosing their disabilities and using appropriate accommodations without fear of retribution, everyone is aware of the disability, and patient safety is enhanced.


A change in attitude regarding the potential of these nurses is necessary. Employers need to actively recruit nurses with disabilities by specifying in employment ads that these nurses are wanted and welcomed. These employers should be recognized for their efforts by health care agencies and disability organizations, and serve as resources. Professional assessments of nurses should address years of experience, sign language or lip reading skills, empathy, and leadership skills. Employers must also work with insurance companies to identify ways to address liability concerns, a common reason why disabled nurses are denied employment.


There needs to be more research, especially on safe practice. The U.S. Division of Nursing Survey needs to add questions about disabilities to its survey, and state boards of nursing also need to collect data. Nurses with expired licenses should be asked if a disability was the reason.


Let's make a place for nurses with disabilities by expanding reasonable accommodations and treat these nurses the way we would like to be treated.