Disabled Nurses: Disclosure and Safe Practice

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By Joan Fox Rose, RN, MA, contributor

The problem of disabled nurses and safe practice is a complex one with no easy fixes, according to Donna C. Maheady, Ed.D., ARPN, Founder and President of Exceptional Nurse. One major safety concern is the lack of disability disclosure at the time of hire.

“Lack of disclosure is more of a safety risk than working with known disabled nurses,” she said. “Disabled nurses are reluctant to disclose because they fear employer reprisal.”

Beka Serdens, RN, BSN, feared reprisal when interviewed by a nurse recruiter who, she said, stared at her but would not ask what was wrong. “ I did not disclose my disability at that interview, she said. “I thought, if I do, I won’t be hired.”

A nurse for 17 years, Sardens was diagnosed with Dystonia ten years ago. Dystonia causes the body’s neurons to misfire and this malfunction precipitates involuntary muscle movements that impairs mobility. “People tend to stare at the way you look and move, and there is a social stigma associated with fear about those who have disabilities, Sardens said.

Prior to her present employer, Sardens said she worked in a hospital where nurse co-workers “harassed and ridiculed me, and nurse managers were not supportive.”

For the past five years Sardens has been employed at New York’s Columbia Presbyterian Hospital as a float, ICU nurse. “My employer and co-workers have been very supportive, and while at work I focus on my patients and not myself,” she said.

“For me, patient care overrides my own health issues like spasms and pain. Disabled nurses make good employees because they want to do a good job and often find inventive ways of doing it.”

Born without her left hand, Susanne (Susan) Fleming, RN, BSN applied to a nursing school during the early 1970s but was met with professional resistance when she disclosed she had one hand.

“I was told I would endanger patients’ lives because I could not perform a bilateral backrub,” she said.

Determined to be a nurse, she was admitted to Los Angeles Hospital School of Nursing, and after graduation 25 years ago, Fleming has worked at medical centers in Hawaii, Texas and Germany. At present she works at the Deaconess Medical Center in Seattle in the Mother-Baby unit.

“ I am lucky that my employer and co-workers support me,” Fleming said, “ but I couldn’t do a better job if I had been born with two hands. I can put on sterile gloves, start IVs, give injections, and have two strong arms to lift patients better than some of my co-workers,” she said.

Fleming is the 2004 Grand Prize winner in the RN category of the Cherokee Inspired Comfort Award “for professional dedication, and advocacy for disabled nurses from all over the world.” She said a co-worker was surprised when she heard about the award. “She told me she never realized I had only one hand,” Fleming said. “I focus on what I can do, and try to be a good team player,” she said.

“Employers center on people with physical disabilities, but are not aware of those with disabilities they cannot see,” Fleming said. “What about foreign nurses who set up the wrong blood type for a transfusion because they do not have mastery of the English language, or the X-ray tech I saw run screaming out of a room when a patient coded? How about the anesthesiologist who was so busy talking he did not notice a patient’s IV running out?”

When Rosetta Jackson, RN, a licensed health care risk manager, learned she had to undergo dialysis treatments eight years ago she quit her hospital job“ because I knew I couldn’t work full time anymore,” she said. “I needed a job that allowed flexibility that would allow me to take breaks when I needed them, and leave work when I was not feeling well.”

To meet her personal needs this veteran nurse of 25 years chose to work for several Florida-based nursing agencies as an independent contractor.

“I am a risk manager who assists long term care facilities with their compliance issues, and I review charts for legal reasons,” she said.

Disclosure about her dialysis treatments created a problem in the past when one agency thought it would be required to financially cover her treatments, Jackson said.

“ Now I disclose my disability at the first interview, and I have a good rapport with agency personnel,” she said. “It is important for disabled nurses to consider their disabilities and then work at what they know and like to do.”

Employers tend to “get hung up on physical disabilities, and may not be aware they have hired nurses with mental health problems, or nurses with drug or alcohol addictions,” Maheady said. “Disabled nurses need to feel safe enough to disclose their disabilities at the time of hire,” she said, and pointed out employers are required by law to provide reasonable accommodations for physically disabled nurses, like having amplified stethoscopes available for hard of hearing nurses. Trial periods to assess job performance also need to be in place.

“When disabled nurses do not perform well during the trial period, employers should show them the door,” she said.

Nurses with disabilities are not legally required to disclose, at time of hire. When they do not disclose they are ineligible for reasonable accommodations assured by the American Disabilities Act, said Susan Matt, RN, MN, a hearing impaired, nurse attorney who counsels and represents disabled nurses.

Nurses who are chemically dependent should disclose because they can be a threat to safe practice, Matt said. State programs to address the problem exist through state to state nurse practice acts. “Oregon has monitoring programs for chemically impaired nurses, and those with psychiatric disorders who work in clinical settings,” Matt explained.

Disclosure is “a touchy issue,” she said, and barriers exist to exclude nurses and potential nurses with certain disability disorders. “When disabled nurses become patients and do not see caregivers like themselves, they feel stigmatized,” Matt said. “Patients with disabilities who are cared for by others like them have a higher self esteem because they know their care providers have a better understanding of what they have experienced.”

“The majority of disabled nurses are aware of their disabilities and are safe practioners,” Maheady added.

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