Successes and Challenges of a Nursing Student with Dyslexia
The International Dyslexia Association describes dyslexia as “a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities.” Dyslexia is a condition that does not change in one’s lifetime.
I knew I had dyslexia when I applied to nursing school in 2007. About a decade prior, I received the diagnosis of dyslexia during my unsuccessful attempt to get into graduate school. At age 43, with a daughter in middle school and a supportive husband, I was willing to try a career change again. I succeeded in my prerequisites courses, receiving A’s in Chemistry and Microbiology and a B in Anatomy and Physiology. I thought somehow maybe I “outgrew” being dyslexic. I really knew nothing about what dyslexia was. I knew learning to read was really hard and I got pulled out of reading groups in fourth grade, but I still don’t know very much about it. I knew I did not want reading differently to stop me. I still have so much to learn.
My first try at nursing school was in an accelerated nursing program. The documentation stating my dyslexia diagnosis was more than 10 years old. I attended a community college to complete my prerequisites. The community college was able to accept the documents I had and explained that a university would require updated documentation confirming the condition. To get retested and get current documents would cost approximately $600 to $1,000—an added burden to the cost of tuition and books.
Accommodations for my dyslexia during the accelerated program could not be available because of the outdated status of my documents. Nevertheless, I felt elated because my grades from my prerequisites were high. Fifteen weeks into the accelerated program, I “washed out” and voluntarily withdrew. But, I had a plan. I got retested and got the updated documentation. I also became a Certified Nursing Assistant (CNA). In seven months, I got the call inviting me to join the traditional Bachelor of Science in Nursing (BSN) program. I literally cried with joy. I had another chance.
The tests to assess learning disabilities are not difficult. There were four one-hour sessions, including tests—some written, some verbal, and one involving making shapes with blocks. One test measured my reading speed. I was instructed when to start and, at different times, I was asked to point to where in the article I had read to in the given time. Once the allotted time was completed, I was asked a series of questions to test my comprehension.
Soon after completion of the testing, I enrolled in CNA training. Becoming a CNA significantly contributed to my understanding of many principles I had learned in lecture on the fundamentals of patient care. As a CNA, I was able to learn at the bedside while developing relationships with patients and practicing the skills from both lab and clinicals. Nineteen days after finishing CNA training, I was employed at the location where we completed our clinicals. Having a job as a CNA provided me with the opportunity to make real the theory I had learned in class. The opportunity to work next to real nurses let me watch the lessons you cannot learn through books. My confidence grew as my dedication to complete the BSN degree cemented. Once I returned to the classroom as a student nurse, I was wholly committed to completing the program.
Being back in class gave me the opportunity to fulfill my dream of being a nurse while receiving a variety of accommodations for dyslexia:
Transparencies: Color transparencies over a printed page, which function like sunglasses on a sunny day. The distortion is minimized. This simple fix considerably reduces the strain from reading.
Kerzweil Text-to-Speech Reader: A computer program that changes text into audio. All the computers on campus can utilize Kerzweil, so I bring earphones in order to listen to my tests or texts.
Testing Center: All of my test taking is completed in the test center. An appointment with the test center is scheduled four days prior to each exam. To limit distractions and noise, I test in a room alone.
Time-and-a-Half: My test appointment time is 1.5 times the allotted time in the classroom. So, I go to the testing center early, usually 7:30 a.m. for an 8:00 a.m. test. Rarely do I need the extra time, but the benefit is not having to worry that I might run out of time near the end of the exam. This reassurance really makes a difference, especially when I go back to recheck answers.
There are many parts when I take an exam—it resembles conducting an orchestra. All of the material requires management to maximize my comprehension of the technical questions being asked. There are inputs from four tests simultaneously, so I can receive the information efficiently. There is one test in front of me that I manually mark up, which is covered with a color transparency. This paper test is returned to my instructor. It is a back-up in case there is a computer malfunction.
There are also two tests on the computer. One of the tests on the computer is in the Kerzweil program. This program reads the test to me so I can hear it in my earphones. Kerzweil highlights each sentence in yellow as it is being spoken and each word in that sentence is highlighted in pink.
The second version of the test on the computer is the one that I must complete and submit to the instructor for grading. The final version of the test is the audio in the Kerzweil program. Most of my classmates don’t notice that I am out of class during tests. Usually, when I explain I have a learning disability, the first reaction I get is disbelief since I always participate in class discussions.
It is best for me to prepare for lecture prior to class time. I ask many questions as the material comes up in lecture. To classmates, it might appear that I am really enthusiastic—which I am—but I don’t really have many other options. If I can’t understand a concept from the book, it is easiest to ask during lecture. I am always the most surprised when I get high grades on exams.
During the summer of 2010 between my junior and senior years, I enjoyed participating in an externship. This consisted of fifteen 12-hour shifts, during which I followed a preceptor on the telemetry floor at a major medical center. This externship provided many opportunities for verbal questions and answers—my preferred learning style. My preceptor was incredible. She was open to learn about my learning needs, and we discussed possible precautions to take in order to maximize my performance on the floor.
According to my preceptor, there was no evidence of disability in my performance. I did use a color transparency when there was a lot of material to read and comprehend, but that was the only accommodation I used on the floor. The transparency was also a folder that held materials that I needed, so it blended in discreetly.
Despite research articles in the medical literature raising skepticism about nurses and nursing students with dyslexia, most articles call for the need for more research. There are laws that prohibit discrimination against individuals with disabilities, but application of these laws to nursing students and new nurses with dyslexia is an area that appears vacant. I have not found another group of student nurses that is directly being targeted in this way.
The United Kingdom leads the way in accommodating the needs of dyslexic students. England has a complete, published protocol that details how to best maximize the learning abilities of dyslexic student nurses while ensuring the safety for all. The idea of whether dyslexic student nurses should be allowed to practice in the United Kingdom is never questioned.
Unable to locate a voice from the perspective of dyslexic student nurses, I founded Nursing Students with Dyslexia (NSwD) on www.NursesLounge.com, which is a social networking site geared specifically to nurses and student nurses. Students are able to join NSwD directly at http://community.nurseslounge.com/join/nswd. This page includes research available on assisting student nurses with dyslexia, along with resources and scholarship opportunities.
Someday, I hope to develop a scholarship that encourages student nurses with dyslexia to network together. Maybe by sharing our stories of success we can offer greater insights into the challenges that dyslexic student nurses must overcome. Nursing education is expanding its understanding of how to provide the most successful learning experience for students, including student nurses with dyslexia. I am proud and honored to be a voice as a student nurse who is not letting a disability define or limit me.
