Working with a disability might require accommodations to help you perform your job better or an open approach to different specialties. “Being honest with yourself regarding your strengths and weaknesses will go a long way toward facilitating success,” says Donna C. Maheady, EdD, APRN-BC, founder of ExceptionalNurse.com.
McCulloh, who lost her vision over a 24-hour span, says her nursing skills were enhanced. “We’ve found that nurses with disabilities have a sense of compassion for patients and what they are going through because they’ve been there,” she says. But for nurses who become disabled while already working as a nurse, McCulloh says there’s often an adjustment phase. “You think about, ‘who am I now? What about my self-esteem, self-identity, self-worth, and self-confidence? Am I still the same person?’”
Every Path Is Different
Sandra Nosek, MSN, RN, has been a nurse for over 30 years with experience in management, staff development, QA wound care, long-term critical acute care, hospice, and skilled nursing facilities. She had a hearing aid in her right ear but woke up with sudden bilateral deafness in 2015. “It rocked my world and was very scary,” she says. Navigating without her hearing proved exceedingly challenging.
Nosek thought she’d have surgery and be able to return to work quickly, but her path proved challenging. She obtained her MSN in nursing education (with a 4.0 GPA) in 2019 and, after receiving improved Bluetooth processors in 2021, sent out more than 400 applications with little result.
She landed a job at a skilled nursing facility that restored some of her self-confidence lost in the job search process, and she eventually began working in hospice, a nursing specialty she loves. She recently obtained an RN case manager position with a small hospice in her community. “To other nurses with disabilities, don’t give up,” she says. “Continue to pursue options in your career.”
Kim Hickman, DNP, APRN, Adult PMHNP-BC, works as an adult psychiatric mental health nurse practitioner with the VA Health Care System and has more than 36 years of nursing experience, including in the Army Nurse Corp, as a lieutenant stationed at Walter Reed Army Medical Center (three years on active duty), and roles in medical surgical nursing, home health nursing, occupational health nursing, and volunteer work as a faith community nurse. But Hickman, who has a speech impediment of a stutter/stammer, almost didn’t pursue this career.
“I was unsure if I would be an effective nurse,” she says. “I shared my concerns with my mother, an ICU nurse at the VA then. My mother paused for a few minutes before answering. She looked at me and said, ‘Remember, it’s more important what you say than how you say it.’ Her confidence in me encouraged me to continue pursuing my nursing degree. From that point on, I focused on the content of my speech, making sure the information was accurate and relevant.”
Hickman says her stutter/stammer can fluctuate depending on the situation and her stress level. “Learning to be patient with myself has been a tremendous achievement. I am learning to accept that my stutter/stammer is a part of who I am,” she says, noting that it has positive impacts. “Stutter/stammering has allowed me to actively listen to others, to be patient with others, to be present, and to be compassionate and empathetic toward the suffering of others. It has also helped me recognize and value words’ power and importance. It has given me a chance to pause and decide if I want to say what I intended and time to decide if my comments add value or take away value to the conversation.”
Lois Taurman (who has a nursing degree, national certification as a poison information specialist, a master’s in educational counseling, a jurist doctorate, and also represented the United States as a wheelchair athlete in the Paralympics Games in Seoul) had plans to work in the Navy as a nurse or as a pediatric nurse when a fall from a ladder just before graduation paralyzed her (she can move her arms, but has no finger movement). Taurman, who now works in America’s Poison Centers, a poison specialist in the Kentucky Poison Control Center of Norton Children’s Hospital, says that while she isn’t doing hands-on nursing, her work fulfills her drive to help children.
That doesn’t mean the role was anywhere on Taurman’s radar. “I didn’t know poison center nursing even existed,” she says. “This is a blessing for my career, but also to feel like I have valuable nursing skills.” Her employer has made adjustments and accommodations so Taurman can work, including adaptive technology and spaces. Still, she knows not all nurses have such proactive employers and may feel like they can’t reach their dreams. “Be persistent in looking for jobs,” she advises. “Your skills may differ, but you can show them how to accomplish the job. It may not be how you envisioned it, but it is still possible. Disability isn’t something that should hinder someone.”
PoisonCenters.org is available for all health care professionals to access assistance during a poisoning emergency, and nurses can also find job opportunities there. Always keep the Poison Help number 1-800-222-1222 with you.
Nurses must assess their interests and how they work when thinking about a nursing path. Consider the specialties you enjoy working in, determine how fast you can work or prefer, and what accommodations you’ll need to know what’s possible.
According to Maheady, the career options available for nurses with disabilities are very wide and include the following partial list:
Teaching nursing online
Diabetes nurse educator
Pharmaceutical or insurance company (Nurse Line)
Legal nurse consultant
Home health nurse
Poison control hotline
Technology is changing the options available to nurses with disabilities. Some apps help nurses with color blindness, and assistive technology will read out information for those who can’t see it.
As a nurse with a disability, the Americans with Disabilities Act protects you from having to disclose your disability, but if you need accommodations, then you will need to disclose. Nurses with visible disabilities (such as amputation or paralysis) will likely address their needs earlier in a job search than those with invisible disabilities (such as anxiety or fibromyalgia). Nurses who an organization already employs could become disabled and will need to determine the next steps.
Despite the tendency for some nurses to not want to reveal any disability for fear it could impact their job, Maheady says sometimes that approach backfires. “Undisclosed invisible disabilities can provide a privacy shelter for some nurses,” she says. “However, it may not serve the nurse or institution well.” Colleagues and supervisors might not know about the disability and could make hurtful comments about not looking sick or faking symptoms to struggling nurses.
So, when is a good time? McCulloh says once you have a job offer, you should consider the need for any accommodations. But before that even happens, you’ll want to think about precisely what you’ll need to do the job best. Even the most accommodating human resources department can’t guess your needs, so having a detailed plan will help get you what you need and help human resources make the best plan.
When you have the job offer, approach the topic with your natural enthusiasm for the position, the new opportunity, and the skills you’ll bring. And then relay having a disability and needing specific accommodations to perform the job. Put everything in writing, says Maheady. See this Sample Language for Accommodation Request Letters from JAN – Job Accommodation Network.
Work with HR
The more specific you can be and the more resources and examples you can offer, the better your chances for getting the accommodations you need, says Maheady. “Do you need a sign language interpreter? If so, provide your employer with a list of resources in your community that provide sign language interpreters,” she says. “Offer to start a sign language club for staff to help staff learn basic sign language to work better with you and patients with hearing loss.”
She says that if you need frequent breaks, be specific about how often you need a break and for how long. Suggest to your employer ways you could be covered for breaks specific to your clinical setting/area of practice.
Nurses with mobility issues might need a scooter to navigate long hallways, so they can help their employer by providing resources for purchasing new and used scooters. “Show the cost-benefit of purchasing a scooter compared to the cost of hiring a new nurse or travel nurse for your position,” says Maheady.
Despite awareness around nurses working with disabilities and the protections of the ADA, not all employers are receptive. “If you are met with a negative response, don’t take no for an answer,” says Maheady. “Ask, ‘Who else can I talk to?’ ‘What else can I provide you with to help me be successful?’”
Nurses with disabilities also reflect the diversity in a patient population and can show people that their life doesn’t stop after a disability. Nurses can share resources with patients and act as important mentors to other nurses. “I can share in an hour what took me ten years to learn,” says McCulloh.
Nurses are needed to help guide policy, and the information is particularly validating to listeners when it comes from a nurse with a disability. “Nurses with disabilities are transforming healthcare and patient care practices,” says McCulloh. “The priority with every nurse is to ensure patient safety. And because of the critical eye toward us, we have direct awareness of that requirement.”
Nosek, who eventually found a role in a specialty that is meaningful to her, says that all nurses must realize that no one is protected from having or developing a disability. “To all nurses, I strongly suggest obtaining some experience in an office-type position at some point in your career to be able to fall back on if you were to become disabled,” she says, noting that her extensive education and management experience wasn’t enough of a buffer to prevent roadblocks in her path to finding a job that would fit her needs.
“There should be more care and compassion by healthcare administrators to ensure healthcare staff can continue to work no matter their disability,” she says, noting industry-wide changes for additional skills training and compassion from health care administration when faced with a nurse’s disability are needed. “I would have gone right back to work had I had the support and training to do another job within nursing,” says Nosek.
Hickman advises nurses to embrace their differences, acknowledge their strengths, work on their weaknesses, and not hide behind a disability. “You are more than your stutter/stammer or any other disability you may have,” she says. “Above all, love, respect, and be patient with yourself and teach others to love, respect, and be patient with you. You truly are unique! You inspire and motivate someone because you have decided to be courageous, present, and speak up!”
Nurses don’t always find the exact specialty that fuels their passion when they start out on a nursing path. Nicole Reid, BA, RN/BSN, EdM, CSPI, DABAT, now the managing director of the National Capital Poison Center in Washington, DC, didn’t expect her early career work in geography would lead her to a nursing career that she loves. Career opportunities and connections brought her to work as a poison control nurse, and Reid realized she found her place. The career has helped her grow professionally and has also helped her manage to continue to work through health setbacks.
Here, she shares some of her story about being a poison control nurse with Minority Nurse.
Please tell me a little about your background. How and why did your career path lead you to poison control nursing?
I took a roundabout path into poison control nursing. After graduate school, I started out as a geographer and a researcher working for fair housing non-profit organizations. I worked in that sector for three years until 2004 when I was hired by the American Association of Poison Control Centers as a Research Associate. Until that point, I had never had any contact with Poison Centers. As part of my new role, I had the opportunity to visit the National Capital Poison Center (NCPC) in Washington, DC and observe how the Poison Center nurses performed their work and how a poison center operated. I was hooked! The nurses and pharmacists on the phones were true experts in their field and were helping people who were scared or sick or both. At that time, I formed a relationship with the center director and about 18 months later, she helped me form a plan to become a Registered Nurse and work my way into my position at NCPC as a Specialist in Poison Information (SPI).
After a year spent working as a SPI, I sat for my national certification exam and became a Certified SPI. At the time, this exam required the candidate to have worked 2000 hours on the phones and manage 2000 human exposures in order to qualify. It was a whirlwind but I learned so much! Once I was certified, I spent the next six years managing cases over the phone, advising the public and healthcare professionals about how to manage poisonings and suspected poisonings. Thus far in my career, I have assisted 36,000+ callers with their poisoning exposures. I really feel like I have made a positive impact in the lives of others, which makes the work so rewarding.
During those six years, while working on the phones, I also worked on becoming a leader in my field. I gave lectures and created webinars for healthcare professionals; I trained new specialists and created new teaching and orientation materials; I published several journal articles; I had the opportunity to travel to national and international toxicology conferences to present my research and take specialized toxicology courses to enhance my knowledge; I took on a large amount of administrative work at NCPC and worked hard to build my leadership skills.
Seven years into my poison center career, I became credentialed to sit for a board certification exam from the American Board of Applied Toxicology. This exam is open to nurses and pharmacists (but it is mostly geared toward pharmacists) who want to become leaders in the field of toxicology. It usually requires 5-10 years of study and portfolio-building to qualify. With the support of my colleagues at NCPC, I was able to qualify and I passed the exam in 2014 on my first attempt. I am currently the only Registered Nurse in the country to possess this credential.
At this point I was promoted to an administrative position as clinical operations coordinator. Think of a “charge nurse” for the poison center and that is a good approximation of my role. I was responsible for scheduling, shift coverage, producing monthly metrics reports for my team, writing staff evaluations, training, and of course, continuing my work on the phones.
In 2018, I was promoted to my current role of managing director of NCPC. At this time, I transitioned to a more intense administrative role. I became responsible for supervising all of our clinical personnel, for maintaining funding for the center (a 501-c3 not-for-profit organization, maintaining national accreditation of the organization and the clinical staff, optimizing our complex hardware and software and the use of technology in providing our core poison center functions, performing 24/7 toxicosurveillance to search for public health threats in the DC metro region, and taking on anything else that comes up in order to keep the center open and functioning efficiently.
What are some aspects of your nursing role that you didn’t expect?
I became a liaison to several community and regional health organizations, including the DC Health and Medical Coalition whose primary responsibility is to prepare to cope with natural or man-made disasters that may impact the healthcare systems of the Washington DC region. This was rather eye-opening, as it takes an enormous amount of work and collaboration necessary to pull together a functional disaster preparedness plan. I met so many amazing people who donated their time and expertise to the project. I never expected to become an expert on the toxicology and treatment for weapons of mass destruction, chemical and bio-weapons, and radiation-induced injuries, but that was a major focus of the Coalition and my role in particular. I was able to translate this new expertise into training courses NCPC provided for clinicians in our region.
I have been particularly fortunate that NCPC’s leadership has always been dedicated to embracing new technology. Back in the old days, we were one of the first poison centers to develop a website! That was a bit before my time though. During my career, I have had the opportunity to learn the details about how to set up a state-of-the-art call center telephony system and how to rapidly transition to a functional remote poison center model with our staff distributed across three states and the District of Columbia in response to the pandemic. I have learned more about IT support than I ever thought I would have to know as a nurse.
My newest project that combines advanced technology with clinical expertise is webPOISONCONTROL. This is an innovative, free, online triage tool and app that guides users faced with a poison emergency through a series of simple questions to determine the next steps they need to take. It helps you decide what to do when substances are swallowed, splashed in the eye or on the skin, inhaled, or injected.
The tool collects brief, targeted information from the user and provides a recommendation of whether it’s safe to stay home, if the emergency department is warranted (for very serious exposures), or that further guidance from Poison Control (a phone call to 1-800-222-1222) is needed. When it’s safe to stay home, the user is also given information on specific symptoms that are likely to occur and not of concern, and symptoms that should trigger a call to Poison Control or an ER visit, if they develop. The tool also provides automated follow-up to the user and has the capability to provide further triage recommendations based on the interaction with the user during follow-up. webPOISONCONTROLwas developed and is maintained by a team of board-certified medical and clinical toxicologists. Since 2016, webPOISONCONTROL has assisted almost 800,000 people worldwide with their poisoning exposures.
Can you tell me a little about your disability and how that had an impact on your nursing career as a poison control nurse?
I have Idiopathic Pulmonary Arterial Hypertension (IPAH), a rare lung disease that ultimately leads to heart failure and death. Untreated, the average life expectancy was two years. With optimal treatment, the average life expectancy was about seven years. This was the average prognosis in 2015 – but no one has an expiration date stamped on them. There is no cure, but new treatments continue to emerge so I am hopeful. I suffered with symptoms for many years before getting a diagnosis. By the time I was diagnosed at 40 years old, I was in heart failure and was pretty close to death, but as is pretty typical for most nurses, I still showed up to my shifts everyday even though I was exhausted and dragging myself in to work.
After that fateful doctor’s appointment, I immediately went on sick leave and then short-term disability. I was fortunate enough to work for an organization that had these benefits in place. My supervisor valued me enough to work with me to allow me to work part time from home while I was on disability (this was pre-COVID when most people were not working remotely). This was extremely important to my mental health since I had worked very hard in my career and felt that my illness was stealing it away. Also, work served as a distraction from my devastation at being diagnosed with this brutal disease.
After six months of intense cardiopulmonary rehab, and challenging medication and dietary regimens, I decided that I was going to live like I was going to keep living, instead of living like I was dying. I started the process of returning to work. I had recently become a board-certified clinical toxicologist at that time and because of my experience and credentials, I was able to negotiate a return-to-work plan with temporarily reduced hours and more importantly, regular hours instead of shift work.
I had initially thought my career was over, but once I started feeling better I found I could still meaningfully contribute to the mission of the Poison Center. A new chapter began where I assumed more administrative duties and reduced my clinical practice. In 2018, I became the managing director of the Poison Center and along with my co-director, we have run the organization ever since. I am now seven years out from diagnosis and my life and career are still going strong. I continue to lead the organization, publish research, and develop new problem-solving skills. I am extremely grateful for the support of my colleagues and my board of directors. I could not have done it without them.
Have you worked with accommodations or found anything in particular that has helped you succeed in your role?
By 2022, I was working full time in my leadership role when I contracted COVID and became seriously ill. My IPAH made me especially vulnerable and after managing to avoid COVID for two and a half years, it was finally my turn. I developed bilateral pneumonia and was hospitalized but thankfully not put on a ventilator. I spent five days in the hospital and was discharged home on oxygen. I was able to take another five months of disability leave to recover.
I was still fairly frail when I returned to work, so I was able to negotiate with our disability office to allow me to have flexible hours (flexible start and end times, longer or more frequent breaks during the day)to allow me time to rest. They also granted me the ability to work remotely from home most of the time for a period of six months.
I am feeling much better these days and am working full time again. I am still in cardio-pulmonary rehab (rehab is for life y’all) and though my six-month period of accommodation is nearly over, I have been able to negotiate a plan for continued flexibility. This allows me to continue to be productive in my work while I maintain my health and go about all the activities of daily living. In August I will be taking on a new leadership role within my organization that will help facilitate this flexibility and help me maintain my quality of life.
What would you like other nurses to know about working as a poison control nurse?
Working in poison control is my passion. It’s a hard job and there is a lot to learn but it is so rewarding. Most of what we do as a poison control nurse, we do not learn in school or even on-the-job in a hospital environment. If you enjoy an academic setting and are a life-long learner, this may be a great option for you. Poison center nurses usually have at least two years of experience working in an ICU or an Emergency Department, but nurses in other specialties such as pediatric, geriatric, or transplant nursing can successfully make the transition into toxicology. The most important thing is that you are willing to study and learn.
Also, you need to possess or develop an excellent telephone presence. Most of the work is over the phone. You cannot see your patient directly. You have to picture yourself in the room with them and ask the critical questions that will reveal the heart of the matter and quickly translate the answers into a coherent plan for the patient. Sharp listening and clinical skills are a must. A strong rapport with the caller is necessary to get them to open up and tell you what is happening – even if those things might be embarrassing or even illegal. And I should mention, this all has to happen within about three minutes!
A career in poison control is really what you make of it. Some of our nurses have spent their entire career working on the phones and have helped thousands of people during their career. The clinical focus is their passion and they are dedicated to excellent patient care. Others have a more academic focus and enjoy publishing their research and presenting it at national conferences. Still others prefer the administrative route and work their way into leadership positions. Seek out the opportunities and develop your role.
What additional training, education, and/or professional organization memberships have been helpful in your career as a poison control nurse?
I consider myself a life-long student. I have always enjoyed learning which is what made this field perfect for me. The knowledge base and standards of care are constantly changing and you have to take an active role in staying up-to-date.
The American Association of Clinical Toxicologists has been a great support in guiding the scope of my career and providing high-quality continuing education programs. Their national conference has provided the opportunity for me to present my research and participate in larger conversations about toxicology and patient care.
America’s Poison Centers has informed my awareness of the national Poison Control landscape, especially about challenges that poison centers encounter such as remaining relevant in the face of rapidly changing technology and information (e.g., the advent of artificial intelligence), increasing utilization of our services to prevent and mitigate poison injuries, and obtaining funding to support our mission. It has allowed me to connect with many of my colleagues across the country and develop supportive relationships and facilitate the sharing of ideas to improve efficiency and the quality of our services.
Six years ago, Conville was a gunshot wound victim. The bullet injured the left side of his face, and he was rushed into life-saving surgery.
“I woke up in a lot of pain, in a dark room. I was alone except for my nurse. I couldn’t do anything but cry.”
“I woke up from later that night and realized I was still alive. I was relieved, but at the same time I woke up in a lot of pain, in a dark room. I was alone except for my nurse. I couldn’t do anything but cry,” Conville said. “I was a 21-year-old and supposed to be this big, strong athlete, but I felt weak and powerless. But my nurse stayed there, comforted me during my worst moments. That inspired me to want to do something to help other people.”
Over the next few months, Conville underwent several surgeries and faced a long road to recovery. His initial plans—playing college baseball and attending medical school—were derailed as recovery took a mental and physical toll.
But the support of friends and family and an opportunity at UAB Hospital helped him rediscover his passion.
“It was very difficult for me to take my next steps forward in my education, but the one thing that always spurred me on a little bit, or kept my feet moving, was my nurse that night after surgery,” Conville said. “I can’t remember her name, and I hardly remember her face, but I will always remember what she did for me.”
His nurse’s care led Conville to seek out ways to help others. When a family friend and Senior Director of Emergency Services at UAB Medicine Frankie Wallis, DNP, NP-C, NEA-BC, COI, reached out about a shadowing opportunity in the emergency department, Conville jumped at the chance.
“I knew Cade wanted to help people and make a difference, and I said that if he wanted to be in health care, UAB was the place to be,” Wallis said.
“It was very difficult for me to take my next steps forward in my education, but the one thing that always spurred me on a little bit, or kept my feet moving, was my nurse that night after surgery.”
After shadowing in the emergency department, Conville knew it was the right next step.
“UAB is such a big, bustling hospital. I recognized all of our patients in need, but there is also an excitement because there was so much we could do at once,” Conville said. “It brought me back to this team atmosphere, where I could be part of a group that cared about something, where everyone pulled in the same direction. That spoke to me—I put my resume in the same night.”
Conville took a job as a patient care technician and thrived in the experience, but eventually, he felt compelled to return to school and further his education. Through the support of his family and Wallis, he applied to nursing school.
“I looked up to the nurses I worked with, and it brought back the memory of the young woman who helped me that night,” Conville said. “I thought that if I could do the same thing for someone else, it would make all the hours of extra work worthwhile.”
After consulting with mentors, including Wallis, and doing research of his own, Conville decided the Accelerated Masters of Nursing Pathway at the UAB School of Nursing was the best step forward. The program is designed for students with a bachelor’s degree or higher in another field and creates an accelerated track toward licensure and a master’s in nursing.
“I knew the program was for me. I already had a degree under my belt, but it also felt like I had the time management skills to take on such a rigorous program,” said Conville, who also has a Bachelor of Science in molecular biology.
“I’ve had several other staff members who have come through the AMNP program,” Wallis said. “It’s a great program, and when I talked to Cade about it, I had every bit of belief he could do it. I talked to him about pursuing this degree, while cautioning him about the tough road ahead. But at the end of the road there is a reward.”
When Conville started the AMNP program in fall 2020, he found another team in pursuit of helping others. Faculty offered continuous support and encouragement throughout challenges, he said, and provided the tools necessary to move forward.
“I looked up to the nurses I worked with, and it brought back the memory of the young woman who helped me that night. I thought that if I could do the same thing for someone else, it would make all the hours of extra work worthwhile.”
“One day I sat down with [AMNP Pathway Director] Michael Mosley, MSN, CRNP, ANP-BC (MSN 2012) and we talked about why he pushes us so hard to get the right answer and to understand why we got that answer,” Conville said. “He said that when you’re working with a patient, you’re not just checking boxes. And while you can make two or three mistakes on a test and still get a 96, if you make two or three mistakes with a person, you can really hurt them. That told me a lot about him as a person—he truly cares about us and wants us to be the best nurses possible.”
Conville also made an impact on his peers in his AMNP cohort. They selected him as the fall 2021 recipient of the Florence Nightingale Award, a recognition of his passion for quality of nursing care and pursuit of excellence. It was also the reason he stood up to speak about resilience at the Senior Recognition Ceremony.
“This award reiterates Cade’s personal characteristics and his commitment to nursing,” Wallis said. “It shows his dedication and how well he works within a team, how he incorporates team theory to develop relationships with his peers and colleagues. He is a great young man with great potential, great abilities and he will move forward to do great things in the future of health care.”
Conville finished the AMNP program in fall 2021 and accepted a job at UAB Hospital in spring 2022. He wants to further his education and work toward a career in nursing management.
Conville continues that refrain of resilience, for his future and the future of nursing.
“I know the state of nursing isn’t perfect right now, that a lot of us who are graduating and going into the workforce have a difficult road ahead of us,” Conville said. “We’re joining health care in one of the most difficult times to be a health care professional, and we just have to be as diligent as we possibly can. We need to understand that our patients need us, and we need each other. We’re going to get through this together. While there are a lot of tough times going on, it’s still a great time to be a nurse.”
Nursing can sometimes be a difficult profession for many of the men and women who choose to give their lives to the service of others. However, many nurses bring additional challenges to their calling, such as physical and mental hurdles that extend beyond the nursing experience. Although physical disabilities can make nursing hard at times, mental roadblocks are just as common and essentially hidden from teachers, coworkers, and sometimes the nurses themselves.
The good news is, though, dealing with an invisible challenge isn’t insurmountable.
For example, attention deficit disorder (ADD) can cause difficulty focusing, brain fog, and trouble concentrating. Nursing school requires attention to detail and focused concentration. Yet, this is just one of the many challenges that nurses can overcome—and many have.
For instance, Carin Shollenberger, RN, CRNA, has had ADD since childhood. She wasn’t diagnosed until well into adulthood, and she could have let it hold her back.
“Not being diagnosed impacted my ability in succeeding to my highest potential in nursing school and anesthesia school,” Shollenberger says. “With ADD, the ability to focus on what you are told to focus on is nearly impossible.”
When nurses are drilled on how to use their senses to assess patients, those with ADD must marshal all of their will to get the job done. Success is doable, but it requires a strong effort and indefatigable motivation to overcome a brain that fights back.
It isn’t merely issues with focusing that can potentially stand in the way of a successful nursing career. Post-traumatic stress disorder, or PTSD, can make entering the nursing field complicated. Some of the tasks asked of nurses can trigger unwanted emotions and feelings.
Miranda Gallegos, RN, is one such nurse who has succeeded in nursing and even flourished while facing PTSD. Like most nurses—those who enter nursing with relatively few challenges and those who have to work harder to attain the same goals—she dedicated her life to making nursing work for her no matter what.
In fact, Gallegos states, “I found nursing school to be a welcome distraction and almost a period of remission. I had no interest in my peers so I could 100 percent focus on my studies. I did have a tendency to zone out or dissociate in times of stress.”
Gallegos, a hard worker, took refuge in the high attention to detail that nursing requires. In her case, her PTSD symptoms could help her to push through and succeed.
And this is the point: nurses who are faced with physical and mental challenges can become excellent nurses. Nursing may seem intimidating, especially to someone who is struggling. Nursing can sometimes seem impossible as a profession with a diagnosis of an attention disorder.
Yet these two women have shown what can happen with effort.
“My tip to prospective nurses would be to seek professional help sooner,” advises Shollenberger. “I would have told my past self that it was not normal to procrastinate nor was it normal to have the inability to focus on school work while most everyone else could. I didn’t know that I could be helped!”
Gallegos agrees: “I found that nursing school really empowered me to get help. Once I got help for my conditions my grades went from B’s to A’s. I didn’t know I had something wrong at the time until through school I learned about these disorders and realized I fit into a lot of these categories and symptoms.”
Surely, early detection is key. If you are having trouble with focusing or intense anxiety, these are symptoms worth checking out. Nursing is hard enough as it is, and no one should work with any hindrance that can put a patient in danger. Examine yourself. Know yourself. Discover what your needs are to make nursing a success.
Shollenberger found that both nursing school and anesthesia school could prove challenging before she knew about her ADD.
“In nursing school, I did not have a husband or kids. My friends in the dorm got a visit from me several times a day when it was time to study. In anesthesia school, it was even tougher with a family. I wish I would have been diagnosed and treated early on…it wouldn’t have been so stressful.”
Gallegos found that her PTSD actually helped her be a better student and a better nurse.
“PTSD has a known symptom of hyper vigilance and I use that to my advantage. I am able to quickly scan whole pictures and scenarios to develop my assessments and my priorities,” she explains.
These nurses have documented challenges they faced when they entered the profession. Both faced them head on and used their diagnoses to make their skills better than they may have been without them. Although they both walked a hard road at times, they have succeeded well in the profession.
What is it that helps them overcome what could be a daunting challenge? What should other nurses know about traveling down this road?
“My tips for other nurses is to just keep your head down, study, and do your work,” Gallegos explains. “Focus on lots of self-care, whatever that means for you. Don’t worry about what other people are doing.”
Nurses tend to compare themselves to others, trying to be the super nurse that doesn’t need any help. For someone facing additional challenges, this could be disastrous. Focus instead on introspection and using your unique skills to make yourself the best you can be.
Shollenberger sums up her positive nursing journey this way: “Before my diagnosis, I felt like a failure because even though I got good grades, my struggle to get them was real. I felt even more of a failure in anesthesia school because I couldn’t skate by the skin of my teeth anymore. Once I had the diagnosis, a lot of what happened in my life made sense, but I still had to work to overcome the adversity. Medication helped but knowing in my mind that I could overcome this was an even bigger push to succeed.”
Going back to work after a disability can be tough for anyone, and especially for nurses whose jobs are incredibly demanding. Returning to work can seem like an insurmountable obstacle on bad days, but don’t think about hanging up your stethoscope quite yet. There are plenty of legal and social resources for you to fall back on if you’re a nurse with a disability. Read on to discover seven strategies for nurses with disabilities who wish to return to work.
1. Know the Americans with Disabilities Act well.
Passed in 1990, the Americans with Disabilities Act (ADA) is designed to protect individuals with disabilities from discrimination in a variety of settings, including jobs, schools, and transportation. (Additional amendments went into effect in 2009.) Many different conditions may qualify as a disability if they significantly impair your ability to engage in one or more major life activities. Categories of disabilities include neurological, musculoskeletal, respiratory, cardiovascular, digestive, immune, circulatory, lymphatic, skin, endocrine and more. In the U.S., the ADA is the single most important law for dictating how employers can treat employees during and after the hiring process, so study up on the ADA and get intimately familiar with what it means for you.
2. Learn your employer’s benefits package.
Beyond the ADA, your employer might also have certain benefits or protections that are relevant to employees with disabilities. For starters, see if your employer offers any short-term or long-term disability insurance. Your employer might also provide Family and Medical Leave Act (FMLA) and/or stay-or-work or return-to-work policies in the context of employees with disabilities. If you have questions about what your employer does and does not provide, the HR department should be able to answer your questions. If you need accommodations in the workplace as a result of your disability, such as the use of a wheelchair, you’ll also need to discuss that with HR (they have a responsibility to work with you on accommodations under the ADA).
3. Seek out other nurses with disabilities.
No one will be able to understand your challenges quite like another nurse with disabilities. Even if they have a different disability from you, they’ll still be able to empathize about issues such as working with an employer to get necessary accommodations or understanding the ins and outs of the ADA. Ideally, you’ll be able to find an experienced nurse or two who can serve as a mentor and help guide you through the transition of returning to work with a disability. Even if the nurses aren’t experienced enough to serve as your mentors, you will still benefit greatly from building connections with others who know what you’re going through.
4. Build a support network for yourself.
Your connections shouldn’t stop with other nurses with disabilities. Other nurses, especially your immediate coworkers, can be a huge help as you transition back to your job. Of course, this depends on how supportive your company culture is, but your coworkers might be able to help you brainstorm small changes that you all can make together to make your return to work more seamless. (And if you need any accommodations or other changes, you’ll need to discuss them with your supervisor for sure.) If you have a spouse, partner or roommate, they can also help you with non-work tasks—like cooking and cleaning—to make your return to work less stressful as well.
5. Keep your license and certifications up to date.
State boards vary in terms of what certifications they require from disabled nurses, so look up your state’s guidelines and make sure that you’re in compliance with them. Wherever you leave and whatever the state requirements are, make sure that you renew your nursing license while you’re on active duty and that you keep up with any and all continuing education requirements. Keep in mind that sometimes additional training or refresher workshops may be necessary before you can renew your nursing license. Keeping your license current is important because you don’t want anything to jeopardize your standing with your employer and everything that goes with it (insurance, paycheck, etc.).
6. Get involved in professional organizations.
There are many professional organizations available for nurses, including the National Organization of Nurses with Disabilities (NOND), which works to promote equality for people with disabilities and chronic health conditions in nursing through education and advocacy. Beyond NOND, there are plenty of other associations for just about every nursing specialty and issue available, so there’s bound to be something that connects with your interests. Participating in these organizations will help you build your network and advocate for nurses with disabilities within the profession. This network will be critical if you decide that you need to make a career change because of your disability (see the next tip).
7. Explore new specialties to find your niche.
No matter how accommodating your employer is, after returning to work with a disability, you might decide that it’s in your best interest to make a career change. If that describes your situation, start exploring other options. Perhaps you can find a job where you don’t have to be on your feet as much, or you can transition to a lower-stress unit that won’t cause your symptoms to flare as often. Reach out to your fellow nurses, especially those who also have disabilities, and ask them about the pros and cons of their positions and how accommodating their employers are. If you don’t feel like you have the right experience to make the career change you want, you can also consider going back to school for additional certifications or even an advanced degree to help you make the leap.
Putting on your scrubs and returning to nursing work after a disability can be daunting, but thankfully there are resources available for nurses in this exact situation. Do as much research as you can about the ADA and your employer’s policies, and don’t be afraid to ask for help or advice if you need it. Plenty of nurses with disabilities do meaningful work and take care of their patients very successfully, and even if you need accommodations, we know you can do the same.
As a nursing student, asking for accommodations can help level the playing field by giving you a different environment or approach so you can adapt to any kind of physical or cognitive disability. As mentioned in a previous blog, extra time on tests, a quiet environment , or possibly even a note taker in class are all accommodations that can help nursing students perform their best.
Once you graduate and enter the workforce, how can you make sure you have accommodations you might need?
Many laws in the Americans with Disabilities Act prevent discrimination or retaliation based on accommodations, but the workplace isn’t always as adaptive to requested accommodations. If you know what you need, can request what has worked for you, and the accommodation will fit into the required job description, then your chances of successfully blending the two are much greater.
Keep in mind realistic expectations. If you can’t lift more than 30 pounds due to a previous injury, that will restrict you from doing some specific hands-on roles. But you might be able to with assistive devices. And if you have a hard time writing discharge information or charts in any kind of excessive noise, knowing that will help you prepare for what you need—possibly just a quiet space. If hearing loss makes listening difficult, amplified equipment can help. But not being able to lift heavy things, needing a quiet place to do administrative work, and progressive hearing loss never mean you can’t be an excellent nurse.
In fact, asking for an accommodation when you know it helps you do your job better keeps nursing standards high and ensures patient safety. Asking for an accommodation at work is often done through the human resources department where they can help guide you and determine what will best suit your needs and those of your unit or department. You might be asked to provide medical verification or some kind of official documentation of your disability.
From that point on, you are not obligated to share the reasons of your accommodation with anyone else at work. Accommodations are often a personal matter and many nurses fear a pushback or a stigma if others realize a change has been made for their benefit.
Is that fear realistic? Possibly. Revealing too much personal information in the workplace always has the potential to return to you in unexpected ways, so it is better if you keep the details to yourself. As long as your workplace helps you and assists you in working out a new approach or by offering different equipment, you can continue to do your job with the exacting precision expected of nurses.
Deciding when and how to talk about accommodations depends on how big of an impact it has on your work and then you should consider the impact it might have on your career. You don’t want to mislead a potential employer and you also don’t want to do substandard work because you are afraid to disclose your need for an accommodation in your current role. For example, if you have progressive hearing loss, but it is not impairing your job now, you might choose to wait a while to disclose. But if you are having trouble haring through a stethoscope, you cannot wait to bring that to the attention of your employer so you can get assistive equipment.
The decision is personal and weighing when and how to tell an employer is crucial to making sure you can do your job while also ensuring you are meeting the high standards expected in the nursing profession.