Monday, December 18, 2017

Self defense and responsible gun ownership for a nurse amputee

Carolyn McKinzie, LPN

It’s been a little more than 16 years since I lost my right lower leg following a car accident.  I didn’t lose it right away. I went through numerous surgeries over the next 2 years. Sadly, it never healed solid the way I had hoped.  I was 32 when I was injured and 35 when I had my leg amputated.  Fortunately for me, I’ve always been fairly independent so I’ve done very well over the years in keeping and maintaining a home by myself.

I’ve been able to work part-time, off and on at various jobs in health care.  My primary role has been that of an LPN, but after my accident I soon learned that working full time in an LPN job wouldn’t be a realistic goal.  I did great with my prosthesis, but I  wasn’t able to work a full shift on my feet. I had some jobs that were great and some I failed at miserably---but I continue to try to do the work I love!

I’ve been single for a lot of years and grown accustomed to dealing with things alone, but recently I started thinking about my own personal safety and how I would protect myself in a dangerous, life-threatening situation.  

It didn’t just come into my head out of the blue.

I moved into a small house in the country, located on a dead-end road.  There were neighbors across the road but at such a distance I could barely see them moving around outside.  The next closest house was hidden by a line of thick pine trees.  I loved the privacy and the quiet area and felt lucky to have come across such a great rental opportunity. Initially, the landlord was very kind, but not long after I moved in he did something that I really took offense to.  He was so proud of himself when he told me that he had touched base with 3 of the nearest neighbors and let them know there was a single, disabled woman renting his house.

I was instantly and totally angry at him.  I told him the last thing I needed was for word to get around that there was a helpless female living there and I didn’t appreciate him setting me up for a bad situation that could potentially be a detriment to my own personal safety and well-being.  I was very unnerved that he had spewed my story to people I didn’t even know. 

I don’t think I ever considered my vulnerability as a disabled woman until that day.  I didn’t like the feeling at all.

After that, I found myself being spooked by every little sound I heard after getting into bed at night.  I sleep with my prosthetic leg off and I’m medicated so I don’t have phantom pain in my sleep.  I felt like a sitting duck and knew if there was to ever be a home invasion, burglary or other intrusive scenario I would be helpless to protect myself and at the mercy of whomever might strike in the darkness.

When I was a kid, my dad and brother hunted and had guns that were kept in a locked gun cabinet.  I didn’t really have an interest in firearms, I think primarily because that was a “guy thing” when I was growing up in the 70’s. 

Fortunately for me, I have a friend who was in the military and has a concealed carry permit.  He carries his gun everywhere it is allowed but mainly has it for home protection.  He encouraged me to arm myself, but I knew nothing about guns and felt I would be a bigger danger to myself than to anyone else.  My friend took it upon himself to educate me about handguns, signed me up for a gun safety class and helped me to buy a 9mm handgun.

I completed the NRA endorsed safety class in a day. I was very nervous about actually shooting the gun because I had no idea how much kick there would be and/or if it would be enough to make me lose my balance and fall.  At the end of the class, we went out to the shooting range and fired a dozen shots at various targets. Thankfully, the kick from shooting wasn’t nearly as strong as I feared it might be so I never lost my balance. I hit bullseyes from 30 feet. I give credit for that to the red dot laser that came on my gun when I bought it.  I hope I will never need to fire at a person that far away; I got it for self-protection at night when I am least able to defend myself.

When I got my certificate in my hand, I realized what a huge step I had taken……it made me feel safe and empowered.  I didn’t feel like the sitting duck as I had before.  

I think single women always have some amount of worry when living alone, as far as having to possibly deal with an intruder in their home.  But when you have a physical impairment, the worry is even greater.  Just being ready was a victory for me!

I’m very fortunate to live in Maine where the overall crime rate is low in comparison to other states in New England.  But drug use here is high and many drug users will do anything they can to obtain drugs, money or property to sell for cash.  This includes home invasions.  In a 2015 report published on the Disabled World website (, it states the disabled and elderly people are the easiest targets for victimizing, since they are often unable to retreat from any type of “attack”.  A firearm is the best defense, provided the user has been properly trained and is proficient with its use.  Otherwise, there is a significant chance of their gun being used AGAINST them.

Gun ownership may not be the best option for everyone with a disability, but self-defense training is important for all. For information on safety training for individuals with disabilities and persons needing adaptive shooting solutions, visit the NRA’s Adaptive Shooting Program website at Self defense classes are also offered by colleges, police departments, nonprofit organizations, martial arts businesses and local municipalities.

Carolyn McKinzie, the Amputee Nurse Consultant, can be reached at: or

Tuesday, December 12, 2017

2017 Top 10 blog posts about nurses with disabilities

As we look back on 2017, let's revisit the top 10 Exceptional Nurse blog posts about nurses with disabilities. 

                                       Silent No More! Nurse beaten and raped!
Attorneys representing two nurses and a nurse’s husband called a press conference to counter official statements that nurses taken hostage at Northwestern Medicine Delnor Hospital were not injured in a May 13 incident in which a jail inmate was shot dead by a SWAT team. The horrific events at Delnor Hospital cannot be forgotten or pushed under the rug. Nurses need to stand together for much needed change.
Breath of a nurse with a tracheostomy
Michelle DiGiacomo, LPN
My trach is a part of me, like being brunette, short in stature or female, but it alone does not define me.  I am the sum of all of my parts. So you will never hear me trying to deny my trach, hide it or eliminate it from the equation.  Sometimes, people with disabilities, in their fight for equality, want others to ignore their issues in the hope of being treated like everyone else. But we are not like everyone else. One might even argue, we are in some ways better, stronger, more determined, resilient and empathetic. I will use my trach and any tool in my arsenal—everything I am and every breath I take--- to be the best nurse that I can be.
Listen up! What not to say to a nurse or nursing student with a disability
A group of nurses and nursing students with disabilities was asked to share comments made to them. Responses included the following:
"Maybe this is God's way of saying you shouldn't be a nurse."
"You will not be able to work as a nurse."

Permanent hearing loss as a Mom and nurse: What do I do about...?
Sarah Matacale, RN
I AM A NURSE in my heart and soul.  So what do I do about…???….I grieve, get mad and frustrated, bargain, beg, pray and cry a lot. Then, I put on my big girl panties and went back to school for medical documentation, billing and coding.  I took and passed my CCS exam; I opened myself to finding another passion.

From nurse to patient to disabled nurse

Danielle Fullen, RN
 I have been diagnosed chronic lower back pain, degenerative disc disease, lumbar radiculopathy, lower extremity radiculopathy, spondylolisthesis, spinal fracture (L5), spinal stenosis, lumbar pseudo arthritis, herniated disc (L4-L5), lumbar discogenic syndrome, post laminectomy syndrome, spinal hemangioma, and left hip bursitis.
Through all this excruciating pain, I remain positive.  Positive that one day, I will have some relief and get back to work in nursing, as a nursing instructor.

Helen Lindsey, BSN a quadruple amputee working to get her nursing license back
Helen lost her arms and legs to bacterial meningitis but not her passion for helping others. She is an Army veteran who received her BSN from Winston-Salem State University.
According to in Winston-Salem, N.C.: She is currently working toward getting her nursing license back, and she will be the first student in the state's nursing re-entry program to have a disability to this extent.

Anita Lesko, a nurse with Asperger's syndrome invited to World Autism Day at the United Nations
Anita Lesko has Asperger's syndrome. She is a nurse anesthetist, military aviation photojournalist, author, public speaker, advocate and founder of a non profit organization...and now invited speaker at the United Nations!

The nurse with dementia: Where do we go from here?
Gail Weatherhill, RN, BSN
The British Royal College of Nursing (RCN) recently shocked many by passing a resolution that nurses with dementia should be supported to continue practicing as long as possible. Their reasoning was that most fears of these nurses constituted discrimination based on old prejudices and misconceptions.

Army nurse set on fire by a colleague wants to resume career
In September 2016, First Lieutenant Katie Ann Blanchard, a nurse in the Army serving at Ft. Leavenworth in Kansas, was set on fire and attacked by a colleague. Almost 20 percent of her body was severely burned, including her entire face and ears, and parts of her arm and chest.

For nursing students with learning disabilities: Is speed associated with ability?
Jamie Axelrod, AHEAD President and Nicole Ofiesh, Ph.D., Learning and Education Specialist, Lecturer, Stanford University wrote a letter to the Chronicle of Higher Education in response to an article by Ari Trachtenberg titled Extra Time on an Exam: Suitable Accommodation or Legalized Cheating?

Happy Holidays and Happy New Year!


Tuesday, November 28, 2017

#Giving Tuesday! We are raising money for scholarships for nursing students with disabilities

Exceptional Nurse is raising money to support our scholarship program for nursing students with disabilities. 

Can you help? All donations large or small are welcomed!

Thank you!


Please visit the website to donate.

Sunday, November 12, 2017

Listen up! What not to say to a nurse or nursing student with a disability

Painting by Thomas Saliot

A group of nurses and nursing students with disabilities was asked to share comments made to them. Responses included the following:

"Maybe this is God's way of saying you shouldn't be a nurse."

"You will not be able to work as a nurse."

"There are no accommodations in nursing school."

"Let me do it for you." 

"How are you going to be a nurse when you look like a patient?"

"What's wrong with your neck?"

"Why are your hands always shaking?"

"You can't go in there blind."

"How can you be a nurse if you are hard of hearing?"

"Maybe you should go on disability".

"Turn up your hearing aid."

"People with ________can't make good nurses."

"You don't look like you have a disability."

"Nobody wants a nurse with a bad back."

In health assessment lab, "You can go outside in the hall and read."

"You should think about another career choice."

"You don't look sick."

"Do you know what patients think when you limp into their room with a service dog?"

"Who is going to hire you?"

"I knew something was wrong with you from the start."

"What's your problem? Can't you hear?"

"If you use a wheelchair and have a service dog, how will patients know you are the nurse?"

"You can't work in _____area because of your speech impediment."

"You can't be a nurse. You struggle to walk." 

"Why do you want to work when you could sit home on disability?"

"What's your problem, can't you hear?"

"You don't have what it takes to make it."

"Patients won't want you to care for them."

"What kind of nurse will you be with one leg?"

"You can't do that."


Love to read your thoughts!


Sunday, October 22, 2017

Welcome to Florida: A parable for nurses who become disabled

      At some point in time, most parents of children with disabilities come across the “Welcome to Holland” message written by Emily Perl Kingsley in 1987. The message originally appeared in the Los Angeles Times, in Abigail Van Buren’s “Dear Abbey” column. For those who aren’t familiar with the story, it’s about someone who plans a vacation to Italy but ends up in Holland instead. This story has guided my life as a parent of a child who is disabled and my work as a nurse and nursing educator. Below, I have adapted this message for nurses who become disabled.

            I am often asked to describe the experiences of nurses who become disabled — to try to help people who have not shared that unique experience understand it and imagine how it would feel. It’s like this…

            It’s like planning a fabulous trip to New York City after graduating from nursing school. You plan to work at a prestigious medical or research center there. You buy a new stethoscope, lab coat, scrubs and medication handbook. You plan to work as a staff nurse and eventually get promoted to unit manager of a busy intensive care unit or emergency department. On your days off, you are eager to visit the Statue of Liberty, Ellis Island and the Metropolitan Museum of Art. You can’t wait to see the bright lights, Time Square and Broadway. It’s all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags, and off you go. Several hours later, the plane lands. The flight attendant comes in and says, “Welcome to Florida.”

            “Florida?” you exclaim. “What do you mean Florida? I signed up for New York! I’m supposed to be in New York. All my life I’ve dreamed of going to New York. I’m not old enough to move to Florida!”

            But there’s been a change in the flight plan. The plane has landed in Florida, and there you must stay. The reason is that you have a disability.

The important thing is that they haven’t taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It’s just a different place.

            So you must go out and buy new guide books. And you need to learn a whole new language — the Americans with Disabilities Act, vocational rehabilitation, reasonable accommodations — and perhaps go back to school for an advanced degree. You may need to buy some new equipment and learn new ways of performing your nursing skills. But a bonus will be that you will meet a whole new group of people whom you would never have met.

            Florida is just a different place. It’s slower-paced and less flashy than New York. But after you’ve been there for a while and you catch your breath, you look around and begin to notice that Florida has beaches, warm weather, magnificent sunsets and palm trees. Florida has the Salvador Dali and Morikami museums. And it has patients who still need your care — in hospitals, nursing homes, health departments, schools, community centers, camps, case management, infection control, administration, teaching and
research positions.

            But everyone you know is busy coming and going from New York City. And they’re all bragging about what a wonderful time they are having as nurses in New York. For the rest of your life, you will say, “Yes, that’s where I was supposed to go. That’s what I had planned.”

The pain of that will never, ever, ever, ever go away, because the loss of that dream is very significant.

            But if you spend your life mourning the fact that you didn’t get to New York City, you may never be free to enjoy the special, lovely things about being a nurse in Florida.

This is an excerpt from the book "Leave No Nurse Behind: Nurses working with disAbilites". 

Please share your thoughts below.

With thanks,

Monday, October 16, 2017

Advice for healthcare providers from a nurse with autism

Anita Lesko, BSN, RN, MS, CRNA

As a mother of a daughter diagnosed with autism and related disabilities, I am so pleased to announce the publication of Anita Lesko's much needed book. It should be required reading for nursing, nurse practitioner, medical and allied healthcare students. It would also make a wonderful gift for parents to give to their child's healthcare provider.

The book provides quality advice from a nurse with autism! 

"The book is geared for use in healthcare curriculum courses, as well as a guidebook for all healthcare and allied healthcare providers. It's important for healthcare professionals to realize that communication starts at the Admissions Desk and follows through to the patient's discharge, Whether the patient is simply going for a routine doctor's appointment, or getting admitted for major surgery, the autism patient needs specialize care for optimal results."

"This book is a comprehensive guide in understanding autism, formulating effective communication strategies, and developing best care practices. It covers sensory issues, pain tolerance, body awareness, communication challenges, legal and ethical issues, HIPPA compliance and the Americans with Disabilities Act." 

Congratulations Anita! 


Thursday, October 12, 2017

Breath of a nurse with a tracheostomy

Michelle DiGiacomo, LPN

Born and raised in New Orleans, Louisiana, I am 44 years old and divorced with one daughter.  Neither of my parents attended college. My mother was born in the USA but my father is a Cuban refugee who sought asylum here in 1961. I attribute my determination to them.

I attended a local university right after high school, unsure of what I wanted to study. In my senior year, I decided to take a year off to get married. I later learned that I had obstructive sleep apnea.  Because I only had a health insurance policy through school, I went to Charity hospital. I was told that the solution to this problem was a trach to allow me an alternate airway to avoid my obstruction. I was not told about a CPAP machine or offered other less severe procedures.

 After the trach, I was unable to speak for 6 months. I was depressed and certain that this was it for me. No career. No normal life. Awarded social security disability.  When our family moved to Memphis, I found a new ENT to oversee my care. This doctor explored the nature of my obstruction and determined that my over-sized tonsils formed a barrier with my uvula.  After surgery, I was able to reverse the trach. But, just a few months later, I started having difficulty breathing again.  This time, the culprit was scar tissue at the site of the original trach. It was suggested that the first procedure was done incorrectly. Where the trach should have been excised, it was folding back and the outer portion of my neck, skin that I needed later, was removed. This made it bulky and pulled in irregular ways. I endured 5 more procedures in an attempt to correct this stenosis before it was decided that it was a permanent situation.

I will always have to have scar tissue surgically removed every few years.  When I have 50-60% of my airway open, I can comfortably cap my trach or wear a speaking valve.  When scar tissue grows, I have to leave it open to breathe below the problem area.  Other than that, I don't have any respiratory issues.

I could not fathom a job that I could do. Depressed, I thought life was over. I stayed home to avoid public stares and questions. It was not living at all. Then one day it all changed. I was out, forced by my family, and a stranger was staring at me. After the meal, she approached to explain and apologize. She said that she had a baby who has a trach and seeing me out with my family, living a normal life as she put it, gave her hope for own child's future.  In the next few days, I went out more and had similar experiences. That's when I knew that my trach could be useful. My life could be used as a living testimony and example for others.

So, with a tracheostomy, a toddler and no hope of working, I decided that I wanted to complete my Bachelor's degree in nursing. After applying and being rejected from every nursing program in Louisiana, Hurricane Katrina forced me to relocate. The good news is that the move provided new nursing programs to consider.  I applied and was rejected by RN programs in Tennessee, Mississippi, and Arkansas. I was very sure that my trach was the reason for my rejections. I had to find another way!

 I read that licensed practical nurses (LPNs) could get nursing degrees online. I didn't even know what an LPN was but I decided that I had to become one so that I could use that avenue to get to my ultimate goal. I applied and was rejected by a few LPN programs until I found one that accepted me. The Director of Nursing explained all of the reasons that she did not want me to attend and all the reasons that she legally could not stop me.  She  hoped I would forfeit my place for someone who had a chance at success.

I claimed my rightful place!

So began my mission. I met more than a few critics and doubters and hit one brick wall after another but I refused to give up!  I started to think, even if I cannot actually work in the field, I still wanted to know if I could succeed. If I had the stuff to become a nurse. Once I finally got into a program, there was no stopping me. It was there that I got my first support. Not from the instructors, or administration, not even from my husband, but from the patients I met at clinical sites.  Before them, I was pretty sure I was wasting my time. In the hospitals, I was so well received by staff and patients. I was encouraged by everyone at every turn.  I freely answered questions, taught my fellow students from my experience and began to accept this as part of me. It was no longer a problem, just a difference.

I graduated with a 3.86...third in my class!

I have never had any difficulty getting a job or been mistreated by employers.  I have had issues with coworkers. The main issue on the job has been questions about infection control. Once the facility and legal department are satisfied that I am not at any additional risk, I am hired and treated as everyone else. I have not needed any accommodation except when I need time off for procedures.

My first job was at a skilled nursing facility in Memphis. Then, I was hired at a large hospital in New Orleans in the oncology department.  An RN and LPN team provided total care for a pod of up to 8 patients, many receiving chemotherapy, radiation or a bone marrow transplant. I also worked PRN at a home infusion company as a clinical liaison where I primarily did patient teaching. Later, I was offered a full time position with the  home infusion company monitoring transplant patients on inotrope therapy. After that, I worked in nursing homes. I am currently working in a hospital setting in  long term acute care.  Its med/surg with a fairly high acuity. 

Looking back, I was afraid that life would never be the same after my trach. I was right but not in the ways that I first thought.  I struggled with self-image. I was so young and overwhelmed by the medical equipment.  I had to breathe humidified air several times a day, clean my inner cannula, or use disposable ones. To keep the skin intact around the stoma, I had to fight moisture, suction myself and change the actual trach tube every few months. It was so much to learn and so many ways I had to adapt my life around my special needs.

I am hardly qualified to dole out words of wisdom as I am still trying to figure it out myself. I can say that taking the power back was key for me.  If I allowed my trach to steal my future, then it truly would be a disabling condition. I had to carry on as I would have without it. I lost a lot of time being angry about what amounts to a botched surgery that I didn't need in the first place. Once I decided that I would pursue my career and socialize again, this issue could no longer hurt me. I am living my life and enjoying the same ups and downs as everyone else. I also learned that before I could put actions behind my decisions I had to accept my difference. Once it was no longer a problem for me, it would no longer be a problem for anyone else.

My trach is a part of me, like being brunette, short in stature or female, but it alone does not define me.  I am the sum of all of my parts. So you will never hear me trying to deny my trach, hide it or eliminate it from the equation.  Sometimes, people with disabilities, in their fight for equality, want others to ignore their issues in the hope of being treated like everyone else. But we are not like everyone else. One might even argue, we are in some ways better, stronger, more determined, resilient and empathetic. I will use my trach and any tool in my arsenal—everything I am and every breath I take--- to be the best nurse that I can be.

Michelle can be reached at: