Saturday, December 3, 2016

How can someone with a hearing loss become a nurse?

The experiences of students with hearing loss can vary significantly among individuals. A number of personal and environmental factors will have an impact on how the student learns and how he or she interacts with instructors, peers, and patients. Other factors include degree of hearing loss, age of onset of hearing loss, and educational background. Ambient noise levels, room acoustics, and lighting also can have a significant impact on how well communication might flow between a health care provider and a patient. 
     In many settings, simple changes can be made that may benefit more than just one person. Using the principles of universal design, adding visual signals such as flashing lights in addition to auditory signals can alert any member of the staff. Using pagers is a common way of communicating, and it creates a more accessible work environment for everyone.

Students who need additional visual cues for classroom access may request speech-to-text services, sign language interpreters, or oral interpreters. Speech-to-text service providers (often referred to as a captioner or transcriber) use specialized software and a display device to provide a text format of the lecture and discussion.

     Students who use sign language interpreters should discuss the preferred mode of communication (e.g., use of American Sign Language or use of Contact Sign), review terminology, and establish what signs could be used to express specific concepts for each class. Students with strong speech reading skills may request an oral interpreter. An oral interpreter will present on the lips and face what is being said during the conversation or presentation.

  Many students use personal hearing aids to understand speech and detect environmental cues. Although hearing aid technology has improved tremendously over the past few decades, there are limitations to how strong the signal might be.  Older analog hearing aids tend to amplify all sounds, making it difficult to separate background noise from speech; the sound produced by newer digital hearing aids is clearer and has reduced distortion and internal noise. High-end digital hearing aids may also be programmed for different listening situations. 

       Purchasing and maintaining a personal hearing aid is the student’s responsibility. Assistive listening devices (ALD) amplify the speaker’s voice and reduce the influence of background noise. Commonly used ALDs include FM systems, infrared systems, and electromagnetic induction loop systems. Because an ALD might be used by several different students, this equipment is generally purchased and maintained by the institution.

    In the college environment, students who are deaf or hard of hearing are strongly encouraged to take an active role in planning their communication access services. Discussions with the staff in the disability services office can be helpful prior to the start of a new term, especially when the student’s course load includes laboratory work or clinical assignments. Service providers, such as interpreters or speech-to-text providers, may need to prepare for the terminology used in the classes or work with the student to determine the best sight lines to see the access service, the instructor, and any visual course materials used.

     In clinical settings, students will be expected to identify heart, lung, and bowel sounds; communicate in settings in which surgical masks are used; and communicate with patients in a clinical setting or on the telephone. Students with hearing loss may not be able to utilize a traditional acoustic stethoscope. Several amplified stethoscope models are available, and students who benefit from hearing aids are encouraged to work with faculty and their audiologist to determine a good match. Technology such as text pagers and smartphones can be an effective strategy for handling alerts and telephone messages. There are numerous materials available on the PEPNet website that may provide a student with additional information:

*Note: The PepNet website will close December 31, 2016 and transition to working with the National Deaf Center on Postsecondary Outcomes   
This information is an excerpt from a chapter commentary written by Marcia Kolvitz, PhD, Director of PEPNet-South at The University of Tennessee, Knoxville in the book "The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities". To order a copy, visit:

Monday, November 28, 2016

Nurses: How do you don gloves with a different hand?

How does a nurse or nursing student with short, partial or missing fingers; or who wears a prosthetic hand don gloves in a healthcare setting?

The question was posted to a group of nurses with disabilities. The responses included the following: 

"You could use different size for each hand. I have no fingers on my right hand and use different sizes to have less latex in the way."

"Tuck the extra tips of the gloves in. I'm missing a finger (had it amputated due to cancer) and I just tuck the extra finger in. No one notices."

 "I have two fingers on my right hand. I turn the glove inside out and slide it over my two short digits and the other finger sleeves are tucked in automatically."

Susan Fleming, RN, PhD., a nurse who was born missing her left hand demonstrates how she dons sterile gloves in this article:

Dr. Fleming also demonstrates donning sterile gloves in this video "Nursing with the hand you're given"

An article about surgeons with amputated fingers, published in 1982, may also be helpful.

Brown, P.S. (1982). Less than ten--Surgeons with amputated fingers. The Journal of Hand Surgery, 7(1), 31-37.

If you are a nurse with a similar challenge, please feel free to add a comment or suggestion to this post so others can benefit. Or, email me at

With thanks!


Tuesday, November 15, 2016

Will President-elect Donald Trump support nurses with disabilities?

So much has been said and predicted about a Donald Trump presidency. Can we turn our attention to nurses? And, specifically nurses and nursing students with disabilities? 

Will he stand with all nurses and nursing students? 

Will he support safe staffing ratios and safer handling policies?

Will he encourage employers to comply with the Americans with Disabilities Act and reasonable accommodation for nurses with disabilities?

Will he support reasonable accommodation for nursing students with disabilities in higher education?

Will he see the potential in a nurse or nursing student with a disability?

What can we do to bring the issues to the attention of the President-elect?

Please feel free to post a comment below or email me at 

I will update this post as the new administration moves forward.

With thanks,


Thursday, November 10, 2016

Why do libraries matter to nurses with disabilities?

Recently, I was asked why I encourage nurses, nursing students, nursing faculty and disability services staffers to ask their university, college, hospital or local library to purchase copies of my books.

Of course, the stories shared in books offer inspiration and hope to nurses and nursing students with disabilities, but there are other reasons......

If you purchase a copy as an individual (thank you!!!), but I would venture to guess that after you read the book it will be placed on a shelf and later end up in a landfill or thrift store.

But if a library purchases the book, the stories shared by trailblazing nurses with disabilities will live on for generations to come. 

The stories serve as examples of nursing students and nurses who benefited from the Americans with Disabilities Act. Some asked for reasonable accommodation and often fought the system, overcame challenges and moved forward to do the work they love. Information is shared about nursing school, gaining employment, accommodation, reactions from patients and fellow staff nurses.... and so much more.

If books about nurses with disabilities are available in libraries, nurses who are working on masters and doctoral degrees and doing research on the experiences of nursing students and nurses with disabilities will find the stories. Nursing historians will be informed as well.

Disability services staffers, human resource staffers, nursing administrators, attorneys, law students, vocational rehabilitation counselors, physical and occupational therapists need to know about nurses with a wide range of disabilities who have been successful in school and work place settings. They need evidence that a person with one hand, mental illness, lower limb amputation, spina bifida, learning disability, spinal cord injury, chronic illness, epilepsy, essential tremor, hearing or vision loss can become a nurse with and without accommodation! 

Most libraries have an easy online form you can complete to request a purchase.

Can you help the stories live on?

Maheady, D.C. (Ed.). (2014). The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities. CreateSpace Independent Publishing Platform.   ISBN: 13:978-1495400933

Maheady, D.C. (2006). Leave No Nurse Behind: Nurses Working with disAbilities.
Lincoln, NE: iUniverse, Inc.       ISBN:13:978-0-595-39649-8

Maheady, D. (2003). Nursing Students with Disabilities Change the
Course. River Edge, New Jersey: Exceptional Parent Press. (Now available from

With thanks in advance!


Thursday, November 3, 2016

"Breaking it down" for nursing students with learning disabilities

   Breaking a task down into micro-units, using prompts, and assistive technology can help all students. We all do this whether we realize it or not (Brandt and Alwin, 2012; Kolanko, 2003). As nurses we develop sliding scale charts for delivering different dosages of IV medications, write laboratory results on our hands, and enter prompts into our iPods to be on time for medications and treatments (Kolanko, 2003; and McCleary-Jones, 2008).
     Understanding deficits in social processing or lack of social skill learning is more common in college students today. Developing a network of support is important to all students with disabilities. Students with LD tend to be individual rather than group learners. But this characteristic sometimes isolates the student. Finding ways to integrate them into study groups, peer tutoring, or group discussions may help to increase the comfort level of group work and as nurses with supportive staff (Brooke, 1999). The student feels at ease and can see the group as a support rather than a source of stress.
When students with LDs learn to micro-unit (break information down into its smallest units), use various learning strategies and are provided more time, they can see the relevance of these techniques for patient care. Nurses with LD are uniquely prepared to care for patients who have the same needs. Upon learning of their LD, students report reactions of grief and loss as they see themselves as a person with a disability and not “a normal person.” Helping them to self- advocate, learn success strategies, and referrals to specialists can support their needs. It should be emphasized that this is something they can help patients do for themselves as well (Kolanko, 2003). 

This information is an excerpt from a chapter commentary written by Katherine Kolanko, RN, PhD in "The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities".

Please share your thoughts below.

With thanks,

Saturday, October 29, 2016

Are you a nursing student with a learning disability? Sharing a “Learning Bio” with faculty may help!


Tino Plank, Pre-Nursing Student

My name is Tino Plank, and I’m in the process of completing my nursing school pre-requisites. At the suggestion of my academic counselor, Bill Jones, I’ve put together this “learning bio” as a way to introduce myself, my scholastic goals, and my learning disabilities.

I already have a B.S. degree, which I completed in 1980. However, at that time, I struggled in many of my core science classes because I didn’t realize that I had learning disabilities that impacted my capacity to process the material I was studying. Specifically, I have auditory and visual processing deficits and dyslexia/ADD characteristics that slow down the way I integrate information.

I always wanted to continue my science education, but had been intimidated by the testing challenges from my undergraduate days. Fortunately, I’ve been through the learning skills assessment offered by Student Supportive Services, and with their guidance and support, we’ve worked out learning/testing accommodations that have improved my ability to learn and retain information.

I look forward to learning from you this semester and working with you to incorporate my accommodations into the classroom.


Tino Plank

Read more about nursing school with a learning disability in chapter 5 “Ain’t No Mountain High Enough: Paths to Success for Nurses with Learning Disabilities” in The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities.