Sunday, January 15, 2017

Martin Luther King Day: How social justice led to disability justice for nurses with disabilities

The work of Dr. Martin Luther King has lived on and impacted so many-- including nurses with disabilities. The civil rights movement led the way to passage of Section 504 of the Rehabilitation Act in 1977 and the Americans with Disabilities Act in 1990.

Alice Wong penned the following message In a blog post originally published on January 16, 2014 for BK Nation“Disability Justice and Social Justice: Entwined Histories and Futures”. Alice Wong is the Project Coordinator of the Disability Visibility Project:

“Just as Dr. King and the many activists involved in the civil rights movement were influenced by Gandhi and Thoreau’s use of civil obedience, leaders of the disability- rights movement witnessed first-hand the power of non-violence in the 1950s and 1960s.

Similarities exist among the Montgomery bus boycott, the Birmingham campaign in 1963, and actions taken by disabled activists in the 1970s. Section 504 of The Rehabilitation Act prohibits discrimination against people with disabilities from participating in any program or activity receiving federal funds based on incapacity.

Secretary of Health, Education, and Welfare Joseph Califano refused to sign regulations related to Section 504. On April 5, 1977, non-violent protests and demonstrations began nationwide. A group of disabled activists began a sit-in at the San Francisco offices of HEW, the longest such demonstration ever undertaken. Kitty Cone, one of the demonstrators at the 504 sit-in, recalls:

“At every moment, we felt ourselves the descendants of the civil rights movement of the ’60s. We learned about sit-ins from the civil rights movement, we sang freedom songs to keep up morale, and consciously show the connection between the two movements. We always drew the parallels. About public transportation we said we can’t even get on the back of the bus.”

On April 28, 1977, Califano signed the regulations and the historic protest ended. Section 504 codified civil rights for people with disabilities and the notion that people with disabilities are a distinct minority group and protected those individuals from discrimination.”

The disability rights movement continued to seek justice in the courts and in the halls of Congress. The Americans with Disabilities Act (ADA) was signed into law on July 26, 1990.

The spirit and letter of the law continues to be challenged as more and more people with disabilities push the door open in a variety of professions. The nursing profession is one example. Nurses with vision and hearing loss, mental and chronic illness, spinal cord injuries and other disabling conditions continue to face discrimination and struggle to obtain access to educational programs and employment opportunities. Much has been accomplished...but much remains to be done.

Today, we remember and give thanks for the work of Dr. Martin Luther King, Jr. 

“Injustice anywhere is a threat to justice everywhere.” 
(Dr. Martin Luther King, Jr.)

Saturday, January 14, 2017

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? (

The letter to the Editor included the following:

....The first incorrect assertion is that there is no research evidence connecting accommodation to disability. In fact, there is a substantial base of research dating back to the 1980’s.... There continue to be researchers contributing to this area today including Educational Testing Services, College Board, National Center for Educational Outcomes.... What we know is that the largest population of students with disabilities in post-secondary settings are students with cognitive impairments such as Specific Learning Disabilities, Attention Deficit/Hyperactivity disorder and various Mental Health conditions. What all of these conditions have in common, other than being covered by the Americans with Disabilities Act, is that they are associated with functional limitations which require more time be provided to best ensure the student has an opportunity to demonstrate what they have learned in an academic setting.... 

What is often misunderstood is that the various disabilities whose impacts require more time are not all the same nor is more time provided for the same reason. For example, a student with a reading disorder such as dyslexia may need more time to actually read sentences and process the questions and answers being presented on the exam. A student with AD/HD (of which there are three subtypes) may need more time to focus and attend to the task at hand, read and reread information to ensure that they comprehend the questions being asked, and attend to the visual details in sentences and problem sets..... These individuals may need more time to hold and manipulate a test item or question in their mind and retrieve the appropriate answer, a facet of cognition known as working memory..... 

The second issue raised in the article seems to be an assumption that all exams need to include speed as a test construct. This appears to arise from a belief that speed is associated with ability. However, similar to other research in the field, Horn and Blankenship (2012) report that in homogeneous samples of young adults “…measures in which there is much emphasis on speediness correlate near zero, perhaps negatively, with tests that require solving difficult problems.”(p.91)..... While it is true that assessments designed to measure proficiency on some types of tasks, such as responding with particular actions in a medical emergency, may require time as an element, most academic exams do not fall in this category..... 

Prof. Trachtenberg’s assumptions that students without disabilities might be disadvantaged by the provision of time accommodations given to students with disabilities is also contradicted... Published research..... in this area reveal that, in general, students without disabilities tend to see no statistically significant benefit if they are provided more time than what is typically allotted to complete scientifically validated, standardized exams... 

Prof. Trachtenberg’s call for specific accommodations for specific disabilities.... assumes that human cognition can be quantified in the same terms as an engineering or mathematical solution. Moreover, his suggestion places the responsibility, and to some degree blame, squarely on the person with the disability......

The final, and the most unfortunate, assertion is that “time extensions re-victimize some of (his) students”. ... Victims of what? The A.D.A. recognizes... that disability is a natural and normal part of the human experience and not an affliction which victimizes otherwise “normal” individuals....

 Students with disabilities are well aware that what accommodations provide is a level playing field upon which they can demonstrate that they have achieved the level of mastery in their academic coursework which rises to the standards of the institutions they attend. In the end, this does not diminish their achievements but in fact highlights their abilities, which is all that that they are asking for and justly deserve.

The complete letter to the editor can be read at:

Please feel free to share your thoughts about speed and testing accommodations for students with learning disabilities in nursing education and clinical practice settings. 

With thanks!

Monday, December 26, 2016

Nurses with disabilities: Top 10 blog posts in 2016!

As the New Year approaches, it is time to look back at 2016. Included below are the top 10 Exceptional Nurse blog posts about nurses with disabilities. 

Nurse with Asperger's is champion for 

       others with autism spectrum disorder

So how does a person with Asperger's disorder move forward to become a nurse anesthetist, military aviation photojournalist, author, public speaker, advocate and founder of a non profit organization?
Just like the answer to "How do you get to Carnegie Hall?" 

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.

Deaf Nurse helping to break the sound barrier
Lucy Eels, RN shared her story in a blog post for "Break the Sound Barrier" the Australian national campaign to make hearing health and well-being a national health priority.

Hurricane Hugo: Remembering nurses 
who worked through the storm
Imagine how many nurses worked through the storm. Were they injured? Did they suffer from PTSD? Did they receive mental health counseling following the storm? Margot Withrow and John Owen share vivid details of working through the storm.

"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.

Moving forward with a disability: Returning to work as a nurse after an amputation
Carolyn McKinzie returned to work as a nurse following a below the knee amputation. Her journey and suggestions for other similarly situated nurses are included in a series of blog posts.

A message for nurses with disabilities from Neil deGrasse Tyson, the astrophysicist
Neil deGrasse Tyson talked about how his colleagues and co-workers with ADD, dyslexia and autism spectrum disorder cope with not being what some people consider "normal".
Libby Sanders is a nurse in Jasper, Indiana. Earlier this year, she lost her left pinky finger after a freak accident with a screen door. Since the accident she was a little self-conscious about the missing finger.

Nursing students with a wide range of disabilities are increasing in number every year. Disabilities may include hearing loss, low vision, learning disabilities, limb differences, paralysis, mental illness and chronic conditions such as multiple sclerosis, lupus and movement disorders.

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?

Saturday, December 17, 2016

Holiday gift ideas for nurses and nursing students with disabilities

A group of nurses and nursing students with disabilities was asked about holiday gift ideas. Here are a "few of their favorite things" to put on your holiday list. 

Compression socks on

Gripsors Bandage Sissors on

Leave No Nurse Behind: Nurses working with disabilities on

Belt Holster on

Super Markers on
White Coat Clip Board fits in a pocket on 

Anatomy Coloring Book on

Stethoscope Holder on

The Exceptional Nurse: Tales from the trenches of truly resilient
nurses working with disabilities on

Watches for Nurses on

Happy Holidays from!!!!

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!