Research evaluates frequency of nursing students with disabilities in traditional prelicensure BSN programs

 

Research Letter 

Equity, Diversity, and Inclusion

February 20, 2025

Disability and Accommodation Use in US Bachelor of Science in Nursing Programs

Brandy L. Jackson, MSN, MBA^1,2; Vanessa K. Cameron, MSN^2,3; Tiffany M. Hodgens, MEd⁴; et alSabrina A. Jamal-Eddine, PhD, RN⁵; Vera Kunte, DNP⁶; Kathleen Marsala-Cervasio, PhD, EdD⁷; Lydia Smeltz, BA⁸; Rylee Betchkal, BA⁹; Tess Carichner¹⁰; Krista Jones, DNP¹¹; Linda Morrow, DNP, MBA¹²; Jaclyn Bandell, DNP¹³; Katie Pawloski, PhD¹⁴; Anna Valdez, PhD, RN^2,15; Lisa M. Meeks, PhD, MA^2,16

Author Affiliations Article Information

JAMA Netw Open. 2025;8(2):e2461038. doi:10.1001/jamanetworkopen.2024.61038

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Introduction

Medical associations’ commitment to advancing disability-inclusive practices has led to data collection on, and a significant increase in representation of, medical students with disabilities.^1,2 However, information on disability representation and accommodation use in US nursing programs remains scarce. The lack of data collection on this population impedes the ability to identify barriers, benchmark, and measure progress. To address this gap, we quantified disabilities and types of accommodations used among traditional prelicensure nursing students in US Bachelor of Science in Nursing (BSN) degree programs.

Methods

This exploratory cross-sectional study, conducted from April 1 through July 30, 2024, used national data from nursing schools to examine disability and accommodation use in traditional prelicensure BSN programs. Participants were recruited through convenience and snowball sampling from social media, American Association of Colleges of Nursing (AACN) listservs, and the AACN newsletter. US traditional prelicensure BSN programs accredited by the Commission on Collegiate Nursing Education were eligible. Postlicensure and accelerated BSN programs were ineligible. The study was exempted and no consent was required by the University of Michigan institutional review board because we collected aggregate data that belong to the institution. We followed the STROBE reporting guideline.

Questionnaires from previous works of the senior author (L.M.M.)^1 -3 were adapted from medical to nursing education (eMethods in Supplement 1). The nursing questionnaire collected data on the number of students with disabilities registered with their school’s disability services office by disability category and approved accommodations. Program characteristics, including size, geographic location, private or public designation, and structure of the disability office, were also collected. Schools’ disability resource professionals completed the questionnaire.

Descriptive statistics were used to summarize survey results. To account for heterogeneity between schools, random-effects logistic regression models were used to calculate pooled estimates (weighted by sample size) of disability proportions along with 2-sided 95% CIs. Analyses were conducted using R statistical software, version 4.4.1 (R Project for Statistical Computing).⁴

Results

Twenty-two schools responded to the social media and listserv call; 19 met criteria for the study and completed the questionnaire. The schools identified 562 of 6416 nursing students with disabilities, representing 8.4% of the total enrollment, with school percentages of nursing students with disabilities ranging from 2% to 21.2% (Table). Psychological disabilities were the most common category reported (224 [3%]), followed by attention-deficit/hyperactivity disorder (ADHD) (141 [2.1%]) and chronic health conditions (98 [1.2%]). Mobility (6 [0.1%]) and sensory (23 [0.4%]) disabilities were less common. School-based testing accommodations were most frequently used (19 [100%]); clinical accommodations were less frequently used (Figure). Nine schools (47.4%) reported using a disability determination structure that included assistance of the disability services office without a liaison.

Discussion

This is the first study, to our knowledge, to evaluate the frequency of nursing students with disabilities in traditional prelicensure BSN programs. We found a proportion estimate of 8.4%, exceeding the prevalence in medical schools (5.9%).¹ Differences in accommodation provision and disability proportions between schools may stem from variations in admissions practices, disability expertise, or resource allocation. The prominence of psychological disabilities and ADHD suggests these areas should be prioritized in future research, including studies on student performance and efficacy of accommodations. Conversely, the scarcity of nursing students with mobility and sensory disabilities warrants future investigation on barriers to entering and fully participating in the profession.

The use of a convenience sample and resulting small sample size limits generalizability and can amplify the influence of outliers. Although some heterogeneity between schools is expected due to the differences mentioned; a larger, more representative sample would allow these differences to be further explored. However, the accuracy of schools’ reported disability proportions is supported by federally mandated documentation of disability decisions.

This study provides insights into disability, accommodation use, and school-specific differences, including structure of disability determination. Given the valuable contributions of nurses with disabilities to the workforce⁵ and commitments to disability inclusion by nursing associations,⁶ collecting standardized data and prioritizing research on experiences of nursing students with disabilities are essential.

Jackson, B. L., Cameron, V. K., Hodgens, T. M., Jamal-Eddine, S. A., Kunte, V., Marsala-Cervasio, K., Smeltz, L., Betchkal, R., Carichner, T., Jones, K., Morrow, L., Bandell, J., Pawloski, K., Valdez, A., & Meeks, L. M. (2025). Disability and Accommodation Use in US Bachelor of Science in Nursing Programs. JAMA network open, 8(2), e2461038. https://doi.org/10.1001/jamanetworkopen.2024.61038

Visit https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830457 to view tables/figures and list of references.

Cheers!

Donna

Meriah Ward, DNP, FNP-BC, PMHNP-BC shares her lived experience as an autistic nurse practitioner

“Growing up, I felt very out of place,” Ward explained to host Sophia Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FAANP, FNAP, FAAN, on the latest episode of NP Pulse: The Voice of the Nurse Practitioner^® entitled “Neurodivergence: An Autistic NP’s Lived Experience.” Ward recalls they would “often get in trouble for speaking during class,” and “got into conflict with other students because there was a big social gap — and we know that’s a huge component, as one of the diagnostic criteria for autism. When I struggled with those social connections, I would get very frustrated, and I would find myself arguing with other students...and I would get put in in-school suspension (ISS).” In ISS, Ward was able to “finish all my work within the first day of my suspension, and then I would spend the rest of the time just reading books, and it was the best time that I ever had in school.”

“I only got diagnosed because I had gotten pregnant with my daughter, and I just didn’t feel connected to my body, to her, and I was really worried something was wrong with me,” they tell Thomas. “I had her, and then spent a year trying to find a good fit to get diagnosed.” Ward connected with a psychologist (“she was wonderful”) and went through the assessment process, which Ward recalls “was about two whole days’ worth of diagnostic procedures.” At first, Ward suspected they might have PTSD or autism, and then learned that they in fact had both. Later, Ward was able to combine this new knowledge with their training as an NP, and created a presentation entitled “Neurodivergence in Clinical Practice: Perspectives from an Autistic NP,” which they recently gave to other NPs at the 2024 AANP National Conference.

Read more at:

An Autistic Nurse Practitioner Speaks on Neurodivergence

Cheers!

Donna

Jessica Eastes, cardiac nurse, with "half a heart" undergoes risky transplant

 

Jessica Eastes at Texas Children's Hospital

People Magazine reported this story by Wendy Grossman Kantor, on March 12, 2025. 

"Born blue due to lack of oxygen — "I looked like a Smurf," she tells PEOPLE — she was diagnosed with a congenital heart defect when she was a few days old. By the time she was 7, she'd had eight open-heart surgeries."

"Eastes was shocked to learn in fall 2021 from her doctors at the University of Kansas Medical Center that she was experiencing heart failure and would likely need a heart transplant. The medication she was taking had helped for years, but she was having more issues requiring multiple hospital stays."

"It was scary,” she says. “Being a nurse is a great thing, because you kind of understand what they're saying to you. So they can talk to you like normal medical jargon. But it's also a curse because you know what to expect.”

"Her cardiologist referred her to Texas Children’s Adult Congenital Heart Program, part of the Texas Children’s Heart Center in Houston. Her first appointment was in May 2022."

"Jessica had a “complicated cardiac lesion,” says  Dr. Edward Hickey, surgical director of the program."

“She essentially has half a heart,” Hickey explains.

 “These are some of the most extreme transplants in terms of risk and complexity. In all the databases and registries, this category of transplants are particularly challenging and risky, which means that historically people have shied away from them.”

Read more at: 

Cardiac Nurse, 43, Gets Her Own Heart Transplant (Exclusive)

Cheers!

Donna

Epilepsy patient becomes a nurse at B.C. hospital that treated her and changed her life

Dr. Chantelle Hrazdil, left, a Vancouver General Hospital neurologist and epileptologist, and Keri-Rose Tiessen. Photo by Eduardo Caceres

 "Keri-Rose Tiessen's struggled with a rare type of seizure - once the SIU diagnosed and treated her, she became a nurse in neuroscience." 

"Today, at 39, she’s able to play hockey, swim in open water, hike and run, drive a vehicle — all the things she loves and once was told she couldn’t do anymore."

"Her pacemaker isn’t a magic wand, she cautioned. It and her medication are like a bandage, preventing her from having heart-stopping seizures, but she still has smaller, less severe seizures on occasion."

"Being a nurse had always been her dream job. The team at VGH and the epilepsy clinic worked her medical schedule around her school work, as well as her days-long stays in the unit."

"So to be able to help calm some patients whose shoes she’s been in, it’s not exactly paying it forward, it’s more like things have come full circle.

“I’m not here without the SIU, you have no idea,” Tiessen said. “I wouldn’t be doing what I’m doing without them.”

Read more about Keri-Rose Tiessen at:

VGH Seizure Investigation Unit saved her, so she went to work for them | Vancouver Sun

Epilepsy patient becomes nurse at the same B.C. hospital unit that changed her life | Globalnews.ca

Cheers!

Donna

Results of a Study of Disability and Accommodation Use in BSN Programs in the USA

 

JAMA Network Open published the following study results.

"Twenty-two schools responded to the social media and listserv call; 19 met criteria for the study and completed the questionnaire. The schools identified 562 of 6416 nursing students with disabilities, representing 8.4% of the total enrollment, with school percentages of nursing students with disabilities ranging from 2% to 21.2%. Psychological disabilities were the most common category reported (224 [3%]), followed by attention-deficit/hyperactivity disorder (ADHD) (141 [2.1%]) and chronic health conditions (98 [1.2%]). Mobility (6 [0.1%]) and sensory (23 [0.4%]) disabilities were less common. School-based testing accommodations were most frequently used (19 [100%]); clinical accommodations were less frequently used. Nine schools (47.4%) reported using a disability determination structure that included assistance of the disability services office without a liaison."

"This is the first study, to our knowledge, to evaluate the frequency of nursing students with disabilities in traditional prelicensure BSN programs. We found a proportion estimate of 8.4%, exceeding the prevalence in medical schools (5.9%). Differences in accommodation provision and disability proportions between schools may stem from variations in admissions practices, disability expertise, or resource allocation. The prominence of psychological disabilities and ADHD suggests these areas should be prioritized in future research, including studies on student performance and efficacy of accommodations. Conversely, the scarcity of nursing students with mobility and sensory disabilities warrants future investigation on barriers to entering and fully participating in the profession."

Read the entire article via the link below.

Jackson BL, Cameron VK, Hodgens TM, et al. Disability and Accommodation Use in US Bachelor of Science in Nursing Programs. JAMA Netw Open. 2025;8(2):e2461038. doi:10.1001/jamanetworkopen.2024.61038

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830457?widget=personalizedcontent&previousarticle=2830459

Cheers!

Donna

Hearing loss didn't stop this ICU nurse

The Cleveland Clinic shared this story about Marissa Pusateri, BSN, RN. 

"Marissa  was diagnosed with bilateral profound hearing loss at 9 months old. She received cochlear implants as a toddler and then embarked on several years of speech therapy and auditory training. Although she says her hearing loss was never much of an obstacle during her school years, “everything changed” when she began working in the ICU."

“Everyone has a hard time with masks, but it is even more of a challenge for someone like me,” she explains. “Masks constrict the sound of a person’s voice and obviously make it impossible to read lips. The stress was overwhelming at first, but I quickly realized that the best – and only – solution was to be open about my needs. Once I made it clear to my colleagues that they had to speak up, things instantly improved.”

"Receiving a phone call or interpreting verbal instructions from a physician – especially one with an unfamiliar accent – can be particularly difficult, she notes. She has learned to manage the sounds in the ICU — the equipment and cacophony of voices — by positioning herself in locations that give her a clear view of the room and her fellow clinicians."

"Pusateri explains that she initially had trouble hearing through the Vocera devices that the staff uses to communicate with each other. Always willing to find a solution, she discovered how to route Vocera calls through her cell phone, which is connected by Bluetooth to her hearing aids."

“That was life-changing for me,” she says.

Read more at: Nurse Overcomes Career-Limiting Disability With Openness, Ingenuity

Cheers!

Donna

 

ICE at Healthcare Facilities: What Should You Do

 The law firm of Husch Blackwell wrote an article that includes a wealth of information for nurses and other healthcare providers.

"During the first hours of Trump’s second term, the administration rescinded these “sensitive location” protections. Given the Trump administration’s swift actions on immigration and statements made by the administration during the first few days in office, we expect ICE to be emboldened when it comes to accessing hospitals, clinics, and other health facilities to carry out their enforcement actions. ICE’s presence can be discomforting and disruptive. Although ICE agents are not police officers, their uniforms may say “Police” or “Federal Agent,” and they may even be accompanied by local law enforcement."

"While it is prudent for healthcare organizations to not be seen as uncooperative with law enforcement, they must be mindful that ICE and other law enforcement must still go through a judicial process to access a patient or their PHI, and there is no affirmative legal obligation to collect or report information about a patient’s immigration status just as there is no legal obligation to report on a patient’s drug use. Healthcare organizations should balance respecting the confidentiality of undocumented immigrants as if they were any other patient with maintaining a good rapport with ICE."

1. Make a plan and practice it

2. Limit cooperation without a warrant

3. Maintain patient privacy

4. Create private areas

5. Document everything

6. Reassure patients

7. Stay calm and professional

To read more from this article visit:

ICE at Healthcare Facilities: What Should You Do | Husch Blackwell

Stay safe,

Donna

Emmy Nix, RN shares her journey with an ostomy and liver disease with her patients

 

Emmy Nix, "a graduate of Greenfield Central High School,  went on to earn her degree from Chamberlain University College of Nursing in December 2019."

“I first worked bedside with surgical patients but from the time I walked across that stage to get my nursing degree, my heart was with ostomy/GI patients,” said Nix. She is working on her wound and ostomy licensure and in August began working with IU Health wound ostomy patients."

“I’m a huge advocate and have lots of patients keep in touch with me. I’m an open book and tell patients they can ask me anything,” said Nix. She’s a big proponent of helping alleviate the stigma that comes with ostomies."

Read more about Emmy's story at:

Nurse: ‘Ask me Anything About an Ostomy Pouch, Liver Health’ | IU Health

Cheers!

Donna

Little but fierce, meet Maggie Chin, RN "thetinynurse"!

 

 Maggie's introduction to thetinynurse blog starts with:

"My real name is Regina but please call me Maggie! Maggie is actually a nickname I’ve had since literally the day I was born. I can tell you that fun short story later. I am 24-years-old and I am probably one of the shortest people you will virtually meet. I’m 4’9” over here, no, actually down here, and yes, I get the question, “are you tall enough to be a nurse?” from time to time. I just respond, “maybe not, but my license qualifies me to be one!” Patients really get a kick out of that. I grew up in a Filipino household with very Asian parents. I know, I know, following that Filipino stereotype, but what can you do? It’s a great career! I am an avid Target goer, my favorite color is yellow, I am mom to a 16 year old weenie dog, and a coffee enthusiast!"

"My journey to becoming an RN was not an easy one, 'cause girl, that shit was hard. I graduated from California State University, Long Beach in 2019 and started my new grad career at the peak of the COVID-19 pandemic. I am a cardiac nurse, which I never thought I would be, but that’s another story for later. I have been an RN for 3 years now, and although I still have much to learn, come with me on my journey as I grow as a nurse and become the best version of myself. Everyone’s experience is different, but I just want to share my story and advice and guide those seeking help and comfort."

Read more of Maggie's blog at: thetinynurse.

Cheers!

Donna