Leg-Heel CPR for nurses with disabilities...Why not?

Some nurses and nursing students with disabilities are unable to perform CPR with two hands (nurses with one hand or arm, cerebral palsy, or paralysis). 

Responses to requests for disability-related accommodation for CPR classes can vary from one instructor/provider to another.

Should we consider the leg-heel method as a reasonable accommodation?

Positive results of a pilot study of the “leg-heel method” were reported in JAMA 38 years ago (Billfield & Regula (1978).

In 2012, Fernando Perez, MD, and Robert H. Trenkamp, Jr., EMT-P, presented their research findings at the American Heart Association Resuscitation Science Symposium. Perez & Trenkamp studied the duration an adult could maintain two-inch deep chest compressions at a rate of at least 100 per minute using “Hands-Only” and then Pedal Compressions (“Heel CPR”) in two sequential tests (SCAF, 2012). 

"The test subjects were all 35 years old or older, and half of the cohort was between 50-80 years old. Fewer than 20 percent of the cohort was able to perform two-inch manual chest compressions for four minutes at the required one hundred per minute or higher rate.

In contrast, more than 60 percent of study participants were able to perform two-inch pedal compressions for 10 minutes at that rate—and those subjects felt that they could easily perform adequate depth and rate pedal compressions for another extended period, if necessary." 

In an article published in the American Journal of Emergency Medicine, Trenkamp & Perez (2015) "reported that heel compressions are useful in situations where a lone rescuer cannot get down on the floor, cannot compress the chest to guideline depth because of an infirmity or lack of weight, or becomes too tired to continue manual compressions. Heel compressions significantly increase the bystander population's ability to provide effective, uninterrupted compressions until EMS arrival."

Do these findings merit a closer look?

Could this approach to CPR be considered as a reasonable accommodation for CPR certification for some nurses with disabilities? For example, nurses working in home health or community settings? 

Would a write-in campaign to the American Heart Association and American Red Cross help?

Appreciate reading your comments about this important topic.

Thanks!
Donna




Billfield, L., Regula, G. (1978). A new technique for external heart compression.  Journal of the American Medical Association, 239(23): 2468-2469. doi:10.1001/jama.1978.03280500064023.

Durham, J. (2013). CPR Pedal-Heel Compressions. Frontline First Aid and Emergency Training.
http://frontlinefirstaid.ca/on-the-frontline/cpr-pedal-heel-compressions

Trenkamp, R., Perez, F. (2015, October).  Heel compressions quadruple the number of bystanders who can perform CPR for 10 minutes. The American Journal of Emergency Medicine, 33(10):1449-1453. Retrieved at http://www.ajemjournal.com/article/S0735-6757(15)00560-4/abstract

Sudden Cardiac Arrest Foundation (SCAF) (2012) Can heel CPR help?
http://www.sca-aware.org/sca-news/can-heel-cpr-help

For more information visit: www.slicc.org

JUST EAT THE COOKIE!!

Are you struggling with life issues? Or, health or 

disability related challenges?

Have you lost a job?


Are you going back to school?

Do you have a gnawing hunger for something?

Is your life dry?

Do you need to take a bite out of life?

Do you have a shirt with a deer on it?

Do you need some timeless advice from the best life coach?

Today is your lucky day! Here is a free session with Cookie Monster.

https://www.youtube.com/watch?v=HDxgn-LS520

Please share your thoughts and pass the milk!

Donna 

Playlist for nurses and nursing students with disabilities

I asked a group of nurses and nursing students with disabilities the following questions:

Do you have a favorite song? Music video? Special lyrics?What type of music helps you stay motivated to charge ahead in spite of your personal challenge? 

The following "playlist" was developed from the responses. If you need some inspiration, these songs may help!


"Hit Me with Your Best Shot" by Pat Benatar
https://www.youtube.com/watch?v=iM1a5D3fBAo


"Under Pressure" by Queen and David Bowie
https://www.youtube.com/watch?v=zRbXMWYMNno

American Sign Langage Interpretation by Amber Galloway Gallego

https://www.youtube.com/watch?v=deGnEhHQzLM

"My shot" From "Hamilton" by Lin-Manuel Miranda, Anthony Ramos, Daveed Diggs, Okieriete Onaodowan, Leslie Odom, Jr., the Original Broadway Cast.
https://www.youtube.com/watch?v=VK4Wk_8PbcI

American Sign Language Interpretation by Maddie Stengel

https://www.youtube.com/watch?v=DRZ4Q8n11i8

"Wait for it" From Hamilton" Leslie Odom, Jr., the Original Broadway Cast.
https://www.youtube.com/watch?v=VK4Wk_8PbcI

American Sign Language Interpretation by E Karll

https://www.youtube.com/watch?v=V_O704jy7sU

"Roar" by Katy Perry
https://www.youtube.com/watch?v=CevxZvSJLk8

American Sign Language Interpretation by Rosa Lee Timm

https://www.facebook.com/rosaleeshow/videos/1596550030584138/?hc_location=ufi

"Respect" by Aretha Franklin
https://www.youtube.com/watch?v=6FOUqQt3Kg0

American Sign Language Interpretation by amrobi314

https://www.youtube.com/watch?v=8KEaas1N71I

"I will survive" by Gloria Gaynor
https://www.youtube.com/watch?v=8jyvmFyxm8E

American Sign Language  Interpretation by Soph 1951 https://www.youtube.com/watch?v=ldaw9YTodO8

British Sign Language version by Gordon Newton Wylie-Black

https://www.youtube.com/watch?v=KXegNmn4xJQ

"Beautiful" by Christina Aguilera
https://www.youtube.com/watch?v=eAfyFTzZDMM

American Sign Language Interpretation by Dpanvideos

https://www.youtube.com/watch?v=C6zVFGpGNJQ

"Casting Crowns: Praise you in the storm"
by Stephen Henderson
https://www.youtube.com/watch?v=uHdcyue0bSw

American Sign Language Interpretation by Soph 1951

https://www.youtube.com/watch?v=K6_Q_UUDsEw

"Secrets" by Mary Lambert
https://www.youtube.com/watch?v=cqqqV50zaAc
          American Sign Langage Interpretation by Amber                    Galloway Gallego 
                                     https://www.youtube.com/watch?v=jSpLo8ajtkk

"Overcomer" by Mandisa
https://www.youtube.com/watch?v=b8VoUYtx0kw

American Sign Language Interpretation by Ayorkor Adjei

https://www.youtube.com/watch?v=AUG1znmyt2c

My personal favorite...........
"I say a little prayer" by Aretha Franklin
https://www.youtube.com/watch?v=7OP9bZDAR6U

American Sign Language  Interpretation by Bethany Smith

https://www.youtube.com/watch?v=V72q3JMesi8

What do you think? Do any of these songs help you? Would you add to the list?

Love to read your responses.

With thanks,
Donna

Top reasons to hire a nurse with a disability: An open letter to employers

Dear health care employer:

Are you looking for talented nurses to fill current positions?

Does your ad read,"Nurses with disabilities encouraged to apply"? 

A good reason to consider a nurse with a disability is because the individual may be the best person for the job! Unless you recruit and consider disabled candidates, you may not know the following information.

Nurses with disabilities can provide care based on years of experience, skill, and expertise (with and without accommodation).

They can teach patients based on their personal experience of being on the "other side of the bed".

They have knowledge about medications and treatments from their education as well as personal experience.

Nurses with disabilities can benefit patients by sharing first-hand experiences coping with limb, vision or hearing  loss.

Some can use sign language, read lips or have personal experience living with chronic pain, fatigue, or mental illness.

Retaining nurses who are injured on the job or who become disabled makes good business sense when you consider the cost of hiring a new person. 

There is no evidence that nurses with disabilities pose any greater risk to patient care than employing a non-disabled nurse.

Nurses with disabilities can serve as role models to patients. 

Patients can relate to nurses with disabilities who have first-hand experiences living and coping with chronic illnesses.

Employing nurses with disabilities demonstrates a health care organization's commitment to diversity and inclusion.

Employing nurses with disabilities can benefit an organization's public, media and community relations.

Employing nurses with disabilities can provide tax benefits.

Employing nurses with disabilities helps an organization demonstrate a commitment to the spirit and letter of the American with Disabilities Act.

Employing nurses with disabilities helps an organization lead by example.

With thanks for your consideration.

Sincerely,


Nurses with disabilities eager to work!



http://www.washington.edu/doit/why-should-company-hire-person-disability

https://www.irs.gov/Businesses/Small-Businesses-&-Self-Employed/Tax-Benefits-for-Businesses-Who-Have-Employees-with-Disabilities

Color blind nurses and nursing students: there's an "app" for you!

Nurses, nursing students, nursing faculty and disability services staffers have asked, "how can a nurse who is color blind practice in areas where color recognition is needed?"

Fortunately, technology has come to the rescue! Here are a few "apps" and resources.

Colorblind Assistant is a free software program that instantly picks the color from the mouse pointer providing a written name of the color. The app has a zoom pane for fine pixel detection and sits neatly in a desktop tray when not in use. Colorblind Assistant runs in a small window that can be used alongside other programs and applications. The pixel data updates in real-time. Users hover their mouse over the pixel in any running application (Excel/Powerpoint/PDF/Word) and the program displays the name of the color.

The Color ID uses the camera on your iPhone or iPod touch to speak the names of colors in real-time. It's a free augmented reality app for discovering the names of the colors. Users point their phone or tablet device at any object and the software displays the name of the currently viewed color. It is available on iTunes.

ColorBlind Vision is a free app on Google Play. It includes a classic dot test to test for colorblindness and a tool to extract colors from the world.

Colorino can detect more than 150 different colors and announce them in a clear voice. It offers 3 volume levels as well as an earphone jack to plug in earphones for more privacy. It is small enough to fit in a pocket and is battery operated.

Vischeck allows users to upload an image and view it in three different displays of color blindness: deuteranopia, tritanopia, and protanopia. Vischeck's color vision model allows users to simulate how the world looks to people with various types of color deficiency. Many pictures, documents, and web pages are hard for color blind people to read. Vischeck allows developers to check their work for color blind visibility.


Are there other "apps" available? Are you a nurse who is color blind or have you worked with a nurse who is color blind? 

Please share!

With thanks,

Donna



http://colorblind-assistant.software.informer.com/

https://itunes.apple.com/gb/app/color-id-free/id402233600?mt=8 and 

https://play.google.com/store/apps/details?id=greengar.color.identifier&hl=en )

http://www.perkinsproducts.org/store/en/ocr-scanning-products/1228-colorino-color-identifier.html

http://www.vischeck.com

How do some nurses with disabilities bloom where they are planted?

As an advocate for nurses with disabilities and 

founder of a nonprofit group, I am often asked 

what actions can help a nurse with a disability 

continue to work as a nurse. Why does one nurse 

continue to work and another struggle? How do 

some nurses bloom where they are planted?

Every nurse is different disabled or not…so “one 

size doesn’t fit all”. This is my best general 

advice:

Acceptance. Meet the challenge head on and learn compensatory skills. Get connected with other nurses with similar challenges. Find helpful resources and organizations and learn all you can. Research the nursing literature and read books and articles about nurses with disabilities. Get comfortable in your “own skin” and show up head held high.

Find a mentor. A nurse mentor with a similar challenge can offer help, provide support and offer suggestions. Over time, consider giving back and become a mentor to other nurses or nursing students.

Know your rights.  Study your rights to reasonable accommodation under the Americans with Disabilities Act. Become familiar with the U.S. Equal Employment Opportunity Commission (EEOC), Family Medical Leave (FMLA), U.S. Department of Labor, Office of Disability Employment (ODEP), Social Security Disability and Ticket to Work.

Cast a wide net. When looking at career options, think outside the box. Consider telephone triage, case management, teaching CPR or Lamaze classes or teaching nursing as a clinical instructor or online, working as a school or camp nurse, legal nurse consulting, poison control call centers, parish nursing, home or public health, medical billing, coding and tutoring nursing students. Some nurses combine nursing with yoga, massage or Reiki and start a business. Still others write books, articles, continuing education programs or blogs. Nurses with disabilities have also invented health care related products. They have also produced podcasts and become hosts of radio programs.

Stay current. Stay up to date with computer technology and the Internet. Get involved in groups and with social media (e.g. Facebook, Twitter, Pinterest).

Study. Return to school to obtain an advanced degree or certification. Advanced degrees and certifications can open more doors of opportunity.

Volunteer. Free clinics, non-profit organizations, schools, support groups, churches synagogues and mosques provide opportunities to volunteer. Use volunteer opportunities to learn new skills, maintain skills and network with others.

Join groups. Membership in professional nursing organizations can help with networking. Also, join organizations that support nurses and healthcare workers with disabilities.   

Ask for help. Recognize your limitations and don’t be afraid to ask for help from co-workers. In exchange, be a team player— eager to pitch in and help others when needed.

Consider disclosure carefully.

Disclosure is a difficult, deeply personal decision.

The decision can come with benefits and risks.

If you decide to disclose:

Document. If you need reasonable accommodation, make your request in writing.

Assist employers. Help your employer help you. If you need special equipment or technology (amplified telephone, computer software program), research the marketplace and present your employer with available options and price quotes.

Utilize resources. Contact your state vocational rehabilitation office.  A state vocational rehabilitation program may be able to fund equipment (amplified or electronic stethoscope), a return to school for an advanced degree or provide other services.

Share. Tell co-workers or prospective employers about your disability and ways to most effectively work with you.

Advocate. Toot your own horn when appropriate. Talk about your abilities, experiences and desire to work.  Become the “go to expert” regarding how to help people with disabilities. 

Persist. Don’t take “No” as an answer. Turn “NO” into an opportunity or challenge. Find another way.

At the end of the day, there is no “one” best 

approach. Every situation is different. 

Nurses with disabilities who continue to work try many approaches and find what works best for them. The good news is that it can be done!

Once a nurse….always a nurse.

Here's to more blooming nurses!

Donna

References

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

Maheady, D.C. (2006). Leave No Nurse Behind: Nurses Working with disAbilities.

Lincoln, NE: iUniverse, Inc.     

Sample reasonable accommodation request letter for nurses with disabilities

Sample Accommodation Request Letter

Nurses with disabilities often ask, "how do I ask for reasonable accommodation"?

The Department of Labor's Job Accommodation Network (JAN) suggests the following:

"According to the Equal Employment Opportunity Commission (EEOC), the federal agency charged with enforcing the ADA, an accommodation request does not have to be in writing. However, the EEOC suggests that individuals with disabilities might find it useful to document accommodation requests in the event there is a dispute about whether or when they requested accommodation. One way to document an accommodation request is to make a written request."

The following is an example of what can be included in an accommodation request letter. It is not intended to be legal advice:

Date of Letter

Your name

Your address

Employer’s name

Employer’s address

Dear (e.g., Supervisor, Manager, Human Resources, Personnel):

Content to consider in body of letter:

Identify yourself as a person with a disability.

State that you are requesting accommodations under the ADA (or the Rehabilitation Act of 1973 if you are a federal employee).

Identify your specific problematic job tasks.

Identify your accommodation ideas.

Request your employer’s accommodation ideas.

Refer to attached medical documentation if appropriate.*

Ask that your employer to respond to your request in a reasonable amount of time.

Sincerely,

Your signature

Your printed name

Cc: To appropriate individuals

 *You may want to attach medical information to your letter to help establish that you are a person with a disability and to document the need for accommodation.

Source: Department of Labor, Office of Disability Employment Policy, Job Accommodation Network http://askjan.org/media/downloads/accommodationrequestletter.pdf