Thursday, June 18, 2015

Interprofessional practice and reasonable accommodation for nurses with disabilities

              Definitions of interprofessional, interdisciplinary, multidisciplinary and inter-professional abound. What remains central to most definitions is the notion of “teamwork” among different professionals working toward a common goal. We often hear these terms used when professionals work together to improve patient care. Could we consider using this approach when a nurse with a disability requests reasonable workplace accommodation?

               Under the Americans with Disabilities Act (ADA), a nurse with a disability can request reasonable accommodation from his or her employer. Typically, this request is submitted to nursing administration, the ADA compliance officer or Human Resources Department. Procedures for examining/granting/or denying a specific request can vary from one institution to the next.

               Interprofessional practice may be an individualized approach which could benefit the nurse with a disability, employer, decision makers and ultimately patient care. The accommodation request could be reviewed by a team of appropriate professionals and information and suggestions could be shared.

               Consider a nurse who presents a request for reasonable accommodation related to a hearing loss.  An interprofessional team might include a human resources staffer, attorney, audiologist, state vocational rehabilitation counselor and a nursing professor. Legal issues related to reasonable accommodation could be shared by the attorney. The audiologist could explain the type and degree of hearing loss and recommend appropriate stethoscopes that could enable the nurse to hear heart/lung/bowel sounds. The state vocational rehabilitation counselor could contribute information about the nurse’s rehabilitation plan and available resources. A nursing professor could share examples of how a nursing program accommodated nursing students with hearing loss in clinical settings. Consultation with the Association for Healthcare Professionals with Hearing Loss could also be included.

               Another nurse might present a request for reasonable accommodation because of a back injury related to lifting a patient.  An interprofessional team might include a human resources staffer, attorney, physical therapist and a nursing administrator. The human resources staffer could share openings in other departments and the cost of the loss of an experienced nurse vs the cost of a new hire. Legal issues could be presented by the attorney. The nursing administrator could share lifting requirements and the average number of squats per shift on various units. Safer handling initiatives could also be presented. A physical therapist could outline the nurse’s limitations and rehabilitation plan. Suggestions based on communication with the Department of Labor’s Job Accommodation Network could be shared as well.

               This team approach may prove to be time consuming. But, the effort offers the potential for a  win-win outcome for the nurse, employer and ultimately patient care.

      As the old proverb states………..many hands make light work!
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