Nursing Education and Campus Support Services for Students With Disabilities
Campus
Support Services In Nursing Education
As previously mentioned, most institutions of
higher education have established an office responsible for providing support
services to students who identify themselves as learning disabled. Use of these
services is voluntary, and they are usually available at little or no cost to
the student.
Services vary among institutions but typically include assessment
and diagnosis of learning disabilities, identification of appropriate
accommodations for the student, guidance counseling, and development of study
and test taking skills.
Faculty education about students with learning
disabilities is another service commonly provided by these offices. Campus
teaching and learning centers can assist faculty with how to design courses in
line with universal design principles.
Accommodations
for the National Council Licensure Examination In Nursing Education
Nurse
educators need to be familiar with the accommodations provided students with
disabilities in their states when taking the National Council Licensure
Examination (NCLEX). Accommodations are offered to individuals with learning
and other disabilities in accordance with the ADA (National Council of State
Boards of Nursing, 2014).
Each state individually determines the degree of
accommodation offered to students on a case-by-case basis. Educators should
investigate and verify the accommodations offered to students in their
respective state and encourage students with disabilities to seek appropriate
accommodations.
One of the most common accommodations has to do with time
allotted for the examination. Regulations do change, and the student and
faculty are encouraged to check with the National Council of State Boards of
Nursing website (www.ncsbn.org) or the individual state board of nursing for
further information.
The student must provide documentation as to what
accommodations have been made during his or her course of study before arriving
at the testing center.
Student with Physical Disabilities and
Thinking
of physical disabilities as hindrances as well as providing only environments
that favor those without disabilities may limit opportunities for students and
nurses with disabilities (Hargreaves & Walker, 2014). Required abilities
that schools use to exclude students may include hearing, seeing, and lifting.
Essential competencies for basic nursing programs may be different from those
required in specialty graduate programs. For example, Helms and Thompson (2005)
suggested that nurse anesthetists and nurse anesthetist students must be able
to work in a fast paced environment using complex information that is
translated into immediate action.
Nurse anesthetists must also be able to work
closely with team members, so those who have any impairments that affect their
ability to work in groups might not be suited for nurse anesthetist roles.
The
United States Supreme Court ruled more than 35 years ago that a prospective
nursing student with a hearing impairment could be denied admission because of
the potential for lowering educational standards (Southeastern Community
College v. Davis, 442 U.S. 397 [1979]). However, the ADA and ADAAA have
clarified that, with reasonable accommodations, such a student has the
potential to succeed.
Published reports of students with hearing impairments
who have achieved success in nursing programs and in subsequent employment do
exist (Manning, 2013; Sharples, 2013). Many aids, such as sophisticated
amplified stethoscopes, are now available, and an interpreter could be used for
auscultation (Association of Medical Professionals with Hearing Losses, n.d.).
Through the use of note takers and tape recorders, many students with hearing
impairments have little difficulty participating in the classroom. Pagers and
cell phones that vibrate may help students keep in contact with others in the
clinical setting.
Much
of the evidence regarding physical disabilities is case study evidence. Because
some nurses with visual impairments are active in the workforce (American
Foundation for the Blind, 2014), faculty could assume that some students with
impaired vision may be accommodated.
Providing alternative learning environments
and enabling students to work with preceptors may be accommodations that can
reasonably be made. For example, a student with a visual impairment might need
a magnifier to help with reading printed matter, larger font sizes on a
computer, or a text-to-voice apparatus.
Students in wheelchairs may also be
accommodated and go on to have a successful nursing career (National
Organization of Nurses with Disabilities, 2012). Pecci (2013) presented the
case of a nurse who has been in a wheelchair and functioned as a staff nurse.
Nurses with missing limbs have also functioned as staff nurses, including
starting intravenous infusions (Maheady & Fleming, 2012).
Lifting
restrictions may not be a barrier because many hospitals and nursing homes are
striving for an environment that minimizes lifting. Teaching students how to
properly use lifting equipment may help prevent workplace injury and future
physical limitations. Students who are in their late teens and early 20s may
not be fully physically developed, which makes them susceptible to injury
(Kneafsy, 2010).
Working with clinical partners to promote role modeling of
proper patient handling by teaching students how to safely use lifting
equipment may prevent injury on the job (Kneafsy, 2010). However, students
often observe poor practice during their program of studies.
In
a study conducted by Cornish and Jones (2010), students described poor
practices by staff for using lifting equipment and using sheets to move
patients. Students also shared that they engaged in these practices themselves
because of the need to feel a part of the staff and because in some cases the
staff may not have been qualified to use the available lifting equipment
(Cornish & Jones, 2010).
Students
may become disabled during their time in school, and thus reasonable
accommodations for students with physical disabilities may include time
extensions for assignments and the assignment of an “incomplete” grade for
courses that may not have been completed on time.
Smith Stoner, Halquist, and
Glaeser (2011) presented a case study of a baccalaureate nursing student who
developed cancer. She continued in her classes, but had to delay clinical
experiences because of chemotherapy. The student also received extensions on
assignment due dates to accommodate treatment.
The student did graduate, albeit
later than planned. Faculty need to be careful not to assume what a student may
or In a study conducted by Cornish and Jones (2010), students described poor
practices by staff for using lifting equipment and using sheets to move
patients.
Students also shared that they engaged in these practices themselves
because of the need to feel a part of the staff and because in some cases the
staff may not have been qualified to use the available lifting equipment
(Cornish & Jones, 2010).may not be able to do when facing a physical
limitation or illness, and should consider ways to provide reasonable
accommodations.
Students
may have disabilities that are less readily apparent. Dailey (2010) conducted a
phenomenological study of 10 students with various chronic illnesses such as
multiple sclerosis, diabetes, adrenal hyperplasia, and asthma. Students
reported they were determined to finish their programs of study despite feeling
ill much of the time.
Students expressed a desire to appear normal and they
feared being penalized for excessive absences, so they often placed their own
health, and perhaps those of their patients, in jeopardy by attending class and
clinical experiences when perhaps they should not have done so.
Dailey (2010)
recommended that faculty accommodate students by providing short rest periods
during clinical experiences; promoting group work for learning activities, so
that the load for all students was lessened; and incorporating self-care
strategies into the curriculum that would benefit all students, not just those
with chronic illnesses.
Disabled
military veterans are a special population that may require assistance from the
veteran support office or the office that handles all students with
disabilities. Veterans may have missing limbs or posttraumatic stress disorder
(DiRamio & Spires, 2009).
The campus support service offices may assist
veterans by providing mentors to guide the veterans through the educational
process. Learning communities specifically for veterans may also facilitate
their academic success (O’Herrin, 2011).
When
students with physical disabilities graduate, their successful employment may
depend on nurse managers’ experience in working with nurses who are disabled. A
study by Wood and Marshall (2010) revealed that nurse managers rated disabled
nurses’ performance as outstanding 22% of the time and rated them as below
average only 11% of the time. Most would surmise that disabled nurses’ job
performance mirrors that of nondisabled nurses.