Role of Educator In Nursing Education The Language of Disabilities in Nursing Education
Since the 1960s, the disability rights movement has played a pivotal role in enhancing the quality of life for individuals with disabilities through advocacy and political action. Over time, this movement has achieved significant progress, including better access to public spaces, education, and employment. One essential aspect of the movement has been advocating for the proper use of language when referring to people with disabilities. This is because language shapes perception, and the terms used to describe individuals with disabilities can either empower or marginalize them.
In the late 1970s, advocates for disability rights began to promote the use of “people-first language” (Family to Family Network, 2016; Haller, Dorries, & Rahn, 2006). People-first language emphasizes placing the person before the disability in both writing and speech. The goal is to describe what a person has rather than what a person is. This linguistic shift recognizes the importance of human dignity by ensuring that a person is not defined solely by their disability.
The rationale behind people-first language is rooted in the understanding that language is powerful. Referring to someone by their diagnosis or disability reduces their identity to that condition and can lead to devaluation (Snow, 2012). As a result of these advocacy efforts, people-first language has been adopted by the federal government and is often mandated in professional publications, with authors required to use it in their work.
Consider these examples: “Justin, a 5-year-old asthmatic, has not responded well to treatment,” or “Developmentally disabled people, like Marcy, do best with careful direction.” In both statements, the focus is on the disability rather than the individual. Using people-first language, these would be rephrased as:
- “Justin is a 5-year-old boy diagnosed with asthma. He continues to experience symptoms despite treatment.”
- “Marcy is a woman with a developmental disability. She learns best when provided with clear, careful direction.”
Despite its widespread acceptance, people-first language has recently become a subject of debate. Some individuals within the disability community argue that disabilities are an integral part of their identity and should not be seen as secondary characteristics (Dunn & Andrews, 2015). These advocates prefer “identity-first language,” which places the disability term before the person. For example, someone would be referred to as “autistic” rather than “a person with autism.” Advocates of identity-first language believe that a disability significantly shapes how individuals experience the world around them and should be celebrated rather than diminished (Brown, 2011). By affirming the disability as central to identity, identity-first language can foster a sense of community and solidarity among people with disabilities.
However, there are no strict rules governing the use of language when discussing disabilities. Both people-first and identity-first language can be appropriate depending on the individual’s or group’s preference. Nurses must be cautious when speaking about or to people with disabilities, as the words and labels they choose can significantly influence how those individuals perceive themselves and how society views them.
Guidelines for Language Use in Nursing
When working with or writing about individuals with disabilities, nurses should consider the following guidelines:
- Respect Preferences: When addressing groups or individuals with specific disabilities, it is essential to understand their preferred terminology. Advocacy groups, professional literature, and relevant websites can provide insights into these preferences.
- Differentiate Between Disability and Illness: Illnesses such as cancer are distinct from disabilities. For example, children with leukemia should be referred to as “children with leukemia,” not “leukemics.” Similarly, autism is a lifelong condition, and many people with autism prefer to be called “autistic” because it defines how they view and experience the world.
- Avoid Negative Labels: Terms such as “handicapped,” “wheelchair-bound,” “invalid,” and “mentally retarded” carry negative connotations. Instead, focus on describing an individual’s needs, not their limitations. For instance, a person does not have a “hearing problem” but may require a hearing aid.
- Use Empowering Language: Avoid phrases like “suffers from” or “victim of,” which evoke pity. When comparing individuals with disabilities to those without, refrain from using terms like “normal” or “able-bodied,” as these can place individuals with disabilities in a negative light.
By using thoughtful and respectful language, nurses can create a more inclusive environment and ensure that people with disabilities feel valued and understood.
The Roles and Responsibilities of Nurse Educators
The role of nurse educators in teaching individuals with disabilities has evolved significantly. Today, patients and their families are increasingly expected to take responsibility for self-care, which means that nurse educators must focus on empowering individuals by highlighting their strengths rather than their limitations. The role of the nurse educator is varied and depends on the specific needs and circumstances of each patient.
Nurses may work with patients who have acquired a disability due to injury or illness or with those whose existing disabilities are impacted by new health conditions. For example, a nurse might teach self-care techniques to a patient with a new spinal cord injury, help modify self-care strategies for a patient recovering from orthopedic surgery, or adapt a teaching plan for a blind patient newly diagnosed with diabetes.
In each case, the nurse’s responsibility is to provide the skills and knowledge necessary for the patient to maintain or restore health, independence, and quality of life. This process often involves both habilitation (teaching new skills) and rehabilitation (relearning skills that have been lost due to illness or injury). Nurses must adapt their teaching strategies to accommodate the unique needs of individuals with disabilities, ensuring that these patients can learn effectively about their health, illness, treatment, and self-care.
Assessing Family Involvement in Patient Care
When teaching patients with disabilities, it is crucial to assess the role of the family. For patients with new disabilities, family involvement is often essential in their care and rehabilitation. However, when working with individuals who have had a disability for some time, it is important to evaluate whether family involvement is appropriate or necessary. Nurses should avoid assuming that a person with a disability is incapable of self-care simply because of their condition.
Interdisciplinary Collaboration
The complex needs of individuals with disabilities often require an interdisciplinary approach to healthcare teaching. Nurse educators must assess the need to involve other healthcare professionals, such as doctors, social workers, physical therapists, psychologists, and occupational or speech therapists. These collaborations ensure that patients receive comprehensive care and support.
Nurse educators are also responsible for working closely with patients and their families to assess learning needs, design educational interventions, and foster an environment that supports learning. The teaching plan should reflect a deep understanding of the patient’s disability, incorporating technologies and interventions that help the patient overcome learning barriers. The goal is to promote adaptive behaviors that enable the patient to fully participate in activities that promote health and, in the case of illness, facilitate optimal recovery.
The Teaching-Learning Process in Disability Care
The teaching-learning process in nursing must be tailored to each patient’s unique circumstances. It often involves changes across three domains: cognitive (knowledge), affective (attitudes and emotions), and psychomotor (physical skills). A thorough assessment is always the first step, allowing the nurse to understand the nature of the patient’s disability, the short- and long-term effects, the effectiveness of their coping mechanisms, and the extent of any cognitive, perceptual, or communication deficits.
When working with patients experiencing a new disability, nurses must assess their level of knowledge regarding the disability, identify any gaps in understanding, and determine their readiness to learn. This assessment may involve direct feedback from the patient, observations, diagnostic testing, and input from the broader healthcare team. In some cases, interviewing family members or significant others can provide additional valuable insights.
Diehl (1989) outlined several questions that remain relevant today for assessing a patient’s readiness to learn:
- Do the patient and family demonstrate interest in learning by seeking information and asking questions?
- Are there barriers to learning, such as low literacy, vision or hearing impairments, or mobility issues?
- If sensory or motor deficits exist, is the patient willing and able to use supportive devices?
- What learning style best suits the patient for processing information and applying it to self-care?
- Are the goals of the patient and their family aligned?
- Is the patient’s environment conducive to learning?
- Do learners value education as a means to improve functionality and quality of life?
By carefully considering these factors, nurse educators can develop effective teaching plans that empower patients to manage their health and disabilities.
Mentorship and Multidisciplinary Support
Nurse educators must also serve as mentors to patients and their families, helping them navigate the often-complex healthcare system. This role is especially important when working with individuals who have newly acquired disabilities. In these cases, family members or significant others, who often act as the patient’s primary support system, should be involved from the outset. They must be equipped with the necessary knowledge and skills to assist with self-care activities and treatments, ensuring that the patient receives continuous, well-rounded support.
Conclusion
Language and the role of nurse educators are critical components in nursing care for individuals with disabilities. Whether using people-first or identity-first language, nurses must remain sensitive to the preferences and needs of each individual. Additionally, nurse educators have the responsibility of teaching patients with disabilities how to manage their health and maintain independence. Through effective communication, interdisciplinary collaboration, and mentorship, nurse educators can make a significant impact on the quality of care and education for people with disabilities.