Navigating Nursing As A Nurse Living With Disabilities

About 1 in 4 U.S. adults lives with some type of disability, according to the Centers for Disease Control and Prevention. That can mean challenges with mobility, cognition, hearing, vision, or self-care.

A disability can shape your nursing career, and it can also be an asset. "Living with a disability, or chronic illness, or health challenge gives us as nurses such a unique perspective," said Leah Parker, a full-time traveling family nurse practitioner who was diagnosed with rheumatoid arthritis early in her career.

The Experience on the Floor

A lack of awareness breeds insensitivity and rejection. Parker believes the experience is largely what you make of it, and that communication with colleagues and management is the key. Diagnosed with a progressive joint disease, she found her colleagues "loving but tough."

"Learning to speak up for yourself early and having a good relationship with your manager is vital," she said.

Anne Llewellyn had a different path. A registered nurse for more than 43 years in critical care and case management, she survived a brain tumor and now works as an independent nurse advocate. She finds nursing versatile enough that, with the right attitude, support, and resources, you can still reach your full potential. In her view, a disability can make you a better nurse by deepening your empathy and giving you something to model for others.

"You can be an example for someone with a disability, which could be a game-changer for someone who does not have the confidence in themselves," Llewellyn said.

Common Challenges

The Americans with Disabilities Act opened doors, but workplace challenges remain, and they depend on the disability. Nurses with nonvisible disabilities face different hurdles than those with physical ones.

After chemotherapy left her with cognitive issues, Llewellyn moved into independent nurse advocacy, and she recommends the same kind of pivot to nurses going through similar midcareer changes. "Be patient and keep your eyes and ears open for opportunities in the field you want to work in," she said. "Look for roles that fit your abilities and tap into your expertise."

For Parker, the bigger challenge is the lack of a flexible schedule that accounts for specific needs.

Research from the MGH Institute of Health Professions found that nurses with disabilities sometimes worry they could compromise patient safety. Parker's and Llewellyn's experiences run counter to that fear. Parker finds that nurses with disabilities often work harder, and Llewellyn argues that a nurse who acknowledges a disability is no more of a risk than any other nurse.

Progress Is Real, but Barriers Remain

Concerns from nursing managers still get in the way. One study of 600 hospitals asked managers about their attitudes toward nurses with disabilities and their performance. While some cited worries about specific job duties and acceptance by coworkers or the public, most rated these nurses' performance as exceptional or above average. Managers who had worked with a nurse with a disability before were more willing to hire one again.

Llewellyn encourages nurses to be upfront and ask for the accommodations they need. Most cost little, so employers tend to grant them. Parker notes that some managers hesitate, worried it might look like they are handing out an easier assignment.

A Sense of Belonging Matters

The 2020 National Nursing Workforce Survey found that 10.7% of RNs who were not working as nurses cited a disability as the reason. That does not capture everyone. Many find accommodations that work and keep practicing, and some patients feel more comfortable with a nurse whose experience mirrors their own.

According to the National Organization of Nurses with Disabilities, healthcare professionals with disabilities use tools such as service dogs, wheelchairs, assistive software, and accessible smartphones and apps. Many use no accommodations at all.

Know Your Rights

Congress passed the Americans with Disabilities Act in 1990 to protect people with physical disabilities from discrimination. A 2008 amendment expanded it to cover any physical or mental impairment that substantially limits one or more major life activities. The amendment also gave individuals room to challenge the misconceptions and biases that had kept some students out of nursing programs. With the ADA in place, Llewellyn believes, nurses with disabilities are far more likely to find somewhere they can learn, grow, and thrive. The point worth making to managers is simple: the competent nurse is the right nurse to hire, disability or not.

Finding Support

Llewellyn's tumor was diagnosed at 60, a few years short of retirement, and she suddenly found herself recovering from treatment with no job. Her husband applied for Social Security Disability Insurance, a difficult process he navigated with help from Allsup, a company that assists with the application. When she was ready to return to work, she hit a new problem: she could lose her disability coverage if employment did not stick, leaving her without income and forced to reapply. The fix was Ticket to Work, a Social Security program that helps people with disabilities move toward financial independence.

Several organizations help with workplace accommodations:

• The National Organization of Nurses with Disabilities promotes equity for nurses with chronic conditions or physical disabilities.
• The Job Accommodation Network offers free, confidential guidance and a list of accommodation ideas.
• The What Can YOU Do? campaign lists national and local groups that help with job searches, federal employment, and training.
• The U.S. government disability services site lists federal and state programs for housing, jobs, education, and healthcare.
• The National Disability Rights Network provides legal services for people with disabilities.

At work, Parker suggests partnering with your HR department, which should know federal disability law and can mediate between a nurse and a unit manager. Llewellyn also points to Exceptional Nurse, founded in 2001 by an advanced practice nurse, which offers equipment, latex alternatives, uniforms, and legal resources. She found additional support through online communities like PatientsLikeMe and Smart Patients.

Advice From Nurses Who Have Done It

Between them, Parker and Llewellyn have decades of experience practicing with a disability, and both see broad opportunity in the field.

"Flexibility has been one of the most important factors when choosing a job versus setting," Parker said. As with any worker, the right schedule and shift length can decide whether you succeed.

Her advice to anyone hesitating is to lean on what their experience gives them. Nurses who have spent time as patients can offer something that cannot be bought or taught. "Empathy cannot be bought with money or learned in school, it is a gift," Parker said. "The world needs our gift. Our patients need our gift."

Llewellyn uses her blog to educate and empower others, and she urges nurses with disabilities to be patient with themselves. Understanding your functional abilities, she says, helps you find the right role in or out of healthcare, and talking with others often reveals options you would not spot alone.

If one setting does not fit, try another. "The best part of nursing is that the opportunities are so broad and vast," Parker said. "If one area is not a good fit, try another!"

Contributors

Leah Parker, RN, NP

Anne Llewellyn, MS, BHSA, RN, CCM, CRRN