Michael G. Fitzsimons, MD, Jason C. Brookman, MD, Sarah H. Arnholz, JD, and Keith Baker, MD, PhD
Cognitive and physical disabilities among anesthesia residents are not well studied. Cognitive disabilities may often go undiagnosed among trainees, and these trainees may struggle during their graduate medical education. Attention-deficit/hyperactivity disorder (ADHD) is an executive function disorder that may manifest as lack of vigilance, an inability to adapt to the rapid changes associated with anesthesia cases, distractibility, an inability to prioritize activities, and even periods of hyperfocusing, among other signs. Programs are encouraged to work closely with residents with such disabilities to develop an educational plan that includes accommodations for their unique learning practices while maintaining the critical aspects of the program. The authors present the management of a case of an anesthesia resident with a diagnosis of ADHD, the perspectives of the trainee, program director, clinical competency director, and the office of general counsel. This article also provides follow-up in the five years since completion of residency.
(C) 2015 by the Association of American Medical Colleges
It was midnight in the emergency department of my hospital, and the chief resident was on a roll. Clad in green scrubs — two sizes too small for his body, they emphasized his muscular physique — he dashed between the ambulance bay and the critical care rooms.
“Wen!” he barked at me, the medical intern. “Come over here to do the ‘rule-out-heart-attack’ in 3.” Two medical students grabbed their notepads and followed the chief resident and me into the room.
The patient did not look as if he were having a heart attack. Dressed in a tailored suit, a young man with a neat ponytail sat in bed, texting on his BlackBerry. The nurse’s note said the 31-year- old was having chest pain. His vital signs and electrocardiogram were normal.
“Good evening!” boomed the chief. We formed an imposing circle around the stretcher. “How are you doing?”
ODEP and National Organization of Nurses with Disabilities (NOND) Alliance
ODEP and NOND recognize the value of establishing a collaborative relationship to promote the employment of people with disabilities in the healthcare industry. ODEP and NOND hereby form an Alliance to conduct outreach, education and technical assistance activities that promote the recruitment, hiring, retention and advancement of individuals with disabilities, including veterans with disabilities, in the healthcare sector.
Beth Marks, NOND President, and ODEP Assistant Secretary Kathy Martinez, sign the Alliance agreement.
Working as a Nurse With a Disability
by Elisabeth Greenbaum Kasson
What are your options if you aspire to be a nurse and are disabled? What would you do if you were already working as a nurse and became disabled? Whether you are living with obvious disabilities such as limb differences or paralysis, or less visible ones such as a chronic illness, sensory impairment or post-traumatic stress disorder, there are few reasons that would prevent you from successfully completing a nursing program, or continuing your career. The field is diverse and there is a place for nearly everyone.
by Ruth Carol
People with disabilities are one of the most underrepresented voices in nursing. But like nurses of color, they have a lot to say about overcoming discrimination and barriers to take their rightful place in the profession.
Some people who dream of nursing careers are told they will never make it through nursing school. Some nurses who hear about a potential dream job are told they won’t even be considered a candidate for the position. Some are even told they have no business pursuing or continuing a career in health care altogether.
Although many of these nurses are not members of racial or ethnic minority groups, they are still a minority within the nursing profession. They are nurses with disabilities.
by Rachel Adams
A colleague in a wheelchair goes into an underground passage connecting two campus buildings. Once the entrance locks behind him, he discovers that the door at the other end refuses to open with his swipe card. Although he is a vigorous man of middle age, the maintenance worker who comes to his rescue calls him Pops.
A student with a sensory-processing disorder needs to sit in the front row of class and take notes on a laptop computer, but the professor insists that laptops may be used only in the back of the room. After the student explains her situation, he announces to the entire class that he is making a “special exception” for her.
I heard these and other stories about broken elevators, stairs without handrails, and inaccessible bathrooms at a recent panel on disability and the university that I organized on campus for students, faculty, and staff from our Office of Disability Services.
by Lennard J. Davis
It has been more than 20 years since the Americans With Disabilities Act took effect, but while the law has changed some things in higher education, it hasn’t changed the way academic culture regards people with disabilities. While our current interest in diversity is laudable, colleges rarely think of disability when they tout diversity. College brochures and Web sites depict people of various races and ethnicities, but how often do they include, say, blind people or those with Parkinson’s disease? Or a deaf couple talking to each other in a library, or a group of wheelchair users gathered in the quad? When disability does appear, it is generally cloistered on the pages devoted to accommodations and services.
It’s not that disability is simply excluded from visual and narrative representations of diversity in college materials; it is rarely even integrated into courses devoted to diversity. Anthologies in all fields now include theoretical perspectives devoted to race, gender, and sometimes social class, but disability is almost never included. Indeed, in my field, literary theory and cultural studies, The Norton Anthology of Theory & Criticism had only one essay on disability in its thousands of pages, and that was removed in the second edition. (Full disclosure: I wrote the essay.)
Like Missing an Arm Should Stop Me Being a Nurse!
by Liz Perkins ABD, RNMH
When I left high school I was like so many others – unsure of what I really wanted to be when I grew up. All through my school years I had never felt any different from my peers. But I was different – I was a congenital amputee – I had no right arm save about six inches from the shoulder down. My nick-name was the one-armed bandit – not very original, but having grown up and gone through school with the same group of friends my disability really was a non-issue. Furthermore, prosthetic arms were merely an annoyance to me, I much preferred having the use of my “little arm” as I always referred to it. So anyway – I was one of those kids who really enjoyed school – I was a bright student and did well in sports too. I played for my school teams in hockey, rounders (similar to softball), netball (like basketball), and my strong left arm meant that I was pretty good at all throwing events in athletics!
The Changes Life Brings!
by Tewanna R. Cleveland Johnson, R.N.
Growing up in a small country town, as a military dependent, I loved children. I did not have to hold down a job because I babysat a lot. By my sophomore year in high school, I decided to become a nurse. I loved learning about the body and the way it works. I was a healthy, active, young person. I loved to play soccer and basketball. In school, I was an above average student.
In a few months, the newest doctor – and one of the first doctors of her kind in the nation – will hang her shingle in the Portland, Oregon area. Chris L. Cooke will become one of the first totally blind doctors in the US with a specialty in naturopathic medicine.
The new Dr. Cooke, blind since birth, will carry the usual medical instruments in her black bag, including a blood pressure cuff, a thermometer, and a Pocket PC crammed with medical references – a tool most modern doctors rely on to help with diagnosis, prescribing the right medicine, and ordering and interpreting lab work. The difference is her tools of the trade will talk. In fact, in large part, she credits her ability to be a good doctor to a PAC Mate™ accessible Pocket PC for the blind and two Oregon men who made medical reference software accessible to the visually impaired, using the PAC Mate.