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Annotated Bibliography: Nursing students and professionals with disabilities

1.� Anderson, A.� (1981).� One step at a time.� Journal of Nursing Education, 20(4), 22-27.

TYPE OF ARTICLE:�
Commentary.�����������
PURPOSE:� To describe the experience of one nursing faculty member with a last-semester student with a new onset physical disability; specifically, how she attempted to balance the behavioral objectives of the school of nursing while meeting the student�s needs.�����������
FINDINGS:
� Anderson describes her personal struggles of deciding whether a person with a disability can be an effective and safe nurse, through her experience of working
with a student with a new onset physical disability.� She shares how the law and her prior experience with this student influenced her decision.

Key words: nursing student, nursing faculty, physical disability, accommodations, law.

2.� Aroskar, M. A.� (1993).� Incompetent, unethical, or illegal practice�Teaching students to cope.� Journal of Professional Nursing, 9(3), 130.

TYPE OF ARTICLE:� Commentary.
PURPOSE:� To briefly outline the ethical standards of the nursing profession and identify how they guide awareness and reporting of incompetent, unethical, or illegal practice.

METHODS:
� The American Nurses Association�s interpretive statements (1976, 1985) on ethics were used as the basis for discussion.

FINDINGS:� The author focuses on the ethical principles of respect and non-maleficence� as being the central tenets of good nursing practice.� Although this article is not disability specific, the information does yield insight into what types of behaviors the nursing profession views as incompetent, unethical, and illegal.

Key words:� nursing profession, practice, ethics.

3.� Beeker, B. A.� (1985).� Helping students succeed despite learning disabilities.� Nursing & Health Care, 6(10), 558-61.

PURPOSE:� To relate the University of Vermont�s experience in developing a Learning Disability Program (1981-1983).
FINDINGS:� Beeker explains how the program helped 17 nursing students who were not previously diagnosed with a learning disability (LD) prior to university entrance.� She explained that faculty education about learning disabilities were helpful in identifying and referring students with possible learning disabilities during the advent of the LD program.� As the program became increasingly known on campus, students began to self-refer.

Examples are provided about how students were provided diagnostic testing and appropriate accommodations.� Success rates were compared across accommodations. In addition, Beeker explains that because of student requests and University support the Vermont State Board of Nursing was successfully granted NCLEX accommodations from the National Council of State Boards of Nursing (national body governing NCLEX exams).

Key words:� nursing students, learning disability, disability program development, diagnostics, accommodations, and NCLEX exams.

4.� Brillhart, B. A., Jay, H., & Wyers, M. E.� (1990).� Attitudes toward people with disabilities.� Rehabilitation Nursing, 15(2), 80-85.

TYPE OF ARTICLE:� Research.
PURPOSE:� To compare attitudes held by nursing faculty, beginning nursing students, graduating nursing students, registered nurses, and people with disabilities.�����������
METHOD:�
This study quantified and compared the attitudes of the 92 beginning and 36 graduating nursing students, 62 registered nurse students, 31 nursing faculty, and 143 adults with disabilities using a questionnaire.�����������
FINDINGS:
� The researchers found that persons with disabilities had the most positive attitudes toward people with disabilities.� Beginning nursing students had the second most positive attitudes toward people with disabilities, followed by registered nurses, graduating students, and nursing faculty, respectively.
�����������

The researchers conclude that it is through nursing education and faculty attitudes that nursing students� attitudes towards disability are negatively influenced.� As a result, they suggest that faculty and schools of nursing concentrate efforts on incorporating positive images of persons with disabilities and to work on improving their own impressions/attitudes of people with disabilities.� The researchers suggest this take place by to adding rehabilitation nursing content to the curriculum.

Key words:� nursing faculty, nursing students, disabilities, attitudes,
faculty, research, curriculum.


5.� Browning, H. K. E.� (1980).� Careers for diabetic girls in nursing.� British Medical Journal, 281(6325), 307.

TYPE OF ARTICLE:� Commentary.�����������
PURPOSE: To respond to the Journal�s prior publications on disabilities and schools of nursing (May 17, 1980 and June 28, 1980) around the issue of admissions.
�����������
FINDINGS:
� The author was upset that schools of nursing were feeling that they did not have a legal right to deny students with disabilities admissions, even when the school felt that the disability compromised the applicant�s ability to function in the nursing role.� She wanted to remind schools of nursing that they are to decide who will be granted admission based on what skills are needed in order to be a nurse.� Essentially, programs and graduates should not be compromised in quality or integrity when admitting students.

Key words: nursing schools, disability, admissions.

6.� Christensen, R. M.� (1998).� Nurse educators� attitudes toward and decision-making related to applicants with physical disabilities.� Journal of Nursing Education, 37(7), 311-314.

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To determine the attitudes of those in decision-making positions in nursing education toward people with physical disabilities in general, the factors related to those attitudes, and what decision-making processes nurse educators used when faced with an applicant with a physical disability.
�����������
METHOD
:� This descriptive study used both open- and closed-ended questions on a mail survey to compile data from 84 nursing faculty.� Their response rate was 55%.
FINDINGS:� The findings from this study show that nursing educators in general have positive attitudes towards persons with disabilities.� Moreover, the likelihood of a positive attitude is increased when the nurse educator has more frequent contact with persons with disabilities.
�����������
In terms of admissions decision-making, most of the respondents stated that they preferred to assess the applicants� disability and the ability of the institution to provide reasonable accommodations prior to granting admission.� However, this is in direct conflict with the ADA.� The author, therefore, recommends that schools concentrate their efforts on developing essential functions, which would guide decisions about what it takes to be a nurse in their program without focusing on a disability.� Such an effort would eliminate admissions discrimination based on a disability, but would still allow qualified candidates to be admitted.

Key words:� nursing programs, nursing faculty, disability, research, essential functions, attitudes, admissions.


7.� Davidson, S.� (1994).� The Americans with Disabilities Act and essential functions in nursing programs.� Nurse Educator, 19(2), 31-34.

PURPOSE:� To investigate the percentage of BSN nursing programs that have a list of essential functions that students must be capable of performing while enrolled.�����������
METHOD:
� The author conducted a mailed survey to 240 program directors of National League for Nursing accredited BSN nursing programs, representing 98% of all BSN nursing programs.� Questions included:

1.      Demographic information
2.      Lists of essential functions

3.      Requirements during the admission phase related to capabilities to complete the essential functions of the program
4.      Additional comments.

She received a 68% return rate, and a usable sample of 64.� The data was then analyzed as descriptive statistics and summarized the narrative comments in her analysis.

FINDINGS:� Davidson found that most schools of nursing did not have an explicit list of essential functions (EF).� Those programs that did have EFs did not include them as part of the admissions process.� Regardless, once students were enrolled, they were expected to be able to complete the EF skills, which were often defined in terms of physical requirements.�

The author recommends that EF be developed and given to students in the early stages of the admissions process in order to allow students with disabilities to have the opportunity to judge for themselves if they are capable of the meeting the program�s expectations prior to their enrollment.

Key words: nursing programs, nursing students, disability, essential functions, research,� admissions, disclosure.

8.� Davidson, S.� (1999).� Supporting nursing�s essential values.� Oregon Nurse, 64(4), 3.

TYPE OF ARTICLE:� Commentary.
PURPOSE:� To comment on what he believes are the essential values of nursing: caring, competence, consistency, and clout.

FINDINGS:� Davidson briefly explains why each of the above values are essential to nursing.� The importance of this article is its articulation of these values, as this is not common practice.

Key words:� nursing, essential values, caring, competence, consistency, clout.


9.� Eliason, M. (1992).� Nursing Students with learning disabilities: Appropriate accommodations.� Journal of Nursing Education, 31(8), 375-376.

TYPE OF ARTICLE:� Review.�����������
PURPOSE:� To describe in depth the most prevalent learning disabilities people may have and suggests some simple accommodations to help these individuals succeed.
FINDINGS:� Eliason begins his article with a brief review of the legislation and law regulating admissions and accommodations for students with disabilities.� Specific learning disabilities are briefly outlined in terms of their frequency, predominant features, and suggestions for accommodations and teaching strategies are offered.� For example, the most common learning disability is a type of dyslexia that involves difficulty reading and comprehending written words.� The author suggests that such a student may try using audio-taped books instead of written material and/or to read small sections out-loud.� Clinical examples of accommodations are also given.

This article is not limited to nursing students with disabilities.� In fact, the information provided is not discipline specific, and would be useful to a general audience of educators.

Key words: nursing students, learning disabilities, identification, diagnosis, accommodations.

10.� Gething, L.� (1992).� Nurse practitioners� and students� attitudes toward people with disabilities.� The Australian Journal of Advanced Nursing, 9(3), 25-30.

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To compare attitudes towards people with disabilities among four groups: nurse practitioners, nursing students, education students, and the general public in Australia.
�����������
METHODS:� Quantitative questionnaires were given or mailed and completed by 183 nurse practitioners, 93 nursing students, 105 education students, and 4167 persons in the general public.� Groups were statistically compared for demographic and attitudinal differences.
�����������
FINDINGS:� The researchers found that both nursing students and nurse practitioners had more positive attitudes towards people with disabilities than the education students and the general population.� In fact, nursing students that were tested later in their program scored more positively than beginning students.� The accumulation of this data suggests that nursing education positively influences attitudes towards people with disabilities.� These findings directly contrast with prior research in the United States and Britain.� No explanation for why this might have occurred was offered.
�����������

Key words: nursing, students, practicing nurses, disability, education, attitudes.

11.� Gething, L., LaCour, J., & Wheeler, B.� (1994).� Attitudes of nursing home administrators and nurses towards people with disabilities.� Journal of Rehabilitation, 60(4), 66-70.

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To compare attitudes of nurses and nursing administrators employed at nursing homes towards people with disabilities.�����������
METHODS:� A quantitative questionnaire was given to and completed by 76 staff nurses and 75 nursing administrators working within nursing home settings in California.
����
FINDINGS:� The researchers found that administrators had more positive attitudes towards people with disabilities than staff nurses.� Because there were no other statistical differences between the two groups, the researchers speculated that what made staff nurses more negative was their having more regular and direct contact with persons with disabilities, which would allow them to see better the realities faced by a person living with a disability.� This would result in a more realistic perspective on disability, which would probably cause a negative attitude.

Key words: nursing practice, disability, attitudes.

12.� Goodall, C. J. (1992).� Preserving dignity for disabled people.� Nursing Standard, 6(35), 25-28.*** Waiting for article.

TYPE OF ARTICLE:����������
PURPOSE:
����������
FINDINGS:
�����������

Key words:


13.� Helms, L. B., Anderson, M. A., & Hanson, K.� (1996).� �Doin� Politics:� Linking policy and politics in nursing.� Nursing Administration Quarterly, 20(3), 32-41.

TYPE OF ARTICLE:� Review, legal.�����������
PURPOSE:� To introduce nurses to the concept of policy environment and its impact on policy outcomes, and to apply these concepts to the field of health in an effort to understand the environment in which nursing policy is set.
�����������
FINDINGS:� The authors compare and contrast the nursing policy models of the past and future: simple model (past) and the complex/crowded model (future).� The simple model only looks at hospitals, doctors, and nurses as the political influences into nursing and healthcare.� In contrast, the complex model expands the influences to include the public, government, and numerous other agencies, and states that each has intersecting power with the others.�
Understanding this conceptual framework is essential to effective policy development.� �Without understanding the dynamics of the policy environment, efforts by nursing leaders to enhance their growing political sophistication and to articulate nursing interests with maximum effectiveness will be compromised� (p. 32).� Thus, the policy information in this article will help individuals interested in developing policies within nursing around issues of disability.

Key words:� disability, nursing profession, policy development.

14.� Helms, L. B. & Weiler, K.� (1991).� Suing programs of nursing education.� Nursing Outlook, 39(4), 158-161.

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To identify the case law involving programs of nursing education or nursing students and to describe the significant variables that give rise to litigation in programs educating nurses.� The importance of such study is to inform nurse educators about patterns and potential risk of litigation.
�����������
METHOD: The researchers reviewed of all state and federal case law pertaining to nursing education and students, which totaled 24 cases from 1961- September 1989.� Data was aggregated to answer the following questions:

1.      Is there an increase in litigation over time?
2.      Who sues?
3.      Who prevails?

4.      What types of nursing programs are sued?

5.      What facets of the education program are at issue?
��
6.� What legal questions are addressed by the courts?

FINDINGS:� Helms and Weiler found that nursing programs were increasingly being sued over the past three decades, a trend which parallels that of higher education in general.� However, nursing programs were not as frequent targets for suit when compared to higher education in general.� When nursing programs were sued, though, students were the predominant plaintiffs and were more likely to win their case.� Moreover, baccalaureate nursing programs were more likely to be defendants than diploma or associate programs.� The authors offered speculation as to why these litigation trends may be occurring. �����������

The authors concluded that nursing programs should be concerned about their litigation status.� They state that these case law findings are too superficial to provide grounded reasons for why litigation is increasing and how to prevent it.� As a result, they advise programs to be attentive to their policies and procedures, and advocate for more research into this arena.

Key words: case law, research, nursing programs, nursing students, litigation.


15.� Helms, L. B. & Weiler, K.� (1993).� Disability discrimination in nursing education: An evaluation of legislation and litigation.� Journal of Professional Nursing, 9(6), 358-366.

TYPE OF ARTICLE:� Review, legal.�����������
PURPOSE:� To review and evaluate the impact of laws regarding disability and programs of nursing education.
�����������
FINDINGS:� The authors review the Americans with Disabilities Act of 1990, the Civil Rights Restoration Act of 1987, and Section 504 of the Rehabilitation Act of 1973, as well as individual cases (i.e. Davis) and their impacts on schools of nursing.� The results reveal new concerns for schools of nursing on how they outline students� qualifications for admission, retention, and dismissal.� Most schools in the past have relied on working with students on a case-by-case basis without any formal policy or procedure.� In light of recent legislation and litigation, this is no longer acceptable.
�����������

The authors recommend minimizing institutional liability by creating a list of essential functions (non-ability focused) by which all students must be able to do in order to be admitted, progress, and graduate from the program.� In addition, admissions procedures need to be more formalized to prevent discrimination.� For example, schools should not ask if a student has a disability during the application process.� Once a student is deemed qualified for admission, the student should be admitted and asked if any accommodations may be needed for successful completion of the program.� At this time, the school and the student must work together to find reasonable accommodations to insure the students� success.� If the accommodations are not reasonable, this may be the grounds for denial or dismissal.� Through such a process, both the student and the institution are entering the education contract fairly.

Key words:� nursing program, nursing student, disability, law, legislation, education, essential functions, admissions, progression, graduation.


16.� Hull, K.� (1980).� Should handicapped people be allowed to attend nursing school?� Nursing Law & Ethics, 1(3), 1, 4, 8.

TYPE OFARTICLE:� Review, legal.�����������
PURPOSE:� To review the Davis case findings and outline the implications for schools of nursing.� [The Davis case was where a severely hearing impaired student was denied admission to a registered nursing program on the basis of her disability after working as a practical nurse.]�����������
FINDINGS:� As Hull explains,� the middle-of-the-road Supreme Court ruling in the Davis case only provided more confusion for schools of nursing around students with disabilities.� He explains that the Court was essentially saying that the case-by-case evaluation of each student with a disability, which had been the standard; was no longer sufficient because discrimination was occurring.� The Court was calling for explicit essential functions that were not ability-defined to be outlined and used for all students during admissions, program progression, and graduation.� In addition, case-by-case �reasonable� accommodations were to continue.� However, the Court did not did not identify a process for merging these two procedures.�

Hull concludes that the only way to minimize institutional liability is to work towards meeting each of these objectives.

Key words: nursing programs, disabilities, law, essential functions.

17.� Jones, K.� (1998).� Being an �RN.�� Home Healthcare Nurse, 16(9), 648. �����������

TYPE OF ARTICLE:� Commentary.�����������
PURPOSE:� To comment on her personal experience of being a nurse who acquired a hearing impairment.�����������
FINDINGS:� The author describes why she believes that nurses with disabilities add insight to caring for persons with disabilities because of their own lived-experiences.� This is a very important skill in her eyes, as she believes that nurses don�t have the basic of awareness of the experience of a disability.�����������

Key words: nursing profession, disability, value-add, lived-experience.

18.� Lindgren, C. L. & Oermann, M. H.� (1993).� Effects of an educational intervention on students� attitudes toward the disabled.� Journal of Nursing Education, 32(3), 121-126.

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To determine if the attitudes of nursing students toward persons with disabilities would improve following participation in a one-day educational conference on care of the physically disabled and to identify variable influencing these attitudes.
�����������
METHODS:� Two-hundred and sixty-three students were administered a pre-test (attitudinal scale) immediately prior to a one day workshop on working with persons with disabilities.� Students completed a similar post-test questionnaire one month later.�
�����������
FINDINGS:� The findings suggest that (1) nursing students that had worked with persons with disabilities prior to the workshop intervention scored higher on both pre- and post-tests, implying a generally good attitude; and (2) scores for all of the students were higher on the post-test one month later, implying that attitudes improved and were maintained over time.� Based on these results, Lindgren and Oermann suggest that education on working with persons with disabilities improves students� attitudes.� However, it is important to note that no evaluation of student/patient with disabilities� interactions was completed.
�����������

Key words: nursing students, disability, research, training, curriculum, attitudes.

19.� Magilvy, J. K. & Mitchell, A. C.� (1995).� Education of nursing students with special needs.� Journal of Nursing Education, 34(1), 31-36.

PURPOSE:� To report the results of their multi-faceted study investigating the extent to which BSN and ADN nursing programs admit and graduate students with special needs.
METHODS:� Each program was assessed on their admissions and graduation rates of students with disabilities, in addition to the types of granted accommodations.� Eighty-six programs completed and returned the mailed survey, which consisted of open and closed questions.�
FINDINGS:� Magilvy and Mitchell�s findings suggest that programs do admit students with disabilities, but that only half of these individuals on average successfully complete the program.� Of these admitted students, the majority had a learning disability, while others had mental impairments and few had visual and mobility impairments.� Most of the schools were accessible to students with learning and/or mobility disabilities, and few were accessible to students with hearing or vision impairments.� Services for persons with disabilities primarily consisted of counseling.� The researchers conclude that Universities are becoming increasingly aware of students with disabilities.� However, the availability of appropriate accommodations within the curriculum and practice are limited.� Suggestions are offered on how to offer alternative appropriate practices to students with disabilities.
�����������

Key words: admission, graduation, nursing students, disability, accessibility, accommodation.

20.� Maheady, D. C. & Winland-Brown, J.� (1995).� Inclusion of students with disabilities in nursing education programs in Florida.� Florida Nurse, 43(10), 11.


TYPE OF ARTICLE:� Research.
�����������
PURPOSE:� To evaluate if more students with disabilities are applying and being admitted to Florida schools of nursing, the types of disabilities these students had, the types of accommodations that were being given, and if there were faculty suggestions on how to facilitate the needs of nursing students with disabilities.
�����������
METHODS:� Thirty-two deans and directors of nursing programs in Florida were surveyed.� The response rate was 59%.� No information was provided about what questions were asked.�����������
FINDINGS:� The researchers found that there was a moderate increase in the number of students with disabilities that applied to each of the schools over recent years, and that the types of disabilities students had were vast and varied.� As a result, the accommodations and adaptations that were provided to the admitted students with disabilities were also varied.� The types of recommendations offered by faculty focused on keeping creative and open-minded when working with nursing students with disabilities.�����������

The overall recommendation of the researchers was to call for more research regarding nursing students with disabilities.�����������

Key words: nursing students, nursing programs, disabilities, research, admissions, accommodations, recommendations.

21.    Maheady, D. C.� (1999).� Jumping through hoops, walking on egg shells: The experiences of nursing students with disabilities.� Journal of Nursing Education, 38(4), 162-70.

TYPE OF ARTICLE:� Research.
PURPOSE:

METHODS:
FINDINGS:

Key words:���

22.� Maher, A. B.� (1996).� A lesson in mobility.� Orthopaedic Nursing, 15(4), 8.����������

TYPE OF ARTICLE:� Commentary.�����������
PURPOSE:� To describe author�s personal experience with short-term mobility impairment.
�����������
FINDINGS:� The author describes societal attitudes towards her after she incurred an ankle fracture, which forced her to use at times a wheelchair, walker, and crutches.� She concludes that her experience further validates that patients understand best their health and illness, and how it plays out in their lives.
�����������

Key words:� physical disability, nursing practice, and patient understanding.

23.� Marks, B. A.� (2000).� Jumping through hoops and walking on eggshells or discrimination, hazing, and abuse of students with disabilities?� Journal of Nursing Education, 39(5), 205-210.�����������

PURPOSE:� To provide a critical response to Maheady�s (1999) study exploring the experience of nursing students with disabilities.
FINDINGS:� The core criticism that Marks addresses is how Maheady�s use of the medical model of disability to further perpetuate the image that disabilities are compromised functions and that nurses with disabilities may threaten patient safety because of this compromised function.� After outlining the medical model, Marks suggests that the social model of disability is more appropriate.�
A systematic critique of Maheady�s research is then offered from the social model.� Marks concludes by stating that Maheady�s findings further discriminate against persons with disabilities, especially around issue of the quality of care provided by nurses with disabilities.� Marks challenges nurses to abandon the traditional medical model for the social model of disability, because of the medical model�s oppressive and discriminatory nature. [See Maheady�s bibliography for additional information]�����������

Key words: medical model of disability, social model of disability, nursing profession, nursing practice, research, curriculum, attitudes.

24.� Murphy, G. T. & Brennan, M.� (1998).� Nursing students with disabilities.� The Canadian Nurse, 31-34.�����������

TYPE OF ARTICLE:� Commentary.�����������
PURPOSE:� To describe Dalhousie University�s attempt to build guidelines and basic practice standards for schools of nursing.�
FINDINGS:� Murphy and Brennan describe why the development of guidelines and practice standards is to benefit all students, including students with disabilities.� These standards can help applicants identify what it takes to be admitted and successfully complete the program, and if the program is for them.� Sample student requirements include the cognitive ability to �carry out health assessments, to engage in independent thought, to think critically and to make clinical decisions.� Students must also be able to acquire the appropriate technical skills to provide safe and competent nursing care in a variety of settings� (p. 32).� Murphy concludes with the recommendation that the option of a restricted license be offered for students with and without disabilities.� This would allow nurses with disabilities who may not be able to work in one area well, to work in one that may be more comfortable and appropriate just like nurses without disabilities.� In addition, students without disabilities may have a practice specialty already in mind.�����������

Key words: Practice standards, education, nursing students, licensing, disability.

25.� Northway, R.� (1997).� Disability and oppression: Some implications for nurses and nursing.� Journal of Advanced Nursing, 26, 736-743.�����������

TYPE OF ARTICLE:� Commentary.�����������
PURPOSE:� To respond to Goodall�s (1992) article, which suggested that persons with disabilities have begun to view professionals as oppressors.�
FINDINGS:� Northway describes how the medical model of disability used by nurses both in academics and practice to conceptualize disability may be the root of people with disabilities� oppression.� In addition, she asserts that this oppression is not limited to patients with disabilities, but also includes nursing students, practice nurses, and faculty with disabilities.� She proposes a process of re-conceptualizing �disability� to a social model as a means of combating this oppression.� The steps included in this process are: awareness, practice reflection, and development of a partnership between nurses and persons with disabilities.� Assumed is that changes in the concept of disability by nurses will directly impact how nurses interact with one another and their patients; thus, impacting related outcomes.�����������

Key words: Concept of disability, medical model, social model, oppression, nursing students, nursing profession, nursing practice, education, curriculum, and research.

26.� Pohl, C. M. & Winland-Brown, J. E.� (1992).� The meaning of disability in a caring environment.� Journal of Nursing Administration, 22(6), 29-35.����������

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To examine the perceptions of disabled nurses about their disabilities and identify what nurse administrators and others can do to create a caring environment that would encourage disabled nurses to return to nursing practice.�����������
METHODS:� Six nurses with disabilities (half had acquired their disability) were interviewed using open-ended, nondirective questions about their experience as a person with a disability.� Each of the interviews were taped, transcribed, and thematically analyzed.� After analysis was completed, another nurse with a disability validated the themes that had emerged.�����������
FINDINGS:� The two predominant themes were �self-image� and support.� Many of the nurses who had acquired their disability had, among other things, poor-self images due to the reduction in work productivity, and resulting resentment and negative perceptions from other staff.� The researchers suggest that nurses with disabilities participate in workshops to prepare them for reentry into the work world (as a new or continuing nurse) in order to learn and practice assertiveness skills to deal with potential employment situations where their independence and personal strength could be questioned.� In addition, they suggest that staff and administrators work at creating a supportive environment for nurses with disabilities through, for example, teamwork.�����������

Key words: nursing practice, disability, research, support, accommodations, attitudes.

27.� Scullion, P.A.� (1999).� Conceptualizing disability in nursing: Some evidence from students and their teachers.� Journal of Advanced Nursing, 29(3), 648-657. �����������
PURPOSE:� To investigate into how �disability� is conceptualized by nurses and examined how curriculum influences this.�

METHOD:� This investigation is framed by multiple concepts: the experiences of persons with disabilities within healthcare; how �disability� appears to be a medical role wherein it is equated with an illness; and the influence of health professionals as recipients, contributors, and influences on nursing curriculum.�

FINDINGS:� Scullion found that nurses, both in academic and practice settings, view �disability� as a �deviation from the norm.�� As such, an inherent dependency was created and could be equated with care required for �ill� persons.� In addition, this was consistent with their nursing curriculum.� Scullion, thus, proposes re-conceptualizing disability be in nursing practice and education to support the social dimensions of disability.
�����������

Key words: Disability, deviation, dependence, equality, nursing profession, nursing programs, education, attitudes.

28.� Shellenbarger, T.� (1993).� Helping the dyslexic nursing student.� Nurse Educator, 18(6), 10-13. ����������

TYPE OF ARTICLE:� Review.�����������
PURPOSE:� (1) To describe different ways to identify students with dyslexia both in clinic and the classroom; (2) to identify what diagnostic processes are required for a �dyslexia� diagnosis; and (3) to suggest some simple accommodation strategies for students with dyslexia.
�����������
FINDINGS:� Shellenbarger briefly describes that �dyslexia� is a blanket diagnosis for having difficulty with language.� Because the term is used so universally, there is no simple or exact way to identify students with dyslexia.� What Shellenbarger suggests is that faculty look for students that display academic and clinical performance discrepancies; for example, a student who clearly demonstrates knowledge both orally and in clinically, but fails on a written exam of the same material.� Other examples of dyslexic behavior include numerical errors (e.g. switching 12 for 21) and writing letters/numbers backwards.� When faculty recognize these types of behavior in a student, the author suggests that the student and faculty discuss the possibility of a referral for academic testing.�����������

The author describes academic testing for dyslexia briefly.� She recommends referring the student to a learning disability expert examination.� The battery of tests is both written and oral, and the results display where certain neurological and/or processing gaps occur.� From this information, the learning disability specialist can make recommendations for specific accommodations to help the individual student succeed.� Accommodations may include audiotapes, calculator use, and different teaching strategies.�����������

Shellenbarger concludes by saying that even though students with learning disabilities may be an additional burden on faculty to teach creatively and to spend a little more time with the student, all students benefit from the presence of these individuals.� There is greater student diversity with students with disabilities, and sometimes the innovative teaching strategies help the general student population.�����������

Key words:� nursing students, nursing programs, education, curriculum, learning disabilities, accommodations, diagnostics.

�����������
29.� Shuler, S. N.� (1990).� Nursing students with learning disabilities: Guidelines for fostering success.� Nursing Forum, 25(2), 15-18.
�����������

TYPE OF ARTICLE:� Review.
PURPOSE: To describe:
(1) why learning disabilities (LD) are coming to the attention of schools of nursing;
(2) how the perception of learning disabilities has changed in recent history;
(3) give characteristics by which the student with a learning disability can be idenitified; and
(4) suggest how faculty members may intervene to help students in school and on the NCLEX.

FINDINGS:� Schuler states that schools and universities are heightening their awareness of students with disabilities primarily because of their increasing number.� This rise in students with LDs is due to: (1) more students being diagnosed prior to admissions to college and they disclose this disability and (2) education about LD has assisted faculty and students in identifying students who had not previously had a LD acknowledged.� As a result, more education and research about LDs have been and continue to be conducted.�����������

The perception of LD has changed over the last several decades from minimal brain dysfunction and dyslexia to specific learning disabilities and attention deficit disorder.� As such, persons with LDs are being perceived as being of average to superior intelligence, but with some neurological interference that present challenges to development, integration, and/or demonstration of verbal and nonverbal abilities.� Schuler suggests that this disconnect between intelligence, and academic and clinical performance can be illuminated by watching for �red flags,� which she lists (e.g. disparity between classroom and clinical performance, poor math skills, spelling problems, disorganization, and difficulty concentrating).�����������

Schuler states that the challenges faced by the student with an LD may be met by combining remediation and accommodations.� These strategies should be outlined under the guidance of a learning disability specialist and Schuler emphasizes that strategies must be customized to the individual.� With the documentation of the LD and strategies, Schuler states that students should be able to receive the same accommodations while taking the NCLEX exam.�����������

Key words: nursing programs, learning disabilities, secondary education, identification, accommodations.

30.� Strader, M.� (1983).� Schools of nursing and the handicapped applicant: Status of the law.� Nursing & Health Care, 4(6), 322-326.�����������

TYPE OF ARTICLE:� Review, legal.�����������
PURPOSE:� To review legislation both prior and subsequent to the landmark Davis case and clarify admission criteria for schools of nursing.
�����������
FINDINGS:� Strader divides her article into sections: legally defining �disability;� where accommodations for disability apply in education; affirmative action and the Davis case; conditions for schools of nursing must provide accommodations; and proposes a judicious admissions process.� Disability is defined using the Vocational Rehabilitation Act.� She, then, distinguishes programmatic and institutional applicability of �handicap� status.� For example, only programs (i.e. schools of nursing) receiving federal funds are culpable for providing services to students with disabilities.� Institutions, such as universities, become indirectly responsible (and liable) when students at the university are enrolled in a school of nursing and require federal financial aid to attend.� This is an important distinction for some smaller, private schools.
�����������

Strader describes the Davis case in detailed terms around affirmative action.� Schools, under Section 504 must accommodate qualified students to pursue their professional education.� In the Davis case (Davis v. Southeastern Community College), an applicant with bilateral hearing loss was denied admission to a registered nursing program on the basis of her disability.� This particular applicant had been working as a practical nurse in the past, using hearing aids and lip reading as effective practice accommodations.� When the case was brought to the Supreme Court, she lost on the basis that her accommodations were that of a �personal nature.�� However, the Court did say that if she were able to prove that she would be successfully employed after graduation, the school would be forced to admit the student.� The later statement by the Court created much confusion among schools of nursing about the conditions in which they were required to provide accommodations.� Strader explains that schools are responsible for accommodations under four conditions:
(1) program receives federal aid,
(2) the candidate has a reasonable chance for employment,
(3) auxiliary aids make a difference between failure and completion of the program, and
(4) the cost of the accommodations are not an undue burden.

Finally, Strader concludes by offering a three step admissions process that could help schools better comply with the law.� First, she instructs schools not to ask applicants about the existence of a handicap; instead, look at all applications equally.� Second, she suggests that schools use explicit academic and technical standards to evaluate an applicant�s qualifications.� Third, when a student is deemed qualified, Strader suggests that students be invited to disclose their disability.� The admissions committee and school should then take into account the disability and determine with the student what modifications would be required for successful program completion.� It is in this last step that schools may legally determine if a student with a disability is no longer qualified on the basis that their disability conflicts with their ability to meet the programmatic essential functions despite the provision of reasonable accommodations.

Key words: nursing students, nursing programs, disability, law, admissions, accommodations.

31.� Swenson, I., Foster, B. H., & Champagne, M.� (1991).� Responses of schools of nursing to physically, mentally, and substance-impaired students.� Journal of Nursing Education, 30(7), 320-325.�����������

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To describe the responses of schools of nursing to physically, mentally, and substance-impaired applicants and matriculating students.�����������
METHODS:� A self-administered questionnaire concerning experiences, policies, procedures, and factors influencing decision-making was sent to 132 deans and directors of nursing schools and programs (constituting a 12% random sample of National League for Nursing accredited national BSN and associate schools).� In addition, criteria for defining impairments, resources for developing criteria, methods of identifying impairments, actions taken, and individuals involved in the decision were also assessed.�����������
FINDINGS:� While the researchers detailed how schools of nursing respond to people with specific disabilities, there were some important themes that bridged across them.� The majority of programs did have some external resources (i.e. University or college) guiding the admissions decision-making, but the primary responsibility was left with the schools of nursing and their faculty.� In addition, students� abilities and� identification of disabilities were implied in the nursing curricula and no formal policies abounded.� Because of the informality of this process, students with the same disability were not always treated the same.�

For example, the admission of students with disabilities varied by the type of disability the student had, when it was disclosed, and what types of accommodations were requested.� Students that required less accommodations and adaptations were more likely to be admitted, progress, and graduate.� However, the authors suggest that because schools were more likely to conditionally accept and return �impaired� individuals than to deny admission or to expel, individuals with disabilities were being given an opportunity to enter the nursing profession.Another important finding was that the most common requirement for continuation in programs was seeking treatment, regardless of the type of disability.�

Although this is not addressed by the authors, the implication of this requirement is that a disability is a compromised condition that requires rehabilitation, and perhaps, could be cured.The authors conclude that schools of nursing need to continue to work with students with disabilities and that faculty may need additional support to do so.� Moreover, the authors encourage early identification of students with disabilities in order to make the appropriate accommodations and adaptations to insure student and programmatic success.

Key words: nursing students, nursing programs, disability, research, admissions, accommodations.

32.� Thompson, J. S.� (1995).� Disability, fundamentals of nursing care: Able to care.� Nursing Times, 91(44), 40-41. ����������

TYPE OF ARTICLE:� Commentary.�����������
PURPOSE:� To consider the question: �Can people with disabilities be nurses?�

FINDINGS:� Nurses were defined in terms of nursing excellence and the characteristics of �good nurses� as a means to discover if there is anything required of a �good nurse� that is universally beyond the capabilities of any person with a disabilitiy.
Core nursing competencies included having a strong knowledge base; the ability to communicate effectively as a team member; and the capability of assessing, planning, implementing, and evaluating nursing care, both from a research-based perspective and with consideration of the legal and ethical implications of her or his actions.� In addition, the nurse should act as client advocate and focus on caring.�

The practical implication of these competencies is that a nurse must be able to observe, collect data, have strong decision-making, be organized, and possess good triaging skills.Having outlined the core competencies, characteristics, and skills required of nurses as documented in the nursing literature, the author concluded that having a disability does not inherently violate the tenets of nursing.� However, the nursing literature continues to raise this question.� The author blames this foundationless debate on attitudes and perceptions of nurse on disability (typically in a medical model mind-set)�from education to the profession.�����������

Key words: nursing profession, disability, competencies, clinical performance.

33.� Trevelyan, J.� (1995).� Rough justice.� Nursing Times, 91(49), 47-49. �����������

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To gather information about how nurses view disabilities and how a disability might affect nursing practice.
�����������
METHOD:� A descriptive survey asking� both opened and closed-ended questions about persons with disabilities within nursing was mailed to one hundred and seven nurses (with and without disabilities).� No demographic information was provided.
�����������
FINDINGS:� The overwhelming message found in this survey was that nurses with and without disabilities believe that nurses with disabilities can and are productive members of the healthcare team.� Despite this belief, many of the respondents stated that having and disclosing a disability does or would threaten their employability.� As a result, most nurses with disabilities do not disclose to their employers and/or colleagues.
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Key words: nursing profession, nursing practice, disabilities, nursing attitudes, nursing practice, research.

34.� Watson, P. G.� (1995).� Nursing students with disabilities: A survey of baccalaureate nursing programs.� Journal of Professional Nursing, 11(3), 147-153.�����������

TYPE OF ARTICLE:� Research.�����������
PURPOSE:� To investigate nursing programs� responses and reactions to applicants and students with disabilities.� The response rate was 59%.�����������
METHOD:� Two-hundred forty-seven nursing programs were mailed a survey to solicit information on the methods they used to determine the existence of disabilities, special services and accommodations provided to disabled nursing students, and student satisfaction with the special services provided.�����������
FINDINGS:� Fifty-three percent of the responding programs reported using a variety of strategies in attempting to determine the disabilities or special needs of applicants; for example, making an explicit request of voluntary disclosure on the admission forms and direct contact with applicants.� Using similar strategies, almost all programs reported efforts to determine existing disabilities of admitted students.� Moreover, the study revealed that the nursing programs provided an extensive array of special services for their disabled students, and student satisfaction with these services were high.�����������

The underlying theme that transcended across all programs was the need for schools to establish core performance expectations and technical standards in baccalaureate nursing education.� Not only would this take some of the labor off the institution in determining who has a disability and how to make accommodations, it would also allow students with disabilities to critically evaluate their ability to meet these standards with reasonable accommodations.�����������

Key words:� nursing students, nursing programs, disability, research, accommodations, admissions, technical standards, essential functions.

35.� Weatherby, F. & Moran, M.� (1989).� Admission criteria for handicapped students: Focus on the ability to provide safe, effective nursing care rather than on individual deficits.� Nursing Outlook, 37(4), 179-181.�����������

TYPE OF ARTICLE:� Review.
PURPOSE:� To review current legislation on admission and program completion criteria for students with physical disabilities seeking nursing education.�

FINDINGS:� The authors use the example of the University of Oklahoma�s College of Nursing as an example of how schools develop admission guidelines based on physical attributes required for safe patient care.� Included in this discussion is a debate on what physical attributes are required for safe care.� These comments are substantiated by court cases and stories of nursing students who completed their education and moved successfully into practice.� The article concludes with recommendations for admission and progression protocols for Schools of Nursing.
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Key words: ADA, legislation, admission guidelines, progression protocols, nursing students, nursing programs, physical disabilities.

36.� Weiler, K. & Helms, L. B.� (1993).� Responsibilities of nursing education: The lessons of Russell v Salve Regina.� Journal of Professional Nursing, 9(3), 131-138.�����������

TYPE OF ARTICLE:� Review, legal.�����������
PURPOSE:� To explore the questions raised by Russell (senior nursing student dismissed from program due to obesity and inability to lose weight):
(1) What constitutes substantial compliance with both academic and non-academic performance criteria in a contract between a student and an educational institution?�
(2)� What duties to preserve the privacy interests of students may be imposed on programs and educators?
�����������
FINDINGS:� After a lengthy discussion of student and institutional contract responsibilities from the eyes of the law, the authors conclude that institutions have the responsibility to educate their clients (students) if they meet the essential academic and non-academic criteria (non-ability defined) required of all other students.� Moreover, institutions and individual faculty members must treat their students with consideration, respect, and concern for the protection of the students� rights of privacy.� Therefore, the authors state that schools of nursing, like other educational institutions, must be aware that they should first outline what is required of all students in order to complete the program of study and, second, work with students with disabilities on an individual basis to insure their privacy in relation to meeting these goals.� This is the first case to show that institutions are not immune from contractual challenges and must demonstrate respect and consideration for the student�s personal concerns.
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Key words:� nursing, disability, law, education, privacy, contract, essential functions.

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