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L earning Disabilities

OR scrub nurse Steve Patten, RN works several hour shifts in surgery, he prepares a sterile field, preps instruments in proper order, keeps detailed count of all the supplies used, and assists the surgeon with sutures. When working with him as he efficiently manages the surgical care of veterans and their families at the Veterans Affairs Medical Center in Portland, Oregon, most of his colleagues are unaware that he experiences a learning disability.

Patten has dyslexia, a learning disability that affects his ability to read and write well. He first learned that he had dyslexia in college when a professor noticed that he offered thoughtful and intelligent contributions in class discussions, but did not perform well on essay exams. This professor referred him for academic testing through which Patten discovered that his IQ score was extremely high, but his spelling, writing and reading were well below average. However, he did not receive any assistance or accommodations for his learning disability. Still, he managed to complete a business degree by using a number of strategies, including selecting classes that primarily used multiple-choice tests. Although he was unable to take detailed lecture notes, he was bright enough to remember the information by simply listening very carefully. Reading full chapter assignment in textbooks was laborious and not an effective way for him to learn the information. Instead, he used the texts primarily as a resource for looking up specific information.

After college, Patten was trained as a medic in the U.S. Army. He came out of the army with a L.P.N license and with a desire to get a R.N. license. He did not disclose his disability to the nursing program, because he felt embarrassed about his difficulty reading. However, he again devised his own strategies to accommodate his disability by careful class selection and help from family and friends. In his nursing coursework, he had to write several lengthy case management reports. He would dictate these reports to his wife who would type them for him. This worked out well until one day when an instructor had the students write up a mock case study in class. Because Patten wrote his report using only the words that he knew that he could spell correctly, the instructor thought that the other reports he turned in were plagiarized. He explained to the instructor that he experiences a learning disability and he remembered, "I challenged her to ask me any question about any of the other reports I had written, and I repeated the answers to her almost verbatim to what was written in the reports. I knew the material that well." This convinced the instructor that he did experience a learning disability, that he was very bright, and that he did have an in-depth knowledge of nursing concepts and procedures.

Patten had wanted to go into emergency nursing because he thought it would be exciting, but worried about the amount of fast-paced documentation it required. His last clinical rotation in school was in the OR, where most of the documentation was done on a one-page form that only required him to make checkmarks, circles, plus marks or minus marks. He took the form home and memorized it and many of the common short word phrases that might be added to the form. He also found that the computer system he used only required him to pick words from a list of available choices, rather than coming up with the words and spellings on his own. Patten decided to stay in the OR he said because, "It still had some of the excitement of emergency medicine, but without the stress that the charting would have caused."

Patten believes that most people know where their strengths and weaknesses are and automatically put themselves in situations where they can be successful. "People want to go to work where they feel comfortable and where they are confident they will do a good job. People with disabilities know what they can and can't do and will adapt. The biggest disability in the healthcare field are not the traditional ones, but probably lack of sleep." Patten feels that each individual in the health care field is a professional. As professionals, all health care workers undertake the responsibility to ensure patient safety. "Most people in health care are not in it for the money, they are in it to provide quality care. People with disabilities are very aware of how to do this."

Although Patten never previously disclosed his disability in his work or school settings, he did talk to his employer about his dyslexia upon granting this interview. He felt that it was easier to talk with his employer about it after he had already proved himself to be an excellent nurse. However, he admits that school may have gone much smoother if he had disclosed to his instructors and received accommodations. To learn more about accommodations and teaching strategies for students with learning disabilities, click here.

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