Working as a Nurse With a Learning Disability
- Nursing students and nurses with a learning disability face challenges when they choose a healthcare career, including greater fatigue that can impact performance.
- Nurses working with a learning disability have several options to improve their performance and increase their job satisfaction.
- Nurses must advocate for themselves within the educational setting and with nursing administration to receive the accommodations needed to be successful.
Experts estimate that nearly 20% of the population has one form of a learning disability. As a nursing student, when a learning disability goes unrecognized it can interfere with success and passing the National Council Licensure Examination.
In the past, students may have experienced more challenges as learning disabilities were not easily recognized or treated. Now, more students with learning disabilities are identified in primary and secondary school and offered accommodations needed for success.
Although you may think a learning disability prevents you from working in nursing, most nurse managers in 2010 rated the work performance of nurses with a learning disability as "exceptional" or "above average."
We talked in depth with Gail Trauco, RN, BSN-OCN, who is the CEO and founder of PharmaKon. She was diagnosed with dyslexia in her first year of college and has spent four decades in healthcare.
Learn more about Trauco's journey and discover the strategies nurses and workplaces can use to accommodate the needs of nurses with learning disabilities.
What Is a Learning Disability?
According to the Learning Disabilities Association of America, a learning disability is a neurobiological or genetic factor that alters cognitive processing related to learning. This can include reading, writing, or math skills. Learning disabilities can also interfere with organization, abstract reasoning, attention span, and planning.
An alteration in these skills can also create challenges for people in their relationships with friends, family, and in the workplace. Many students who have a learning disability are identified during grade school or high school. Some may not be diagnosed until they are adults or in college.
There are five types of learning disabilities that are recognized under federal law in the Individuals with Disabilities Education Act (IDEA).
This learning disability impacts a person's ability to read and related language-based processing. Individuals struggle with spelling and word recognition. Reading comprehension can be impaired.
This specifically affects a person's ability to understand numbers and do math calculations. Individuals may have difficulty solving real-world problems.
Individuals with dysgraphia have problems with fine motor skills, which affects handwriting ability. This can include letters and numbers. If the ability to write numbers is affected, it can also impact math skills.
Individuals have difficulty with reading and interpreting nonverbal facial clues and body language.
Oral/Written Language Disorder and Specific Reading Comprehension Deficit
This affects a person's ability to understand what they have read or heard.
An individual examination in childhood will include a medical history and examination to rule out a physical health condition. It also includes academic and psychological testing and reviewing the child’s developmental performance.
Accommodations for learning disabilities in primary and secondary school involves monitoring the student's progress, providing help on different levels, and moving the child to increased levels of support if needed.
As individuals move into adulthood, diagnosis is made through formal testing for intelligence and processing. Specific strategies that can improve work and daily activities are recommended.
How Learning Disabilities Impact Nurses
A nurse with a learning disability might face challenges when they choose a healthcare career. For instance, Trauco's dyslexia created unique challenges for her while learning biochemistry. She found strategies that helped her learn and retain the knowledge she needed.
"I attended ALL additional lab review sessions and was often the only student seeking one-on-one professor assistance," she says. "Writing out chemical formulas and calculations was helpful with memory retention. Additional study time was always required to review and re-review written materials."
Nearly all colleges and universities have a disability services center. The office offers accommodations for learning disabilities to students. They help interface with professors and teachers, and they provide additional resources for note-taking, test-taking, and studying.
Other strategies that nursing students may use include:
- Prereading a chapter before reading and taking notes
- Using different colored highlighters to identify key details
- Structuring checkpoints within the text to stop and check for comprehension
- Reading aloud
- Visualizing the material by drawing charts, graphs, or diagrams
- Considering an academic coach to focus on study skills
Working nurses also face challenges with ensuring accuracy in medication administration, calculations, and tasks that require multiple steps, such as wound care. Trauco also warns that technological devices, meant to make care easier, can create additional challenges.
"Nursing utilizes more 'devices' such as chemotherapy infusion pumps. Programming may be challenging for a nurse with a learning disability. Check, double-check, and request another nurse to verify settings to ensure programming accuracy," she advises.
Nurses with a learning disability may experience greater fatigue than other nurses as many cognitive tasks take more energy to complete. Specific challenges that nurses may face include:
- Fatigue and stress
- Executive function deficits
- Time management
- Memory loss
- Planning and prioritizing
- Difficulty reading
- Difficulty writing or spelling
- Difficulty taking shift notes
- Difficulty processing facial cues or emotions
Despite these challenges, nurse managers report their staff with learning disabilities perform above average or better. Dyslexia was one driving force that motivated Trauco to push harder and perform better.
"Discipline and focus helped me develop an outstanding work ethic. Today I own a mobile nursing company that generates over seven figures annually," she says. "Discipline, dedication, and drive to excel were learned at an early age secondary to dyslexia."
Ways Workplaces Can Help Nurses With a Learning Disability
According to Trauco, 12-hour shifts, doubles, and high patient-to-staff ratios do not maximize the performance of a nurse with a learning disability. The administration must be made aware of how fatigue affects performance.
"Exhaustion after about nine hours of bedside nursing creates a disadvantage for nurse performance for the last three hours of a 12-hour shift. Nursing shortages and the pandemic do NOT allow most nurses any breaks," Trauca says. "This contributes to the exacerbation of a learning disability."
Before choosing this career, nurses with learning disabilities should become aware of the legal protections they have under IDEA, the Americans with Disabilities Act, and the Rehabilitation Act. New programs and technologies can also assist nurses working with a learning disability to enhance their working environment and improve their performance.
Sharing this knowledge with nursing administration is necessary since they may not seek out nursing accommodations for learning disabilities. Nurse managers may rely on the nurse to communicate what is needed to function best.
Nursing is a physically demanding profession and the pandemic and global nursing shortages have not helped improve working conditions. However, there are adaptations and adjustments administration may offer a nurse working with a learning disability that does not negatively impact patient care or other staff.
- Learn the specific challenges that a nurse working with a learning disability experiences to develop customized adaptations.
- Evaluate the need for education and training for other nursing staff.
- Recognize the impact fatigue has on nursing performance and patient outcomes.
- Adjust 12-hour shifts to avoid fatigue.
- Provide an experienced and compassionate nurse mentor to help ensure accuracy.
- Encourage smartphone apps for nurses that help with patient management and clinical decision-making.
- Routinely meet with the nurse working with a learning disability to evaluate the need for adaptations.
- Provide for routine breaks for nutrition and hydration.
- Suggest the nurse with a learning disability share their story with the staff.
- Ensure an open, authentic working environment to improve staff interactions and nurse retention.
- Encourage physicians and nurses to have open, nonjudgmental communication.
Resources for Nurses With a Learning Disability
The following organizations provide helpful resources for nurses living with a learning disability.
As Trauco and many other nurses with a learning disability have demonstrated, you can have a successful career as a nurse.
"Find your passion and develop your expertise as a 'Master' of your determined career focus," Trauco urges.
Consider the specialties that play to your unique strengths. For example, communication skills are essential for telephone triage, administration, legal consultant, and case management. They make excellent choices for nurses working with a learning disability.
Don't let a learning disability stop you from experiencing the rewards and benefits of working with and helping patients in some of the more challenging times of their lives.
Meet Our Contributor
Gail Trauco, RN, BSN-OCN
A registered oncology nurse, pharmaceutical trials expert, and long-time patient advocate, Gail Trauco has spent four decades helping patients navigate the sea of red tape in the U.S. healthcare system. She is the CEO of The PharmaKon LLC, which specializes in clinical pharmaceutical product development and trials.
Barto A. (n.d.). The state of learning disabilities today. https://ldaamerica.org/lda_today/the-state-of-learning-disabilities-today/
How are learning disabilities diagnosed? (2018).
Individuals with disabilities education act. (n.d.). https://sites.ed.gov/idea/
The adult learning disability assessment process. (n.d.). https://ldaamerica.org/info/adult-learning-disability-assessment-process/
The rehabilitation act of 1973. (n.d.) https://www.eeoc.gov/statutes/rehabilitation-act-1973
Types of learning disabilities. (n.d.).
Wood D, et al. (2010). Nurses with disabilities working in hospital settings: Attitudes, concerns, and experiences of nurse leaders. https://www.researchgate.net/publication/44616990_Nurses_With_Disabilities_Working_in_Hospital_Settings_Attitudes_Concerns_and_Experiences_of_Nurse_Leaders
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