Working As A Nurse With A Learning Disability

A learning disability does not have to keep you out of nursing. Most nurse managers in a 2010 study rated the work of nurses with learning disabilities as exceptional or above average. The challenges are real, including greater fatigue that can affect performance, but so are the strategies that work around them. The key is advocating for yourself, both in school and with nursing administration, to get the accommodations you need.

Experts estimate that nearly 20% of the population has some form of learning disability. For a nursing student, an unrecognized disability can interfere with success and with passing the National Council Licensure Examination. Earlier generations had it harder, since these disabilities were rarely identified or treated. Today more students are diagnosed in primary and secondary school and given accommodations early.

To understand what this looks like in practice, we talked with Gail Trauco, RN, BSN-OCN, founder and CEO of PharmaKon. She was diagnosed with dyslexia in her first year of college and has spent four decades in healthcare.

What Is a Learning Disability?

According to the Learning Disabilities Association of America, a learning disability is a neurobiological or genetic factor that alters the cognitive processing tied to learning, including reading, writing, and math. It can also affect organization, abstract reasoning, attention span, and planning, which can strain relationships at home and at work. Many people are identified in grade school or high school, though some are not diagnosed until adulthood or college.

Five types are commonly recognized:

Dyslexia affects reading and language-based processing. People struggle with spelling, word recognition, and sometimes comprehension.

Dyscalculia affects the ability to understand numbers and do calculations, which makes real-world math problems harder.

Dysgraphia affects the fine motor skills behind handwriting, including letters and numbers, and can carry over into math.

Nonverbal learning disability makes it hard to read facial cues and body language.

Oral and written language disorder affects the ability to understand what you read or hear.

A childhood evaluation includes medical history, an exam to rule out physical conditions, academic and psychological testing, and a review of developmental performance. In adulthood, diagnosis comes through formal testing for intelligence and processing, paired with specific strategies to improve work and daily life.

How Learning Disabilities Impact Nurses

Trauco's dyslexia made learning biochemistry harder, so she built strategies to retain the material. "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 every college has a disability services center that arranges accommodations, helps interface with professors, and provides resources for notetaking, test-taking, and studying. Other strategies nursing students use include prereading a chapter before taking notes, using colored highlighters for key details, building checkpoints into the text to confirm comprehension, reading aloud, drawing charts and diagrams, and working with an academic coach on study skills.

On the job, the harder tasks are the ones that demand accuracy and multiple steps: medication administration, dosage calculations, and wound care. Trauco warns that the devices meant to simplify care can complicate it. "Nursing uses 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 accuracy," she advises.

Because many cognitive tasks take more energy, nurses with learning disabilities may tire faster. Common challenges include fatigue and stress, executive function deficits, time management, memory, organization, prioritizing, reading, writing and spelling, taking shift notes, and processing facial cues.

Despite all of it, managers report these nurses perform above average or better. For Trauco, dyslexia was a driver. "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

Trauco is direct about what does not work: 12-hour shifts, doubles, and high patient-to-staff ratios do not get the best out of a nurse with a learning disability. Administration needs to understand how fatigue affects performance. "Exhaustion after about nine hours of bedside nursing creates a disadvantage for the last three hours of a 12-hour shift. Nursing shortages and the pandemic do not allow most nurses any breaks," she says. "This contributes to the exacerbation of a learning disability."

Before starting out, know your legal protections under IDEA, the Americans with Disabilities Act, and the Rehabilitation Act. Then share that knowledge with administration, because managers often will not seek out accommodations on their own and rely on you to say what you need.

Workplaces can make adjustments that protect both the nurse and patient care:

• Learn the specific challenges a nurse faces and build customized adaptations.
• Evaluate whether other staff need education and training.
• Recognize how fatigue affects performance and outcomes.
• Adjust 12-hour shifts to avoid fatigue.
• Pair the nurse with an experienced, compassionate mentor to ensure accuracy.
• Encourage smartphone apps that help with patient management and clinical decisions.
• Meet routinely to reassess what is working.
• Provide regular breaks for food and hydration.
• Invite the nurse to share their story with the staff if they want to.
• Keep communication between physicians and nurses open and nonjudgmental.

Resources

• National Organization of Nurses with Disabilities: an open-membership organization that promotes equity for nurses with learning and physical disabilities and chronic conditions through education, advocacy, and research.
• National Center for Learning Disabilities: works to improve the lives of children and adults with learning and attention issues through research, innovation, advocacy, scholarships, and awards.
• Job Accommodation Network: free consulting for employers and individuals on job accommodations, adaptation solutions, and assistive technologies.
• Learning Disabilities Association of America: advocates for federal policy and offers teaching resources, podcasts, state-based resources, and an annual conference.
• LDOnline: information and a searchable resource database for educators and families to understand a child's needs, rights, and responsibilities.

As Trauco and many other nurses have shown, you can build a strong career. "Find your passion and develop your expertise as a master of your chosen focus," she urges. Play to your strengths. Strong communication skills, for example, make telephone triage, administration, legal consulting, and case management excellent fits. A learning disability does not have to stand between you and the work.