Nurses with Disabilities 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

2 

Preface 

The Job Accommodation Network (JAN) is a service of the Office of Disability 

Employment Policy of the U.S. Department of Labor. JAN makes documents available 

with the understanding that the information be used solely for educational purposes. 

The information is not intended to be legal or medical advice. If legal or medical advice 

is needed, appropriate legal or medical services should be contacted. 

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contacting product manufacturers/vendors and service providers directly to ensure that 

they meet the intended purposes. This guarantees that the most up-to-date information 

is obtained. 

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105 of the Copyright Law provides that no copyright protection is available for works 

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provision. While individuals may use such work with impunity, individuals may not 

claim copyright in the original government work, only in the original material added. 

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are not altered, and that proper credit is given to JAN as the source of the information. 

For further information regarding this or any other document provided by JAN, please 

contact JAN. 

Updated 05/03/11.
Practical Solutions • Workplace Success 

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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction 

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition or 

occupation and provides information about the condition or occupation, ADA 

information, accommodation ideas, and resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://AskJAN.org/soar. 

Information about Nurses 

In the United States there are 2.6 million registered nurses (Bureau of Labor Statistics, 

2008). The Department of Labor has predicted that the number of nurses in the 

workforce will grow by 582,000 to 3.2 million nurses by the year 2018 and that there will 

be over one million job openings due to growth and replacement needs between 2008 

and 2018 (Bureau of Labor Statistics, 2008). 

Nurses and the Americans with Disabilities Act 

Are nurses with medical conditions covered under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must meet 

(EEOC Regulations . . ., 2011). Therefore, some nurses with medical conditions will be 

covered under the ADA and some will not. 

A person has a disability if he/she has a physical or mental impairment that substantially 

limits one or more major life activities, a record of such an impairment, or is regarded as 

having such an impairment (ADAAA, 2008). For more information about how to 

determine whether a person has a disability under the ADA, visit Accommodation and 

Compliance Series: The ADA Amendments Act of 2008 at 

http://AskJAN.org/bulletins/adaaa1.htm. 
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 Accommodating Nurses with Disabilities 

(Note: The following is only a sample of the possible accommodations available. 

Numerous other accommodation solutions may exist.) 

Questions to Consider: 

1. What limitations is the nurse experiencing? 

2. How do these limitations affect the nurse and the nurse’s job performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? Are all 

possible resources being used to determine possible accommodations? 

5. Has the nurse been consulted regarding possible accommodations? 

6. Once accommodations are in place, would it be useful to meet with the nurse to 

evaluate the effectiveness of the accommodations and to determine whether 

additional accommodations are needed? 

7. Do supervisory personnel and employees need disability awareness training? 

Accommodation Ideas: 

Cognitive Impairment – Cognitive impairment, as used in this publication, refers to 

disturbances in brain functions, such as memory loss, problems with orientation, 

distractibility, perception problems, and difficulty thinking logically. Cognitive impairment 

is a syndrome, not a diagnosis. Many conditions can cause cognitive impairment, 

including multiple sclerosis, depression, alcoholism, Alzheimer's disease, Parkinson's 

disease, traumatic brain injury, chronic fatigue syndrome, and stroke. 

Memory Deficits: 

 Allow the employee to tape record meetings and provide written checklists 

 Provide type written minutes of each meeting 

 Provide written instructions and allow additional training time 

Difficulty Reading and Writing: 

 Use speech recognition or word-prediction software if handwriting is poor or 

difficult 

 Use a personal data assistant to help with spelling 

 Seek areas of employment where charting is done by computer or in settings 

where reading/writing may be decreased, for example in an operating room 
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 Use dictation equipment and/or scribes 

Motor Impairment – Motor impairment, as used in the publication, refers to limitations 

in motor movements such as walking, lifting, sitting, standing, typing, writing, gripping, 

and maintaining stamina. Many conditions cause motor or mobility impairment, including 

multiple sclerosis, cancer, stroke, spinal cord injury, cumulative trauma disorder, back 

condition, arthritis, and heart condition. 

Difficulty Lifting or Transferring Patients: 

 Transfer aids 

 Team lifting 

 Height adjustable examination tables 

 Walkup changing tables that allow a child to be assisted in climbing to the 

changing table/examination table height 

Use of One Hand: 

 One-hand syringes 

 One-hand IV pole 

 One-handed keyboards and keyboard software 

Fatigue/Weakness: 

 Reduce or eliminate physical exertion and workplace stress 

 Shorten work day and extend work week 

 Schedule periodic rest breaks away from the unit, floor, or workspace 

 Allow a flexible work schedule and flexible use of leave time 

 Implement ergonomic workstation design 

 Provide a scooter or other mobility aid if walking cannot be reduced 

Access to Building and Work Environment: 

 Install ramps, automatic doors, and internal and bathroom doors that push open 

 Lower shelves and provide access to file cabinets 

 Provide preferred seating during training, classes, and meetings 

Maintaining Sterile Technique for Nurses Who use Wheelchairs: 

 Wash and dry hands, apply clean gloves, and maneuver to area; when gloves 

are removed hands will remain clean 

 Keep extra clean gloves in pockets 

 Use a strap or belt to secure self in chair when leaning forward to assess patient, 

perform wound care, etc. 
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Psychiatric Impairment – Psychiatric impairment, also called "mental illness," refers 

collectively to all diagnosable mental disorders. Mental disorders are health conditions 

that are characterized by alterations in thinking, mood, and/or behavior. Examples of 

psychiatric impairments include depression, bipolar disorder, anxiety disorder, 

schizophrenia, and addiction. 

Depression and Anxiety: 

 Reduce distractions in work environment 

 Provide to-do lists and written instructions 

 Remind employee of important deadlines and meetings 

 Allow time off for counseling 

 Provide clear expectations of responsibilities and consequences 

 Provide sensitivity training to co-workers 

 Allow breaks to use stress management techniques 

 Develop strategies to deal with work problems before they arise 

 Allow telephone calls during work hours to doctors and others for support 

 Provide information on counseling and employee assistance programs 

Stress: 

 Allow work during shifts that are less demanding 

 Adjust supervisory method 

 Have more frequent meetings to discuss performance 

 Develop strategies to deal with work problems before they arise 

 Employer may provide sensitivity training to coworkers 

 Allow telephone calls during work hours to doctors or counselors and others for 

support 

 Provide information on counseling and employee assistance programs 

Sensory Impairment – Sensory impairment, as used in the publication, is any condition 

that affects hearing, speech, vision, or respiration. 

Speech Impairments: 

 Word prediction computer software 

 Text telephones (TTY or TDD) 

Vision Impairments: 

Monitoring Vital Signs 

 Talking thermometers 

 Talking scales 

 Talking blood glucose monitors 

 Talking blood pressure monitors 
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 Talking watches 

Reading/Documentation 

 Provide signage in large print and Braille 

 Text-enlargement computer software 

 Hand or stand magnifiers for printed material 

 Closed-circuit television (CCTV) 

 Reduce glare via glare guards on computers and adjust lighting or blinds 

 Electronic note-taking devices with speech or Braille output 

Deaf/Hard of Hearing: 

Monitoring Vital Signs 

 Blood pressure monitors with displays showing pulse and blood pressure 

 Graphic auscultation systems 

 Equipment with digital displays 

 Vibrating alert to signal a monitor’s alarm 

One-on-One Communication 

 Written notes 

 Email, instant messaging, speech recognition software 

 Interpreters 

 Augmentative communication devices 

 Basic sign language training 

 Text telephones (TTY or TDD) 

Group Communication 

 Assistive listening devices 

 Communication Access Realtime Translation (CART) services 

 Computer-assisted note taking 

 Tape recording meetings 

 Video conferencing 

Telephone Communication 

 Amplification (enhancing volume) 

 Clarity (adjusting sound frequency) 

 Headsets; HATIS manufactures the only headset available that is specifically 

designed for use by individuals with a moderate to profound hearing loss and 

who wear behind the ear (BTE), t-coil equipped hearing aids. For more 

information regarding HATIS products, go to http://www.hatis.com. 

 TTY or TDD 
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Responding to Fire or Emergency Alarms 

 Vibrating pagers 

 Lights hard-wired to alarm system 

Allergies/Multiple Chemical Sensitivity: 

 Modify or create a fragrance-free workplace policy 

 Provide an air purification system 

 Modify the workstation location 

 Have an air quality test performed by an industrial hygiene professional to assess 

poor air quality, dust, mold or mildew accumulation, VOC concentration, etc. 

Situations and Solutions: 

A nurse with bilateral hearing loss has been using an amplified stethoscope that 

requires her to take her hearing aids in and out. She called JAN seeking a stethoscope 

that will work with her hearing aids in. JAN referred the nurse to a company who makes 

a stethoscope that can be used with a direct audio input port. The stethoscope was 

purchased. 

A nurse with fibromyalgia syndrome working in a county health clinic experienced a 

great deal of fatigue and pain at work. The nurse typically worked evening shifts but her 

doctor recommended a schedule change so she could regulate her sleep patterns. 

Accommodations suggestions included changing her shift from evening to day, 

restructuring the work schedule to eliminate working two consecutive twelve hour shifts, 

reducing the number of hours worked to part time, and taking frequent rest breaks. 

A nurse with drug addiction was restricted from dispensing medication after she was 

caught using illegal drugs. Her employer had a policy allowing employees to participate 

in drug rehabilitation and return to work with a last chance agreement. When the nurse 

returned to work after rehabilitation, she was reassigned to a job that did not require her 

to dispense medication and given periodic drug tests. 

An operating-room nurse with chronic fatigue syndrome had difficulty rotating 

schedules. She was accommodated with a permanent day schedule. 

A resource nurse with multiple sclerosis needed changes to her workstation and 

schedule. The employer made the workstation wider and added an adjustable keyboard 

tray. The employer also allowed periodic rest breaks and moved the employee closer to 

the restroom and break room to help reduce fatigue. 

A psychiatric nurse with cancer was experiencing difficulty dealing with job-related 

stress. He was accommodated with a temporary transfer and was referred to the 

employer's employee assistance program for emotional support and stress 

management tools. 
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A nurse with insulin-dependent diabetes and hypoglycemia was having problems 

regulating her condition (specifically, eating regularly while at work). Her schedule was 

altered by eliminating the evening rotation until her blood glucose levels could be 

controlled on a consistent basis. The employer reported this as a very effective 

accommodation. Cost of accommodation: none. 

Products: 

There are numerous products that can be used to accommodate people with limitations. 

JAN's Searchable Online Accommodation Resource at <http://AskJAN.org/soar> is 

designed to let users explore various accommodation options. Many product vendor 

lists are accessible through this system; however, JAN provides these lists and many 

more that are not available on the Web site upon request. Contact JAN directly if you 

have specific accommodation situations, are looking for products, need vendor 

information, or are seeking a referral. 
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@AskJAN.org 

http://AskJAN.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

American Foundation for the Blind AFB Career Connect 

Toll Free: (888)824-2184 

http://www.afb.org/Section.asp?SectionID=7 

AFB CareerConnect is a free resource for people who want to learn about the range 

and diversity of jobs performed by adults who are blind or visually impaired throughout 

the United States and Canada. 

American Nurses Association 

8515 Georgia Avenue 

Suite 400 

Silver Springs, MD 20910 

Toll Free: (800)274-4262 

Direct: (301)628-5000 

Fax: (301)628-5001 

http://www.nursingworld.org/ 
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The American Nursing Association is the only full service professional organization 

represented the nation's 2.9 million registered nurses(RNs) through its 54 constituent 

member associations. The ANA advances the nursing profession by fostering high 

standards of nursing practice, promoting the economic and general welfare of nurses in 

the workplace, projecting a positive and realistic view of nursing, and by lobbying the 

Congress and regulatory agencies on health care issues affecting nurses and the 

public. 

Association of Medical Professionals with Hearing Losses 

secretary@amphl.org 

http://www.amphl.org/about.php 

The Association of Medical Professionals with Hearing Losses provides inofrmation, 

promotes advocacy and mentorship, and network for individuals with hearing loss 

interested in or working in the health care fields. 

Exceptional Nurse 

13019 Coastal Circle 

Palm Beach Gardens, FL 33410 

Direct: (561)627-9872 

TTY: (561)776-9442 

Fax: (561)776-9254 

ExceptionalNurse@aol.com 

http://www.exceptionalnurse.com 

ExceptionalNurse.com is a resource network committed to inclusion of more people with 

disabilities in the nursing profession. By sharing information and resources, 

ExceptionalNurse.com hope to facilitate inclusion of students with disabilities in nursing 

education programs and foster resilience and continued practice for nurses who are, or 

become, disabled. 

National Nurses Business Association 

P.O. Box 561081 

Rockledge, FL 32956-1081 

Toll Free: (877)353-8888 

Direct: (321)663-4610 

bemis@nnba.net 

http://www.nnba.net 

An association promoting, supporting and educating nurses who are, or desire to be, in 

business for themselves. 
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National Organization of Nurses with Disabilities 

1640 West Roosevelt Road 

Room 736 

Chicago, IL 60608 

Direct: (312)413-4097 

bmarks1@uic.edu 

http://www.nond.org 

NOND is an open membership, cross-disability, public education, and advocacy 

organization that works to promote the full inclusion and acceptance of people with 

disabilities and chronic health conditions into nursing careers. 

Nurse Friendly, The 

38 Tattersall Drive 

Mantua, NJ 08051 

Direct: (856)415-9617 

info@nursefriendly.com 

http://www.nursefriendly.com/disabled/ 

Nursing and Healthcare directories for nurses with disabilities and more. 

Nurses House 

VMD Center for Nursing 

2113 Western Avenue, Suite 2 

Guilderland, NY 12084 

Direct: (518)456-7858 

Fax: (518)452-3760 

mail@NursesHouse.org 

http://www.nurseshouse.org 

Extends short term financial assistance to registered nurses in a difficulty as a result of 

an injury, illness, or disability. 

Rehabilitation Institute of Chicago 

345 E. Superior Street 

Chicago, IL 60611 

Toll Free: (800)354-7342 

Direct: (312)238-1000 

TTY: (312)238-1059 

http://www.ric.org 

RIC is a leader in patient-care, advocacy, research and educating health professionals 

in rehabilitation. 
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References 

Americans with Disabilities Act of 1990, as Amended, 42 U.S.C.A. § 12101 et seq. 

(2008). 

Bureau of Labor Statistics. (2008). November 2008 national occupational employment 

estimates for registered nurses. Retrieved May 3, 2011, from 

 http://data.bls.gov/oep/noeted?Action=empoccp 

EEOC Regulations to Implement the Equal Employment Provisions of the Americans 

With Disabilities Act, as Amended, 29 C.F.R. § 1630 (2011). 
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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.