Making the invisible visible Supporting Nursing Students with Hidden Disabilities in Clinical Practice A Presentation by Daniela Blumlein MA, Cert Ed, RGN

Background According to the Equality Act (2010) it would be illegal to automatically refuse a student admission to a nursing or midwifery programme. Mentors supporting students with disabilities in a placement must be aware of their duties under this act to ensure they comply with this legislation.

Definition  The Equality Act (2010) defines a disability as a physical or mental impairment that has a significant, long term, adverse effect on an individual’s ability to carry out day to day activities.  Reasonable adjustments must be made

This may include( but is not restricted to ) conditions such as:  Specific Learning Difficulties (such as dyslexia, dyspraxia, ADHD)  Mental Health Issues (such as depression, bi-polar disorder)  Long-term medical conditions (such as HIV, cancer, multiple sclerosis)  Unseen disabilities (such as diabetes, asthma, epilepsy)  Sensory impairments (such as visual impairment, hearing impairment)  Mobility or physical impairments (such as paralysis, arthritis).

Hidden Disabilties  Conditions/ impairments that are not visible  Mentor may not know about these unless the student chooses to disclose  Disclosure is personal to the student and not mandatory

Barriers  Some students may be reluctant to disclose their disability because of barriers such as negative attitudes towards disability or previous discriminatory experiences.  Student Nurses who have one or more disabilities reported that they have faced discriminatory attitudes from mentors whilst on placement. Tees& Cowen ( 2012)

Discriminatory Experiences  Mentor voicing doubt about the student’s ability to perform tasks without evidence to the contrary  Calling a student 'brave’  Lack of knowledge on how to support a student with a specific need and making reasonable adjustments  Expecting the student to work without reasonable adjustments

Research Project for Professional Doctorate  Early Stages  Plan Do Study Act (PDSA) cycle 1 completed  4 Student nurses took part ( Bsc and PG Dip)  Variety of hidden disabilities ( Dyslexia, Anxiety, Depression)  Semi structured interviews were conducted after first placement

Findings  All students chose to disclose their disability to their mentors  1 student reported good support and no discriminatory experience, although they felt the mentor was unsure of how to support them properly.  2 students with MH issues reported they felt unsupported and that mentors had voiced concerns about their suitability for the role of a RGN based on their condition alone.  1 student with MH problems felt well supported by mentor and team

Mentor Support  Having a non-judgemental and positive attitude  Maintaining confidentiality  Helping students to discuss reasonable adjustment that could be made.  Flexibility  Allowing students to attend support sessions( e.g. skills tuition) during placement  Having patience and repeat instructions or write them down if required  Providing the student with access to a computer if necessary  Allowing additional time to take notes or complete documentation  Providing the student with a calculator if needed  Scheduling regular breaks and rest periods  Make use of the Link Lecturer

References  Great Britain. Parliament. Equality Act 2010: Elizabeth II. Chapter 15. (2010) London: Stationery Office.  Morris, D. Turnbull, A. (2006) The disclosure of dyslexia in clinical practice: Experiences of student nurses in The United Kingdom. Nurse Education Today,27(1), p  Tee,S.,Cowen,M.(2012)Supporting students with disabilities-Promoting understanding amongst mentors in practice, Nurse Education in Practice 12, p6-10