Work After Breast Cancer

Posted by Kim Cordingly on October 16, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Sheryl Grossman, Consultant – Motor Team

One of the most positive things about more people surviving breast cancer, and cancer diagnoses in general, is that life after a diagnosis goes on, including one’s work life. Many are able to continue working through treatment, while others choose to focus on treatment and then return to work. Often less recognized is that while a clinical diagnosis is made on a specific date, and various treatments are done on specific dates, the side effects may linger on for weeks, months, and sometimes years.

Cancer, as many oncologists say, is a lifelong, chronic condition. For some this may be a direct result of the disease process, while for others it may be the result of side effects from necessary, but often potent, treatment protocols.

Just like with any other chronic condition, people who have had breast cancer can be fantastic employees. Some return to work and continue on as they did prior to their diagnosis. Others may need accommodations to be the best employee they can be.

The following are some potential areas of accommodation that may assist someone who has had a diagnosis of breast cancer:

Need for ongoing medical treatment, follow-up appointments, and monitoring:

  1. Allow for a flexible schedule
  2. Allow employee to telework
  3. Allow for additional leave time

Need for an ergonomically adjusted workspace due to lifting restrictions, pain management, and so on:

  1. Provide workspace adjustments to desk height, monitor height, chair, arm support, and reach ranges for equipment and materials
  2. Provide ergonomically appropriate tools
  3. Allow for breaks from repetitive tasks
  4. Modify workspace layout to avoid tasks done over the head
  5. Allow time for physical movement to help circulation

Need for supports with cognitive processing:

  1. Allow for self-paced workload
  2. Adjust supervisory method to allow for prompting, adjusting instructional or management method, breaking large tasks into smaller tasks
  3. Allow for one task to be completed before the next is presented

Need to manage fatigue:

  1. Allow for periodic rest breaks
  2. Allow for a modified schedule
  3. Redesign workspace to bring all necessary materials within easy reach range
  4. Limit physical exertion required
  5. Move workspace closer to door, break room, or restroom
  6. Provide personal mobility device to maneuver around workspace without exerting more effort
  7. Allow telework from home and remote access to meetings

While wearing pink brings awareness to the needs of those who are living with or have survived breast cancer, providing accommodations concretely changes the lives of those who are affected, as well as strengthening the business as a whole.

For more information:

Accommodation Ideas for Cancer

EEOC Fact Sheet: Questions and Answers About Cancer in the Workplace and ADA

Strategies for Developing a Transgender-Inclusive Workplace

Posted by Kim Cordingly on October 14, 2015 under Accommodations, Employers, Organizations | Comments are off for this article

By: Tracie DeFreitas, Lead Consultant – ADA Specialist

Inclusion. Equality. Fairness. Respect. It’s reasonable to say that all of these words have significant meaning to everyone, particularly at work. All employees should be able to participate in, and contribute to, the progress and success of an organization by being included, by being afforded equal rights, and by being treated fairly and respectfully. However, sometimes employees feel they cannot be themselves at work and will not fully engage as part of the team if they don’t believe these basic human rights can be realized – if the workplace is not inclusive of all employees or the culture is not forward-thinking. This can be especially true for individuals who transition from one gender to another, or who identify as a different gender than what they were assigned at birth.

JAN receives inquiries from employers seeking information about ways to include transgender employees in the workplace. Transgender is a term for people whose gender identity, expression, or behavior are different from those typically associated with their assigned sex at birth (NCTE, 2015). For example, a transgender man may have been assigned female at birth, but identifies as a man. Many of the inquiries JAN receives related to transgender issues come from employers who have an employee who has been employed for some time and is known as one gender, but is transitioning to a different gender. Our discussions with employers and others often center-around supporting the employee’s transition and making modifications at work that ensure that transgender employees are able to work in a manner consistent with how they live their daily lives, based on their gender identity.

The Americans with Disabilities (ADA) does not apply to situations involving workers who are transgender because being transgender is not considered a disability under the ADA. However, more and more businesses are recognizing the need to establish policies related to accommodating transgender workers – without an established federal mandate to do so. The accommodation process can be similar to that applied to workers with disabilities. When a transgender employee makes the employer aware of his or her transition and identifies work-related needs as part of the process, it’s time to have an open dialogue with the employee to discuss the employee’s needs, work-related barriers, and solutions for overcoming those barriers. Ask how the environment or means of communication can be adapted to promote inclusion and make the effort to maintain a supportive work environment that enables the individual to be him or herself. It’s also critically important to educate human resource personnel, supervisors, and managers about respectfully discussing transgender issues with employees.

Having gender transition guidelines available for human resource personnel and supervisors and managers will prepare staff to appropriately communicate with transgender employees and manage accommodation situations. The Human Rights Campaign (HRC) offers practical information and examples of gender transition guidelines that can be adapted and implemented to promote a transgender-inclusive business. To learn more, see HRC’s Workplace Gender Transition Guidelines. For examples of guidelines implemented by national corporations, see Chevron’s Gender Transition Guidelines and Ernst & Young’s Gender Transition Guidelines.

There are many ways to support transgender workers. The following suggestions will be useful to businesses trying to promote a transgender-inclusive workplace:

  • Educate staff about what “transgender” means. A transgender person is someone whose sex assigned at birth is different from who they know they are on the inside. This includes people who have medically transitioned to align their internal knowledge of gender with their physical presentation and those who have not medically transitioned (HRC, 2015).
  • Train management staff to lead by example by treating transgender workers respectfully and fairly, and by becoming part of the individual’s support team.
  • Respect the name a transgender person is using. During the transition process, an individual will often change his or her name to align with their gender identity.
  • Use the individual’s preferred pronoun and encourage others to do so. For example, when an individual presents as female, use feminine references like she, her, hers. When a person presents as male, use masculine references like he, him, his. In uncertain cases, use the person’s first name (GLAAD, 2015).
  • Talk with the individual about ways to communicate his or her transition to others they must interact with at work – if the employee would like others to be informed. Ask if he or she wishes to inform their manager, co-workers, clients, etc. on their own, or if he or she prefers that this be done by the employer. Learn what information the employee would and would not like to share with others.
  • Remove gender-specific rules from a dress code or grooming policy.
  • Permit employees to use the restroom facilities that correspond with their gender identity. Employers may also establish single-occupancy gender-neutral (unisex) facilities or allow use of multiple-occupant, gender-neutral restroom facilities with lockable single occupant stalls. The Occupational Safety and Health Administration (OSHA) has issued transgender inclusive restroom access guidelines. For more information, go to Best Practices: A Guide to Restroom Access for Transgender Workers.
  • Allow a flexible schedule and permit the use of leave for medical procedures.
  • Discuss if there is a preference to remain in his or her current position or to consider reassignment to another position during transition.
  • Update name and gender designations for human resource and administrative records once an employee has officially transitioned. Also, update employment-related photo identification.
  • Finally, respect the individual’s privacy and allow him or her the right to be who they are.

References

National Center for Transgender Equality. (2015). Transgender Terminology. Retrieved June 19, 2015 from http://transequality.org/issues/resources/transgender-terminology

Human Rights Campaign. (2015). Reporting About Transgender People? Read This. HRC’s Brief Guide to Getting It Right. Retrieved July 31, 2015 from http://www.hrc.org/resources/entry/reporting-about-transgender-people-read-this

Human Rights Campaign. (2015). Workplace Gender Transition Guidelines. Retrieved July 17, 2015 from http://www.hrc.org/resources/entry/workplace-gender-transition-guidelines

GLAAD. (2015). GLAAD’s Tips for Allies of Transgender People. Retrieved July 31, 2015 from http://www.glaad.org/transgender/allies

Mental Health Awareness – Creating a More Inclusive Workplace

Posted by Kim Cordingly on October 9, 2015 under Accommodations, Employers, Organizations | Comments are off for this article

By Daniel Tucker, Consultant — Cognitive/Neurological Team

October 10th is World Mental Health Day. Originally celebrated in 1992 as an initiative of the World Federation for Mental Health, its objectives included raising awareness of mental health issues throughout the world; encouraging individuals to educate themselves about mental health; and searching for ways to provide greater supports. With this in mind, we wanted to draw attention to the prevalence of mental health conditions, common misconceptions, and steps employers can take to foster a supportive and inclusive work environment.

According to a National Institute of Mental Health (NIMH) survey, approximately 43.8 million adults experience some form of mental health condition in a given year. That’s 18.5 percent or nearly 1 in 5 of all adults in the U.S. It’s a common misconception that mental health impairments affect a small number of individuals. These statistics show that mental health conditions as a whole are actually relatively common.

Given these statistics and the number of individuals employed or seeking employment with mental health impairments, employers may want to consider steps they can take to raise awareness in the workplace. With October being National Disability Employment Awareness Month, it’s a good time to consider providing disability awareness training where topics relevant to mental health can be discussed. By bringing attention to the fact that mental health conditions are common, and only one part of a person’s identity, employers may help reduce the still pervasive stigma around mental illness, and make employees feel more comfortable and supported in the workplace.

In terms of disability etiquette, it’s important to know how to talk about mental health in a way that is respectful rather than offensive. For example, the terms “mental defective,” “afflicted,” “victim of,” and “sufferer of” are generally antiquated and offensive. The terms “mental health impairment” and “psychiatric impairment” are generally accepted, and individuals may have a personal preference as to what terms they prefer. Also, it’s generally better to use person first language – focusing on the person first, not the disability. For example, “an employee with bipolar disorder,” as opposed to “a bipolar employee.” When speaking with an employee that has disclosed a mental health impairment, it may be helpful to listen for the words they use to describe themselves, and to ask whether they have a preference about what terms you use.

The Employer Assistance and Resource Network (EARN) offers employers numerous resources for creating a more inclusive workplace including information on disability etiquette.

JAN also offers a wide variety of resources to support the successful employment of individuals with mental health impairments.

If you have a specific situation or question you’d like to discuss with a JAN consultant, we encourage you to contact us directly or visit AskJAN.org.

References:

Any Mental Illness (AMI) Among Adults. (n.d.). Retrieved October 7, 2015, from http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-adults.shtml.

Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

Validation as a Key to Workplace Success for Employees with Borderline Personality Disorder (BPD)

Posted by JAN Tech on September 29, 2015 under Uncategorized | Comments are off for this article

by: Kelsey Lewis, MSW, LGSW

This past summer, I attended a session at the National Alliance on Mental Illness (NAMI) conference entitled “Borderline Personality Disorder: Demystified and Destigmatized” led by Dr. Alan Fruzzetti, a Professor of Psychology at the University of Nevada, Reno. As a featured speaker, he opened the session by sharing the most up-to-date research on individuals with Borderline Personality Disorder (BPD). In his presentation, Fruzzetti focused on the concept of emotional dysregulation as a central process in BPD.

Emotional dysregulation (ED) is characterized by quick and frequent mood swings that are beyond the control of the person with the problem (New Harbinger Publications). ED can also be associated with fear of negative emotions, difficulty concentrating, impulsive behavior, low self-esteem, and fear of abandonment. Although heightened in individuals with BPD, such feelings are shared by many individuals with or without a diagnosed mental health condition. These dysregulated emotions may significantly affect an individual’s relationships, both personal and professional, in and out of the workplace.

Fruzzetti explained that when an individual reaches a heightened state of emotion, he or she is more inclined to think in rigid terms — black or white, good or bad. It’s during these periods of emotional arousal that dysregulation may occur, particularly for those with BPD. In order to function happily and effectively in any relationship, we must first accept the ambiguity of the other person’s intentions, including the constant change of expectations and preferences. But how is this possible when one is thinking in such a polarized way?

Fruzzetti suggests learning to take a step back – giving yourself a breather – and then addressing the situation more tactfully so, as he explains, you learn to interact healthily, express yourself and your needs when your arousal has lowered. This will help you express yourself more accurately and appropriately. Instead of reacting when your coworker or supervisor has acted in a way you perceive as offensive, you instead walk away until you have reached a point of calmness, and then readdress the situation. You can now explain that the interaction did not sit well with you instead of blaming, calling someone names, or potentially overreacting in a way that will make you feel embarrassed later on. He emphasized that the more accurately you explain your feelings, the easier it is for the other person to understand and validate your experience. This does not necessarily mean that the other person will be able to fully understand why you feel this way, or even agree with your position, but at least this opens the line of communication that will enable you to feel heard and respected.

Fruzzetti believes that if people do not feel validated in their feelings, their arousal will not drop. For employers, this can mean that employees with BPD may not be able to work effectively, without distraction, if they feel unsupported in their workplace. Instead of moving on from a negative event or encounter, they may alternatively believe their feelings aren’t safe in their workplace. Although difficult at times, particularly if an employer is unfamiliar with BPD, validation can change this frame of reference and potentially lead to a more productive employee.

According to Fruzzetti, the tricky part is learning to differentiate between validating “false” perspectives versus emotions regarding the matter. This means that you don’t necessarily want to validate an employee’s perspective if it could cause more harm, but instead validate the feelings attached to this perspective. For example, if an employee wrongfully believes that her supervisor is singling her out, it would cause more harm to agree with this perspective. However, you can still express your understanding that she is upset over feeling this way. This interaction can help the employee feel supported while also providing a different viewpoint on the situation.

Relationships can be challenging — especially with our work colleagues and supervisors with whom we interact during a large portion of our days. But in trying to relate to each other through validation and respect, these relationships can provide many benefits that will enrich our workplace lives. Particularly for those with BPD, this relational strategy can make a huge difference in both morale and productivity. Through simple but new levels of understanding, we can allow our professional relationships to provide collaboration, inspiration, motivation, and a new perspective on life.

For more information on Accommodation Ideas for Mental Health Impairments, JAN publications offer a variety of suggestions. JAN consultants can also provide one-on-one consulting to discuss a specific workplace situation.

Resources:

  • Fruzzetti, A. (2015, July 8). NAMI Presentation — Borderline Personality Disorder: Demystified and Destigmatized. San Francisco, CA.
  • New Harbinger Publications. (n.d.). Borderline Personality Disorder. Oakland: New Harbinger Publications, Inc. https://www.newharbinger.com/psychsolve/borderline-personality-disorder
  • National Alliance on Mental Illness (NAMI)
  • “NAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.”

Healthcare Workers with Motor Impairments – Part 2

Posted by Kim Cordingly on August 18, 2015 under Accommodations, Employers, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

In this final segment of the 2-part Blog on accommodations for healthcare workers with motor impairments, JAN Lead Consultant Elisabeth Simpson, MS., CRC, in collaboration with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, continues the discussion on some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the remaining four questions and offering resources and information on the topic.

Questions:

1) When a limited schedule is needed (e.g., 10 hour shift in place of a 12 hour shift), would allowing this for one nurse on a unit really be a hardship for the other nurses working?

The accommodation of a schedule modification, as well as modifications of a workplace policy regarding scheduling, are a couple of types of accommodations an employer would need to consider providing, absent undue hardship. The EEOC’s Enforcement Guidance on Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act (ADA) offers guidance on this area of accommodation that might be useful for an employer or individual to review.

According to Dr. Maheady, in some cases an employer may be able to limit an individual’s schedule without it posing a hardship. However, in most situations, nurses are working with limited staff and adding additional work can be problematic for various reasons. Safe staffing ratios are critical to patient care outcomes and allowing a nurse to leave early or come in late could impact safe staffing ratios.

Alternative options could be to consider accommodations that would enable an individual to work the hours required. This could include periodic breaks, modifying policies around eating and drinking, providing equipment, or restructuring a job to reallocate marginal functions. Reassignment may be necessary if accommodations would not be effective or would pose a hardship. This type of accommodation may also be necessary if an individual needs to limit hours to the extent at which they would be working part time rather than full time.

2) For medical professionals with upper extremity limitations, what are some alternative ways to place a catheter (male or female)? Is maintaining a sterile field ever a concern?

It depends on many factors (age of patient, patient’s condition, etc.). For males, in some instances, it is appropriate to have the patient assist while placing the catheter. Also, if teaching the patient to self-catheterize (or a family member), this is part of the teaching/learning process.

What would work best is to have a second person, possibly a nurses’ aid or family member, don gloves and assist. Then the individual can don gloves, clean the meatus, and insert the catheter. Dr. Maheady notes that, in her experience, many nurses ask for assistance, disabled or not.

3) How can a medical professional who uses a cane or mobility device address concerns around sterilizing the device?

In these situations, Dr. Maheady recommends that the Infection Control Department or designee should always be consulted. There may be specific infection control issues related to a facility or unit. Collaboration with all parties in determining effective solutions can help to speed up the process and ensure that policies and procedures around sterilization are kept in mind.

Concerns around cane or wheelchair use in sterile medical environments can be addressed by:

  • Having two wheelchairs available and keeping one chair in a sterile area. The individual could switch chairs in a dedicated area.
  • Using wheelchair tire covers.
  • Wheeling into the room with one pair of gloves and changing to a new pair of gloves before touching the patient.
  • Surgical gowns could also be used to cover exposed areas of the chair.
  • A long narrow plastic bag (like ones for wet umbrellas) could be used with a cane and taped around the cane to secure. Bags could be changed as needed.

It is important to note that in general patient care areas, nurses do not sterilize their shoes, sneakers or clogs. An employer would not want to unnecessarily impose more stringent rules or requirements for employees with disabilities as this could be a violation of the ADA.

4) When a patient lifting device is not available, what are some alternative options that a medical professional with a lifting restriction could consider?

This is another situation where job restructuring may be the most effective form of accommodation for individuals who have lifting restrictions and are working in healthcare positions that require them to lift. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as patient lifting techniques, individuals with a disabilities should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. For example, an individual could be permitted to ask for assistance when lifting a patient. Team lifting, or lift buddies, can also be a solution. However, there will still be risks associated with lifting patients and injuries can occur with any employee, not just those with restrictions. It is important to remember that team members have different strengths and body sizes and may contribute differently when lifting a patient.

Ultimately, if an individual is not able to lift patients even with accommodations, reassignment would need to be considered. Reassigning the individual to another unit (e.g., pediatrics, newborn nursery) where there is a vacant position could be explored.

JAN and Elisabeth would like to extend our appreciation to Dr. Maheady for her assistance in answering these common, but difficult questions related to healthcare workers with motor impairments. For assistance in determining accommodation options for individuals with motor impairments, JAN consultants are ready to assist!

The Importance of Soft Skills for Entrepreneurs with Disabilities – Three Important Tips

Posted by Kim Cordingly on July 7, 2015 under Accommodations, Entrepreneurship / Self Employment | Comments are off for this article

By: Kim Cordingly, Lead Consultant – Self-Employment Team

Over the years, JAN consultants have fielded questions from aspiring entrepreneurs with many different types of disabilities and every conceivable variation of business idea. Frog farm – we’ve heard of it. Opera singer and teacher – how wonderful! Used automobile sculptures – why not? Many of the business ideas we hear about are absolutely brilliant – inspired – practical – imaginative – marketable – and feasible. But to get from here to there takes lots of good information and support, and on the part of the individual wanting to start a business, both knowledge and practical skills.

Many so called “soft skills” cannot be emphasized enough as being critical to the success of both planning and operating a small business or self-employment. Soft skills are frequently characterized as those that encompass proficiency with verbal and nonverbal communication, a positive attitude and enthusiasm, teamwork and networking behaviors, problem solving and critical thinking skills, and acting with professionalism. The very process of researching and planning for a business requires skills that will be necessary in the start-up and operations stages of business development. As a result, these are skills we try to focus on from the outset — either as best practices or in the context of accommodations — and encourage JAN customers to develop further both in how they interact with us, as well as those they reach out to with other programs and services in their local areas.

Based on our experience, I’ve highlighted below some “Dos and Don’ts” that frequently come up with our customers. Often they seem small or common sense, but they frequently have huge implications in how seriously one’s ideas will be taken by others, and whether an individual is perceived as committed to a business idea and the development process.

Tip 1: Be Specific

You’ve requested information from a program or agency and they’ve responded to you by preparing information based on your request. You have follow-up questions. What do you do?

DO: Review the information they sent to you carefully. If you need support to do this, let an appropriate person/service provider know. I cannot emphasize this enough. If they’ve prepared the information for you, take the time to review it thoroughly.

DO: Once you’ve reviewed the information, write down (or prepare somehow) follow-up questions that reference as specifically as possible the material you received. This communicates to the person or agency that you value their time; this also makes it more likely they will be able to respond appropriately to your questions, as well as be willing to network with you in the future.

DON’T: Ask extremely general questions – ask questions that show you have reviewed the information and reference it. This demonstrates good critical thinking and communication skills – you are sharing the concrete steps you’ve taken to review the information and follow-up if applicable. Again, if accommodations are needed, JAN consultants can assist with this.

REMEMBER:

An unhelpful question tends to be very general – “I don’t understand the information you sent to me. Could you explain it?”

A helpful question is more specific – “On page 3 of the information you sent to me you talk about Social Security work incentives and self-employment. This is confusing to me. I wonder if you could explain more clearly how these rules work. If you need more information about my specific situation, I’d be glad to share this information.”

Tip 2: Always Be Professional, Even When Irritated

You’re in the process of putting together your business plan and are following up with business development organizations to schedule an appointment with a counselor. Some agencies you’ve contacted have not called back in a timely manner, so you’re feeling frustrated. What do you do?

DO: Keep a good record of the dates and times you’ve contacted an agency and cite this information when you call back. If they have not called back in a reasonable amount of time (I usually say a few days unless they’ve said it will be within another time frame), call back and let them know you called earlier, left a message (if you did), and have the date/time information ready.

DO: Make sure you are (and sound) assertive, not agitated. If you’re not sure, take a break before contacting them. Don’t make the call until you are in a calmer state of mind.

DO: Write down what you want to say beforehand. Being prepared in this way tends to present clarity on your part and lessen anxiety.

DON’T: Never take out your frustration on the individual you finally get to talk to whether it’s a receptionist or the counselor. While it’s perfectly understandable to feel frustrated when you’ve made repeated calls, you don’t know why there was a delay in getting back to you. Now that you’ve gotten ahold of the person you want to speak with, use this opportunity wisely.

REMEMBER: You are building social capital with every contact you make. How you present yourself in each conversation — even in these initial steps — is setting the groundwork for your future plans. People always remember when they are treated kindly and respectfully. You can’t control how other people behave, but you can always be professional from your end, even if you decide not to work with that person or agency.

Tip 3: Be Reliable

You have scheduled a meeting with your vocational rehabilitation (VR) counselor and a small business counselor. You’ve been trying to schedule this meeting for many weeks. Due to unforeseeable health issues, you need to reschedule the meeting. What do you do?

DO: As soon as you know you will not be able to make the meeting, let both parties know. Let them know by the means you know they are most likely to receive the message. If not sure, contact both by email and phone.

DO: If possible, try to reschedule the meeting during that conversation. Let them know you are committed to meeting and regret having to reschedule.

DON’T: Unless appropriate, don’t feel you need to give explicit details about the medical reasons for the cancellation unless it is relevant to your relationship with that individual and the issues at hand. In other words, they don’t need to know all the details, just the parts that are relevant based on the type or relationship you have and the purpose of the meeting.

REMEMBER: We all have unforeseen things happen when we may need to cancel meetings. The important part is to be courteous and timely in the cancellation process. Unfortunately, we hear too often that individuals simply do not show up at the meeting and call afterwards to apologize. This makes it much less likely these persons will want to work with you again.

Reference:

Office of Disability Employment Policy (2012), Skills to Pay the Bills – Mastering Soft Skills for Workplace Success. Retrieved from http://www.dol.gov/odep/topics/youth/softskills/softskills.pdf

Healthcare Workers with Motor Impairments

Posted by Kim Cordingly on July 1, 2015 under Accommodations, Employers, Organizations, Products / Technology | Comments are off for this article

By: Elisabeth Simpson, Lead Consultant – Motor Team

According to the Bureau of Labor Statistics (2013), the health care and social assistance sector will account for almost a third of the projected job growth between 2012 and 2022. With 16,971,800 healthcare workers employed in the United States in 2012 (Bureau of Labor Statistics, 2013), accommodations for those with disabilities working, or planning to work in, the healthcare field is a timely topic to be discussing.

With the over ten thousand calls JAN has received related to accommodations in healthcare settings, JAN consultants can offer a wealth of experience with accommodation situations. For healthcare workers with motor impairments such as carpal tunnel, back conditions, leg impairments, or arthritis, certain job duties – tasks such as lifting, carrying, moving, transferring, standing, walking, manipulating extremities, and positioning individuals for activities of daily living or physical therapy – may be difficult to perform without accommodations.

There are a variety of accommodation options that can be implemented in order for an employee to perform the essential functions of the job. Proper lifting techniques, lowering adjustable exam tables and equipment (low-lipped showers), ergonomic layouts for equipment (cranks and handles on beds and carts) and supplies (storing items at waist height, lowering bed rails when attending to patient needs, etc.), and team lifting are beneficial work site and procedural changes.

Still, accommodation situations in healthcare settings can be tricky or complicated. When this is the case, JAN consultants might turn to other experts in the field for assistance so that those contacting us for guidance are provided with the most beneficial and accurate information. For this two part blog, I collaborated with the founder of the non-profit resource network Exceptional Nurse, Dr. Donna Carol Maheady, to discuss some of the more complex accommodation questions JAN Motor Team consultants are fielding. Seven questions were directed to Dr. Maheady. This month we will be looking at the first three questions and offering resources and information on the topic.

Questions:

1) For medical professionals with either a hand or arm amputation OR restrictions that limit the use of one hand, what are some alternative methods for giving injections? What about placing IV’s?

According to the Equal Employment Opportunity Commission (EEOC), a reasonable accommodation must be provided to enable a qualified employee with a disability to perform the essential functions of a job currently held. In general, an accommodation is any change in the work environment or in the way things are customarily done that enables an individual with a disability to enjoy equal employment opportunities.

Job restructuring may be the most effective form of accommodation for individuals who have limited or no use of one hand and are working in healthcare positions that require them to perform injections, place IV’s, etc. Job restructuring can be an adjustment in how and when a job is performed, including reallocating or eliminating marginal functions of a job. However, the EEOC has indicated that an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

While there may be a common or typical way a job function is performed by healthcare workers, such as placing an IV, an individual with a disability should be given the option to perform the same job task in a manner that works best for them while keeping patient care and safety in mind. Time to practice clinical skills or tasks may be needed as part of the accommodation.

A number of videos and articles are offered as an additional resource to support the work of those with motor impairments in healthcare settings:

Videos

Foreign object removal with prosthesis

Adult CPR with prosthesis

Nursing with the hand you are given

Disabled Nurse: Focus on abilities

Danielle’s story (nurse missing her lower arm)

A sequence of photos demonstrating the donning of sterile gloves with one hand can be found within the article: “Nursing with the Hand You Are Given

Articles and Book Chapters

In the book Leave No Nurse Behind: Nurses Working with Disabilities by Donna Maheady, Susan Fleming (nurse born missing her left hand) wrote a chapter about her journey.

In the book The Exceptional Nurse: Tales from the Trenches of Truly Resilient Nurses Working with Disabilities, edited by Donna Maheady, Connie Stallone Adleman wrote a chapter called “Loving Ourselves Exactly as We Are: Nursing after a Stroke.”

In the article “Missing a Limb but Not a Heart,” Carey Amsden, RN, discussed how she practiced performing certain job tasks with the use of one arm, such as starting an IV, and donning a sterile glove in nursing school and has been able to successfully work in the field of nursing.

2) For medical professionals who need to wear a brace or post-burn glove, how can concerns around sterility be addressed?

An employer may require as a qualification standard that an individual not pose a “direct threat” to the health or safety of the individual or others, if this standard is applied to all applicants for a particular job. Additionally, employers may comply with medical and safety requirements established under other Federal laws without violating the ADA.

However, an employer still has an obligation to consider whether there is a reasonable accommodation, consistent with the requirements of other Federal laws, which would not exclude individuals who can perform jobs safely. In situations where sterility is a concern, alternatives to standard practices should be explored with the individual.

One option could be for the employee to wear a sterile glove (perhaps a larger size), gown or drape over the brace or glove. In doing this, sterility would be addressed to the same standard that others would be held to.

It is also recommended that the Infection Control Department or designee be consulted. There may be specific infection control issues related to a particular facility or unit to consider.

3) Are there alternatives to taking a leave of absence during flu season for medical professionals who are not able to receive the flu vaccine?

Flu season, in some areas, can last a while and a leave of absence may not be feasible or could pose an undue hardship to the employer. Alternative options for accommodating those who are not able to receive the flu vaccine can include: allowing the employee to wearing a mask or protective gear, reassigning the employee to a position that does not require direct-patient contact, considering flu shot alternatives, modifying a policy if applicable and depending on state law, or allowing an extended leave and offering reassignment to a vacant position upon return. For more information, see the following article: “Vaccinating the Health-Care Workforce: State Law vs Institutional Requirements.”

Next month we will be exploring schedule modifications and specific work tasks, so stay tuned!

Resources:

Monthly Labor Review (2013). Bureau of Labor Statistics. Retrieved from http://www.bls.gov/opub/mlr/2013/article/industry-employment-and-output-projections-to-2022-1.htm

The Power of the Doodle

Posted by Kim Cordingly on June 5, 2015 under Accommodations, Employers | Read the First Comment

By: Melanie Whetzel, MA, CBIS, Lead Consultant – Cognitive/Neurological Team

Doodle

Are you a doodler? If you are, then you know how much your concentration and focus are improved while you doodle. If you aren’t a doodler, you just might not understand. Look up the term in a dictionary and you will find several similar definitions: wasting time in aimless or foolish activity, killing time, or drawing while bored. These definitions couldn’t be further from the truth. We receive questions at JAN from employees who say that doodling helps them stay focused and remember more from meetings, while their employers think that doodling is a sign of boredom, inattention, or preoccupation with something else.

Full disclosure — I am a doodler so I know its power. Now we have more than the word of those who understand and experience its potential — we have research that confirms what we doodlers have known all along.

In a nutshell, here is what was noted in this study. Forty participants monitored a monotonous mock telephone message for the names of people coming to a party. Half of the group was randomly assigned to a ‘doodling’ condition where they shaded printed shapes while listening to the telephone call. When given a surprise memory test, the doodling group performed better on the monitoring task and recalled 29% more information.

Unlike many multi-tasking situations, doodling while working can be beneficial. Doodling can help thoughts come together, solidify ideas, sustain attention, process information, and ease tension. That is a big benefit for some aimless scribbling, isn’t it? Are you wondering what it is that people doodle? Doodles take many forms, from abstract patterns or designs to images of objects, landscapes, people, or faces. Some people doodle by retracing words or letters, even writing a name over and over.

Questions from JAN callers have included “Can I be allowed to doodle as an accommodation?” and “Can my employer really stop me from doodling?” The answer to that would be to look at what is effective for each individual. If doodling truly does provide benefits to the employee such as increasing attention, focus, and information processing, why would the employer want it to stop? If a coworker can take notes of a meeting to distribute to all employees, then the employee who needs to doodle gets an effective double bonus. She gets to doodle and increase her attention, focus, and concentration, and receive the written notes as a back-up. While doodling may not be appropriate in every situation, it might be prudent to seriously consider the benefits for employees who claim its advantages.

Citation:

Andrade, J. (2010), What does doodling do?. Appl. Cognit. Psychol., 24: 100–106. doi: 10.1002/acp.1561

 

“But you don’t look sick…”

Posted by Kim Cordingly on under Accommodations, General Information, Organizations | Read the First Comment

 

It’s late spring and with that comes many things: warmer weather, rain showers, flowers (and with them the pollen), Mother’s Day, Memorial Day, and a personal favorite of mine, the Indianapolis 500. But it also brings with it awareness — awareness of different disabilities — such as National Fibromyalgia Awareness Day; Better Speech and Hearing Month; Mental Health Awareness Month; National Headache Awareness Week; and National Arthritis Month. As I think about all of this and observed all of the various posts about it on social media, it brings to mind how many of my friends and family (myself included) deal with silent disabilities on a daily basis and how many people out there are unaware that silent disabilities exist.

There are many individuals who have silent disabilities and hearing these words uttered can be hurtful. Many people do not realize that it can be a daily struggle for some just to get out of bed, take a deep breath, put on their shoes, walk the dog, etc. It can be difficult to do the most mundane of everyday tasks that most people take for granted.

So, the next time you see someone park in an accessible parking spot or use one of the scooters at the store, please try not to judge them. You just never know — they may be dealing with a hidden disability and could probably use a kind word or a smile.

And while many struggle daily to deal with their disabilities, they often do not let it stop them from working and doing what they want to and can do. Here are some famous people with disabilities who never let their disabilities define them or stop them:

Charlie Kimball – The first and only licensed Indy Car driver with Type I Diabetes -3rd place finish in the 2015 Indianapolis 500!

Muhammad Ali – Professional boxer with Parkinson’s

Abraham Lincoln –16th President of the United States believed to have experienced depression

Mary Todd Lincoln – Former First Lady of the United States who was believed to have had schizophrenia

Woodrow Wilson – 28th President of the United States who had dyslexia

John F. Kennedy – 35th President of the United States who had asthma

Ronald Regan – 40th President of the United States and actor who had dementia

Michael J. Fox – Actor with Parkinson’s disease

Harrison Ford – Actor who has experienced depression and OCD

Bob Hope – Actor who had asthma

Rita Hayworth – Actress who had dementia

Agatha Christie – Author who experienced epilepsy

Alexander Graham Bell – Scientist credited with being the inventor of the first telephone who had dyslexia

Albert Einstein – Theoretical physicist was thought to have autism, dyslexia, and obsessive compulsive disorder (OCD)

John Nash – Mathematician who lived with schizophrenia

(And the list goes on…)

For more information on silent/hidden disabilities:

Job Accommodation Network (JAN) – A to Z of Disabilities and Accommodations (Includes workplace accommodation information for many of the disabilities mentioned)

JAN Presentation – Shedding Light on Hidden Disabilities
Anne Hirsh, M.S. and Beth Loy, Ph.D.

Invisible Disabilities Association

But You LOOK Good – How to Encourage and Understand People Living with Illness and Pain

 

 

Autism Spectrum Disorders (ASD) and Disability Awareness Training

Posted by Kim Cordingly on April 22, 2015 under Accommodations, Employers, Organizations | Comments are off for this article

By: Daniel Tucker, Consultant – Cognitive/Neurological Team

April is Autism Awareness Month, and in honor of that, we wanted to touch on how to accommodate employees with ASD by incorporating disability awareness training into the process. In many cases, the problem an employee may be having at work is related to social interaction and communication. Because individuals with ASD may have deficits in understanding social cues and norms of communication, they may have difficulty working effectively with coworkers. Something employers may want to consider in such circumstances is providing disability awareness training. This could be a broad training that covers disabilities generally, but in some cases, it may be beneficial to have a training specific to the disability. This will allow an employee (with his consent) to be a part of the training process and to explain how the disability specifically affects him. This empowers the employee to suggest steps that may be taken to help with more effective interaction and communication.

When coworkers are not aware of the characteristics of ASD, miscommunication can easily arise. For example, in some cases an individual with ASD may speak louder than is appropriate in a given situation. This could be perceived as aggressive or dominant behavior by coworkers, when in fact the employee doesn’t even realize he is speaking loudly. An individual with ASD may also seem to display inappropriate affect, such as not smiling when greeting someone. These behaviors can be considered rude, but in actuality, the individual may have no idea that his actions are being perceived this way; his behavior is simply being misunderstood.

Disability awareness may be able to address this particular issue to some extent because when coworkers are aware of the unique communication differences that individuals with ASD exhibit, they may be more tolerant and able to find better ways to interact and ensure they are being understood by the employee as well. It may be beneficial to have agreed upon “signal words” that a coworker can use when the employee is speaking too loudly, for example. The employee can then rely on the feedback of coworkers to make adjustments as needed.

It is important to stress that this type of training should only be done with the permission of the employee. Employers should not try to push an employee into talking about a disability if he is not comfortable doing so. It has been our experience at JAN that many employees would appreciate the opportunity to have an open conversation about their disability if it means the possibility of better working relationships with coworkers and a better chance of being successful in their work.