By Kaye Spector
Health and Medical Reporter, The Plain Dealer
Carey Lewis was sitting in a graduate school preparatory class, an 11-year career behind her, when she decided she just didn't want to be a financial analyst anymore.
She turned back to the college's catalog and made a list of all the courses that appealed to her. They all were nursing classes. And so, while continuing to work full time, and with the support of her employer, Lewis enrolled in nursing school.
For anyone, the decision to move mid-career from a relatively sedate office job to a fast-paced profession with high physical and emotional demands is not one to be taken lightly. For Lewis, the decision had an added dimension: she lost part of her left forearm and her hand in a lawnmower accident when she was five years old.
Her disability has never been an issue. Lewis was a cheerleader in junior high, played trumpet in the school band and ran cross-country for the Strongsville High School team. She earned an accounting degree from Cleveland State University, and worked for nearly a decade in finance all over the country.
Like Lewis, more and more people with visible disabilities are entering the recession-proof nursing profession, says Donna Maheady, an RN and a Florida-based advocate for nurses with disabilities.
Nursing advocacy and professional organizations don't have a tally of the number of working nurses with disabilities -- a broad term that can range from hearing loss to multiple sclerosis. But they agree on one thing: admission to nursing school and finding a job can be difficult for those with a disability.
According to a study in the Journal of the Ohio Nursing Association, nurses with disabilities experience negative responses from their peers and employers.
Disabled nurses reported that their co-workers grumble about accommodations made for their disabilities, such as assignments or scheduling. The nurses also said that their employers don't want to make accommodations, or they insist that a disabled nurse perform a task in a way that is not mandatory, such as insisting a procedure be done while standing.
"Sometimes they are welcomed. Sometimes they are treated poorly. Sometimes they won't even have a chance at a job interview," says Maheady.
Lewis, now 35, says her admission interview at the Huron School of Nursing in East Cleveland went without mention of her disability, much to her surprise.
Nursing school, however, was tough. Lewis continued to work full-time, and there were many skills to learn. Lewis had to devise her own way of doing each task that required two hands.
She learned to start IVs, insert catheters and roll patients by watching other people closely, come up with an adaptation, then practice endlessly. She spent hours in the lab working on how to start an IV.
The simple act of putting on sterile gloves, which are required almost constantly, proved to be particularly nettlesome. On the advice of an instructor, she took a pair of gloves home and practiced putting them on over and over.
For actions requiring two hands, she often uses her left arm to steady things or hold them in place, while her right hand does the work. When she puts on sterile gloves, Lewis uses an extra-large pair. She pins the glove to her body with her left arm, then slides her hand inside.
One instructor told Lewis she'd never get through nursing school or find a job because of her disability. But when she aced her skills exam, the instructor admitted she was wrong -- and expressed her admiration.
Last spring, Lewis began working at the Cleveland Clinic. She joined the staff of H81, an internal medicine floor that's also a teaching unit. Most patients on H81 have been admitted from the emergency room with serious illness or injury, and the skills of newly minted nurses are quickly honed.
By law, Lewis' employer has to make accommodations for her disability. But so far, the Clinic has not had to, says Luann Capone, director of nursing quality.
"Carey has been similar to our other graduate nurses, doing a good job using the skills she went to school for," Capone says. "It might look different, but she's able to do it. She's figured this all out already."
On a recent day, Lewis sped about H81, a purple stethoscope around her neck and her long hair tied in a ponytail.
She cradled a thick pink-and-brown striped binder filled with policies, checklists and assessments in her truncated left arm. Her right hand handled everything else.
That day, Lewis had to start an IV in an older patient, with hard-to-find veins, "a difficult stick." It would be a challenge for any new nurse, and Lewis talked over what to do with her co-workers. She decided to ask a more-experienced nurse to start the IV if she was unsuccessful after a few attempts.
"Some things are just hard to do," she says. "It has nothing to do with being disabled."
Brigitte Folds, assistant nurse manager on H81, says that a few patients have expressed concern about having Lewis take care of them because of her disability. Other patients are too sick to notice. But most are welcoming, she says.
"They almost look at her as an inspiration, which I think is really cool," Folds says.
