The Americans with Disabilities Act (ADA) of 1990 was enacted by Congress to prohibit discrimination against qualified individuals with disabilities. Schools of nursing, like other state- and federally funded entities, are required to comply with the stipulations of the ADA.
The ADA defines a qualified individual as an individual with a disability who, with or without reasonable accommodations, can perform the essential functions of the employment position that such individual holds or desires. In addition, the Rehabilitation Act of 1973 prohibits discrimination in admissions of a qualified person with disabilities.
The ADA and the Rehabilitation Act of 1973's eligibility requirements vary depending on the type of services, activities and functions needed in particular areas. Because the practice of nursing is an applied discipline that uses cognitive, sensory, affective and psychomotor elements, students must be able to perform necessary functions safely, including:
- The ability to think critically and make clinical decisions.
- The ability to interact appropriately with individuals, families and groups from a variety of social, cultural and intellectual backgrounds.
- The ability to communicate clearly in verbal and written forms, in order to communicate nursing actions such as health teaching.
- The ability to move in small places. Nursing students need to be able to move in clients’ rooms and bathrooms and into and out of work spaces, and they need to be able to access treatment areas and obtain emergency equipment when required. While health care agencies must meet ADA physical access standards, potential clients and equipment may limit the amount of available space in which to move.
- The ability to demonstrate both gross- and fine-motor skills sufficient to provide safe and effective nursing care, such that the student can move and position clients in and out of bed, calibrate and use equipment and perform cardiopulmonary resuscitation (CPR).
- The ability to hear well enough to monitor and assess the client’s health needs, including hearing a client’s cries for help; alarms on equipment; emergency signals; and heart, lung and bowel sounds via auscultation.
- The ability to see well enough to observe and assess the client’s health status and changes in condition, such that the student can see grimacing, movement, changes in skin color and other critical assessment data. Students must be able to read fine print for medication.
- Tactile capability sufficient for physical assessment so that the student can successfully perform palpation, note changes in skin temperature, performs skills related to therapeutic activities and identify by touch other changes in client condition.
- The ability to physically care for clients, such as bathing or lifting an average-size client.