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Practice comment

"You can nurse with dyscalculia - but know your limitations"

Whether it’s Florence Nightingale or Hattie Jacques, we all have an image in our heads of what a nurse is and what they look like.

Whatever your stereotype of choice, right in the heart of it is our belief that nurses are accepting of human faults, are decent and kind and embrace the diversity of life. But are we? Sometimes it seems we fall short when it comes to colleagues and friends.

What am I talking about? Accepting diversity and, specifically, disability. When I use the term disability, I’m not referring to the more overt disabilities but to specific learning disabilities such as dyscalculia, dyspraxia or dyslexia.

How often do we challenge our assumptions about disability? I’ve heard numerous times: “They can’t be a nurse because….” As nurses, our priority is always patient safety, as it should be.

I sometimes wonder if we hide behind the phrase because we don’t challenge our assumptions. Take, for example, dyscalculia. It’s a specific learning need that relates to mathematical processing. Already, I can feel disquiet and mutterings of “what about drug calculations?”, “what about patient safety?” but I would argue back: “What about reasonable adjustments?” That question is to the organisation, to the individual, to the profession.

There is no reason why reasonable adjustments cannot be made for students and nurses with dyscalculia to level the playing field. For example, using a calculator or flexible number boards to visualise the number can help.

Yet it is imperative that all nurses know their limitations. We have to recognise that, sometimes, a reasonable adjustment is just not enough. In this instance, a nurse under the code of conduct would need to accept that. The important thing is that we consider this.

Are we so vocal about other types of diversity? For example, wearing glasses or contact lenses is making a reasonable adjustment and levelling the playing field if you are short-sighted. Clearly, under the code of conduct, we must acknowledge any limitations that affect our ability to practise. This stands whether we are short sighted, have dyscalculia, have a back injury or have flu. If we cannot see properly, we go to the optician. If we have flu, we take to our bed until we feel better. Whatever it is that has affected our ability to practise effectively, we address it.

By offering reasonable adjustments, we’re addressing the issue. Equally, we have a duty to acknowledge if what we’re doing isn’t effective, including adjustments for specific learning needs. Patient safety is always first - that’s never in question.

By raising awareness of specific learning needs we are acknowledging an increasing diversity in our nursing teams. We then increase knowledge, and acceptance which, by default, allows those with a need to understand and make essential reasonable adjustments.

Kirsty Kirk is professional lead, pre-registration nursing, University Campus Suffolk

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Readers' comments (62)

  • Dyscalculia, dyspraxia or dyslexia are axiomatic disqualifiers for someone who wish's to be a nurse or midwife working in an acute environment.

    The ability to read, do simple arithmetic and have skill skill necessary to plan and implement patient care is central to the provision of SAFE care.

    I have no doubt that the Author wants to maximise opportunities for her students. Leading students toward an unrealistic goal is dishonest.

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  • Absolutely agree with the above. All nurses MUST have all the skills needed to nurse safely. Suppose the dyscalculic nurse is the only one on duty, a not uncommon situation, and they need to administer life saving medication? Suppose test results are conveyed innacurately? Basic nursing procedures such as injections not able to be performed safely?

    The emphasis is on REASONABLE adjustments, and some just are impossible. A blind pilot? A front line soldier with epilepsy?

    People must be supported to do jobs they are suited to. And patients must be kept safe.

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  • The lack of specific 'reasonable adjustments', beyond a calculator, identified by the author makes me sigh. Another fluffy article without any evidence to back up her assertions. When are we going to stop being PC and accept that there are some limitations to being a nurse? As a result of surgery for cancer, my ability to carry out my previous nursing post was seriously compromised, and I had to take the decision to move to another job which could accommodate my different abilities. Reasonable adjustments were made, and were simply not enough to enable me to carry out my job safely and effectively. Some things are difficult to accept, but they are nonetheless true. Patients in this country are already at risk due to the way the NHS is being rundown. Let's not throw another barrier in the way of patient safety.

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  • I am sure there are many nurses highly successful in their careers, like those in many other professions, with the conditions mentioned in this article. only commentators like to exaggerate and bring in additional disorders of their own and embroider the tale. nurses who profess to be a profession should be the last people to discriminate against their colleagues or discourage new entrants to the profession or anybody else - sadly all to common in this so-called profession.

    surely patient safety is more secure in the hands of a highly qualified nurse despite one of these listed handicaps than many of the staff who are permitted access to patients and involvement in their care without any form of qualification or regulation at all.

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  • Anonymous | 9-Sep-2012 11:45 am

    Starling and erroneous assumptions made by you about other commentators.
    This is not about discrimination and it shows immaturity and ignorance to state that it is. Having read the other comments, I see no discrimination, but I knew that it was only a matter of time before someone would make discriminatory comments such as yours. Disgraceful.

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  • Anonymous | 9-Sep-2012 11:45 am
    Anonymous | 9-Sep-2012 11:28 am

    "...only commentators like to exaggerate and bring in additional disorders of their own and embroider the tale..."

    I find your comment offensive and it would appear to be deliberate. You have missed the point of my post completely, instead calling into question the integrity of the person who wrote it. I stand by the content of my post and refute your allegations.

    You state,
    ".....nurses who profess to be a profession should be the last people to discriminate against their colleagues....."

    It is a pity that you have failed to live up to your proclaimations. A little less hypocrisy wouldn't go amiss.

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  • Anonymous | 9-Sep-2012 3:27 pm

    my comment shows immaturity and ignorance. fine. thank you!

    Anonymous | 9-Sep-2012 11:28 am

    several comments here and mine referred to them in general and to no specific one. perhaps you have a poor conscience about what you wrote.

    in a true profession providing healthcare one does not need to make such discrimination against individuals with dyslexia.

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  • Anonymous | 9-Sep-2012 3:27 pm

    it is preferable to think before writing!

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  • and read the article!

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  • "By raising awareness of specific learning needs we are acknowledging an increasing diversity in our nursing teams. We then increase knowledge, and acceptance which, by default, allows those with a need to understand and make essential reasonable adjustments."

    yes, Ms Kirk but unfortunately some nurses, as illustrated above, are not capable of such broad, lateral and forward thinking.

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  • Moving forward: challenging dyslexia, dyspraxia and dyscalculia in the workplace

    RCN Nursing Department,_dyspraxia_and_dyscalculia_in_the_workplace

    Dyscalculia: awareness and student support

    7 September, 2012,-clinical-research&contentID=20

    Medical students with dyslexia

    Dyscalculia and dyslexia in higher education

    – “Pathways to Progress”
    Report on DDIG event held 27 March 2007 at Loughborough University

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  • Anonymous | 9-Sep-2012 4:15 pm


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  • solidarity instead of discrimination!

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  • Anonymous | 9-Sep-2012 10:28 pm

    how about, level-headedness instead of accusation! i suggest a little lesss name-calling and multiple accusatory posting. show a little more tolerance for the views of others.

    i don't see discrimination here. i see views which i may not necessarily agree with, but which have been sincerely expressed.

    the article is a bit light on any detail, as is often the case with nursing times. i agree that nursing should be open and welcoming to as many as possible. but let's be honest here, there are many who are already excluded from nursing. if you do not achieve the prescribed requirements for university, you are excluded from becoming a qualified nurse. is this discrimination? i think that there are many who would make excellent nurses, but will never get the chance because they fall a bit short on entry quals. i think that it is not entirely fair, but i do not call it discrimination.

    as was pointed out by anonymous 9 sept @ 11.28am, recognising your limitations is important. the degree of disability is important. he/she made a decision based on his/her own disability when reasonable adjustments were not enough. i have a colleague who had a similar scenario, but in her case, the type of job we do and the adjustments to her role were enough that she could carry on working. in another area of nursing, it would have been dangerous for her and her patients. each case has to be assessed on an individual basis

    this is a complex subject and there is no one answer. nurses should be able to raise concerns without being accused of making discriminatory comments. i agree with Kirsty Kirk that raising awareness leads to better understanding, and, in turn, improved access. however, that should not be taken as an assertion that absolutely everyone, regardless of ability, should be a nurse.

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  • Anonymous | 9-Sep-2012 11:41 pm

    I refer you to my comment with references

    Anonymous | 9-Sep-2012 5:51 pm

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  • Anonymous | 10-Sep-2012 0:00 am

    having already read all those 'referenced', and others, i am fairly well informed on this subject. perhaps others will find them interesting reading, so it was helpful of you to post them.

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  • Anonymous | 10-Sep-2012 0:51 am

    Think someone has grossly over reacted to your personal opinion, which seems to happen rather a lot on this site.

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  • shame people can't stick to this important discussion instead of speculating on other commentators. this also "seems to happen rather a lot on this site" making the whole exercise rather pointless.

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  • Anonymous | 10-Sep-2012 11:14 am

    ideed. i would agree with you there. i think that same somebody has over-reacted to the content of several commentators.

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  • Tiger Girl

    This degenerated into a row, but it simply isn't true that using a calculator helps, if you cannot also 'see the answer that came up must be wrong'.

    Tinkerbell has pointed that out in another piece.

    It is unacceptably dangerous, to let people who struggle with the understanding of basic maths, to do calculations when the wrong answer could be dangerous (ordering 140 pizzas instead of 14 might be funny - but giving 10x the dose of something like a blood-thinning drug, wouldn't be funny at all).

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