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Case Study – Nursing and Organisational Skills

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Source: High Intensity Job Helps EMT with Attention Deficit Disorder. http://www.healthsciencefaculty.org/profile_gallery/hall.html

"Some careers are made for people with disabilities," says Gill Hall, and he thinks he has one.

For the past fifteen years, Hall has been an Emergency Medical Technician and Paramedic for Medic Seven Emergency Response Services in the suburbs of Seattle, Washington. This job, with its spurts of high intensity and down times, compliments Hall’s Attention Deficit Disorder (ADD) and Dyslexia. In fact, he theorizes that many of his colleagues in the emergency medicine field have some level of Attention Deficit Disorder, and thrive on the multi-sensory stimulation and high activity level that the career provides.

It took Hall some time to find a career that fit his needs. Although it was clear that he was highly intelligent, he struggled to keep up in high school and his teachers and parents repeatedly told him that he "just didn’t apply himself." It was in high school that he was diagnosed with ADD and began taking Ritalin.

After high school he went on to college. He found that he did very well in geology courses. The tactile and concrete nature of geology matched his learning style. He was able t get through these courses with minimal accommodations and completed his degree and became a geologist.

While working as a geologist, Hall volunteered for a rural volunteer fire department. He fell in love with this job and decided to go back to school to be trained to become a full-time EMT. EMT training was not easy for Hall. His learning disability affected his ability to understand what he read, and he spent many long hours reading and rereading texts, taking notes and retaking notes on his notes until he had summarized the concepts in a way he could understand. He also made himself thousands of index cards to separate out specific pieces of information.

Hall found that he could not effectively study while sitting at a desk in a quiet room. He was able to concentrate best when there was a lot of external stimuli (e.g. noise) and when he could move around. He found three other classmates in the EMT program that had similar study needs and they would go on study hikes together. They would quiz each other on drug names, indications, and doses and would act out emergency situations. Acting out scenarios turned out to be a secret success for Hall. While struggling to remember information out of a book or lecture, he found that he could easily remember emergency situations scenarios and what actions he applied to each situation.

This practice of remembering scenarios helps him on the job as well. Hall admits that he was very nervous the first few years of his EMT work. Eventually, he had a bank of real-life scenarios in his mind to call upon. "After a while," said Hall, "I figured out that I had seen it all. Every situation I came across now was simply a variation on a theme. I started building confidence that I knew exactly what to do."

Hall uses a number of strategies on the job to compensate for his disabilities. He carries drug information with him so that he can easily refer to it. he also double-checks all of his drug administrations with his co-workers, which is a common practice for all EMTs. He writes everything down, because the process of doing so helps him to make sure he comprehends it. Usually, emergency call situations have enough visual and auditory stimulation to help Hall to concentrate. When it doesn’t, Hall will look around and give himself more to think about so that he is able to concentrate better. "For example, I may be in a patient’s house and I will look around and start commenting on the pictures on the wall and try to keep my mind busy thinking about what this person’s life may be like. Then I can concentrate on treating the patient," explains Hall.

Hall knows that there are patient safety concerns about people with disabilities working in health care. He feels that people with disabilities are going to be more conscientious about ensuring safety and quality of care for their patients because "No one will give us a second chance. If a person makes a mistake, like we all do, it is usually attributed to lack of training or experience. When a person with a disability makes a mistake, people assume it is because of your disabilities and that you can’t do the job. People with disabilities know this, and are more careful to be safe than others."

Hall believes that it is mainly fear that causes the discrimination that sometimes occurs for people with disabilities in health care. "People with disabilities remind health care providers of patients. And they don’t want to get close to those who remind them of where they don’t want to be. No one wants to be a patient." Hall also points out, "We know the struggle, we have no fear of illness and imperfection because we know we’ve already been there done that. It makes us better at empathizing with the patient and providing better care."

Because of his awareness of the fear and discrimination that individuals with disabilities sometimes come up against, Hall did not disclose his disability to his school nor his employer. He has been able to work on developing systems and accommodations to enable his success on his own and informally with his colleagues.

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