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Students with disability represent an untapped resource to redefine nursing education and practice. This chapter describes how key disability legislation and activism in the US has supported the emergence of new expectations, creative potential, and disability pride among students with disability and discusses how these changes intersect with nursing education and practice. The chapter illustrates the “what” of nursing education along with how nurses with disability can enhance culturally competent care. It also discusses ways in which students and nurses with disability can promote new and innovative “ways of knowing” to enhance patient care, lead the nursing profession in new directions, and improve health services. Finally, it presents and discusses a framework to expand diversity.
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BACKGROUND: THE IMPETUS FOR CHANGE IN NURSING EDUCATION
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People with disability represent the largest minority group in the US. Increasingly more people live with disability (US Census Bureau, 2012). With advances in healthcare and medicine, disability rights activism, and disability legislation that promotes the rights of people with disability, more individuals with disability are attending school, working in meaningful jobs, and considering careers in the health professions—including nursing.
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About one in four Americans has a disability of some kind (US Census Bureau, 2012). While one typically thinks of a person with a disability as someone who uses a wheelchair or some other assistive device, more than 90% of disabilities are nonapparent to others (Steinmetz, 2006). Today, increasing numbers of students with disability are entering the postsecondary educational system due to the following societal shifts (US Department of Education Office of Civil Rights, 2011):
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Increased public awareness of legal protections and career options for people with disability
Improved services and preparation in grades K–12
Technology that bridges communication and accessibility gaps
Veterans returning from deployments with disability ranging from traumatic brain injury, to post-traumatic stress disorder, to amputations
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With more students and veterans who have a variety of disabilities seeking admission to nursing schools, an opportunity exists to bring different views and perspectives into nursing education and practice. The percentage of undergraduate students with a disability increased from 3% in 1978 to 20% in 2015 (Institute of Education Sciences [IES] National Center for Education Statistics, 2019; National Council on Disability, 2003). During this period, landmark civil rights laws pertaining to disability were passed, including the following:
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Section 504 of the 1973 Rehabilitation Act (Public Law 94-142)
Education for All Handicapped Children Act (Public Law 94-142) in 1975
The Americans with Disabilities Act (ADA) of 1990 (Public Law 101-336)
The ADA Amendments Act of 2008 (Public Law 110-325)
Section 503 of the Rehabilitation Act of 1973, as amended at 41 CFR Part 60-741, passed September 24, 2013 and effective on March 24, 2014: Federal Contract Compliance Programs (OFCCP) 7% rule requiring a national utilization goal to recruit, hire, promote, and retain individuals with disability
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