Pennsylvania Nursing Student Sues School For Failing To Accommodate Her Anxiety and Stress Under ADA After Twice Failing Required Course

b8nursing_tomkins_christinaThere is an interesting case out of Pennsylvania where a nursing student is suing Misericordia University for failing to adequately accommodate her anxiety and depression after failing a required course twice. While her professor Christina Tomkins (right) gave Jennifer Burbella (left) extra time for her final exam and “a distraction-free” environment, his failure to take her calls with questions during the exam was cited as a violation of the federal disability law.

Burbella alleges “reckless, outrageous, wanton, willful and malicious behavior” by the university and cites another student who she said received greater accommodations for anxiety. Shine Misericordia received federal funding, she alleges that her protection as an “otherwise qualified” individual was denied.

She is seeking $75,000 in the United States District Court for the Middle District of Pennsylvania as well as a jury trial.

Burble says that much of her time at the university since enrolling has been spent at the university counseling center for her anxiety, depression and difficulties with concentration. She says that she had these problems before enrolling.

She said that insufficient support led to her failing the course in November 2013 and that she was required to retake the course as part of her nursing studies. She was given the choice of either retaking the course in the summer or change her major. She opted to retake the exam in the summer. She had two failing grades in the class but was given extra time to complete tests as well as access to a “distraction-free environment” approved by a school psychologist.

Tomkins reportedly offered an additional accommodation in allowing her to ask questions of the professor via cell phone during the test. However, since the alternative test-taking center was located “quite a distance” from where the rest of the students would be taking the test, Burbella asked to take the exam in the same building as the other students to ensure face-to-face communication. Her request was denied. Then, the complaint alleges, Tomkins did not answer her phone. The university counselor reportedly saw Burbella “breaking down and crying” when there was no response to her calls. She ultimately failed the test again.

The question is how far a school must go to accommodate such disabilities, particularly in a stressful profession like nursing. Schools are often faced with uncertain standards in the ADA but this is particularly challenging since the disability is tied to stress and even the denial of accommodations can increase such condition. On the other hand, having access to a teacher does seem an important element of testing if you are addressing a problem of anxiety and stress. This does not mean that she should be given any additional help vis-a-vis other students, but having such access was probably a key component to the plan for stress reduction. Yet, if this is a treatable condition it is not clear why it could not be controlled for the taking of an exam. The treatable element is important since, presumably, if the disability can be controlled, an employer could be sued for refusing to hire (or firing) the disabled individual for merely having the disability. If it cannot be controlled even for the taking of an exam, en employer could face liability if a nurse breaks down on the job in a critical situation. Of course, there are various types of nursing that have differing levels of stress, but it would seem to remain one of the more unpredictable and stressful lines of work.

The case also raises the question of whether some disabilities simply cannot be fully accommodated in preparing students for the real environment of high stress positions. I often say that law school trains students on how to deal and process stress and time pressures. That must be equally or more true for nursing.

What do you think?

94 thoughts on “Pennsylvania Nursing Student Sues School For Failing To Accommodate Her Anxiety and Stress Under ADA After Twice Failing Required Course”

  1. It is fair for a nurse to be a wacko because many of her patients are wacko. Birds of a feather and all that.

  2. “…however in this case the nursing school is not a branch of or a contracted resource of an employer. It matters for the purpose of this lawsuit.

    US healthcare employers depend on nursing schools, med schools, and other technical schools to separate the wheat from the chaff.

    Indeed we have been using these schools as proxies, proving their graduates have passed ” all tests” (reasonable accommodations or not) because those outcomes do pertain directly to work conditions.
    If the law is telling me that schools can do no such thing, they are worthless to employers.

    College diplomas are already worthless as proxies for “Able to do average corporate work.”
    Now I am hearing that schools for the health professions may be similarly worthless.

    As a result, I will be sharing this with my colleagues, to prepare them for the day not too far off where we require nurses to do an internship and pass our tests before being hired.
    Much more expensive for the student, but if schools cannot properly filter out the unwilling, unready and unable, they have no purpose at all.

    Med schools have admitted students like this, sad to say, and the pain they bring never ends. Accommodation breeds requests for further accommodations.
    Constant never-ending whining.
    And worthless as employees.

    My paraplegic colleague didn’t complain as much as these.

    1. Pogo.

      I agree that it would be beneficial to all if having a degree from a particular university guaranteed as much as reasonably possible that a graduate has what the hospital is looking for and that there is a reliance on this. I fully agree in most respects that a school can act as a filtering out for those who cannot hack the requirements of the job and this case presents some unfortunate outcomes pitching the interpretation of the ADA with the need to find qualified employees approved by an academic institution. It does cause the employer to shoulder more of a burden of screening out applicants.

      I know of one hospital where the nursing administrators axed the hospital privileges for one of the nearby college’s students because they were making too many glaring errors and were not properly being supervised by the faculty. It later led to graduates of the college being interpreted almost as personas non-grata with the hiring staff.

  3. Sorry about that.

    Great video.

    Too bad it won’t open.

    Apologies. 🙁

  4. Darren:

    “I suspect it will come down to this and whether or not the accommodation request on behalf of the plaintiff is reasonable.” I think that is the crux of the entire case. What constitutes reasonable.

  5. And while I am good and mad, here’s another thing. We pass the ADA to help people with REAL disabilities like people in wheelchairs, and blind people, and amputees and stuff, and then it gets taken over by all the idiots with supposed mental disabilities looking for a free ride. Like poor little Jennifer above, who suffers from the vapors, and this guy, Stanley The Adult Baby, who of course, is on disability:–IKAn-qMx–/c_fit,fl_progressive,q_80,w_636/17nfeo178yz63jpg.jpg

    We should remember this sort of stuff every time we are tempted to do something nice for people. And what happens when we lose the ability to discriminate and make value normative choices.

    Squeeky Fromm
    Girl Reporter

    1. Squeeky – some people will never understand ‘invisible’ disabilities, but they are there none the less.

  6. This may be what happens after Nurse Burbella has the required meds and encounters some patients.

  7. bettykath:

    “otoh, while she surely isn’t the best choice for the ER or the OR, how about a dr’s office, doing blood draws where ever (or is this a tech’s job?) or some other place in the medical profession that isn’t high stress?” That’s a good point, that there are less stressful nursing positions than at a hospital setting. However, what if she always feels more comfortable and less anxious if she has another nurse around so she can ask questions face-to-face? Should a hospital have to require another nurse shadow her? Even if she is a school nurse, there may come a day when a child experiences anaphylactic shock. Would she be able to handle it? What if she found blood draws stressful when she could not find a vein? If she works in a nursing home, she will have to deal with death more often than in any other setting.

    I do understand that some students with anxiety might feel calmed by having the professor right there to answer any questions. The professor has become their therapy companion. If the professor was proctoring another exam, I am curious if she answered questions for the other students, or she was just there to monitor the class? Were the constant phone calls rendering the professor unable to proctor the exam? And should all students with diagnosed anxiety be allowed multiple chances to pass a test, when others are not?

    I agree that she has chosen an unsuitable degree and profession.

    This is an interesting discussion on just how far the ADA can and should go to help protect those with disabilities. Personally, I consider her demands to be unreasonable, but we’ll have to see how this plays out in court.

    1. Karen – there was an interesting case that went to the Arizona Supreme Court regarding the amount of chances a student should have for taking the bar exam. The young man claim text anxiety (this is 30 years ago) and had failed the test 3 times. He was asking for another try. The Arizona Supreme Court, at that time (pre-ADA), said no. Adding to the pressure, his father had been a Supreme Court justice for the state. Eventually he ran for Corporation Commission and helps decide utility rates for the state. Makes a decent income and doesn’t have to work too hard.

  8. This may be what happens after Nurse Burbella has the required meds and encounters some patients.

  9. And, because these fake-y little whiny-a$$ b*tchez like Jennifer really, really irritate me, and are a discredit to women everywhere, and are just suing for the money, another Irish Poem:

    Deal Dough???
    An Irish Poem by Squeeky Fromm

    In the suit against her alma māter
    She plead they should accommodate her!
    With money beaucoup,
    And some Valium, too,
    And a paid for electric vibrator!

    Squeeky Fromm
    Girl Reporter

  10. As un-PC as this may be, quite frankly, it is irresponsible to allow anyone, with disabilities to this extent, to be allowed to enter into a nursing program. I’m not sure what, if any, profession she should pursue, but it isn’t nursing, which happens to be one of the most stressful of all occupations. If she can’t handle a simple exam, imagine what will happen during the course of a day at a busy hospital. She will graduate with a degree, which she will then submit to unsuspecting hospitals, unaware of her multitude of problems. That degree, I would argue, especially from a nursing school, signifies more than just the mandated attendance or passing grades. The school, to a certain extent, is providing its stamp of approval on her, including her fitness to act as a nurse. Does that degree guard against any and all misbehavior by its graduates? Of course it doesn’t, but the degree is meaningless if it is given to any warm body that enters its doors.

    1. bam bam – she will be required to pass a national test to become an RN, although she might qualify as an LPN without an exam, just from the school work. That would allow her to work in nursing homes where they rarely have a RN.

  11. Hmmm. This sounds like Jennifer Burbella suffers from the dreaded female hysteria. Which wiki says has these symptoms:

    Women considered to be suffering from [female hysteria] exhibited a wide array of symptoms, including faintness, nervousness, sexual desire, insomnia, fluid retention, heaviness in the abdomen, muscle spasm, shortness of breath, irritability, loss of appetite for food or sex, and “a tendency to cause trouble”.

    Sooo, here is my prescription, in the form of an Irish Poem! In addition to “safe spaces” maybe colleges also need a:

    Rub Her Room???
    An Irish Poem by Squeeky Fromm

    There once was a girl named Burbella
    Whose conditions would fill a novella!
    She had numerous aches,
    And anxiety shakes. . .
    But I bet she just needed a fella???

    Squeeky Fromm
    Girl Reporter

    Note: This really is long established science!

    1. Squeeky – do I have to tell you what the remedy for hysteria used to be?

  12. Things get busy and hectic even in the doc’s office. Phlebotomists make far less money than a nurse. I doubt someone will hire a nurse to just do blood draws. There isn’t a unit in hospitals or even nursing homes that isn’t stressful on a daily basis. Those nurses who can’t cope make it more difficult for the entire nursing team and are actually dangerous to the patients. Nursing isn’t for everyone.

    1. Inga – I do not think it is for us or the school to decide what a person’s career should be. Although I did have an acting teacher once tell a student the best thing he could do for the theatre was get a job selling gas.

  13. But very often the stress arises not from the pace/routine of work or the kind of patient seen, but from co-workers and the corporate environment.
    The world can be very hard and unforgiving.

    She is in for a world of hurt if she doesn’t get his problem fixed.

  14. otoh, while she surely isn’t the best choice for the ER or the OR, how about a dr’s office, doing blood draws where ever (or is this a tech’s job?) or some other place in the medical profession that isn’t high stress?

  15. oops. posted before I was done. I don’t think the professor did the right thing by not answering her phone. It should have been on vibrate and she should have answered. I do believe that reasonable accommodations should be made but those who need accommodations need to be realistic about where their real abilities and disabilities lie and choose a profession accordingly. I think this student has chosen the wrong profession. Even if she manages to pass the tests, she would be a very big risk in a high stress environment.

  16. “the stress environment inherent with the job is not applicable to what it is in her present role as a student.

    I disagree. The stress when I went to med school mirrored that of a resident.
    Nurses do lots of clinical work, which is on-the-job training.
    More, health professionals have to continue their education and take courses and tests the rest of their careers.

    My conclusion: If you cannot handle the stress of being a student in the health professions, get out.

    1. Pogo,

      I agree that an essential element of preparing students for a particular career is to introduce and acclimate them to its environment however in this case the nursing school is not a branch of or a contracted resource of an employer. It matters for the purpose of this lawsuit.

      An example of an employer tied education would be a police academy or perhaps a merchant marine academy where a student is hired or pre-hired by the employer subject to completion and proper education of the student for the purpose of furthering their career. In this case the employer can require that the student must pass all reasonably accommodated tests that pertain directly to those conditions that will be manifest in their future full-time employment. It can be in that situation if the student cannot handle the stress of the job during the academic training she is not eligible for future full time employment.

      In the case of this student and the lawsuit she is in an academic environment not necessarily tied to a particular employer. The college provides education not employment. The contract is between the student and the facility. A student may take this nursing education for purposes other than working in a hospital environment. In fact, she might be taking it solely for personal growth or it could be as a compliment to another career or academic pursuit or for the purposes of learning to care for a disabled relative.

      I believe this will be a factor the court might consider, that is the role that the college plays as to whether or not the plaintiff will prevail. I suspect it will come down to this and whether or not the accommodation request on behalf of the plaintiff is reasonable.

  17. I administered GED tests to testers who had special accommodations. I don’t know why they had the accommodations they had but several required a private room. My presence so they could ask questions seemed to be a comforting factor, even if my answer was “reread the question if you don’t understand it”, “just do the best you can”.

    1. bettykath – ASU has a testing center set up for students who need accommodations. They have controlled private rooms for students with anxiety problems. The problem here is the professor.

  18. The role of the college is to provide education not necessarily connected to the role on-the-job training by an employer she is presently working for. Since she is not employed by a medical facility, the stress environment inherent with the job is not applicable to what it is in her present role as a student. The school must accommodate the student for the purposes of education, not employment.

  19. Old nurse: Exactly.

    People have moved away from telling young people the unvarnished truth.
    You can’t be cruel to be kind anymore. It causes #Badfeel and is thus #Wrongthink.

    I tried to counsel a young man from my neighborhood out of going to an expensive private college in hopes of becoming a doctor, but he beleieved all the special snowflake magic fairydust from his high school teachers that he could #DoAnythingHeReallyWanted.

    Except he was rather low wattage in the thinking department.
    Dropped out after one year. Now owes $38K and has no degree.

  20. I hope she gets appropriate treatment for her mental health issues. If she has this much trouble with nursing school exams, what the heck is she going to do when face with a normal busy day on the floor, not to mention an actual medical emergency?? She should drop out now and find a suitable profession.

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