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. As a nursing instructor, this makes me cringe. I am all for reasonable accommodations such as a quiet environment and extra time. Anxiety is a legitimate problem. Colleges must be in compliance with the ADA or they get in trouble. However, access to a mobile phone during a test is very unreasonable. What is to stop her from looking up answers on her phone? I understand that she was alone in the room and unproctored. No news report that I read mentioned that she had anyone with her in that private room. We would never allow any student access to a mobile phone for any exam.

    Furthermore, the state board exam does not make any special accommodations for any applicant. You take the exam in the time that is given to you (with other students – heavily proctored). That’s it. If by the slimmest chance she wins this lawsuit, she will either never be hired (all an employer has to do is google her name) or will be fired from her first job for crumbling under the strain of the work. I suggest a totally different career choice – preferably one that will not involve the health and safety of other people.

    1. The Prof – couple of things 1) the school made the accommodation, the student wanted a face-to-face 2) the nursing department is not safe from the ADA. The fact that you haven’t been sued yet means you have successfully browbeaten disabled students into leaving your program. 3) And since the ACT and SAT have been successfully sued for ADA accommodations, there is no reason the nursing exam cannot be successfully sued.

      1. To Paul, I never said that the nursing department was safe from the ADA. As I had stated before, all colleges must comply with it. I also never said that the state board could not be sued. However, this is a matter of public safety. Nurses like myself have a duty to protect the public. The state boards are there to ensure that the public is protected. Her chance of passing her state exam at this time is quite slim. Do you really want anyone taking care of you or your loved ones who have not proven that they know what they are doing?

        Also, we as educators do not “browbeat” anyone. Some students are simply not suited for this profession. Most of them know it. This young lady clearly does not. Your comments appear to me that you dislike nurses anyway. I saw your comment to the nursing instructor and they were very unfair. Nursing is not just a job to me. It is my career and I am very proud of it.
        Let’s hope you never need a nurse in your future.

        1. The Prof – I have taught nursing students and I have seen ADA students do remarkable things with their careers, including nurses. I had one nursing student who was extremely dyslexic. Now, that gave me pause with the idea that she would be filling prescriptions in a hospital. However, she memorized the spelling of every drug so she would not make a mistake, just brute memorization.

  2. I have a protected disability, I’m asthmatic and am anaphylactic to peanuts. If my employer were to mess with me, they could be in serious trouble with my attorney, because I disclosed to them my healthcare condition, which is a federally protected disability…it’s all contextual

  3. Nursing Instructor, GREAT COMMENT. It’s wonderful to have an RN commenting here. I’m guessing you have a Masters or Doctorate in Nursing.

  4. Modern Miner – OChem! Was the same girl who cried without her teacher near her able to assemble a 3-dimensional molecular model and pass OChem and Biochem? How much help did she get with the rest of her classes that her fellow students did not? At some point it crosses the line from equal access to those with disabilities, and becomes a fairness issue.

    I am very curious what the outcome will be.

  5. Nursing instructor:

    Your points are all very true. She may win the battle with this lawsuit but torpedo her (slim) chances at a nursing career in the process. I cringe to think of all the lawsuits that will ensure if a hospital does hire her. My sister-in-law is a nurse, and she is made of very strong stuff. She has to be. Her patients depend on her. And there are no unicorns prancing down the hallways of her hospital, with Fairy Godmothers urging her to take a nap on this nice fluffy couch when she’s tired.

  6. BFM and Paul – that is a valid point. If the school offered her something and then did not deliver, that might make them vulnerable to a lawsuit, regardless if the demand was reasonable or not.

    I am very curious how this will turn out.

  7. Most stories I’ve read about this allow one to infer that she didn’t graduate, yet her LinkedIn profile ( indicates that she holds a BS in Nursing. She is not currently employed as a nurse, but as a “Behavioral Health Technician” at a hospital, which is quite ironic considering her “condition”.

    The class in question in the lawsuit is “Functional Health Patterns of Adults IV” which students must pass with a “C” or better. Without looking at the school’s curriculum guide, this seems like an upper level, more difficult class one must navigate to obtain the degree, but certainly there must have been other even tough courses Ms. Burbella encountered. What about Organic Chemistry or Biochemistry? Did her disabilities allow her to have the answers to the final exams in advance as an adaptation to her affliction or did she somehow, despite her tremendous disadvantage via her anxieties pass these classes without assistance? (These courses give even the most mentally stable the butterflies the night before the final exam!) A good defense lawyer should be able to punch so many holes in this lawsuit, it should be prime confetti material when all is said and done.

    It might be time for Ms. Burbella to head back to The Shawnee Inn.

  8. 1. We are assuming the instructor knew the student was calling. What if she was busy helping other students?
    2. Why didn’t the psychologist (present in the room at the time) attempt to contact the teacher and inform her this was happening?
    3. If this student thinks she is competent enough to become a RN yet has a mental breakdown just taking an exam, she is going to have a rude awakening.
    4. All an employer has to do now is Google her name and they would be an idiot to hire her.
    5. The attorney for representing this moron will never have a RN as a client again due to this lawsuit.
    6. On the slim chance she does graduate, pass her NCLEX and get’s a job…nurses eat their young. She will be devoured daily.
    7. Ask yourself…would you want this person taking care of you or your loved ones in times of emergency or distress?
    8. She has big brass balls for biting the hand that feeds her. Thank you parents for raising your children to be sissies. She obviously was rewarded for every little thing.
    9. Holding the title of RN is an honor; requiring blood, sweat and tears. She is embarrassing herself.
    10. As a nursing instructor myself I’d like to add…..BUCK UP BUTTERCUP !!! Go flip burgers.

    1. Nursing Instructor – Nursing is just a job, it is not one step down from sainthood. You think far too much of yourself and your profession.

  9. debilities = disabilities. Why, oh why, is there no edit facility?

  10. Darren,

    I like your legal explanation, but to me this is simple. She wanted to take the exam in the same building as the other students in her class with face-to-face access to the professor, but for whatever reason the school did not comply with that request. Instead it offered, and she agreed to, access to the professor by cell phone. The school did not keep its end of the agreement. To me that’s that.

    It may indeed not be wise for a person with these debilities – this sounds like extreme anxiety — to pursue such a career, and not good at all for patients, but an agreement is an agreement. What I would like to know is if she asked, or the school offered, a second bite at the apple? And if she or the school or both did not, why the intransigence?

  11. I took my state boards 37 years ago, I see some things have changed a lot. The testing as it’s done now actually seems like it would be far less stressful. It was quite an ordeal back in the day.

  12. Suppose you are in a hospital as a patient and nurse Cratchett has a mental illness and is assigned to take your pulse very hour to make sure you do not croak. But each hour she is on high anxiety meds and in her hysteria and whatnot she fails to take your pulse or does so and gives a wrong reading. And you croak. You, the patient, have no recourse. The hospital does not give a flying fk that you croaked or that your nurse was out of sorts. If you get sick and need a hospital go to Canada. Or Cuba.

  13. There’s a lesson here. Some of us get it, and some of us never will. My sympathy, for this young woman, ends where the health and well-being of her future patients begins. If she wanted to attend and complete nursing school to challenge herself and obtain a certain level of medical proficiency, well bravo to her. If she wishes to pursue a career in nursing, where patients depend upon her ability to handle stressful situations and deal with life or death scenarios, she is ill equipped to do so. Why are some so incapable of accepting that they just don’t qualify to perform certain tasks competently? It’s the truth. I took years of ballet and tap. Loved it. Still do. At a certain point we all have to accept our limitations. Sadly, I will never be a professional ballerina. Oh, wait. . .the phone is ringing. Maybe it’s the Bolshoi with a job offer. 🙂

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