When accident or disease forces a nurse to become a wheelchair user, they must be courageous, creative and willing to make career moves if they want to continue working in the same industry. Dawn Dubsky was a pediatric nurse when she contracted malaria in Ghana, in 2008, and had to have all four limbs partially amputated. As a power chair user, she thought her days as a bedside nurse were over, so she decided to become a nurse case manager and further her education. In 2010, after rehab, surgeries, and complications, she went back to work as a case manager and enrolled in a doctoral program. She also created America Against Malaria, a nonprofit, to help educate children in Ghana about malaria. In 2017, she graduated from the University of Illinois with a Ph.D.
In 2018, she moved to Seattle and is now working at Seattle Children’s Hospital as an inpatient pediatric case manager. She helps manage length of stay, transition to home, and advocates for services and equipment. “Now I get the big picture better,” she says, “how all this affects patient care. From childhood to adult, there is a gap in health care for people with disabilities. Pediatrics has much more support and resources, but that changes when you go from youth to adult.”
She says the inequities are more related to policy than money. “In Western medicine, we engage in a lot of highly technical services for maintaining life, but we don’t think about outcome later when people need additional services.” She should know. The hospital she works for provides employee transportation, but not for her. “Every day I have to sit and wait for a public bus, and the employee vans drive past me, none of them accessible,” she says. “The hospital is out of compliance with the ADA. I have to sit out in the rain in my wheelchair and watch buses go by. I am an employee but I can’t utilize the same services as others use, so it makes me feel unimportant.”
As a case manager with a Ph.D., she is overqualified for her job. “You have to fight one battle at a time and advocate for yourself,” she says. But her dissertation, which will be published soon, speaks for all nurses with disabilities. “I interviewed 21 nurses with disabilities, four of them wheelchair users, about accommodations in the workplace.”
She found that the same lack of accessibility that creates healthcare inequities for wheelchair-using patients also discriminates against nurses with disabilities: too little room to maneuver, inaccessible bathrooms, exam tables that are too high, steep ramps, too-narrow doorways, hard-to-reach items, unclear process for asking for accommodations, and on and on. “In hospitals, we need to make accessibility improvements for not only clients but employees. It’s just not disability-friendly. Of all places, hospital design is not aimed toward wheelchair use. Universal design should include pediatrics, wheelchair users, strollers and more.”
Now, despite her everyday challenges as a pediatric case manager, as Dr. Dawn Dubsky, she is equipped for the next step in her life. “If I want to go into research or managerial or administrative roles, I have a lot of opportunities that I didn’t have in the past.”
Still, she keeps coming back to what happens to her pediatric patients when they become adults. “We need more facilities and providers that can help people in their homes. In the community. What if you don’t live in a major city? It’s difficult to get to work. What if you need public transport but you are in a rural area and there isn’t any?”
Image credit: Photo by Author