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Bachelor of Science–Nursing Program – Essential Functional Abilities Standards
Purpose: To validate the academically accepted Bachelor of Science–Nursing (BSN) student’s ability to meet cognitive, affective, and psychomotor
requirements of the curriculum with or without academic accommodations and/or auxiliary aids and services, consistent with Title II of the Americans with Disabilities Act, as amended, and Section 504 of the Rehabilitation Act of 1973.
Preamble : The University of Wisconsin–Madison School of Nursing will make appropriate academic accommodations to facilitate enrollment and
participation of qualified individuals with temporary or permanent disabilities. The School of Nursing has established these Essential Functional Abilities Standards to provide a framework to balance several competing interests, including:
- The rights of students
- The safety of students, their peers and faculty, and patients
- The significant clinical component of the BSN curricula
- The requirements by clinical agency agreements allowing the School to place students in various healthcare organizations for clinical education
These competing interests and the nature of nursing educational activities may prevent some students with disabilities from qualifying for enrollment or
continued enrollment and may limit access to the academic program(s) of the School of Nursing.
Essential Functions
I. Essential physical/neurological functions: Nursing students must be able to accurately observe close-at-hand and at-a-distance to learn skills and to gather data. Students must possess functional use of the senses that permit such observation. I-A. Tactile Essential Functions
- Feel vibrations
- Feel differences in sizes, shapes, surface characteristics
- Detect temperature and temperature differences
Clinical Examples
- Palpate pulses, detect fremitus
- Palpate vein
- Identify body landmarks
- Assess for skin turgor, rashes, skin temperature
- Detect deviations in skin temperature
I-B. Visual Essential Functions
- Visualize objects at a close distance (e.g., information on a computer screen, skin conditions, wound dressing)
- Visualize objects at a far distance (e.g., client in a room)
- Possess adequate depth perception and peripheral vision
- Distinguish color (e.g., color codes on supplies, charts, dressing drainage)
- Distinguish color intensity (e.g., flushed skin, skin paleness)
Clinical Examples
- Accurately observe changes in: o Skin condition, including distinguishing change in skin integrity such as evidence of allergic response o Breathing patterns (including absence of respiratory movement) o Color intensity such as the ability to identify cyanosis or bleeding/drainage o Tissue swelling or edema such as with IV infiltration
- Read medication administration records as printed on medication labels, equipment calibrations, IV infusion pumps, LED output on electronic devices
- Perform skills necessary for medication administration such as drawing up correct quantity of medication into syringe
I-C. Hearing Essential Functions
- Hear normal speaking level sounds (e.g., person-to-person report)
- Hear faint body sounds (e.g., blood pressure sounds, assessment placement of tubes)
- Hear in situations when not able to see lips (e.g., when masks are used)
- Hear auditory alarms (e.g., monitors, fire alarms, call bells)
Clinical Examples
- Assess o Vital signs o Changes in heart, breathing, abdominal, and vascular sounds
- Recognize electronic device alarms and auditory alarms such as call bells, fire alarms, etc.
I-D. Smell Essential Functions
- Detect odors from client (e.g., foul smelling drainage, alcohol breath, etc.)
- Detect smoke
- Detect gases or noxious smells
Clinical Examples
- Detect odors exhibited by body fluids which may be indicative of disease processes
II-D. Physical Strength Essential Functions
- Push and pull 50 pounds (e.g., position clients)
- Support 50 pounds of weight (e.g., ambulate client)
- Lift 50 pounds (e.g., pick up a child, transfer client)
- Move light objects weighing up to 10 pounds (e.g., IV poles)
- Use upper body strength (e.g., perform CPR, physically restrain a client)
- Squeeze with hands (e.g., operate fire extinguisher, use a bulb- type sphygmomanometer)
Clinical Examples
- Position patients
- Use transfer techniques in moving and lifting patient in all age groups and weights
- Assist with ambulation
II-E. Mobility Essential Functions
- Twist
- Bend
- Stoop/squat
- Move quickly (e.g., response to an emergency)
- Climb (e.g., ladders/stools/stairs)
- Walk
Clinical Examples
- Maneuver in the patient care areas
- Move independently from room to room
- Engage in direct patient care
III. Essential communication skills: Nursing students must be able to communicate effectively and efficiently. Students must be able to process and comprehend written and verbal material. III-A. Communication Essential Functions
- Teach (e.g., client/family about healthcare)
- Explain procedures
- Give oral and written reports (e.g., report on client’s condition to others)
- Interact with others (e.g., health care workers)
- Speak on the telephone
- Influence people
- Direct activities of others
Clinical Examples
- Communicate with patients/clients, family members and health care providers
- Read, speak and comprehend English
- Document clearly and correctly on patient’s medical record for legal documentation
- Transmit information through written documents that use good grammar, syntax, spelling, and punctuation
- Be able to access and document on the electronic medical record
- Clarify the meaning of verbal and non-verbal communication
- Use physical touch as a therapeutic non-verbal intervention
- Present oral reports
- Clarify physician orders
IV. Essential judgment skills: Nursing students must exercise good judgment and promptly complete all responsibilities required of the program. They must develop mature, sensitive, and effective professional relationships with others. They must be able to tolerate taxing workloads and function effectively under stress. They must be able to adapt to changing environments, display flexibility, and function in the face of uncertainties and ambiguities. Concern for others, interpersonal competence, and motivations are requisite for the program. IV-A. Judgement Essential Functions
- Interpersonal abilities essential to interact with individuals, families, and groups from diverse social, emotional, cultural, and intellectual backgrounds
- Make judgments based on scientific knowledge and thorough assessment of individual patient situations
- Practice in a manner that is non-judgmental and non- discriminatory
- Function as a contributing member of an interdisciplinary team
- Recognize that decision-making occurs in an environment of uncertainty and ambiguities
- Demonstrate capacity to make sound decisions when under stress
Clinical Examples
- Deliver patient care safely in a manner that is non-judgmental and non-discriminatory
- Work as a member of the patient care interdisciplinary team
- Create climate in which patients feel comfortable and able to make informed decisions about their healthcare
- Practice safe care in high-stress and/or ambiguous environments such as ICU, Emergency Department, mental health facilities, and the community
V. Essential intellectual and cognitive skills: Nursing students must be able to measure, calculate, reason, analyze, synthesize, integrate, remember and apply, and evaluate information. Creative problem-solving and clinical reasoning require all these intellectual abilities. In addition, students must be able to comprehend three-dimensional relationships and understand the spatial relationship of structure. V-A. Reading Essential Functions
- Read and understand written documents in English
Clinical Examples
- Read and understand English printed documents (e.g., policies, protocols, standards of care)
- Read measurement marks
VI. Essential Emotional Coping Skills: Essential emotional coping skills: Nursing students must have the emotional health to fully use their intellectual ability, exercise good judgment and complete all responsibilities requisite to the delivery of patient care. Students must be able to develop mature, sensitive and effective relationships with patients and colleagues and be adaptable, flexible and able to function in the face of uncertainty. VI-A. Interpersonal Skills Essential Functions
- Negotiate interpersonal conflict
- Respect differences in clients
- Establish rapport with clients
- Establish rapport with co-workers
Clinical Examples
- Show respect for the differences in patients/clients and co- workers
- Function as a member of an interdisciplinary team (e.g., consult, negotiate, share)
- Establish rapport with patients/clients
- Participate in partnered and group efforts in classroom and clinical learning activities
- Practice in a manner that is non-judgmental and non- discriminatory
- Interact with individuals, families, and groups from a variety of social, cultural, and intellectual backgrounds VI-B. Emotional Stability Essential Functions
- Establish therapeutic boundaries
- Provide client with emotion support
- Adapt to changing environments/stress
- Deal with the unexpected (e.g., crisis)
- Focus attention on tasks
- Monitor own emotions
- Perform multiple responsibilities concurrently
- Handle strong emotions (e.g., uncertainty, grief)
Clinical Examples
- Function effectively under stress
- Assume responsibility/accountability for own actions
- Provide patient/family with emotional support
- Adapt effectively to changing environments and increasing tension levels in a variety of situations (e.g., learning, patient care, emergencies)
Supporting Documents American Association of Colleges of Nursing (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC.
Purdue University Northwest (2017). Essential abilities standards policy Wendt, (2007). Report of findings from the 2006 RN post entry-level practice analysis. Chicago, IL: National Council of State Boards of Nursing, Inc.
Wendt, & Eich, M. (2007). Report of findings from the 2006-2007 RN continuous practice analysis. Chicago, IL: National Council of State Boards of Nursing, Inc.
Yocom, J. (1996). Validation study: Functional abilities essential for nursing practice. Chicago, IL: National Council of State Boards of Nursing, Inc.
Rev. 09.21.
Medical Release to Return to Clinical/Lab/Simulation
To be completed by Provider (Physician, Certified Nurse Practitioner, Certified Nurse Midwife, or Certified Physician’s Assistant)
The individual named below is a Bachelor of Science–Nursing student at the University of Wisconsin–Madison, enrolled in clinical/lab/simulation courses providing patient care, usually in a hospital, outpatient, or community setting. This care may include, but is not limited to, walking, transferring patients, lifting (without restriction), moving, and/or bending, and may require significant physical activity. The school’s BSN Essential Functional Abilities Standards provide details on the broad combination of physical/neurological functions, as well as motor, communication, judgement, intellectual and cognitive, and emotional skills and attributes needed in order to provide highly effective and safe patient care. These standards can be used to assist students and their healthcare providers in determining whether accommodations or modifications are necessary and to provide an objective measure upon which informed decisions can be based about whether students can safely and effectively participate in the nursing clinical program.
To Be Completed by Provider
Student’s Name: _______________________________________________________________________________________
Based on your assessment as the student’s healthcare provider and the UW–Madison School of Nursing’s BSN Essential Functional Abilities Standards, the above-named student: □ Is released for full clinical/lab/sim participation with no restrictions/accommodations, beginning ________________ (date). □ Is unable to return to clinical/lab/sim participation until ________________ (date). □ Is able to return to clinical/lab/sim participation beginning ________________ (date) with the following restrictions and/or recommended accommodations:
(Note: The School of Nursing will work with the student and the university’s McBurney Disability Resource Center to assess this recommendation in an effort to provide reasonable accommodations. The school, in consultation with the McBurney Center and the relevant clinical agency, reserves the right to determine that recommended restrictions/accommodations cannot be provided because they would result in a fundamental alteration to the essential functional abilities standards, compromise patient care, or compromise the student’s safety or the safety of others in the healthcare setting
Provider’s Name with Credentials (please print): ______________________________________________________________
Providers Phone #: _____________________________________________________________________________________
Date: ________________________________________________________________________________________________
To Be Completed by Student
I give the School of Nursing permission to contact the above-named provider and/or the McBurney Disability Resource Center to discuss any questions or concerns regrading these recommendations, the suggested accommodation(s), and/or my participation.
Student’s Signature:_____________________________________________________________________________________
Date: ________________________________________________________________________________________________
Completed form should be returned to the student and submitted by the student to the UW–Madison School of Nursing Office of Academic Affairs.
