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Parul Aurora, NP: I actually have always dreamed of being a nurse, and so I had suppressed those dreams because of the messaging I had received, and the idea that I wouldn't be able to do it because of the disability and when I was exposed to the physicians, although they were not nurses, they were in health care and they had to make accommodations to learn skills and to provide patient care, my thought was if they can do it, I can do it.
Stephanie Moss, MD: Welcome to life as a patient doctor. I'm your host, Dr. Stephanie Moss. Navigating life as a patient and a doctor. Join me as I interview other doctors, students, and healthcare workers on their own journeys. Listen to their unique stories on how they balance their health. While caring for others in the health profession.
Stephanie Moss, MD: Welcome everyone today. I have an amazing guest. I am interviewing Parul Arora, who is a nurse practitioner [00:01:00] who received a bachelor's of science and family community services from msu in 2003. , and then worked in social services to assist people with disabilities to gain employment. She entered an accelerated nursing program at UIC in Chicago. After becoming an RN in 2011, she worked on a project on health promotion and facilitated diabetes prevention workshops for educators, social workers, and nurses.
Parul worked in mental health at a community nonprofit organization while finishing up her nurse practitioner training in 2017. She then joined the Rush University palliative medicine team in 2018 as an RN for 1. 5 years in transition to her current nurse practitioner role. Welcome, Parul.
Parul Aurora, NP: Thank you so much for having me, Stephanie.
Parul's Early Challenges and Career Path
Stephanie Moss, MD: Now you have such a unique story.
So tell me a little bit about what brought you in to where you are today in medicine.
Parul Aurora, NP: I would love to. So like you mentioned in the introduction, I am a registered nurse and a palliative care nurse practitioner. I am a clinician with a disability. I have low vision, which means I do not have correctable vision.
I graduated with an undergraduate degree in family community services from Michigan State University about 20 years ago. And shortly afterwards, I relocated to Chicago because I was actually not able to drive. So if you can imagine I never went through the rite of passage of receiving a driver's license, and that was quite restricting and distressing.
So I knew I had to be in a place that offered public transportation. And so my first job was to actually find employment for people with disabilities. And I did that for about five years. And [00:03:00]ironically, as I reflect on that time of my life, I was working with people in my community people with disabilities.
But at that time, I actually was not the best advocate for myself. And my now husband who was in residency at that time was going to his program with two physicians who had low vision. And I was blown away that these two physicians who had similar disabilities to myself were in medicine.
I had always received this inadvertent message from teachers from family members that I could not be in health care. And I really had to work hard to deconstruct the ideas that others had for me and create my own.
Navigating the healthcare field with a disability can present unique challenges, but it can also lead to incredible resilience and success. In a recent interview with Parul Arora, NP, we gained insight into her inspiring journey of overcoming barriers and thriving in the field of nursing despite living with low vision. Parul's story is a testament to the power of determination, advocacy, and mentorship in pursuing a fulfilling career in healthcare.
Accommodations in Nursing
Parul Aurora, NP: I entered an accelerated program to become a registered nurse and then subsequently a nurse practitioner at a large academic institution in Chicago, and during my training, I had some significant challenges.
For instance, Since I using accessible equipment, such as magnifiers to drop insulin for the injections, and screen magnifiers for computers, once I actually acclimated to the unit I was on, it was time to move on to a different facility or a different unit. It was very challenging for me.
I also worked with the Disability Resource Center to get accommodations at my institution. The classroom setting was actually a bit easier for me. I was able to get double the test time and large print examinations, which was beneficial. I went on to complete the master's portion of the program part time.
Subsequently, I was introduced to the National Organization of Nurses with Disabilities, also known as NOND, because I was having a hard time and they really taught me my rights. I ended up joining their board and I still serve on their board today and I'm heavily involved in advocacy at the national level.
Throughout her educational and professional journey, Parul faced significant challenges but found ways to overcome them. From using accessible equipment to advocating for accommodations at her institution, she paved her path in nursing. By joining organizations like the National Organization of Nurses with Disabilities (NOND), Parul learned her rights, connected with mentors, and became heavily involved in advocacy at a national level.
Parul Aurora, NP: Functionally, I was able to master the nurse practitioner role with greater ease because it was less task driven. I had difficulty disclosing my disability for a very long time. And I knew I had gotten to the point where if I wasn't going to disclose, I would continue to struggle.
I needed support. I had to be transparent. And I learned that the hard way.
I joined my current team as a palliative care registered nurse about six years ago. The first day on my job, I disclosed to my boss that I had low vision, and I was going to be successful, and I needed accommodations to do it.
And her response was what do you need? And I let her know I needed the largest laptop that the institution could order so I could provide direct patient care and of course, I did have to go through their standard way of getting accommodations, and I was able to receive those. One and a half year later, I received a performance based promotion to a palliative care nurse practitioner, which is my current role.
So my current accommodations are, of course, the aforementioned large laptop. I also have desk magnification for my desktop [00:07:00] computer and also the life changing accommodation that I have is a virtual scribe and that is a software that does my patient documentation or assist with that.
Stephanie Moss, MD: Wow. Oh my goodness. That is amazing. And I love how you were very specific on the types of accommodations. You mentioned a lot of things that I had never even thought about and they're relatively easy to get a larger print, , like a lot of technology I'm sure has really been a benefit for you over the years.
When you were younger, growing up, how did they assist you before you got into the college years? Did you have low vision before?
Parul Aurora, NP: I did. I've had low vision for most of my life. I am the daughter of immigrants. And I wasn't aware of advocacy at that time. I did great in school, [00:08:00] but I fumbled through in elementary school and even in my undergraduate training, I did not have accommodations.
And so looking back on it, I don't really know how I did it. And I wish I would have done it differently. I definitely learned along the way. But now things with technology have changed and accessibility is different.
One of the pivotal moments in Parul's career was disclosing her low vision to her employer, which led to receiving necessary accommodations and ultimately a promotion to a nurse practitioner role. By being transparent about her disability, Parul was able to excel in her career and provide quality care to her patients.
Cultural Perspectives on Disability
Stephanie Moss, MD: Yeah. Wow. I can imagine. We spoke to another individual earlier in the other podcast who was also a daughter of immigrants who mentioned just the bias in hiding disabilities. Did that come up for you at all in family environments or in the social environment?
Parul Aurora, NP: Absolutely. Being from the Southeast Asian culture I think that is we see that quite often that they don't want you to disclose your disability. They want you to hide your [00:09:00]disability. And during my formative years, that was absolutely played a part into my identity.
And I really had to shed that when I went into training and things were, becoming harder for me. That's what I spoke to in terms of deconstruct the ideas that others have for you. Because I really had to focus on my capacity and to enhance my skills and the best way to do that.
Stephanie Moss, MD: I love that you said that to deconstruct the biases and all those pains from society that had really impacted your identity.
Stephanie Moss, MD: You mentioned before that and your motivation. You saw , the residents and you hadn't even considered medicine. Why did you end up going the route of nursing?
Parul Aurora, NP: So I actually have always dreamed of being a nurse, and so I had suppressed those dreams because of the messaging I had received, and the idea that I wouldn't be able to do it because of the disability and when I was exposed to the physicians, although they were not nurses, they were in health care and they had to make accommodations to learn skills and to provide patient care, my thought was if they can do it, I can do it. And so it really opened the door for me. To think outside the box and it, it built awareness for me of what is possible.
Stephanie Moss, MD: Amazing. It's amazing what believing in yourself can really motivate you to do.
Coming from a Southeast Asian culture that often encouraged hiding disabilities, Parul had to deconstruct societal biases and embrace her identity as a clinician with a disability. By shedding these preconceptions, she was able to empower herself and advocate for her needs in a healthcare setting.
Stephanie Moss, MD: I do want to ask you one thing , as you mentioned, disclosure. A big topic right now whether or not to disclose in applications and interviews. The thing that constantly comes up is fear of disclosure. I know you said you disclosed your boss later on. Can you speak on that?
Parul Aurora, NP: Absolutely. And so there, there seems to be some difference in opinion about this. If you don't feel comfortable disclosing on your application because you want them to see, what you're marketing and you need accommodations, I think once you get into a program like I did, I had sought the job, I had received the job, and then I asked for accommodations.
I think that process could work well. I've heard of other clinicians actually reveal or disclose on their application because that's the way that they most felt comfortable. And that is okay as well. There are some people with disabilities that actually need accommodations to get through the interview process.
So you would want to disclose so that you're able to set yourself up for success for that.
And so for myself actually for this, because I didn't seek out accommodations,
Stephanie, in my prior roles, I did not disclose to those employers. And so for this employment I had to the role would have been much more challenging for me if I didn't have accommodations.
Stephanie Moss, MD: Thank you so much for sharing that and you are exactly right. There's not one way to do it. It's very individual. Every disability is different. Every single person is different. Every situation is different, but it's really helpful to hear how you navigate your own experience and the lessons that you learned through it.
Finding reasonable accommodations in the workplace, such as a virtual scribe and modified patient census, allowed Parul to practice at the top of her scope and provide safe and efficient patient care. By customizing her practice to fit her individual needs, she exemplified the importance of collaboration and communication in the healthcare setting.
Stephanie Moss, MD: That led me to think about disclosure to patients. Can you mention on whether or not you disclose and how you do it?
Parul Aurora, NP: I think that's a great question. Thank you for bringing this up.
I have to look very closely to my laptop. And my patients have asked me, I cannot count how many times my patients have said, do you need glasses? Do you need glasses? And I say, no, I have low vision. And so they're like, huh.
So I disclose because I want them to identify with me. Healthcare providers come in all shapes and sizes. And disability is a part of diversity. I want them to know that. I'm a human being and I have additional needs and I think this is a part of my acceptance process I'm transparent with them and so far I've gotten positive feedback and sometimes they'll say, Oh, thank you for letting me know.
And so it's been very rewarding.
Stephanie Moss, MD: Thank you. Those are the stories we need to hear. How positive it can be for the patient experience, for the collaboration between patient and healthcare provider or clinician. And then also just how important it is that disability is diversity. And if we are going to Celebrate DEI, make sure we include disability
Stephanie Moss, MD: Were there any notable mentors or role models that you had that continued to support you during your journey?
Parul Aurora, NP: There are one of the mentors that I'm very grateful to is Karen McCullough. She is a nurse and she is also one of the founders of the National Organization of Nurses with Disabilities. And during my training as a registered nurse, I was really struggling. I felt alone. I felt isolated. I felt like I was the only one that was going through a program that was not very supportive and, going against the grain.
And when I found NOND and had sought out mentorship and connectedness and community Karen really was a great advocate and also Reframed and shifted what I could ask for that was reasonable. I was not aware of, what would be appropriate to ask [00:15:00] for as a reasonable accommodation and that really made a big difference on How I continued and pursued my master's training and have a great example here.
And I want to be raw, I want to be vulnerable because for the listeners out there, if you're going through this you're not alone. There are people that have gone through this similarly to you find mentorship. Find your community. There are people that will support you. And so an example, Stephanie, that I want to share is I was in the pre licensure program of the registered nurse program and almost done with it.
And during the last part I was placed on a unit with a preceptor for several months, and I remember she met with myself and my faculty at that time, and I was having a hard time mastering the speed, so I was able to do the tasks, and as you can imagine, I was using accessible equipment, so that tends to be a little bit [00:16:00] more it can be a little bit more elongated.
Of course, I'm trying to be safe, learning new skills. And I remember her saying, I need to hear you say that you don't want to be a bedside nurse. And I was humiliated and traumatized. And I didn't want to be a bedside nurse. Nursing is so vast and so diverse. And so of course I said it because I wanted to move forward.
But instead of empowering me and encouraging me, it was such a, a deficit for me to feel like I wanted this goal, but others did not want me to successfully complete that goal. And I was able to complete the program but really the feelings that I had. Going through it we're really hard and Kieran, I found through NOND at that time and she assured me that a reasonable accommodation would be to ask for less patients so you can learn the skill.
And so I thought that was so transformative. And I was better equipped in the master's portion of the program. I also was able to assert my needs and customize accommodations so that I would be able to provide safe and efficient patient care.
Stephanie Moss, MD: I am so sorry that you had that experience. It felt so painful to hear when individuals are unsupportive of others, especially in the health profession. That really stings in a different way.
Through her involvement in NOND and other advocacy organizations, Parul has found a community of support, mentorship, and resources. By sharing her story and empowering others with disabilities in the healthcare field, she continues to make a positive impact on the profession and inspire future generations of clinicians.
Reasonable Accommodations
Stephanie Moss, MD: Something that you just mentioned that I hadn't even thought about was having less patients. Is that something, because I'm thinking from an administrator perspective of "Oh, you're going to make less money for us". How have you been able to ask for that? Have you needed to ask for that accommodation of needing less patients later on when you're not in training? And if so, how did they respond to that?
Parul Aurora, NP: So that's a great question. Each institution is a little bit different. You can work with your institution to find appropriate ways to provide safe care. And that looks different for each clinician. And for instance, you can, basically account for documentation time within the encounter so that you can, possibly advocate for longer encounters with patients.
And, a reasonable accommodation would be to have less census because it takes more time to deliver care. For myself, the way that I've been able to achieve or get on the same platform as my colleagues would be with a virtual scribe. So I'm accounting for the the documentation that my colleagues could do in the encounter with a patient.
I have support from the virtual scribe who can do that after my patient encounter.
Stephanie Moss, MD: That's really helpful to hear. I didn't think about the virtual scribe as making it then that you can spend more time with patients and, oh, we all need a virtual scribe, but I love, I'm so glad that you were able to get to that resource so you could really focus on providing, like you said, this safe care and the best care that you can provide.
Parul Aurora, NP: So I am aware of some clinicians that have accommodations of having less patients than their counterpart colleagues I do have experience with other clinicians who have longer encounter time that's an accommodation so that they can document afterwards.
So it depends on, again working with your team. To come up with a plan that works for you and customizing your practice so that you feel like you're practicing at the top of your scope.
Stephanie Moss, MD: Yes, I love that. Having a team that you can be very open with and collaborative is so important, communicate.
The Impact of Personal Experience
Stephanie Moss, MD: How has your individual experience impacted your patient care or has your own experience with disabilities impacted how you interact with patients, or how you see patients?
Parul Aurora, NP: Absolutely. I think I have such a different lens on patient care because I'm a patient of many providers.
And certainly the empathetic part of it, butI currently work with cancer patients and my life's work is to help them meet their functional goals. So if they have goals that they want to achieve.
I get that in a very different way than probably most providers because I strive to do the same professionally and personally on a daily basis and an example of that would be, as a reference point it probably takes me about two to three times longer than my colleagues to do many tasks.
And for my patients that are struggling with trying to get back to work part time and they were once full time, I'm an advocate and I empower them life can look different, but still be meaningful.
Stephanie Moss, MD: I love that empowering and advocating for patients that is key. I can feel the amount of emotion and empathy, you have to support others on their own journey. Something you said before is like you are not alone and I love that because that is I think the whole purpose of my own advocacy journey is to show people that they are not alone in their struggle.
Parul Aurora, NP: And I think one of the, process of this journey for me was to find people with disabilities that had thought outside of the box and had to customize certain things that worked for them. And so I didn't need to reinvent the wheel. And I just needed to seek out mentorship.
And I didn't realize how important that was until now. And now my mentorship has been from my colleagues. I've worked with APPs and attendings that I'm so grateful to have in my life. They've evolved my practice and my practice looks so much better. different from theirs. And that's okay.
And there was a very big acceptance process to that. And I own that. And I think finding people who believed in me and believed in my goals and that wanted to help me get there. I think that's been so rewarding for me and so validating.
Stephanie Moss, MD: Yes. Oh, I love that. Especially, [00:23:00] Finding those mentors. You mentioned the NOND organization, how has being a part of that organization supported you in your advocacy journey?
Parul Aurora, NP: So we offer advocacy to nursing students. To nurses working in the field, to instructors and facilitators in educational institutions. And we, of course advocate based on the responses we get in through our website and, and everybody's journey is a little bit different, but we get a lot of correspondence about questions related to accessibility. Questions related to technical standards. And we're providing resources often that are available out there.
One of them just off the top of my head would be the ADA Great Lakes based out of UIC that's available for employers and employees both. And the JAN Network as well. That's also available for employees and Employers.
So these resources and much more can help, reshape or think broadly about what could be available. And and even just jog ideas of how institutions or educational programs can work with either nursing students or workers to think about what can occur to enhance practice. And so I think for me, NOND offered that they offered me resources. They really helped me learn about ADA. And I will say this. I don't think I would be here if I had not found NOND.
Stephanie Moss, MD: I'm so glad that they had such a positive impact on your journey. And then you're able to pass it on to help other individuals.
I'll make sure to include those organizations in the description below and also add it to mywebsite.
I have a disability section on my website for other students and other individuals Those are, all the different types of support groups. This is why I love doing this, is learning and connecting. That's how we learn. it's impossible for one person to know all this.
Parul Aurora, NP: Absolutely. That's how we learn by sharing our stories.
Stephanie Moss, MD: As we start to wrap up, I would just love to hear any final advice or pearls of wisdom you have specifically for other individuals who are going through the health fields as a clinician or as a future doctor. In addition to all the amazing advice you did provide what would you like to leave them with?
Parul Aurora, NP: I am aware that It can be very scary to disclose your disability, and I think there is a fear of rejection. I also am aware that it can be transformative.
To work together and partner with the people around you and allow them to support you. Oftentimes we as people with disabilities are the educators.
I think for me that was a part of the acceptance process, accepting my own disability was a journey as I reflected on.
So I am not saying it's going to be easy. My, journey is not easy, which is why I have disclosed so much of the pain that came with it, but it was worth it. And I would do it all over again.
Stephanie Moss, MD: Amazing. Thank you. Thank you so much for sharing that and you are exactly right. There's not one way to do it. There's not every it's very individual. Every disability is different. Every single person is different. Every situation is different, but it's really helpful to, to hear how you navigate your own experience and kind of the lessons that you learned through it.
Stephanie Moss, MD: Thank you so much.
I'm gonna summarize some of the amazing points You mentioned your struggles throughout your educational journey because you came from a culture and an environment that it wasn't okay to share that you had disabilities.
So you kept that to heart that it was just something for you, but that led to you struggling.
You still did it. You were still a nurse, but it took some additional challenges. That included going part time, and eventually, you were able to get more support and find connections in the community, and once a nurse and able to work, you connected with the NOND organization,
Parul Aurora, NP: the National Organization of Nurses with Disabilities.
Stephanie Moss, MD: That one. . And through that organization you found mentors and one of the ways that you began to really connect and become empowered.
You also mentioned that you heard your future husband working with other residents who had low vision and had disabilities and you're like, "wait, I can do this too! Nursing is part of my dream it's still possible.
Stephanie Moss, MD: And just because I have a little bit additional challenges does not mean I can't be successful and care for individuals." and that's exactly what you did. You went on to get your nursing degree, your nurse practitioner degree, and then you work now in palliative care where you get to really bridge , the patient, and a nurse practitioner where you can help Individuals with cancer or meet their functional needs, because that is something that you've had practice with.
So being able to bridge that personal experience to help other patients, I'm sure has been so meaningful. Then also connecting with your advocacy journeys and helping other individuals find reasonable combinations to fit their individual needs.
Lastly you talked about disclosure of how you (initially) didn't disclose but your current. position you did and that allowed you to provide the best care for your patients. Not that you weren't doing that before, but it really helped you be able to collaborate with your team and be able to find what resources were best for you . You said so many amazing things, thank you.
Parul Aurora, NP: It's been such an honor , to be here with you. Thank you so much for inviting me.
Stephanie Moss, MD: Oh you're very welcome. I'm so glad we are both at rush. And it's so funny because I have done palliative medicine. I don't know how I just missed you by a second. I love palliative medicine.
So giving a shout out for palliative medicine fellowship for anyone considering that as a future fellowship one day, there's so much meaning in. Pain, and end of life, and chronic health
Parul Aurora, NP: I think you would be great at it.
Stephanie Moss, MD: Oh, thank you.
Parul's journey reflects the resilience, determination, and empowerment that can arise from overcoming challenges in the healthcare field. Her story serves as a beacon of hope for individuals navigating disabilities in pursuing their career goals. For those seeking support and resources, organizations like NOND and the Americans with Disabilities Act (ADA) offer valuable assistance and guidance.
Final Remarks and Resources
Stephanie Moss, MD: I want to finish off by saying thank you to the audience so much for coming in and listening to this episode. If you haven't already, please follow and subscribe. I'd like to recommend that you send it to one other person that you think could benefit from these stories, because that's how we can form community.
That's how we can spread the word that individuals in medicine are human. It's empowering for individuals in health care, but it's also powerful for patients to remember that we can provide other experiences and share empathy together.
Something that was mentioned before is that you're not alone if you're struggling.
If you're struggling through school, if you're struggling through your own health, know that you're not alone. We've been there and we are there. Just reach out because there are other people that want to support you and encourage you on your journey.
If individuals want to connect with you, is there a preferred way that you would like?
Parul Aurora, NP: I share my email address all the time. So I'll put it in the bottom. Sure.
Stephanie Moss, MD: That sounds great. Wonderful. So I'll include that on the bottom, thank you, Parul, so much. I will make sure to include all those resources and add them to my website at medpsycmoss.com. You can follow me on social media @medpsycmoss or @mdpsycmoss if you have any feedback or any ideas or even want to be on the podcast and share your story, please send me a message at medpsycmosss@gmail.com
Thank you so much, everyone. Take care!