The U.S. Circuit Court of Appeals for the Seventh Circuit decided in a recent case that the ability to work alone is an essential function of the position of an industrial nurse placed in a large manufacturing facility by a nursing agency.

   The nurse in this case wanted to go back to work after a stroke. Her rehabilitation physician said she had a residual decreased inability to sustain attention and concentration at times, as well as mild decreases in visual spatial skills and scanning and occasional impulsivity.

   The bottom line, according to her physician, was that the nurse probably could function effectively, but only in an environment where she had close supervision and was supported by the resources of other staff members. According to her physician, it was not appropriate for her to return to a nursing position where she had to be able to work alone.

   Theoretically she could have returned to her former position as an industrial nurse if a second nurse were hired to work with her to look over her shoulder and step in in the event of a functional lapse due to her disability.

   However, the court upheld the employer’s determination that hiring a second nurse, effectively paying a double salary for a one-nurse position, was prohibitively expensive and was not a reasonable accommodation for purposes of the Americans With Disabilities Act.

   The nursing agency had other positions available. However, the nurse refused to consider any other option besides returning to her previous job, on the same shift, with an extra second nurse. There were clinical positions where the nurse would be on duty with a charge nurse and nursing coworkers, which might have been appropriate as a reasonable accommodation, but which she never specifically considered, and there were non-nursing positions.