Ableism, disclosure and accommodation among prelicensure bachelor of science in nursing students with invisible disabilities in Saudi Arabia: A qualitative descriptive study.

AIM: To explore how nursing students with invisible disabilities experience ableism and how these experiences shape their decisions about disclosure and the use of academic and clinical accommodations.

BACKGROUND

Disability is increasingly represented in nursing education, yet disabled students remain marginal within many diversity and inclusion agendas. Rigid fitness-to-practise norms and stigma can deter students with invisible disabilities from disclosing and from using academic or clinical accommodations.

DESIGN

A qualitative descriptive study.

METHODS

Twenty undergraduate nursing students with self-identified invisible disabilities were recruited through purposive maximum-variation sampling at a university nursing programme in Saudi Arabia. Individual semi-structured interviews (Arabic or English) were analysed in the original language using Braun and Clarke's reflexive thematic analysis; selected extracts were translated into English only at the reporting stage.

RESULTS

Four themes were constructed: (1) "Reading the room before revealing myself," capturing the anticipatory appraisal of stigma and disbelief; (2) "Choosing silence over support," describing masking and the forfeiting of accommodations as self-protection; (3) "Proving I belong in the uniform," reflecting an internalised, able-bodied ideal of the 'real nurse'; and (4) "When the system bends, I can breathe," identifying trusted allies and universally designed learning as enablers of inclusion.

CONCLUSIONS

Students frequently chose concealment over support because the perceived costs of disclosure outweighed the uncertain and stigmatising accommodation processes. Dismantling ableism requires structural change: normalising disability as professional diversity, embedding universal design for learning, reforming fitness-to-practise standards and building confidential, trustworthy disclosure pathways.