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If you have any questions, comments, or suggestions related to nurses with hearing loss, please contact: Linda Keyes at firstname.lastname@example.org.
Table of Contents
- 1. Do I want to be a Nurse?
- 2. If you do think you want to be a nurse, some thoughts to be considered
- 3. Disclosure to Nursing Schools and Employers
- 4. Selecting a Nursing School or Employer
- 5. Assistive Technology
1. Do I want to be a Nurse?
This is the first step into the journey into nursing. Is this what you would like to do? Do you have a hearing loss? We, as nurses at AMPHL, hope to provide you with the resources and information in making your decision to either pursue a nursing career or to stay in nursing if hearing loss should develop midway into your nursing career. All of us have had different, unique experiences to serve us on our journey. You may find that yours may differ from others’ experience as we all vary with our cultures, schools, states, and our own hearing loss. Everyone’s degree of hearing loss is different. Our life experiences are different. So, please keep in mind that what transpires for one individual may not necessarily be the same for another. These guidelines were created based on everyone's experiences.
The first issue to keep in mind is our hearing losses. We all are diverse. Examples are, some people do not hear high pitched frequencies and only hear the low ones. Others might hear the high frequencies but not so much the low ones. Some may hear sounds but not be able to "process" speech information. Some may not hear anything at all. If your hearing loss has been with you through your lifetime, most likely you will have come to know your comfort level and your "drive" with education and learning. Some of you will know based on your experiences with the past and how much you are willing to run the marathon vs. do short distance running. Key ingredients will be persistence and willingness to learn from experiences (good or bad) to put forth the effort to enter nursing. Some of us at AMPHL may have been raised in Deaf culture whereas others may have been mainstreamed with oral education. Professionals and students in AMPHL use varying means to accommodate for their hearing loss. Some use no device, while others use hearing aids or cochlear implants.
It is our hope that the information available will be useful to you. We will be honest with our stories in that some of us with hearing loss have had a very grueling experience in achieving our dreams of nursing and not deceive you by implying it is always an easy road to take. It really has to come from your heart if you wish to become a nurse. It takes great fortitude to take the road when it comes easier for others who do not have a hearing loss. It is our hope that we will pave a realistic yet encouraging vision for you of the path to a successful journey into nursing.
2. If you do think you want to be a nurse, some thoughts to be considered
Nursing is a very diverse field. Nursing is composed of so many areas to consider that it might be necessary for you to think about where you might "fit" best and what meets your comfort level so that you can function with the amount of stress that is reasonable for you. Nursing can be in medical/surgical, psychiatry, research, case management, long term care, rehabilitation, home care, forensic science, or teaching, to name just a few. The list can go on and on! So, please don't narrow it down to hospital nursing because there are so many other options such as visiting nursing or a clinic. Remember, you can do anything you want to! Nursing can be stressful with or without hearing loss and even more so now with the nursing shortage and resultant increasing workload.
3. Disclosure to Nursing Schools and Employers
We, at AMPHL, individually have decided which route is best regarding disclosure of our disability. Some feel total honesty and full disclosure go further when applying to nursing schools or nursing jobs. Others have found difficulty going that route and/or decided not to disclose until they were accepted by the school or employer. Some found that disclosure sets up for discrimination from being chosen. Although discrimination legally should not be tolerated, it is found by many to be prevalent regardless of the Americans with Disabilities Act. Hearing loss is a "silent" disability especially if one is late deafened and can speak well. It truly is your decision. It is felt by some that honesty shows that you are upfront and are not trying to hide anything. You have no legal obligation to disclose your hearing loss when applying for nursing school or a job. If you do not disclose your hearing loss, the interviewer cannot ask you questions about the disability itself. We all want to be judged by our abilities and achievements, not by our hearing loss. There has not ever been even one documented claim in the literature that a person with a disability has caused harm to a patient as a result of his/ her disability, and such safety concerns are a very common misconception. Safety is an issue for all nursing students. Creativity can provide a supportive environment. At the same time, if you do not disclose, the response may be the opposite than you had planned on especially if they detect your hearing loss (it may be difficult to hide) or if they learn from another source about your hearing loss then it may hurt your application process, even though this would be illegal. This remains a controversial topic.
If your hearing loss is disclosed, some thoughts to consider: Be prepared to answer questions regarding your ability to perform nursing functions, with or without reasonable accommodations.
1. How are heart, lung and bowel sounds going to be assessed?
2. How will you be able to communicate with others when they are wearing a mask and you are unable to see them to lipread?
3. How do you manage communication by phone?
4. How do you follow lectures and group discussions?
5. How are you going to obtain information from taped nursing reports on patients?
6. How will you handle "code" (resuscitation of patients) situations?
For all of the above, what accommodations are necessary? Nurses in AMPHL have successfully managed all of these situations with some creative accommodations.
4. Selecting a Nursing School or Employer
Apply to the schools that have your interest...location, reputation, length of time to attend, percentage of placements of new graduate nurses, private school vs. public university, etc. It may make a difference depending on where you live and how many colleges are available in your area. If need be, contact the school's disability department and set a meeting with an appropriate resource person to assist you. In determining school size, a nurse-aspiring student who benefits from greater interaction and mentorship from the clinical facility may wish to attend a small nursing school (such as 30-40 members in a class vs 90). Clinical rotation numbers to each instructor may want to be considered (such as 6 students to one instructor as opposed to 10 students to one instructor). On the other hand, a larger nursing school mayb provide additional standard resources such as videotaped lectures to supplement learning experiences which can be especially useful for deaf students. Pursue a school that best suits you, your needs, and feels "right." It will be worth your while to explore. Another option is to contact the vocational rehabilitation services in your state for assistance with the pursuit of nursing school and/or adaptive equipment.
It may be helpful to prepare yourself by writing a synopsis of your pursuit of nursing, what makes you want to be a nurse, identifying your hearing loss and support your pursuit of nursing by "teaching" or "educating" the faculty members and/or director of the program. This may or may not be "new territory" for them. If you choose to disclose your disability you may wish to demonstrate your efforts to make this plan workable. (For example, you've met with an audiologist to obtain an amplified stethoscope). It should be mentioned, perhaps, that this is a learning experience for all involved and you are willing to put forth the effort to make this successful but it requires teamwork effort by all. It is normal for prospective students to feel "offended" or "distressed" by unwelcoming comments to inquiries pertaining to admitting or accommodating students with disabilities. Provide suggestions on ways to address them before taking that school off of your list of options for schools.
Finding an employer does not come without its difficulties as well. It is best to pursue, if possible, an employer that demonstrates being a "progressive" institution with a vision. Various locations in the United States can be more progressive than others in employing those with hearing loss and/or any disability for that matter. While most institutions state they employ with "equal opportunities" it sometimes may feel that it simply does not exist. With persistence and motivation, it is our goal as a health care provider with hearing loss to encourage others to learn by educating them with the materials and information necessary to support our career in nursing. It is essential that you present yourself in a positive, professional light to gain acceptance into an institution just like any other individual would when applying for a job. Be open and encourage potential employers to ask questions. Be prepared to provide confident knowledgeable answers.
Once, either before you enter or after you accept a position as a student or an employee, it may be helpful for you to write out some guidelines on ways for them (employers staff members, faculty members, and classmates) to be helpful to you as an individual with hearing loss. For example, you could state that you need to be faced by the speaker when spoken to, and that others need to signal and wait for you to turn to face them before speaking. It is important to think about classroom situations such as where to sit, whether you need a note taker, interpreter, a CART reporter (a reporter types live conversation that comes up onto a screen). CART requires advance planning. Develop a relationship with classmates or co-workers, explain your situation, and ask for assistance with note taking. Perhaps different students will take turns providing notes. Sometimes the school will hire note takers to assist the student.
5. Assistive Technology
1. Stethoscopes - There are several types of stethoscopes available from simple amplification to more complex amplification. There is also a PDA available that is able to be used to assess lung and heart sounds. Stethoscopes are available for cochlear implant users that connect via patch cord to your implant processor. These users may have to work with their audiologists for a suitable map program for their cochlear implant when using a stethoscope. Please refer to the AMPHL website to look at the information and contacts for the equipment. Some areas of nursing do not require stethoscope usage.
2. Phones - There are many different options regarding the telephone. Some individuals with hearing loss may need an amplified phone. Others may use a Telecommunication Device for the Deaf (TDD). This is a device where communication is typed back and forth between a deaf individual via a relay operator communicating from a hearing party. It also may work TDD to TDD (one deaf person to another.) There is also a VCO (voice carry over) telephone available for individuals that speak well but cannot hear or process speech information. This works where the deaf individual speaks and then the information is typewritten back on a screen on the phone. Currently, there is a new device called Cap-tel which is not fully on the market yet. It is a phone which types out the words being said almost simultaneously as the hard of hearing individual listens to the phone conversation. The operator is not identifiable to the hearing party. This type of phone is useful for cochlear implant users in the process of re-learning to hear. Other alternatives to phones are email and fax.
3. Pagers - Pagers can be very helpful to individuals that cannot hear overhead paging. It is also a great tool to use to communicate between staff members on a floor. For example, a secretary at a nursing station/desk is consulted by a patient's family member to see the patient's nurse. The secretary can page the nurse via pager coded with designated numbers for the individual to be made aware of the need for them to come to the desk. For example, 1=pain med, 2=phone call, 3=family at desk wanting to speak with you, 4= iv beeping, 911=code. After this number is put in, a patient's room number can be inserted as well so that there is less waiting for nurse to come to the desk. For example, your pager beeps 1511...this could mean, pain med is needed in room 511. Another example, 911 222 could be a code blue in room 222. So, this way the information is communicated effectively with the hard of hearing/deaf nurse.
4. FM systems/Assistive Listening Devices - Many assistive listening devices are available depending upon the needs of the individual. Contact your audiologist to determine what may work best for you. If someone has a cochlear implant he/she can use one type of FM device while someone wearing hearing aids may use a different type. It can be useful in a classroom setting, meetings, etc. It is up to you to find what works best for you. Many times, there is a window period to trial equipment/stethoscopes to see if it works for you or not. Check with the company that manufactures the products for trial periods.
5. Interpreters - Background knowledge and experience in medicine/nursing among interpreters and captioners are desirable but requires collaboration with the university disability office in locating or recruiting these providers. The disability office should be notified several months in advance prior to enrollment, if possible, so that the deaf student's learning experieince during the first year will not be hampered by accommodation difficulties.
We wish you all the best in your future plans to pursue a career in nursing! Find what fits best for you and go with it. Please feel free to contact AMPHL with any further questions. Remember, it is totally up to you to pave the path of your career. Many people along the way are resistant to change but with education, persistence and resilience, only we can strive to create a larger, creative vision of possibilities to those without hearing loss and continue to bring down the barriers that arise with hearing loss. If you have further questions, feel free to contact AMPHL's resource person and a referral will gladly be made to a current/ recent nursing student or professional with hearing loss is to assist in answering your questions!
A new book by Donna Maheady, an AMPHL subscriber, has been recently published. Entitled "Leave No Nurse Behind: Nurses working with disAbilities," eleven nurses with disabilities share their inspirational stories. Two of the chapters are written by nurses who are d/Deaf---Susan Matt and Morag MacDonald. For more information, please visit the publisher's website here.
If you have any questions, comments, or suggestions related to nurses with hearing loss, please contact Linda Keyes by emailing her at email@example.com.