Nursing with a hearing loss: Yes you can!

[Donna Maheady]

Have you ever found yourself asking a colleague to repeat something? Or, have to take a little longer than usual to assess heart or lung sounds? Ever have difficulty hearing someone on the telephone.

Hearing Loss

According to the American Academy of College of Nursing (2011) there are more than 3 million licensed nurses in this country. If hearing loss statistics for nurses are similar to the 15 to 17% prevalence rates of the general population, there are approximately 450,000 to more than half a million registered nurses who are working with hearing loss (Spencer & Pennington (2014).

So, why are we surprised to learn that a nursing colleague has a hearing loss? Is it part of the stigma associated with invisible disabilities? People can be born with a congenital hearing loss or acquire a hearing loss due to infection, medications, trauma, aging or noise.

Some may ask, "Are students with hearing loss being admitted to nursing programs? And, "Can nurses with hearing loss find jobs"? The short answer is, "yes"!

Nursing students with hearing loss are increasing in number, moving on to graduate and finding positions. Nurses with hearing loss work in a wide array of settings-hospitals, schools for the deaf, camps, case management, long term care and mental health. They also teach in nursing education programs.

Technology

Technology has done much to improve the lives of people with disabilities including nurses with hearing loss. Amplified and electronic stethoscopes are available. Choice of a stethoscope will depend on many factors including degree of hearing loss and if hearing aids (in the canal, totally in the ear, behind the ear) are used. There are different types, so selection should be made in consultation with an audiologist familiar with stethoscope use (Bankaitis, 2010).

Pagers that beep codes that mean different things can also help. One nurse made modifications to her workplace by using a master alarm with a remote receiver, and placing a receiver on IV machines to alert her with flashing lights when alerts went off. She also got help from her coworkers. The "ward clerk or other nurses alerted me if a patient was ringing for me.... other nurses made my phone calls and we used a 'barter' system in supporting each other" Maheady (2006 p.60).

A nurse with moderate to severe sensorineural hearing loss wears bilateral behind- the-ear hearing aids and teaches nursing in Pennsylvania. Her master's degree thesis examined the lived experience of the hearing-impaired nursing student. She serves as a nurse professional leader for the Association of Medical Professionals with Hearing Loss and created a "Guide to requesting vocational rehabilitation services" for nurses and nursing students with disabilities (Machemer, 2014).

During an interview for an ICU position, a nurse who has cochlear implants stated, "I made it very clear to them that if having cochlear implants was an issue for them, to please let me know NOW because I did not want to waste their time or mine....The supervisor smiled and said, "It's not a problem for us. We would love to have you work with us" (Keyes, 2014 p.134).

Appointed to the Governor's Council for the Deaf and Hard of Hearing, a nurse with a genetic hearing loss works tirelessly as an advocate for people with hearing loss. As a nurse, she works as a Quality Improvement (QI) Delegation Coordinator for a Health Plan in Wisconsin (Schwarz, 2014).

In New York, a nurse is studying to be a family nurse practitioner. "I go into the patients' rooms with confidence, introduce myself, tell the patients that I am deaf and will rely on interpreters as needed," she says. "I have been able to make it work effectively (Rochester Institute of Technology).

When a nursing home opened their doors to the deaf and deaf/blind community, they hired deaf CNA's to communicate with the residents. "Now we have the young deaf taking care of the elderly deaf and it's a beautiful thing" (Therapy Center, 2013).

The University of Salford in the United Kingdom began the first nursing program for deaf students. One of their first graduates went on to work as a staff nurse at the National Centre for Mental Health and Deafness (University of Salford, 2009).

These examples demonstrate that nurses with hearing loss are practicing in many different settings and making valuable contributions to patient care.

Do you work as a nurse with a hearing loss? Do you work with a nurse or CNA with a hearing loss?

Do you use an amplified or electronic stethoscope? Do you or a colleague receive reasonable accommodations (Interpreter, amplified telephone)? Is there team support? Is technology helping?

Love to hear about your experiences.

Resources

Exceptional Nurse http://ExceptionalNurse.com provides resources and mentors for nurses and nursing students with hearing loss.

The Association of Medical professionals with hearing loss provides extensive information about workplace supports and amplified and electronic stethoscopes www.amphl.org

The Department of Labor Job Accommodation Network provides information about reasonable accommodation for nurses with a wide range of disabilities Accommodating Nurses with Disabilities

The UK Health professionals with hearing loss group offers resources and connections to other nurses and nursing students with hearing loss in the United Kingdom UK Health Professionals with Hearing Loss

References

Bankaitis, A. (2010). Audiology Online. Amplified Stethoscope Options for Professionals with Hearing Loss. Accessed on July 29, 2015 Amplified Stethoscope Options for Professionals with Hearing Loss A. U. Bankaitis Hearing Aids - Adults Assistive Devices 860.

Keyes, L. (2014) in D. Maheady (Ed.) The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities. CreateSpace Independent Publishing Platform.

Machemer, C. (2014) in D. Maheady (Ed.) The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities. CreateSpace Independent Publishing Platform.

Maheady, D.C. (2006). Leave No Nurse Behind: Nurses working with disAbilities. Lincoln, NE: iUniverse, Inc.

Rochester Institute of Technology. Health Care careers for the deaf and hard of hearing community. Accessed on July 28, 2015 Lauren Searls | Health Care Careers for the Deaf and Hard-of-Hearing Community

Spencer, C., Pennington, K. (2014). Nurses with Undiagnosed Hearing Loss: Implications for Practice. The Online Journal of Issues in Nursing. Accessed July 21, 2015 Nurses with Undiagnosed Hearing Loss: Implications for Practice

Schwarz, E. (2014) in D. Maheady (Ed.) The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities. CreateSpace Independent Publishing Platform.

Therapy Center (2013).

Amelia Manor Nursing Home Opens Doors to the Deaf and Deaf/Blind. Accessed on July 28, 2015 The Therapy Center | Amelia Manor Nursing Home Opens Doors to the Deaf and Deaf/Blind

University of Salford (2009). Salford student becomes first deaf male nurse. Accessed on July 28, 2015 Salford Staff Channel-Home | University of Salford, Manchester.

[annie.rn]

Hi! Thank you for your excellent article. I have almost complete right sided sensorineural hearing loss with tinnitus caused by an acoustic neuroma. The hearing loss has been gradual over the last 13 years so I feel like I have adapted fairly well. I do not require any assistive devices at work. I adapt by using my left ear to talk on the phone, having co-workers stand on my "good" side when giving report, etc.

My biggest workplace challenges are locating where sounds are coming from and hearing clearly in situations with a lot of background noise. The worst is when someone calls my name from a distance. I will hear my name but not know where it came from. I then spin around in circles (literally) trying to find who is calling me : -)

Unfortunately, as my hearing is getting worse I am finding my co-workers less and less tolerant. There is one person in particular who has outright accused me of having "selective hearing". She has made several not so nice comments to my face so I can only imagine what she says behind my back. I might be overly sensitive but I do feel less respected as a nurse since my hearing has declined. I feel like some co-workers think I'm a huge airhead who walks around in la la land when in reality I just can't hear them. I feel like they do little to meet me half way even when I repeatedly remind them of my hearing difficulties.

That's the hardest part for me because I've always taken pride in being respected by my peers for my clinical practice.

[misseileen32]

I always had trouble understanding phone calls but never realized I had a hearing problem until I signed up for a project researching the use of several different isolation masks. Part of the study included a hearing test. My complaints of "I can't hear with some of these masks" proved true; I did having hearing loss. Within 3 years I had trouble hearing discussions during rounds and couldn't follow conversations. Shortly after I tested again and found my loss was bad enough to get hearing aids, bilateral hearing aids that fit behind my ear. Every so often I leave them out while I am at home and I joke about what I think I hear and what was really said. There is a significant difference.

I have learned to use humor when talking with my patients....I warn them that if I answer a question with a really weird answer they might want to ask what I heard. I pay very close attention to my patients when they speak to me and will review whatever they said so I don't miss anything.

I use email almost exclusively since I can read much better than I can hear.

Most important is I don't want to leave the bedside yet. I have no desire to work at a desk. I like being active and I love the interaction I have with patients.

I am lucky enough to have coworkers who understand my problem and are there for me. They don't rescue me; we work together.

[misseileen32]

I am so sorry to hear your peers are becoming less supportive. Without my peers I couldn't make it through a shift. I can't imagine working with people who would act differently. The one who accuses you of hearing selective hearing sounds like she is creating a hostile work environment.

[pockunit, ADN, RN]

I wear bil HA and my facility gave me an electronic scope as an accommodation. I spent the first couple of years of practice thinking I was horrible at identifying lung sounds when it turns out I actually couldn't hear them.

If you have documented loss, ask your occ med department about equipment; you fall under ADA (in the US) so they need to help you.

[MuzzleSnuzzler]

I have a congenital hearing loss; 50% bilat. The loss is in the mid-range where the human voice is. I had always compensated by reading lips. Certain people's voices are nearly impossible to hear while others are easily heard. Last year I bought blue tooth hearing aids that I use but I have to remove them to use my stethoscope. I don't have problems hearing with the stethoscope yet. Most of my coworkers are great about it. A few make snide comments about selective hearing since I am able to hear most things. These few also think it's fun to speak to me as if I have a learning disability instead of a hearing disability. I do struggle with figuring out what direction the sound is coming from. Since I always wear my hair up in a pony tail, it's obvious that I'm wearing hearing aids. I love caring for pts with hearing aids as we instantly have a connection. :)

[rojoflores]

I am so glad this topic came up. I am a deputy sheriff who suffers from hearing loss due to damage caused by gun fire. As I am about to begin my first semester as a student nurse, I was worried about others noticing my two hearing aids and questioning my qualifications.

[Donna Maheady]

So happy to hear you have peer support....!!!

[rojoflores]

So happy to hear if you have peer support....!!!

I will definitely update on the challenges ahead. Thanks again; it is comforting to know I'm not alone.

[kristi623]

I have been HoH basically all of my life. School was difficult. I was intelligent but was mistaken for being "slow" just because I couldn't hear or see very well. Once those problems were corrected I sailed through my academics. Nursing school was different. I didn't have hearing aids at the time and I was so afraid I wouldn't be able to hear BPs, BS, or lung sounds. My instructor almost failed me because I was stalling on an assessment. I admitted I was afraid I wouldn't be able to hear but I had no problem whatsoever once we got to it. She told me afterwards that the person we assessed was a hard one with a low BP that was difficult to hear & if I could hear that then I would do just fine. And I have, for the most part. I wear hearing aids now and I try to use a wrist cuff when possible but if I do need to use the arm cuff, I remove my aids and find that with the stethoscope buds pressed into my ears, I am able to hear sounds pretty well. A friend bought me an amplifying stethoscope as a graduation gift but I find it too "noisy" to use all the time. Because it amplifies, it makes every little brush of fabric or bump of the tube louder and it interferes with the body sounds I'm trying to assess. Anyway, I am absolutely THRILLED to see an article about HoH nurses. Nobody ever talks about this issue!

[Donna Maheady]

Thanks for the encouragement regarding this topic. I will write more:)

[ursus57]

50% hearing loss...58 yr old Male LPN...Medically fragile pts and beginning to work with adults with developmental disabilities. Most see my hearing aids behind my ears as being part of the club. "you too, understand being enabled in different ways." Amplified stethoscope, bought on ebay UK at 1/3 the outrageous price. I advocate strongly for the pts in my care and never had a problem with being hired, due to hearing loss. My older family members of pts have zero issues with my partial deafness. In my most recent job I marketed my hearing loss as a bridge to those struggling with their disabilities.

[Donna Maheady]

50% hearing loss...58 yr old Male LPN...In my most recent job I marketed my hearing loss as a bridge to those struggling with their disabilities.

Good for you!!!! What a great story!