Saturday, December 3, 2016

How can someone with a hearing loss become a nurse?



The experiences of students with hearing loss can vary significantly among individuals. A number of personal and environmental factors will have an impact on how the student learns and how he or she interacts with instructors, peers, and patients. Other factors include degree of hearing loss, age of onset of hearing loss, and educational background. Ambient noise levels, room acoustics, and lighting also can have a significant impact on how well communication might flow between a health care provider and a patient. 
     In many settings, simple changes can be made that may benefit more than just one person. Using the principles of universal design, adding visual signals such as flashing lights in addition to auditory signals can alert any member of the staff. Using pagers is a common way of communicating, and it creates a more accessible work environment for everyone.

Students who need additional visual cues for classroom access may request speech-to-text services, sign language interpreters, or oral interpreters. Speech-to-text service providers (often referred to as a captioner or transcriber) use specialized software and a display device to provide a text format of the lecture and discussion.

     Students who use sign language interpreters should discuss the preferred mode of communication (e.g., use of American Sign Language or use of Contact Sign), review terminology, and establish what signs could be used to express specific concepts for each class. Students with strong speech reading skills may request an oral interpreter. An oral interpreter will present on the lips and face what is being said during the conversation or presentation.

  Many students use personal hearing aids to understand speech and detect environmental cues. Although hearing aid technology has improved tremendously over the past few decades, there are limitations to how strong the signal might be.  Older analog hearing aids tend to amplify all sounds, making it difficult to separate background noise from speech; the sound produced by newer digital hearing aids is clearer and has reduced distortion and internal noise. High-end digital hearing aids may also be programmed for different listening situations. 

       Purchasing and maintaining a personal hearing aid is the student’s responsibility. Assistive listening devices (ALD) amplify the speaker’s voice and reduce the influence of background noise. Commonly used ALDs include FM systems, infrared systems, and electromagnetic induction loop systems. Because an ALD might be used by several different students, this equipment is generally purchased and maintained by the institution.

    In the college environment, students who are deaf or hard of hearing are strongly encouraged to take an active role in planning their communication access services. Discussions with the staff in the disability services office can be helpful prior to the start of a new term, especially when the student’s course load includes laboratory work or clinical assignments. Service providers, such as interpreters or speech-to-text providers, may need to prepare for the terminology used in the classes or work with the student to determine the best sight lines to see the access service, the instructor, and any visual course materials used.

     In clinical settings, students will be expected to identify heart, lung, and bowel sounds; communicate in settings in which surgical masks are used; and communicate with patients in a clinical setting or on the telephone. Students with hearing loss may not be able to utilize a traditional acoustic stethoscope. Several amplified stethoscope models are available, and students who benefit from hearing aids are encouraged to work with faculty and their audiologist to determine a good match. Technology such as text pagers and smartphones can be an effective strategy for handling alerts and telephone messages. There are numerous materials available on the PEPNet website that may provide a student with additional information: www.pepnet.org.

*Note: The PepNet website will close December 31, 2016 and transition to working with the National Deaf Center on Postsecondary Outcomes info@nationaldeafcenter.org.   
This information is an excerpt from a chapter commentary written by Marcia Kolvitz, PhD, Director of PEPNet-South at The University of Tennessee, Knoxville in the book "The Exceptional Nurse: Tales from the trenches of truly resilient nurses working with disabilities". To order a copy, visit: