Communicating with healthcare professionals

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rose1990

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Hi everyone, my names Rose, I'm a paramedic in the UK.
I was just wondering what your thoughts are about communicating with healthcare professionals? I'm doing a presentation on how we can improve services for the deaf and hard of hearing community. I would love to hear how everyone's experiences have been, good and bad! Myself and my colleagues have been discussing how we rely to heavily on lip reading, that and good old pen and paper. We feel this is not right, as you should have the option to communicate however you feel more comfortable. Would it help to have access to a sign language interpreter via skype etc? any ideas or comments would be great :)

Thanks everyone. Much love
 
Consider inviting deaf & other disabled to your next “disaster response training” session.
A deaf friend said our local emergency response organization recently did this.
 
I'm a hearing medical professional. I can't speak to the experience of Deaf people, but if you'd like I can tell you the story of what a hearing physician's office did to one of my Deaf patients, which was the motivation for me to start learning ASL.
 
Lysander said:
I'm a hearing medical professional. I can't speak to the experience of Deaf people, but if you'd like I can tell you the story of what a hearing physician's office did to one of my Deaf patients, which was the motivation for me to start learning ASL.
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Please do. The more knowledge we have, the more power to do the right thing.
 
I notice that our OP is from the UK. I think that makes is especially important to indicate which country your are posting about it you have experience to share. It seems so many of our members are from the USA and forget that not everyone is.
 
Jane B. said:
I notice that our OP is from the UK. I think that makes is especially important to indicate which country your are posting about it you have experience to share. It seems so many of our members are from the USA and forget that not everyone is.
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Poor communication with the deaf is universal. I’m sure the OP would be able to mentally change ASL to BSL to fit his/her location.
 
LoveBlue said:
Poor communication with the deaf is universal. I’m sure the OP would be able to mentally change ASL to BSL to fit his/her location.
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I get so fedup with your negative reaction to everything I write!!!!!

Yes what you say can be done but it would be considerate if people would think to write their replies with with location in mind. What was so wrong with me bring it up?????????
 
Jane B. said:
I get so fedup with your negative reaction to everything I write!!!!!

Yes what you say can be done but it would be considerate if people would think to write their replies with with location in mind. What was so wrong with me bring it up?????????
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And I get fed up with you always pointing out things to us as if we're not smart enough to think of them ourselves. Why don't you just put me on ignore if i bug you so much.
 
Jane B. said:
I get so fedup with your negative reaction to everything I write!!!!!
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This is a forum and we know people come here from all over the world. If you can' t stand the heat, either stay out of the kitchen or just put him/her on ignore. It seems like you can't take people's criticism when you post something or telling us we should pay attention.

I'm sure many of us can read that the OP is from UK in the first sentence, there's nothing wrong with what posters said in this thread. A story, suggestion is a good start to help OP understand things into perspective.
 
So, here is the story that started this whole thing for me.

About 9 months ago, I was working at the hospital. I'm a Nuclear Medicine Technologist. The front office staff called me to let me kow that my patient was ready and was in my waiting room. She also "warned" me that the patient was Deaf. So I asked them if she had someone with her that could interpret or if I needed to get the Video Relay Interpreter. She said that she had no one with her. So I got the VRI and went out to find my patient.

The lady was sitting in the waiting room. So I wheeled the little iPad over to her and got the interpreter on the line. The office staff had given her some paperwork to fill out that was a little complicated if you don't have a lot of medical experience so she asked me if I would help her fill it out. Which I did. Though it seemed odd that while filling out the questionnaire she had a lot of questions. Many more questions than seemed typical. A lot of the questions she asked were asking me why I needed to know these things. Like she asked me why I needed to know when the last time she ate was. I told her that it was so the test results would be most accurate.

Through our questioning more and more things kept popping up that were out of order. Like she told me she had an appointment 1 hour after this one. I told her that wasn't going to work because this test takes 2.5 hours. She seemed shocked. She didn't understand why blood work should take so long. I told her, "Oh no. This isn't for bloodowork. This is a nuclear medicine scan. This test is to see if her gallbladder was infected and needed to be removed. Again she was shocked. And I was confused. This was all information that should have been relayed to her by her doctor. So I asked her what her doctor had told her about the test. She said nothing. Then she showed me the note that her doctor had given her. She said that at her last appointment her doctor had given her this note and seemed frustrated with her. The note literally said. "Go hospital. Apr 14 2pm." That was all.

This poor woman literally had no clue why she was at the hospital, what test she was there for, that the test could potentially lead to surgery, that the test took 2.5 hours, or that the test involved radiation. I was so angry at her doctor for her. They know that she is Deaf. They have it in her file. They should be aware that when she makes an appointment that they need to provide an interpreter for her. They did not. According to the woman, the doctor did everything by making her lip read, or by writing notes.

That is not acceptable. After we finally got everything squared away with the information about the test, we got to a point where I had to actually perform the test. So we couldn't use the VRI anymore. She had a few more questions once I had gotten her in the machine. I had to resort to writing notes. Which I wasn't happy about. I feel like healthcare providers should have at least a basic knowledge of some medical signs to help people.

So that's the reason that I started learning ASL. I can't believe that her doctor did what he did. As a medical professional I take pride in doing everything I can to help my patients and knowing that physician thought that writing notes and lip reading were the best methods to help his patient seems lazy and short sighted.

I've told this story to a number of Deaf people and many have actually put a good bit of the blame on the patient. They've said that she should have known to bring an interpreter. I personally don't feel like that should have been her responsibility. But I'll accept a difference of opinion on that.
 
I also have some EMS friends who have escalated calls because the patient wasn't responding to verbal commands, only to find out later that they were Deaf.
 
Right off the bat, the first thing I would suggest is setting up some type of screen in the waiting room that flashes your name when you are being called....This is the first problem I encounter in medical offices...I cannot hear my name being called.

if you can have some type of word processor screen in your examination room, that would help.. Sometimes I cannot fully understand the questions or advice being given to me...It would be nice to have someone type it on a screen. I mean this is critical stuff....(Sign language would be great to a degree - But the more technical stuff, I do not know if it should be or can be signed).

I find most medical people are really as accommodating and patient as possible. Believe it or not, the one S.O.B. that I felt was immature about the communication problem was an ENT (believe it or not)...He would actually laugh when I could not understand him...(He was not that good...he ran a typical mill, for the money - so I dumped him quick).
 
Lysander said:
They've said that she should have known to bring an interpreter.
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SHE should have brought an interpreter? No... the doctor's office should be responsible for providing it- and I'm seeing some do this (one did for me a couple of years ago). I'm sure some Deaf do bring their own but that will be money out of their own pocket unless they can get VR or some other organization to pay for it. Under ADA law, the service provider is supposed to provide whatever accommodation needed.
 
DeafDucky said:
SHE should have brought an interpreter? No... the doctor's office should be responsible for providing it- and I'm seeing some do this (one did for me a couple of years ago). I'm sure some Deaf do bring their own but that will be money out of their own pocket unless they can get VR or some other organization to pay for it. Under ADA law, the service provider is supposed to provide whatever accommodation needed.
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I was about to make the same comment. A Deaf consumer should never bring the interpreter; they should meet at the assignment. Absolutely the service provider arranges for and pays for the accommodation (interpreter, equipment, service), never the Deaf consumer, and they cannot tack on the cost to the Deaf consumer's bill.
 
Some guy said:
. . .

if you can have some type of word processor screen in your examination room, that would help.. Sometimes I cannot fully understand the questions or advice being given to me...It would be nice to have someone type it on a screen. I mean this is critical stuff....(Sign language would be great to a degree - But the more technical stuff, I do not know if it should be or can be signed)....
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Technical terms should absolutely be signed, with expansion, not just written down. Clear communication with full understanding by the patient is critical. If the interpreter doesn't know the meaning of a technical term, he or she needs the doctor to explain it, the same that any patient, hearing or deaf, would require. Otherwise, just spelling out the name of a procedure or test is just blah, blah, blah. There's no informed consent happening with that.
 
Lysander said:
. . .
I feel like healthcare providers should have at least a basic knowledge of some medical signs to help people.

I've told this story to a number of Deaf people and many have actually put a good bit of the blame on the patient. They've said that she should have known to bring an interpreter. I personally don't feel like that should have been her responsibility. But I'll accept a difference of opinion on that.
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First, I appreciate your awareness of and concern for Deaf patients. :)

Like DeafDucky posted, it's not the responsibility of the patient to bring an interpreter. However, the Deaf patient probably needs to learn how to better advocate for herself, and when her appointments are made, remind the provider that she will need a certified interpreter scheduled.

I'd be careful about healthcare providers signing with Deaf patients. Learning some basic vocabulary is OK but it should never be accepted as a substitute for medical interpreting. A nurse who can fingerspell is not acceptable for interpreting (yes, it has happened, too many times). Deaf signers are very literal in ASL, and ASL is very conceptual, and those are just two of the areas that can cause confusion and misunderstanding for beginning signers (there's more, including cultural context). If you do want to teach some signs for healthcare staff/Deaf patient interaction, make sure the instructor is qualified in that area.
 
Reba said:
First, I appreciate your awareness of and concern for Deaf patients. :)

I'd be careful about healthcare providers signing with Deaf patients. Learning some basic vocabulary is OK but it should never be accepted as a substitute for medical interpreting. A nurse who can fingerspell is not acceptable for interpreting (yes, it has happened, too many times). Deaf signers are very literal in ASL, and ASL is very conceptual, and those are just two of the areas that can cause confusion and misunderstanding for beginning signers (there's more, including cultural context). If you do want to teach some signs for healthcare staff/Deaf patient interaction, make sure the instructor is qualified in that area.
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I totally agree. For me, it wasn't so much that I needed the interpreter for the medical history that bothered me as it was that once she was on the table I couldn't even give basic instructions. Things like, "Don't move during the test" or asking her to move certain ways or when she asked me how long the test would take. Things like that I should be able to answer. Plus, my patients tend to be with me for a long time. Most of the tests in Nuclear Medicine take a long time. I'm used to having normal chit chatty conversations with people about their families or their jobs. Something that I couldn't do with this patient that I would have like to have been able to do.
 
Reba said:
I was about to make the same comment. A Deaf consumer should never bring the interpreter; they should meet at the assignment. Absolutely the service provider arranges for and pays for the accommodation (interpreter, equipment, service), never the Deaf consumer, and they cannot tack on the cost to the Deaf consumer's bill.
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Absolutely. You can request your favorite one, which I did last week. :)
 
Wow, thanks for sharing @Lysander! It breaks my heart to read stories like this: how neglected and unworthy of knowing what the medical issues are from her own doctor. No patient should be treated as such.
 
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