Working in regular health care settings as a deaf nurse?

Hi everyone,

It has been so long since I have written something. My last post was on the 22nd of July 2016, and at that time I just came back from San Francisco… oh how the time flies!

So, what have I been up to? Am I going to start writing again? First I’ll give an update – I’d like to say a ‘small update’, but I can never write short stories, so bear with me! After that I’ll explain a little about the title and my experiences working in a ‘regular team’ with a ‘regular job’ without any accommodations.

Last year of Nursing school has begun!
Where to start? In January I finished my 3rd year internship, and I passed, so that means I’m officially a 4th year Nursing student now! Woop woop! I did a 5-month traineeship as a student-nurse in a mental health facility, and it was such a great experience. I got to work along with registered (general) nurses, psychiatric nurses, nurse practitioners, psychologists, psychiatrists and social workers. Working in psychiatry is a whole other kind of nursing than what I was used to – On my first day working at this facility I started with meeting all colleagues who where there during shift handover, and after that I met all the clients and had breakfast together with them. Everyone was… walking… and… dressed? And were physically fine. That was definitely different!

During my 5 months of internship I learned a lot, but the most important thing is: I learned that this is really the work I see myself doing.

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Writing a group research paper
The past 5 weeks have been busy as well: I started on my thesis and group research paper. I like my own, individual, thesis best – because in the group research I got assigned to a research-request from a health care facility and it’s always challenging to work in a group: will I hear what someone is saying? am I speaking too loud? how many times have I already asked someone to repeat what has been said? can I just nod now, or do I have to check if I’ve understood correctly? It’s exhausting to try and get all the information like this… BUT: I really like doing research in general, finding ways to help improve a facility, being part of something constructive. And I like the subject I got assigned to, so that helps!

“How accessible is health care for D/deaf and Hard of Hearing people?”
My (individual) thesis/paper is also AWESOME. I’m working on a question regarding health care accessibility for D/deaf and Hard of Hearing patients in my country.
I don’t know how accessible health care is for people who are, for example, in a wheelchair, or can’t walk very well, or people who are blind, but I assume (sorry if I’m wrong about this!) that this is mostly ‘physical’ accesibility, for example, in hospitals: can you get in and around the hospital if you’re in a wheelchair – are there elevators, wide corridors, no obstructions on the floors? How do you get around if you’re blind/have low vision? –> if you ask an employee a question, you’ll get an answer that you can hear.

Information is being said to you in (usually) your language, or a language that is easily accessible to you. I think this is different for many D/deaf and HoH people in some cases… they get around physically, they will find their way to the place in the hospital they have to be. But then? How does communication go if you can’t hear other people – or can hear some things, but not everything? If you have surgery and you have to stay in the hospital: will the busy nurses take extra time to make communication smoothly with you, if they are understaffed, overworked, and have 10 other patients to see within the next hour? Or will they say: “It’s not important, I’ll take care of it?”, or don’t finish the intake forms because you have spent a lot of time together clarifying things and figuring out what the other was saying? If they don’t know important information, or if you don’t understand important information that’s being given to you, then what will be the consequences? Do D/deaf and HoH people tell nurses what they need in communication? Or have they tried so many times that they don’t even try anymore? I’ve seen these communication breakdowns happen at work multiple times – and have read / heard about it a lot, in all sorts of health care facilities… so, that’s why I’m focussing on that with my thesis!

Awareness

Working in regular health care settings as a deaf Nurse?
So, now I’ve talked about the subject of my thesis, I’ll give you some of my experiences working as a deaf nurse in regular health care settings. The day I started my 3rd year internship I told my supervisor that I don’t hear much, and so I wear hearing aids. I also told her: just speak normally, if I’m unsure if I’ve heard you I will let you know. During that week it came up a couple of times; sometimes colleagues saw my hearing aids and asked, sometimes I told them. Now, working in mental health care equals constant communication – and the clients who were in treatment knew that I sometimes asked them to repeat what they had said. I was open about it and didn’t want anyone to feel bad for me: I don’t mind putting extra energy in good communication – I sometimes summarized what I think had been said, and it was actually liked: people knew that I had listened to them.

Were there any obstacles or funny moments when working with only hearing people?
I was scared of not being able to communicate with clients and colleagues, of that people would think of me as ‘less’, but that was not the case at all. I think that because I was open about it, and gave information about what they could take into account (face me, or tap me if I haven’t responded, speak in your natural speaking voice, don’t yell – it won’t help, etc.). The only real obstacle was answering the phone, and because I didn’t hear anything through them I didn’t use them, until we got new pagers that amplified… after my shift I went home, and the next day I came to work only to see the night shift nurses’ head almost exploding because the pager was set SO LOUD that she had wrapped it in a bunch of towels so she didn’t go deaf herself.

There were many funny things… sometimes there were a lot of people standing and talking in the nurses station, while my colleague and I were writing the shift handovers. It made it impossible to focus, so I put my hearing aids off and worked along in silence. My colleagues were always jealous that they couldn’t do that too.

A nice moment was when I prepared a poem in signlanguage to practice with the group of clients, nurses and therapists, and everyone told me afterwards that they had really liked the auditory silence and the beauty of a visual language – It’s nice to introduce people to deaf culture/signlanguage, and during my internship everyone has been so open about it, and it has never felt strange.

So. I think that’s enough update for today I suppose! I’d like to do more with raising awareness, I’ve already gotten some emails about this, so I’m going to think about what’s next! Something to definitely look out for is a blog about ‘Tourettes and acceptance’ (self-acceptance and acceptance of others).

Question: what do you want other people to know (about deafness, tourettes, (dis)abilities at work)??

Cuddles for you all!

-Sam

Medication – Yes or No?

Hello everyone,

Today I’d like to talk to you about medication (for Tourettes, ADHD, OCD, depression, mania, psychosis, but also for physical disorders…you name it!) and why and why not? I have loads of  opinions in my head and have my handy dandy Farmacotherapeutical Compas app with me to tell you some side effects of medication.

Medication in general
Can be very neccesary sometimes. When I take Tourettes as an example, I know people who benifit from their anti-psychotics massively, they don’t Tic as much and feel much better about themselves. They can actually do things now because they’re on medication.

You can almost hear a ‘but’ coming. Even as a Deaf person I can hear it coming. Here it is:

But: you always have to compare the up- and downsides. What weighs heavier, the upsides or the downsides of taking medication?

Anti-psychotic medication
Are, like it says, helping people cope with their psychosis better and often ‘get them out’ of psychosis. They also help people with Tic disorders because of – neurotransmitters. I’ll explain how anti psychotics work and why they work for both psychosis and Tourettes:

Your brain has neurotransmitters (‘chemical messengers’) that sends information from one side of the brain to another side. One of those neurotransmitters is called Dopamine. A high concentration of dopamine makes your brain work differently, because information is sent through the brain in another way than it normally does. Or it fires out information too much. Basically the higher concentration of dopamine  can cause both Tics and psychotic symptoms like hallucinations and delusions.
Anti-psychotic medication lessens the signals of dopamine in the brain, so that there’s a better chance of ‘normal information sending’. (Source: Psychosenet.nl )

The reason a lot of people stop this is because of side effects (weight gain, sleepiness, dizzy spells, nightmares, suicidal thoughts etc. – look it up for yourselves if you want to know more about side effects).

Anti-depressants
Are explained most of the time as meds that help with a chemical imbalance of serotonin deficiency. While I was one of the people who thought that too, let me explain further:
There’s no fixed explanation why people get depressed (some through genetics or life events- but why some people do get it and others not, that’s the question!), let alone how anti depressants improve symptoms.

That being said, researchers believe that it’s caused by how they affect certain brain circuits and how they react to the neurotransmitters (like serotonin, dopamine and norepinephrine). Different antidepressants seem to affect how these neurotransmitters behave.

There are different kinds of antidepressants, like SSRI’s, SNRI’s, TCA’s, NDRI’s.. I’m not getting into what is what and might work for what, because that’s individually figured out. That’s the downside of having these kinds of medications: you never know beforehand what will work for you, so you’ll have to try a couple to see which one works for you (With the least side effects!!).

Mood stabilizers

Mood stabilizers are the ones like Lithium, Carbamazepine and Lamotrigine, that stabilize the mood of (usually) people with bipolar disorder. It can also be prescribed to if you have severe mood swings (like in Tourettes, or when you have a antidepressant-resistance and are depressed).

Between 20-50% of the people who start with mood stabilizers will stop because of the side effects like: weight gain, thirst, nausea, muscle weakness/aches, emotional numbness, fatigue and concentration problems. That mean that 50-80% will stay on them, because they probably work! I don’t know how they work, but I’ll figure that out and let you know.

What should you do?
That’s always difficult to tell, because I’m neither a doctor, nor can I look into your brain to see how severe the problems are. If you’re willing to accept that side effects may arise, or really have to take medication because life becomes unmanagable otherwise: take it! Side effects might be bad, but feeling worse is even more detrimental to your health and self esteem.

Love, Sam

Question: what kinds of medications have you been on? Did they work for you or not?
Would you suggest it to somebody else?

My life as a Nurse – an introduction

Hello everyone,

Since I wrote an intro on my Tourettes and my Deafness, I couldn’t resist to make one about me as a nurse. I’m still in training, so I am not (yet) a professional, but I do have some experiences that I’d like to share.

Where it all started
It started with me dropping out of the Signlanguage Interpreting program because of my hearing loss. I KNEW I wanted to ‘help people’, and ‘make a difference’. My mum, dad and sister all work (in some form) in health care, so I knew that they made a difference in people’s lifes. Whether it is by talking to them, or supplying hospitals with equipment that is needed to save people. Nursing at University level seemed like a good idea

Applying and procedures
After I decided I wanted to become a nurse, I applied and did a day of testing at the Uni to see if I was ‘qualified’ to start. And… I was! I was so happy the day I received the news that I got accepted at Uni.

The first year
I followed a program where you do the first 2 years combined in 1 year. That was tough! But I learned so much about the human body and I was surprised that there is SO MUCH that can go wrong, why doesn’t it go wrong more often?! I made new friends, did my first internship at a nursing home and there was one situation that really stuck with me.

silly doctor

2nd year Internship, how to save a life by talking
There was a woman of around 75 years old who had become paraplegic due to cancer about a year before I met her. She got help with daily care, washing, getting dressed, being lifted into the wheelchair and her decubituswounds were taken care of. When the care was done, the nurses left and left her do her own thing, until she was lifted into bed again and then she wasn’t seen for the rest of the night.

I thought to myself: this woman had been able to walk for 74 years, she was independent and did so many things. And now she’s like this. At first I pitied her, but soon I learned that there was no pity neccesary. She was a strong woman, with a strong will for life. I am, in many ways, like her: I’m Deaf and have Tourettes, but I don’t let it hold me back from doing anything!

One day she was told she needed surgery for her wounds. She didn’t talk about it, but I could see she was terrified. One day I asked her directly and sat with her for a long time. She said she had become depressed and anxious – which was no surprise for me, but she hadn’t told anyone. I reccommended some things and that helped her a bit through the surgery. I visited her in the hospital and she was very happy with that. I will always remember her.

Apprenticeship at the university hospital!!
The thing I was working to for 1,5 years finally happened, I got accepted as one of 16 people (out of 200) to not just do an internship at the university hospital, but to get to have the responsibilities that any other registered nurse has and I was going to get paid for it! I was out of my mind so happy.

Neurology
I was placed in the Brain Division, deparment of Neurology. Ironically, since I myself have Tourettes Syndrome, a neurological disorder. I loved working there, I loved my crazy funny co-workers and I loved the patients.
But as you can read, it’s past tense… I had to stop because of my Deafness and there were some things in my family (my mum was diagnosed with cancer 2 months ago and I got overwhelmed by it all), so to be short: it got too much for me. I learned a lot, I’m really humbled that I got to have this experience, but unfortunately something I had to let go of.

The next chapter of my life
I wouldn’t be Sam if I didn’t already have new plans. And I do! There’s a mental health institute for the Deaf in my country where I applied for to do my 3rd and 4th internship. I have an appointment set at the end of this month, and I hope they’ll see my positive attitude and will hire me!

To conclude: you might face obstacles, but if you find a way around them, they won’t bother you as much. “If things don’t go right, turn left”.

smile free

Love, Sam

Question: If you work as a nurse (in training), where do you work? What do you like about it most and want to share that with me? Have you faced obstacles during training?