Communication Strategies for Nurses Interacting With Patients Who Are Deaf

Christine Chong-hee Lieu, BA; Georgia Robins Sadler, PhD, MBA, BSN; Judith T. Fullerton, PhD, CNM, FACNM; Paulette Deyo Stohlmann, MSN, RN, OCN


Dermatology Nursing. 2007;19(6):541-544; 549-55. 

In This Article

Strategies for Improving Effective Communication with Deaf Patients

A first step toward improving communications with the deaf pa tient is to be familiar with the various forms of communication he or she uses in daily life. Two or more of the following means of communication may be utilized. However, the deaf patient may not be equally proficient in the various methods they use (McAleer, 2006).

Essential points for interacting with the deaf patient are identified in Figures 1 and 2. The nurse's demonstration of interest in finding the most effective means of communication may help reduce the deaf patient's anxiety regarding his or her ability to communicate in health care settings (Ekstrom, 1994; Meador & Zazove, 2005; Sadler, Galey, & Bovee, 2004; Steinberg et al., 2006). These communication ap proaches may im prove the health care experience and increase the willingness of the deaf patient to sustain participation in the health promotion process.

How to Communicate Effectively with Deaf Patients When an ASL Interpreter Is Present

How to Communicate Effectively with Deaf Patients When an Interpreter Is Not Present

Eye contact must be obtained and maintained throughout the interaction so the patient knows when comments are being directed toward him or her. Culturally appropriate methods of obtaining the attention of a deaf patient are presented in Figure 3. The deaf patient also should receive care in a clinical space that is evenly lit, with no glare in the patient's visual background. He or she should be positioned to avoid looking into a brightly lit background. A clear visual of physical gestures will help the patient frame the situation even if he or she cannot read lips well. Faces and hands should be kept clear of any obstructions, such as masks or clipboards (Abel, 2003; Barnett, 2002a; Jeffrey & Austen, 2005). When masks are needed in the provision of patient care, the provider can consider the possibility of wearing an eye shield as a face mask so that his or her lips can still be seen by the patient.

Appropriate Methods of Acquiring the Attention of a Deaf Patient

When an ASL interpreter is providing service, the interpreter should be placed to the side and slightly behind the nurse so that both are clearly in the patient's view (see Figure 4) (Barnett, 2002b). This arrangement will ensure that the patient can clearly see the nurse's facial expressions, hand gestures, and lip movements. This placement also is important be cause the nurse can face the patient without the distraction of the interpreter and direct questions toward the patient alone.

Room Arrangement with Nurse, Deaf Patient, and ASL Interpreter

Health care providers also must be aware of the differences in syntax between English and ASL (Barnett, 2002a; Farber, Nakaji, & Sadler, 2004; Lock, 2003). Signing is not a word-for-word translation of the spoken or written words; rather it is a series of pictures that convey a meaning. This may take more or less time than the spoken words. For the provider without prior experience working with an ASL interpreter, a first step is to ask the ASL interpreter to explain the optimal communication pro cess during the three-way communication.


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