Deaf Healthcare Workers Left Behind as Masks Became Universal During Pandemic

By Lorraine L. Janeczko

May 13, 2021

NEW YORK (Reuters Health) - A U.K. survey of deaf healthcare workers shows many feel frustrated by a lack of transparent masks and adequate communication-support policies.

Many deaf healthcare workers communicate visually, through lip reading and sign language. During the COVID-19 pandemic, universal mask wearing and other environmental conditions, such as social distancing, have hindered their ability to communicate with patients and colleagues.

"The shocking finding was the extent to which healthcare professionals were unsupported in their workplace," said lead author Dr. Helen Grote, a neurologist at Chelsea and Westminster Hospital NHS (National Health Service) Foundation Trust in London.

"Several respondents reported the unkindness with which they were treated by colleagues due to communication difficulties, which only served to increase their sense of isolation," she told Reuters Health by email.

Dr. Grote and her colleagues aimed to understand the impact that lack of transparent masks and appropriate workplace adaptations had on communication, confidence and well-being among so-called "D/deaf" healthcare workers during the pandemic.

In the term "D/deaf," the team explains in Occupational Medicine, "'Deaf' (capital D) is typically used to refer to those individuals who are part of the Deaf community, and use BSL (British Sign Language) as their first language, whereas 'deaf' (little d) refers to those who use spoken English and lipreading. Individuals in either group may wear cochlear implants or hearing aids."

The researchers sent a survey to all members of the U.K. Deaf Healthcare Professionals Group on Facebook, to the Healthcare Professionals with Hearing Loss listserv, and to other social media sites.

Of the 83 responses they received from workers in 31 healthcare professions - including 18 doctors and 14 nurses - 68% reported severe or profound hearing loss, and 87% relied on lip reading. Prior to the pandemic, 93% had cared for patients in the clinic.

Only 11% of respondents said they had access to transparent masks. More than three-quarters reported feeling anxious and afraid of making mistakes due to communication problems, and 17% were removed from clinical roles due to a lack of appropriate workplace adaptations.

A third indicated that, if transparent masks or alternatives would not be available, they would need to consider an alternative career.

Overall, 78% of respondents reported that, during the pandemic, the communication needs of D/deaf HCPs were not being met.

"D/deaf HCPs felt left behind, isolated and frustrated by a lack of transparent masks and reasonable adjustments to meet their communication needs," the researchers conclude. "Loss of experienced, qualified HCPs has a significant economic and workforce impact, particularly during a pandemic."

Dr. Grote noted, "These findings do not surprise me. I am a deaf doctor and have firsthand experience with how difficult it is to work without clear masks that facilitate lipreading."

"I've worked in places where senior clinicians have been unkind and unhelpful," she added. "Fortunately, my colleagues and current workplace are very supportive. I now have a cochlear implant and access to other equipment, including Bluetooth microphones for clinics and ward rounds, and these technologies mitigate some impact of loss of access to lipreading."

Under the UK's Equity Act of 2010, employers and training bodies are legally required to provide support to deaf and disabled staff and students.

"We hope employers and national organizations such as NHS England will take note of their legal obligations to ensure that D/deaf healthcare professionals are provided with appropriate reasonable adjustments, are supported to utilize their skills and talents, and are not discriminated against," Dr. Grote urged. "Asking D/deaf staff, 'What support do you need to be the best you can be?' goes a long way not only to improving staff morale and retention, but also to ensuring that patients receive the best care."

Dr. Richard D. Ten Hulzen, an ophthalmologist at Mayo Clinic in Jacksonville, Florida, who has hearing loss, told Reuters Health by email that these communication challenges are a worldwide problem.

"Universal masking and social-distancing policies have detrimental impacts on individuals with hearing loss from every country and socioeconomic class," said Dr. Ten Hulzen, who was not involved in the survey.

"During the pandemic's universal masking requirements, individuals with hearing loss are, at best, patiently enduring," he explained. "At worst, they are miserably suffering. Without adequate support from coworkers and leaders in the workplace and from family and friends at home, the inability to effectively communicate invariably causes the individual to avoid social situations and become more withdrawn from interpersonal interactions."

As a workaround for his hearing loss, Dr. Ten Hulzen said he relies on scribes or medical assistants, who "act as extra pairs of ears that can help recognize and rectify any potential miscommunication."

SOURCE: https://bit.ly/3hlUwiw Occupational Medicine, online April 27, 2021.

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