By Andrea Hadley-Macias,
Monday, April 6, 2009
Deaf People and Health Care System
Patients are dependent on nurses for the delivery of safe and effective
health care and communication is key for success. How does a nurse
accomplish this important task with a person who is Deaf or Hard of Hearing?
In communication people who are deaf use American Sign Language (ASL) which
is a language of its own, few people realize ASL is different from English.
There are other methods of communication such as writing, lip reading, and
auxiliary aids but most people who are deaf or Hard of Hearing (HOH) chose
to use ASL as their method of communication. Besides the rules and
guidelines the federal government sets for the health care system in regards
to people who are Deaf/HOH there is an underlying moral sense and cultural
identity that needs to be addressed. Deaf culture is "a social, communal,
and creative force of, by and for deaf people based on American Sign
Language.
Deaf culture, however, is not restricted to deaf people; families, friends
and advocates of the deaf community may also be a part of deaf culture…It
involves deaf people partaking in "visual literature" (for example, ASL
poetry, plays, story telling, or humor) as well as, sports and many other
physical and visual activities. As a result, the psychosocial basis of deaf
culture is understood to mean that deaf people…regardless of mode of
communication taught in the school will seek out other deaf people and use
sign language as a primary mode of communication.” [1]
In this awareness of Deaf culture, nurses and other health care providers
need to develop a sensitivity to the patient’s preference of communication
in order to be effective and administer proper care. According to federal
law, nurses and their employers have important responsibilities to be
accessible to deaf and hard of hearing patients.
“Failing to provide interpreters and adapted equipment may be discrimination
on the basis of disability. In addition, failure to establish effective
communication with a deaf patient may expose a health care provider to
liability for medical malpractice…This right is established under two
federal laws.” [2]
The Rehabilitation Act of 1973 and the American Disability Act set the rules
and guidelines Hospitals or medical care facilities and its employees must
follow to adhere to the patient’s rights. Under section 504 of the
Rehabilitation Act of 1973 which “requires federal financial recipients’
programs to be equally accessible to handicapped persons…provision of
qualified sign language interpreters is critical to ensure that deaf persons
are able to benefit from and participate equally in the program. The office
for Civil Rights of HHS has consistently required hospitals to provide
qualified interpreters and TDDs to deaf clients…” [3]
How can nurses provide proper care and improve relationships with patients
who are Deaf or HOH?
By following ADA guidelines and the Rehabilitation Act of 1973 regulations
and taking the initiative to become certified ASL interpreters or be able to
work with interpreters and to be aware and respectful of Deaf culture and
the fact that many “…deaf people do not view their deafness as a
disability...”[4] but as an identity.
[1] http://www.enotes.com/nursing-encyclopedia/american-sign-language
accessed 4/4/2009
[2] http://www.nad.org/hospitalsnursinghomes accessed 4/4/2009
[3] http://www.nad.org/hospitalsnursinghomes accessed 4/4/2009
[4] McAleer Moncia, Communicating Effectively with Deaf Patients. Nursing
Standard. 52. (2006) accessed 4/42009