“Do you have a key tip for other d/Deaf and hard of hearing health professionals?” A question I’m asked from time to time and able to answer without a moment’s thought. Because there’s one thing that I’ve found consistently makes a difference to smooth communication with my patients and colleagues. And everyone else, come to think of it! It is,
“Be up-front about your hearing …”
…about your hearing, hearing loss, hearing impairment, deafness, duff ears … whatever term you prefer. Be up-front about it. Tell people early on in the encounter.
- So people don’t think you’re stupid, not paying attention or ignoring them when you miss something they say.
- It gives you the opportunity to mention any strategy that will help you hear them. For example you might tell them you lip read and ask them to face you.
- It makes it easy to ask for another adjustment if further into the conversation you realise it will help. Such as when you realise they talk nineteen to the dozen and you’d like them to slow down a bit.
What should you say?
This has to be individual to you. When I greet a patient I try to remember always to tell them my name and role. I expect that will usually comes first for all of us.
Now’s a good time to say that if you haven’t already heard of Dr Kate Granger’s #hellomynameis campaign, please find out more on the campaign website and Kate’s blog. As a terminally ill cancer patient, Kate noticed that many staff didn’t introduce themselves. She found an introduction makes a connection, begins a therapeutic relationship and builds trust. Join the campaign and, deaf or not, decide to make this your starting point.
So, having introduced myself, I point at my hearing aids and say, “by the way, I’m partially deaf. I use some lip reading and if I miss something you say, I’ll just ask you to say it again.”
Me being who I am, I thought it out in detail and arrived at my “standard patter” by experimenting with different phrases till I found something I felt comfortable with and that achieved the results I was after. Each phrase carries a sub-script and is there for a reason.
- “By the way …” keeps it low key. It implies, “this is just something for you to be aware of but it won’t be a barrier to communication.”
- “… I’m partially deaf.” Personally, I prefer to describe myself as deaf. I’ve found my hearing loss difficult to adjust to and I find social situations so difficult I feel significantly disabled. More than “a bit deaf” and I hate people designating me “hard of hearing.” But when I’ve introduced myself as “deaf,” every now and then someone has queried it. They decided that because I still have some hearing, I’m not “deaf” but “partially deaf.” In a social situation, I probably will say “deaf.” But much as I prefer to choose my own description of myself, at work I usually don’t want to be pulled into this discussion. So I decided it’s usually more straightforward to say “partially deaf.” And I think especially when I’m working as a locum, where patients don’t know me, it is good not to let any perceived barriers be higher than needed.
- “I use some lip reading…” Even if people aren’t deaf aware, most will have an inkling that I need to see their face. Some people tell me they know they usually mumble so I know they’ll make a conscious effort to speak a bit more clearly. Others tell me they know they speak too quickly so will slow down. And others comment that they’ll make sure they face me. So already this phrase is having my desired effect. And even if people don’t cotton on at all to begin with, if I do have difficulty following them and want to ask them to slow down a bit, or some other adjustment, I’ve already created the opening. If I haven’t mentioned lip reading at the outset, it’s a bit awkward to stop them mid-flow and explain. Awkward for them as well as for me.
- “… and if I miss something you say, I’ll just ask you to say it again.” Which means that if I do ask them to repeat something, they don’t think I haven’t been paying attention, or am stupid.
- The “just” keeps it low-key, along with the “by the way” at the beginning. And I rattle the whole thing off in a relaxed manner. Again, communicating the message, “this isn’t going to be a problem.”
And it works! The reactions I’ve mentioned show me it works. And I was very encouraged by something in the BBC See Hear feature broadcast earlier this year. It included a short interview with Chris, the patient who agreed to be filmed to show me at work. I’m not sure if this made it into the broadcast clip, but during his interview Chris said that because I’d told him from the outset that I lip read, he made sure he faced me and spoke clearly. Proof the message in my sub-script was getting through.
That’s the introduction that works for me. Someone else will use different phrases. Think about what you want the introduction to achieve then come up with a few ways of saying it. Practise them out loud on your own so they begin to trip off your tongue smoothly. Then try them out with patients and experiment to see what works best for you. It should become so automatic that you don’t even need to engage brain to say it. That keeps it relaxed and low-key for the patient and you. And quick.
You probably already have pet phrases for all sorts of things you say to patients: ways you’ve found of taking a history that help the patient understand the question, or what you want them to do when you examine them, or explaining something to them. You say them so often they can become automatic. That’s what your standard introduction should become.
I’ve been asked if these introductions are possible in the busy NHS such as a GP with 10-minute appointments? Well, I timed myself and (if I don’t happen to stammer) my standard patter (including “#hellomynameis”) takes about 10 seconds. There are usually another couple of seconds while the patient says “Oh that’s fine,” or “I know I mumble so I’ll try to speak clearly” or similar. And that’s all. So it really doesn’t eat into the consultation time at all. And saves time later explaining if I am having difficulty hearing something.
I’ve never had a bad reaction from a patient and I’ve only heard one account of a patient reacting angrily. That was a drunk in the Emergency Department who was angry and swearing at everyone anyway, so it wasn’t really anything to do with seeing a deaf doctor.
The discussion about telling patients and colleagues we’re deaf or hard of hearing crops up in our email group from time to time and there’s a consensus that this strategy works. I’m always delighted when a newcomer asks about this and is encouraged to give it a go by someone who not long before had been asking the same question themselves.
“Hello, my name is Dr Clare Redstone. I’m one of the travel health doctors here at InterHealth. By the way, I’m partially deaf. I use some lip reading and if I miss something you say, I’ll just ask you to say it again.”
How do you introduce yourself? If you don’t already, how about experimenting to find your own “standard patter?”