Would You Hire a Deaf Nurse?

A nursing school boots out a deaf student over concerns that her hearing loss would limit her ability to safely perform clinical rotations. Nonsense, says the Association of Medical Professionals with Hearing Losses.

There's a moral conundrum playing out in Missouri, where nursing student Jessica Wells sued the college that booted her out of its nursing program. The reason she was ousted? She's deaf.

According to a report in the St. Louis Post Dispatch, the student, Jessica Wells, sued Cox College in Springfield, MO after the college dismissed her from its nursing program in early 2008. In its dismissal letter to Wells, the college asserted that her "hearing loss would substantially limit (and in some cases completely limit) [her] ability to safely perform clinical rotations."

Wells sued the school, and although a summary judgment initially ruled in favor of the college, the Missouri Southern District Court of Appeals overturned that ruling. A jury in a trial earlier this month sided with Wells, saying that the school should have provided reasonable accommodations for her to participate in the program.

According to the court of appeals' ruling, the school "offered nothing more than its subjective belief that the use of an ASL [American Sign Language] interpreter in the clinical setting posed a direct safety threat" and "asserts no facts related to Plaintiff's use of an ASL interpreter in her first semester of clinical rotations that would allow a fact finder to find that such a threat existed."

The appeals ruling also said that Wells' "successful completion of the first semester while using an ASL interpreter during her clinical rotations proved the absence of any such threat."

The lawsuit and latest ruling raise question about whether a nurse with hearing loss could, in fact, safely care for patients. Would he or she be able to respond to alarms and codes? Could he or she effectively listen to patients' hearts and lungs? Could such a nurse find professional success?

The answer to those questions is yes, according to the Association of Medical Professionals with Hearing Losses (AMPHL), which provides guidance and resources for this population. The Association's website says RNs with hearing loss should be prepared to tell potential employers how they'll accomplish certain clinical functions and what accommodations they'd need to do so.

For instance, they should be ready to describe how they'll do things like assess heart, lung and bowel sounds; communicate when colleagues are wearing masks and they're unable to lip read; and handle code situations.

"Nurses in AMPHL have successfully managed all of these situations with some creative accommodations," the AMPHL website says. Such accommodations for the hearing impaired might include specially-amplified stethoscopes, pagers that beep codes that mean different things, and the use of interpreters.

One nurse who's successfully managed these situations is Morag MacDonald, RN, MSW, who writes about her experience as a deaf nurse in the book Leave No Nurse Behind: Nurses Working with disAbilities. She writes that she made modifications to her workplace, such as using a master alarm with a remote receiver, and placing a receiver on IV machines and respirators to alert her with flashing lights when alerts went off.

MacDonald also got help from her coworkers, writing that the "ward clerk or other nurses alerted me if a patient was ringing for me… other nurses made my phone calls and we used a 'barter' system in supporting each other."

But MacDonald's career wasn't only shaped by the accommodations she needed in order to do her work. Her deafness was an asset in some ways, too. For instance, since she was able to read lips she was especially good at caring for patients who were on respirators. And she really connected with certain patients and parents.

She writes, "Many parents of chronically ill or disabled children saw me as proof of what their own children might be able to achieve."

Proof of what they could achieve, that is, if only given the chance.