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A Guide for School Nurses Treating Deaf Patients

Communication: The problem and the solution to adequate health care for Deaf patients.

Communication is the number one priority in the health care field. A patient must be able to communicate symptoms and issues flawlessly with their health care provider, to receive an accurate diagnosis and optimum treatment. Deaf patients tend to face prolonged or unnecessary illnesses due to inadequate communication between their health care providers and themselves. School nurses, in particular, deal with Deaf students at a very difficult period in their life. The usual pains of growing up are multiplied by the difficult communication barriers they may face with other students, their family, and teachers. Ninety percent of Deaf children are born of hearing parents. Some parents do not, or choose not, to learn to communicate with their child in their native visual language. Lessons from home such as eating right, sexual health, and hygiene may be lost in translation.

Can I use spoken English with my Deaf students?

If the student is profoundly deaf, then the answer in short is no. English is a spoken language therefore is widely misunderstood by many Deaf children. Only 30% of spoken language can be understood by reading lips; hardly enough to communicate clearly and effectively. Law requires that interpreters must be hired to bridge communication gaps for Deaf children in hearing schools. The use of an interpreter, while useful in some situations, can be a hindrance in others. Students may not feel comfortable enough to be honest about symptoms they find embarrassing in front of their interpreter, the person they spend the primary part of their day with.

What about communicating with my Deaf students through writing?

Studies have shown that Deaf children who learn American Sign Language or another visual language first, they tend to read and write English better. For students with a clear concise understanding of written English; writing a note back and forth between a nurse and student may be an acceptable option. On the other hand, if a Deaf child does not have access to a visual language they have no way of bridging the gap between concept, visual representation, and eventually English word on paper. Writing notes between school nurse and child may not be an adequate solution if the student is not able to read or write English clearly and concisely. To eliminate any possibility of ambiguity it is best to communicate in the Deaf child’s natural visual language. Writing a note also creates a physical manifestation of the conversation: this may not be ideal, in terms of getting complete and honest information from the ailing student. It is imperative that school nurses learn the basics of American Sign Language, or another form of sign language that is regionally used, as it applies to the health and medical field.

Are their specific physical problems I should look out for in my Deaf students?

There is not a remarkable, definable difference between Deaf and hearing students’ physicality. Deafness may be caused by illness, but illnesses are rarely caused by deafness. Certain diseases are more prevalent in the Deaf community due to a lack of understanding, or prevention of basic health problems, caused by communication issues with their healthcare providers. Studies show that Deaf adults eat less fruits and vegetables than their hearing counterparts, thus increasing their chances for Cardiovascular Disease. Deaf people are more than three times more likely to have high cholesterol, instances of obesity, hypertension, thyroid gland diseases, and respiratory diseases; and twice as likely to get diabetes, heart disease and gastrointestinal diseases. Deaf students are also at an elevated risk for sexually transmitted diseases because of inferior sexual education and communication within the hearing community.

What about the mental and emotional health of my Deaf students?  

Many studies suggest that Deaf people experience anxiety and depression at higher rates than their hearing counterparts. Communication barriers between themselves and the hearing community cause, and exacerbate these problems. The alienation that a Deaf person may experience can cause depression, and if communication is an issue they may not be able to diagnose and treat their depression adequately, causing further alienation. Studies have also suggested higher suicide rate among the Deaf population for these same reasons. Substance abuse problems are also prevalent in Deaf teenagers as they struggle to adjust and cope with everyday frustrations. When treating a Deaf student watch out for signs of emotional distress, offer open and honest opinions and referrals to drug, substance abuse, mental health clinics, or suicide resources.

What can I do to be an excellent school nurse for my Deaf students?

·Communicate clearly: preferably in their visual language
·Provide a confidential, safe environment, where they can be honest and open
·Provide the same amount of service and attention you would with any other student
·Diagnose and treat individual based on their specific needs
·Discuss preventative measures for future health issues: eating right, exercising, sexual health
·Address emotional and mental issues as well as physical: the two may be dependent on one another
·Provide multiple resources and referrals; including drug and/or substance abuse centers, sexual health programs and suicide organizations

School nurses can be an invaluable asset to the deaf student; helping the student to potentially avoid future life threatening illnesses and situations.

National Center for Deaf Health Research: A health research center, based in Rochester, New York, that is working hard to provide research for and health solutions for the Deaf community nationwide.

Deaf Health Information: Quick guide on Deaf people and their relative risks of getting health problems compared with their hearing counterparts

DeafMD.org: provides an A-Z guide on illnesses, has a directory for deaf-friendly healthcare providers by region, and a guide in American Sigh Language to understanding various health related tests.

American Annals of the Deaf: a Gallaudet University printed scholarly journal on issues relating to the Deaf population. All issues are downloadable and free of charge.

Fruit and Vegetable Intake Among Deaf Adults And Risk of Heart Disease: Study performed at the University of Arizona that highlights how an inadequate understanding of good health practices could be the cause of many health problems in the Deaf community.

Assessing Substance Abuse Problems with Deaf and Hard of Hearing Students: Informational materials created to help professionals understand substance abuse problems of Deaf and hard of hearing individuals.

Gallaudet University: Mental Health Care Program: Program provided to medical students to discuss, watch, and understand the trends and issues of the Deaf population while getting health and mental health care.

National Association of the Deaf: General and mental health care page for the Deaf population and their families.