Pints at the Pub

by Jenny

Two friends are having pints at the pub. Their conversation is animated and big, involving lively hand gestures some can identify as British Sign Language. Suddenly, the two friends are on their way to A&E with one of them clutching their chest in increasing agony. Upon arrival, one runs up to a member of staff, using BSL and actions, he tried to tell the staff that his friend is having a heart attack. The bewildered staff mistakenly shuffles him into treatment room, leaving behind his distraught friend desperate for help. That friend ended up dying from the heart attack.

This is, unfortunately, a true story John told us happened to his friends. John works for the charity Deaf Blind Scotland and came with guide Maureen and guide dog Peat to meet us on Wednesday. Being deaf and partially blind himself, John was able to provide us incredible insight into what it’s like for those in his situation and what could be done better, especially in the healthcare setting.

What follows are the main issues John believes should be fixed. Because they are in the context of the healthcare setting, I will use Driscoll’s model of reflection which involves answering the questions “What?”, “So what?” and “Now what?” for an experience in clinical practice.

1. Hearing loops at GP and hospital receptions

What –  All receptions are required by law to have a hearing loop system in which anything spoken into a microphone may be picked up by hearing aids, with the background noise cancelled out. However, John has found that many receptionists don’t even know how to work the hearing loop, the loop has been unplugged or parts of it misplaced. As a result, what is evidently a very useful piece of technology has been deemed useless.

So What – The problem with hearing loops reflect a wider issue – it has made me realized that despite having the technology in place and potentially no matter how many more tools or resources we put in place to better the service for deaf people, it will not work without proper training and awareness.

2. Making appointments

What – John is frustrated that he cannot make an appointment with his GP by himself. He must rely on other people to do it for him because when he calls them, they often do not understand that his hearing aid does not allow him to hear over the phone. When he asks if he can text instead, they say no. This resonates with another story shared by a deaf volunteer who answered our survey. One day, her husband was having a stroke. Not able to call 999, she had to leave her husband and run ten minutes to her GP practice in order to get help.

So What – Deaf people face unfair problems in accessing healthcare. These examples expose how some systems and protocols in healthcare may exclude deaf people. It has also made me realize how I have taken my independence and easy access to help for granted.

3. Low number of interpreters

What – John says whilst there is the option to book interpreters for appointments, it can be hard to find one due to low numbers of qualified interpreters. Maureen supports this observation, saying it may take up to 8 years to become a fully qualified interpreter, with a hefty price tag attached to each level of lessons and exam. As a result, many deaf people rely on relatives to interpret for them in a consultation, which is never a good idea according to John. For instance, he has spoken to a 14 year old deaf girl whose father was the first to find out she was pregnant; and a interpreting daughter who had to tell her deaf mother she has cancer.

So What – I always thought the problem of communication is easily solved through the use of interpreters in appointments. However, I now realise how much more complex the problem is. These stories also made me recognise the importance of patient privacy and how breach of it can lead to awkward or even very distressing situations for all involved.

Now What

I think our conversation with John has provided more clarity to our project. We now have real life accounts on how increasing awareness can really benefit those who are deaf.

In the grander scheme, it should be mandatory for hearing loops (and any other technology that is meant to provide aid) to be checked regularly and for relevant people to receive proper training on using them. Furthermore, John has been campaigning for The BSL Act, aiming to put BSL in school curriculums (as we have foreign languages). For many people, if they speak French, Spanish, or another foreign language, they usually also speak English. However, for deaf people, BSL is often their only language. Therefore, to learn BSL is to be more inclusive of the 6000 people in Scotland who use BSL as their preferred language.* Government subsidy of BSL training courses for becoming interpreters may also help increase the number to meet demand.

However, when it comes to things we can do now, our group has thought of the following.

• Make a poster that show our findings and highlight the things we can do in our everyday life to be more inclusive of deaf people. We hope to display this poster in the medical school or hospital to raise awareness.
• We also plan on submitting a version of the poster to the NHSScotland Event in 2020 in order to call attention of more healthcare professionals to how quality of care can be improved for hearing impaired patients.
• Write to our medical school about including deaf and/or blind awareness training in our curriculum.
• Keep up our BSL skills and encourage our peers to do the same through word of mouth and our blog. As John has explained, he doesn’t expect all doctors to be fluent in BSL but if we all knew the very basic, we’d be able to greet patients, reassure them, and let them know an interpreter is on the way. Whilst it doesn’t seem like much, these small interactions can make the patient feel less isolated and provide comfort.

*http://www.deafaction.org.uk/wp-content/uploads/2016/10/Deafness-in-Scotland-A-recent-analysis.pdf