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Leadership/Management

Practicing as a Deaf Paramedic

Adam Harvey, NREMT-P, doesn't let hearing loss prevent him from practicing as a paramedic.

I work full-time as a paramedic for a busy metropolitan ambulance service. I’ve been employed with this company since 2007 and in EMS since early 2004. The first thing people notice about me is that I wear two hearing aids. I lost my hearing at a very young age due to an overdose of the antibiotic gentamicin. 

I’ve worn these hearing aids and struggled with the realities of being deaf all my life. This included being bullied and teased in school as well being disqualified from joining the U.S. military. My dad, at one point in his long career with the U.S. Navy and Coast Guard, was in charge of dispatching rescue ships and Dauphin and Jayhawk helicopters in search of vessels in distress on the Great Lakes. Occasionally he took me to work with him, and during those interactions I became deeply fascinated with search and rescue.

Being deaf presents challenges in the workforce. You deal with ambient sounds and multiple people talking, as well as opinions on whether you’re even qualified to be in the field. It’s largely not a problem for patients, most of whom don’t notice the hearing aids at all (some think I have a fancy foreign accent). The doubts I initially faced came from coworkers. 

When I was hired people complained left and right about working with a hearing-impaired colleague. They worried my hearing loss would pose a danger to patients and my partners, that I’d be unable to obtain directions from the navigator when going Code 3, that I couldn’t maintain situational awareness in a noisy environment. There was a period where I was banned from 9-1-1 ALS trucks and restricted to working BLS because the company was concerned I couldn’t function at the level needed for 9-1-1, even though I’d had no incidents related to my hearing in the four years I’d worked there.

The funny part is that the people who complained never picked up a shift with me, so they had no idea how I actually operated. My regular partners never complained about my hearing and generally enjoyed working with me. 

Functioning as a Paramedic

I wear two behind-the-ear (BTE) hearing aids. These are the most powerful form of hearing aid on the market for people who are profoundly deaf. They’re sophisticated devices with complex computer programs to automatically change volume and adjust microphone directions, and algorithms to adjust frequencies I can’t hear into ones I can. They allow me to operate in noisy environments such as busy highways, disaster zones and music venues. 

I use these devices in conjunction with excellent eye contact and lip reading to ensure successful communication. I’ve even had some partners tell me that with the hearing aids, I heard better than they did. These hearing aids are also Bluetooth-compatible, allowing me to link them with my phone for clear and concise reports to hospitals and medical control. Some stethoscopes are now Bluetooth, opening the possibility to link auscultation to my hearing aids as well.

My organization was instrumental in helping me obtain these high-tech devices. We worked with an audiologist to conduct a series of exams and tests that led to me being fitted with a pair of powerful Oticon Chili BTE hearing aids. This vastly improved my hearing and ability to function in the workplace. I was soon promoted to paramedic. 

I’ve had to work hard to gain the trust and respect of my peers and management and overcome any doubts I could perform the requirements of my job safely and effectively. I’ve joined our bike team, in which I ride a bicycle equipped with ALS gear at large functions such as triathlons, cancer walks and other crowded events. I also finished a critical care program and hope to join our critical care/NICU division soon. I’m a member of the Minnesota EMS Honor Guard; we perform at line-of-duty death funerals and other important functions. (Sometimes orders given with the guard are silent or in whispers—you can imagine the difficulties that can present!) With the proper equipment, support from management and paramedic colleagues, and assistance from the audiologist, I reached my original goal of being in 9-1-1 and am loving every moment of my job.

Hearing Loss and Being a Paramedic

I’ve been approached by many people, both senior EMS personnel and students, who complain of a wide variety of hearing issues and want advice. Their challenges may include general hearing loss, tinnitus or working with someone with hearing loss. 

Here is my advice to them: If you suspect you have a problem, don’t try to hide it. Seek help from a specialist. There are many kinds of hearing loss, as well as many solutions that are new and not well known these days. Some hearing aids are so small, they fit deep in your ear and never need to be removed. Even if you don’t qualify for hearing aids, stethoscopes come with amplifiers. One of the best things you can do is protect your hearing before it’s damaged: Wear earplugs when driving with sirens on or working on noisy scenes. 

An audiologist or supportive employer may get excited about helping you and recommend fancy high-tech equipment to use in your day-to-day operation. Sometimes this can be a bad thing—you can be overwhelmed by the options or burdened by wires that may be needed to use all the functions of the hearing aid. Devices like this may be fine for an office job, but they’re not always agreeable in a fluid environment such as that of a paramedic. For example, I used to have wires connecting my radio to my hearing aids via a device worn around my neck. On top of that, my partner had to wear a similar device that doubled as a microphone. This usually resulted in tangled messes and crabby partners. 

Instead I found a low-tech solution that has worked fantastically: piping radio communications directly to my ears. Working with the audiologist and a molding company, we drilled a secondary chamber into my hearing aid mold to insert the speaker coil from a Motorola radio accessory. 

Succeeding in EMS

Deaf personnel have excelled in a variety of emergency-services capacities, proving that deafness is no obstacle to providing good service. They often come to the attention of mainstream media.

Amber Tansey, from Santa Rosa, Calif., prepared for a potential EMS career by running calls with San Francisco firefighters. She credits her success at it mainly to good communication skills: Tansey communicates via hand gestures, computer messages, written notes, sign language, eye contact, lip reading and even assistance from an interpreter in some instances.

She says she’s become very observant of what’s going on around her. A former instructor called Tansey “driven.”1  

Chad Grabousky struggled to find EMS work before being hired at Pennsylvania’s Global Medical Transportation Services, where’s he’s liked by patients and coworkers and outperforms some hearing staff, according to his boss.

Grabousky also serves as EMS lieutenant for a local volunteer fire company. He communicates through sign language, lip reading and hearing aids. He says his greatest challenge was communicating over the radio, but his colleagues have worked with him. Grabousky notes that in a team, strong teamwork can help overcome individual deficiencies.2 

Deaf since birth, Joseph Ronan volunteers for his local fire department in West Haven, Conn. He idolized firefighters as a child and sought a role at his local station after school.

Firefighters put him through training, and while the state says he can’t be a paid, full-fledged crew member, he continues to participate as possible. Said the director of his fire school: “The instructors and students alike all said it doesn’t make a difference if you’re deaf or blind: You can’t see or hear anything inside a burning building anyway, so it basically made everyone level.”3

Embrace the Change

In closing, don’t be nervous about hiring or working alongside people with hearing disabilities—they had to pass the same exams and clinicals you did. Take the time to approach them, get to know them and enjoy their company. Ask questions—trust me, you won’t offend most people; they already know they’re deaf! 

If you find yourself working with someone with hearing loss and you notice they seem to say “What?” or “Huh?” a lot, ask them what you can do to ensure better conversation. For some deaf people it’s difficult to ask others to change, so they suffer in silence, in fear of making a shift miserable, even though it might be something as simple as talking just a little bit slower or louder.  

Sidebar: How a Paramedic Can Help the Deaf in Emergencies

The number of people with hearing problems is not small. In the United States about 7.5 million people have hearing disabilities. In roughly 1 million the disability is considered severe, and about 5.6 million need hearing aids. The number of people with hearing problems is only increasing as soldiers return from recent wars and the population ages. During Hurricane Katrina and the Superstorm Sandy, the deaf and other disabled people had more problems compared to the general population, but this has helped raise awareness of their challenges.

The challenges of emergencies involving disabled people existed before 9/11. During the 9/11 attacks, a lack of warning devices geared to the disabled led to difficulty evacuating deaf citizens from hazardous areas. Following 9/11 the U.S. Department of Homeland Security devoted resources for greater awareness of these issues. Even during Hurricane Katrina, fewer than 30% of emergency shelters had American Sign Language (ASL) interpreters to assist deaf victims.4

Include deaf people as part of training scenarios and emergency drills. Paramedics and deaf people should understand how to coordinate during an emergency. It is also important that the deaf have proper emergency information so they can be guided away from hazards. Departments should be prepared to deliver mass care for the hearing-impaired. Translators and communicating devices should be available.

Official interpreters may be difficult to find in an emergency; in immediate cases look for a relative or a friend who can help you communicate. Registers and survey information can help paramedics understand where deaf individuals live and make arrangements for them during a disaster.4 Even more important is education before the fact. The deaf and other disabled should be taught how to build their own survival kits consisting of everything they’ll need in a disaster (e.g., extra hearing aid, batteries, visual alarms, teletypewriters, portable TV, lantern, cell phone, notebook, pen, etc.). This is a good topic for public-information campaigns.

References

1.Smith C. Young EMT out to prove deafness no obstacle. The Press Democrat, 2013 Jan 13; www.pressdemocrat.com/news/2209399-181/smith-young-emt-out-to. 

2.Olanoff L. Deaf EMT ‘better than some hearing staff’ with Bethlehem ambulance company. Lehigh Valley Live, 2013 May 12; www.lehighvalleylive.com/bethlehem/index.ssf/2013/05/bethlehem_ambulance_company_pl.html. 

3.Brennan L. Deaf man realises his boyhood dream as he is allowed to become a fireman. Daily Mail, 2012 June 20; www.dailymail.co.uk/news/article-2162006/Deaf-man-realises-boyhood-dream-firefighter.html. 

4. Lim A, Mazurek A, Updike A, Macgregor-Skinner G. Hearing-Impaired Patients Require Special Consideration During a Disaster. J Emerg Med Serv, 2014; 39(9). 

Adam Harvey, NREMT-P, is a paramedic with Allina Health EMS in St. Paul, Minn.

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