Ask The Nurse: Caring for yourself before, during, and after hospital procedures

In ALDA Archives Newsletter, Ask The Nurse by ALDA News

by Anne Marie Killilea, MSN, RN

nurseSummer is almost over. For those of us in the Northern Hemisphere, soon the days will become shorter, nights will be longer, and winter will be upon us.

We have seen a lot of turmoil in the news lately. From the medical and nursing point of view the most upsetting information is the rise in COVID-19 cases across the U.S. and in the world. Sadly, this was cautiously predicted. Keeping our distance from one another, taking better care of ourselves and others, and staying safe and mindful of our environment dictates where we go and what we do.

Taking care of ourselves means that we need to be aware of changes in our health patterns and pay attention to these variations as they can be the start of diseases. We also need to make sure that we see our physician annually and be sure to have those routine procedures done
(such as colonoscopies, breast exams, and PSA tests) to identify areas before cancer begins.

Too often people become fearful of hospitals because of the way medical and nursing staff treat patients. Sometimes this fear immobilizes them and causes them not to make appointments.

But, for those of us with hearing loss, making appointments and trying to communicate our needs to hospital staff can be the real root of our fear. We need to be heard. We need to be able to communicate our problems to hospital staff who will hear us.

Recently, I had hand surgery done to my left hand. I had put this off for over three years and within this time, the pain and ability to move my thumb became increasingly restrictive. I could not hold a cup, move my thumb to pick up an object, or help my little granddaughter do a few things she needed to do. During this time, I did have steroid injections. While the first injection worked miracles, the next injections proved worthless, and caused the area to become swollen and immobile. I made an appointment to see the hand orthopedic surgeon.

Being a late-deafened nurse, I had a list of things that needed to be done beforehand so that I could participate in the surgical process successfully. This was my initial list:

1. I needed to make sure that everyone knew I was a late-deafened adult and used my bilateral speech processors to hear with. I needed to work out a plan beforehand so that I would have these processors on to hear the names of the medical staff, listen to the information said to me when I was signing the consent form, and be able to move to assist with the surgery. To my surprise, the hospital staff obtained a special tape to tape my external speech processors to my ears. This worked very well, and I was able to communicate my needs.

2. Did the hospital staff have visual masks? I discussed this with my surgeon as speech reading can be a way in which communication is enhanced. He said that the hospital was in short supply of these items, but for my surgery, he would make sure that everyone would be given a “visual” mask. Again, this accommodation was done, and I was pleased at how the hospital staff made every effort to help me hear what was being said to me.

3. I asked for a support person to be with me in case I could not understand everything that was being said to me. Because of the pandemic, the number of outside “visitors” are restricted. But, according to the ADA, if support persons are needed, the hospital must grant this request. Of course, the support person must be infection free and have proof of vaccination status before they can be granted access.

4. I strongly requested I be given some type of medication to sedate me in case I became overly nervous during the pre-operation period. Anxiety can increase when several hospital staff gather to get a patient prepared for surgery. Sometimes the mass influx of hospital staff can
cause needless anxiety in patients, therefore knowing that medication can be given to calm me down was very necessary. And I asked for it! I was given a “nerve block” which numbed my entire left arm and was wheeled into the OR. I was greeted by the surgical staff who made a
point to come into my view and identify themselves. Then, off to sleep I went.

I woke up feeling great as the nerve block was still working, and I felt no pain. I thanked everyone and told them how comfortable I felt going into this operation. The main anesthesia physician said I was the first person to ever fall asleep with a smile on my face and keep the
smile on my face throughout the entire surgery. Of course, I would have a smile on my face! I asked for a few accommodations, and my needs were met.

When we convey our needs and they are understood, we can go into hospital procedures confidently. Preparing our lists and expressing our needs to hospital staff beforehand is an important part of our care. Not everyone understands the various types of hearing loss and
what the individual needs to communicate. We need to feel confident that hospital staff will
know how to take care of us because we have hearing loss and need to communicate in a
different way.

Below are some things to consider when going through procedures in a hospital setting:

1. Don’t wait too long to get a problem taken care of. For me, waiting three years with hand problems was too long and made certain parts of the surgery more complicated than usual. Find a good primary care physician who really listens to your concerns and makes the best
recommendations for your care.

2. Make appointments early in the day. Sometimes trying to hear with hearing loss can be draining, and patients with hearing loss can become tired more easily. Appointments in the morning are better after a good night’s rest.

3. Have someone with you to take notes or help you understand what is being said to you. According to the ADA, you have the right to have a support person with you. Let the office know you are bringing someone with you to help you during the appointment.

4. Don’t bluff! If you don’t understand something, say so! Too often I have encountered hospital staff who speak softly or with an accent, and I cannot understand an important concept they just said. It is OK to say to them “I didn’t get what you said, please repeat it to me.” Or, you can say “Repeat your last statement, thanks.” Be kind, and do not get frustrated. Remember they do not know the full extent of your hearing loss, so you are teaching them to be mindful and educate you through good communication.

5. If possible, try to meet with the OR hospital staff beforehand. Because our disability is not visible, we may need to teach those who will care for us how to comfort us when we are nervous and how to wake us up after surgery. Sometimes comfort items (such as a small blanket or other soft toy dog or doll) can be brought into the pre-op and post-op area to help calm us down. If this has been permitted, make sure these items are clearly labeled with your name on it, and let the hospital staff know you need this item with you before and after surgery.

6. Discuss the different types of anesthesia used for your surgery. I preferred a “nerve block” for my hand surgery. In addition, I was given a mild sedation during the procedure and neither saw nor felt anything.

7. Ask where an IV will be placed. Sometimes hospital staff will put an IV into an area where you do not like it to be. They may need this site for access during the operation. Knowing where the IV will be placed helps you to be more comfortable.

8. Will you have a urinary catheter put in? If so, when will this be placed? Sometimes when surgery is lengthy and hospital staff need to know if you are well hydrated during surgery, so a catheter may be placed. Sometimes it is placed inside your bladder after you are sedated.

9. Will you recover in the same room where you received pre-op care? Being familiar with the room before and after surgery will help you to recover more quickly.

10. Above all, make sure your hearing device is functioning properly. You may need to see your audiologist beforehand to adjust things, to make sure your hearing level is optimal. You also need to make sure your batteries are fresh.

Both your hearing and physical health is important. Without taking care of one, the other suffers. We are all important in this world. One way of being important to others is taking good care of ourselves. Try using these simple steps to help you get the best care you need.

ALDA cares about you!