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Communication is a core value in the nursing profession, as one of the six Cs, it is taught in depth at university and reiterated throughout our careers as an essential foundation to good quality care.
However, what happens when we need to balance communication with risk to health in order to provide that care?
The Deaf community have often been left behind when it comes to receiving information in their first language, with organisations insisting written English is a suitable alternative, despite this having a completely different grammar and structure to sign languages across the world.
Recently the Where’s the Interpreter campaign highlighted the lack of appropriate provision when disseminating vital information during public briefings. Scotland and Northern Ireland ministers have sign language interpreters with them during briefings, but England continues to refuse, citing health and safety concerns, despite multiple MPs, scientists and leaders standing almost shoulder to shoulder.
Working in adult mental health deaf services has seen new challenges arise in the past six months. We have been asked to comply with personal protective equipment (PPE) regulations, which would see our clients vastly disadvantaged due to its impact on communication.
Opaque masks prevent lip reading and facial expressions from being observable, elements which make up a substantial component of the language, alongside handshapes and movements.
Visors affect the ability to complete signs, which rely on placement on or near the face, and deafblind clients require hands-on communication, which makes a two-metre distance impossible.
Our service has adapted as we place our clients’ need to communicate first; meeting outside, conversing through windows and using video calls have all worked well, but as we rapidly approach the winter months, these options will be reduced.
Clear face masks would solve many of the problems, allowing Deaf people to follow facial expressions and lip patterns while maintaining their safety and that of staff, but although the government have promised these, they have yet to appear in frontline services and the proposed 250,000 masks are a drop in the ocean when attempting to meet the demand.
“Why are staff still having to weigh up communication and risk to health when care planning?”
We are six months into the global pandemic, yet the basic needs of the Deaf community are still to be met. The Equality Act 2010 and the Accessible Information Standards are clear about the legal requirements about provision.
The NHS’s values are clear about the moral and ethical obligations that we have to meet an individual’s communication needs, so why are staff still having to weigh up communication and risk to health when care planning?
There are many Deaf people who have survived this pandemic with minimal information and are living in a world of loneliness, confusion and doubt, isolated from their peers and in desperate need of something we take for granted, the ability to communicate.
It’s time we as professionals take a stand and say to the government to live by their own standards and laws. Let’s not make communication an afterthought – bring it to the forefront and remind ourselves why it is one of the six Cs.
How can you help a Deaf person to communicate?
Remove your mask when asked to support lip reading.
If the person does not understand, try saying it a different way, as some words are easier to lip read than others.
Do not stand with a light source behind you, as this puts your face in shadow.
Be patient, never say “it doesn’t matter”. If it’s worth you taking the time to say it in the first place, then it’s worth making sure the person understands.
Book an interpreter for every encounter – it is our legal and ethical responsibility.
Tarnia Lefevre is trainee nursing associate at Derby University and works in adult mental health deaf services for Nottinghamshire Healthcare NHS Foundation Trust