Question

George is a 72-year-old deaf man who was admitted to the hospital with transient chest pain that occurs with activity. During the initial assessment, the RN notes that he is alert, oriented, and follows directions when she can communicate them to him through gestures; although, he does not seem to understand standard sign language, nor can he read or write. However, he does become agitated when blood is drawn for cardiac enzymes.

In reviewing his old charts, the nurse discovers that George comes from a rural farm family with seven children, four of whom were male, and all seven were deaf. They were raised and educated at home and had developed their own sign language to communicate. Because of the perceived stigma attached to the deafness, the parents protected them as much as possible from

contact with people outside the family. George’s last remaining brother died 6 months ago, and George had been living by himself in the farmhouse where he was raised. A home health-care nurse assigned to the client brought him in to the hospital.

The cardiologist who consulted on the case has become very frustrated with his inability to communicate with George. He believes that George needs a thallium stress test and probably a cardiac catheterization to determine the extent of damage and modes of treatment. The cardiologist hands the nurse a special procedures consent form and tells her to get George to put an “X” on the signature line so that the tests can be performed.

Questions for Thought

1. What are the difficulties in communication with this client?

2. What are some possible ways that the physicians and nurse could communicate better with the client?

3. What are the ethical issues involved with the cardiologist’s request of the nurse to get the client to sign the consent form?

4. What would be the best way for the nurse to resolve this situation?

Answer 1

Answer: The major problem is that the patient is deaf. He is unable to hear anything. This creates major hurdle in communication. The other thing is that the patient understand their own sign language and not the common sign or gestures that are being used. Patient is unable to read and write hence this also influences the communication. These are the communication barriers.