Coronavirus and masks challenge deaf nurse in ICU
By: Ashley Miznazi
Tags: Icu, Masks, Nurse, Coronavirus, Covid 19

Photo credit: Erin Folk

By: Ashley Miznazi

Gloved hands prepare equipment and doctors bark orders: “Don’t lay them flat. Grab their feet. Let’s get them over quickly.”

New nurse Alley Mason said she tries to keep up with verbal instructions and the “high energy” of her Intensive Care Unit in Houston, Texas.

“With admissions, everything is happening so fast,” Mason said. “You don’t have time to not be hearing what’s going on. You have to be able to keep up with everybody.”

In April, Mason’s hospital held a meeting after employees, mandated to wear face masks, voiced that they were having trouble hearing each other. They came up with the slogan, “More gear makes it harder to hear.”

But for Mason, it’s more than hard — she is fully deaf without her cochlear hearing implant. With the new face mask policy, she can no longer read lips.

“What I’m struggling with is doctors will be saying something important behind their masks, and I worry that I’m not going to catch it,” Mason said.

Her implant only allows her to hear out of one ear, and now with the new mask policy a major part of her communication strategy is gone.

With the pressure of COVID-19 in the ICU, Mason said she feels challenged both as a new nurse and a person with impaired hearing. As a strategy, Mason repeats back to doctors what they say to her and memorizes equipment panels so she knows when something is wrong.

“My initial months have been sprinting, trying to get up to date on my basics and learning how to be an ICU nurse as well,” Mason said.

Mason is an energetic 22-year-old who recently graduated from the University of Texas. Drawn to action, her mother refers to her as a “little firecracker.” On a typical day she bustles about the ICU in her blue scrubs and scrub cap, stabilizing blood pressures and administering lifesaving medications.

Kevin Chow, Mason’s boyfriend since high school and current McGovern Medical School student, describes her as “someone who embodies Florence Nightingale” and an inspiration for his interest in studying ear, nose and throat surgery.

“She is able to handle herself, and I know she is not afraid to ask, ‘Can you say that again?’ or ‘Can you repeat that?’” Chow said. “On the other hand, yeah, this is obviously an unprecedented global pandemic and when you have these critically-ill patients, it makes the job that much more difficult.”

The staff uses a strategy called closed-loop communication where nurses repeat back instructions to prevent miscommunication.

“So if (someone) says, ‘Grab a scalpel, and I go, ‘OK, I’ll go grab ice,’ then he knows I misheard it,” Mason said.

Mason doesn’t try to hide her cochlear implant but she instead wears her hair, normally just above her shoulders, up while at work to make it visible for her colleagues and patients. She also makes sure to pay close attention to her surroundings.

“I think that’s a big strength in critical care,” Mason said. “I’m never sitting back. I never assume I’m going to hear what’s going to happen. I’m constantly thinking ahead and I think that protects my patients.”

Mason uses her implant to listen to the different sounds given off by monitors, ventilators and IV pumps: she also watches for visual cues from the machines to gauge the status of her patients.

“I just like to quickly look in my room and see if the monitor is flashing,” Mason said. “The light tells me exactly what’s wrong.”

Mason said her passion for nursing began when she spent time in the ICU as a child. Before her fourth birthday, she lost her hearing from bacterial meningitis and spent two weeks at Children’s Health in Dallas. Once there, doctors told Mason’s mother, Janell Briscoe, that her child was deaf.

“I did not believe the doctors,” Briscoe said. “Because I would ask her, ‘Do you want to watch ‘Dragon Tales?’’ And she would say, ‘Yes, ‘Dragon Tales.’’ And so I put in the VHS ‘Dragon Tales’ and she’d sit there and watch it. And I’d say, ‘Do you want something?’ And she would answer yes or no.”

Briscoe said she didn’t know it yet, but Mason had already become adept at lipreading before receiving her implant.

“It blew our minds,” Briscoe said. “Who knew a 3 ½ -year-old could do that? That’s kind of the first obstacle that she overcame really quickly.”

Mason read lips for about a year before she received her implant, Briscoe said. After implant surgery, doctors advised Mason’s family to speak to her with their hands covering their mouths for several months.

Covering lips after implant surgery allows the patient to develop a reliance on the implant, said Mellissa Sweeny, the director of the cochlear implant program at the Callier Center, a partner with Children’s Health for post-surgical care.

“For someone who has had hearing for a period of time, a cochlear is going to sound very different to that person,” Sweeny said.

Sweeny said teenagers report back their hearing sounds a “little bit maybe mechanical” with the implant. However, with practice and time, the person gets used to it.

Mason went on to play trumpet in school for eight years, and when she realized she could tell the difference between the sound of a flute and a tuba, Mason said she felt she probably had limited distortion in her sound pitch and dynamic range with the implant.

“Everybody has their different things they work through when they decide to become an ICU nurse and having a cochlear implant was just my thing to work through,” Mason said.

At the end of her shift, Mason washes her arms up to her elbows with soap and water and trashes the mask she wore for 12 hours. Chow picks her up and asks if she wants to run by the Whataburger drive-thru.

“For someone who has to deal with death and destruction and very difficult patients, she’s pretty cheerful,” Chow said.

Once at home, Mason puts her scrubs into the hot water and dry cycle and prepares her clean cloth scrub cap for the next day. She takes off her cochlear implant and greets her hearing dog named Saki, a mixture of pit bull, terrier and schnauzer. At the hospital with her patients, she is another face in a sea of masked nurses, but in her apartment, she is just Alley.

“Confidence is such a huge part in deciding what you think you can do,” Mason said. “All the cheesy little sayings of ‘you can be what you want to be’ are very true.”

For more on Mason, check out her Youtube Channel.