Hospitals are awful places, aren’t they? Members of my household have had several emergency hospital admissions in recent years. Each time we have been so very thankful for immediate and free access to expertise and treatment. But my husband Tim has just spent two nights in hospital (the same one that brought us together as nurses, thirty years ago) and it has prompted some reflection on what a stressful environment it is, with added difficulties for anyone with hearing loss.

Noise. So much noise. I still dream about being on a ward with machines beeping and buzzers going, decades after I worked on one, but now there seems to be more mechanical noise than ever. Add to that all the noises people make, in big echoey spaces, and it’s a challenging hearing environment for everyone.

We told the paramedics who came to the house that we’re deaf and they made sure to look at us when talking – good. But in the ambulance we strained to hear over loud music. You’ll have to take my word for it that music seemed perfectly acceptable during a journey that was calm and (relatively) unhurried, and potentially conducive to relaxation. But it made it hard for us to hear what the paramedic was saying to Tim and I felt it would somehow be impolite to mention it. In patient/relative mode, I think many of us feel that gratitude for care received trumps everything else, so if something’s not right, well, we just get on with it. From my experience as a nurse, I am well aware that this attitude isn’t universal, and of course it makes sense to ask if an adjustment could be made to improve comfort or communication. But I find that hard when in the situation.

In the hospital almost all staff wore masks. We understand the need for it but of course these present a significant obstacle to communication when you have hearing loss – and for many others too. I was learning to hear with my cochlear implant while we were still having to wear masks in shops, and it was an amazing moment when I first heard what someone was saying despite their mask. But with all the background noise in hospital, it was too difficult for either of us to hear a masked speaker. There seemed to be a lack of understanding about how to accommodate this, among staff, with a common approach being to just keep repeating themselves (or saying something else, who knows!). When we said we couldn’t get what they were saying, reminding them that we’re deaf, no-one offered a solution. Writing down key information would have been such an easy thing. We should have asked, but didn’t… and just hoped that the other one had caught some of it, or that it didn’t matter too much.

Presenting information visually would probably be on page one of Communicating with the Deaf for Dummies (perhaps I’ll write that…!). There could have been a lot more of this, not just supporting verbal communication for us personally, but for the benefit of everyone. In the ‘old days’ we could have looked at the charts clipped onto a board at the end of the bed, for some of the personal information we might want to know, but electronic systems for recording everything have put paid to that.

One source of confusion is who’s who among the staff. Some had lanyards with their role printed on them in large letters – really helpful. The people wearing these tended to also have a name badge and/or an identity badge. But about half the staff displayed no means of identification at all, other than colour-coded uniforms. On a previous hospital visit I saw a chart explaining these, but there wasn’t one here. Photos of some of the team helped, but we never did work out who the people in grey or teal scrubs were. Nor the tall man wearing black scrubs, who cut an imposing figure and whom Tim suggested was the Grim Reaper in modern uniform. We didn’t want to make the mistake of asking the housekeeper about drugs or the registrar about yogurt availability, so we mostly kept quiet.

Some years ago, I wrote about my experiences of navigating other healthcare encounters with hearing loss, published in the BMJ’s innovative series that invited people to share health experiences and tell clinicians what they would like them to know. It’s reproduced here. My requests for clinicians then were to acknowledge my hearing loss and ask “how can I help you hear?”, to do things that help and keep doing them, and to consider supporting verbal communication with visual information. In an ever-noisier environment and with masks a common obstacle to communication, these things remain key. Small things can make all the difference but first there needs to be better awareness. And we probably need to be better about asking for the adjustments that would help us. Better still – stay well. We’re going to try to do just that!