Day In The Life: A Nurse With A Cochlear Implant

This video was made in collaboration with MED-EL. This is a day’s layout on how I use my MED-EL cochlear implant in my job as an ICU nurse. Subscribe if you’re interested in more content as a deaf ICU nurse, and comment if you have an experience with cochlear implant use in everyday life!

Hey, I’m Alley. I’m a new nurse in the intensive care unit. I work in a hospital in Texas, and I use a cochlear implant to hear. So I use a MED-EL SONNET in my right ear, and without it I am totally deaf in both ears. So even when this SONNET is on, my left ear is still deaf. I wanted to take y’all through a day in the life of an ICU nurse who uses a CI to hear.

So I’m a night shift nurse. My day starts a little bit differently than a lot of people, and my shift starts at seven p.m and ends at seven a.m., so I’m the nurse that’s there overnight. I wake up between 2:30 and 3:30 p.m., but do not sleep with my cochlear implants on. I’m totally deaf when I’m asleep. I use the vibrating alarm feature on my Apple watch to wake up, and my hearing dog is a good backup in those cases where I might not wake up quite as quickly. My dog Saki is trained in a lot of different skills to help me in day-to-day life, and one of those includes just waking up.

So once I’m up, I start heading to work, and I usually head to work around six p.m. I do carry disposable batteries with me in the pocket of my scrubs and in my bag at all times. So I at least have two places where I have disposable batteries. I do this because as an ICU nurse, there is no time when I’m on the clock where I should not be able to hear anything. I’m in charge of my patients’ wellbeing, and their life at some times, so I can’t run around with no batteries in my cochlear implant. I need to be able to hear and respond to any critical situation that can occur. MED-EL’s rechargeable batteries have been a great option for everyday life, but I am on shift for 13 hours, so disposable batteries are more likely to last as long as I need them to when I’m in the hospital.

It’s May 2020 right now. My uniform consists of a scrub cap and a mask as well as my scrubs. I’ll usually walk into the building with a cloth mask on, and then exchange it for a surgical mask if the unit has one while I’m caring for patients. Every patient in the ICU gets their heart, lungs, and stomach listened to at the beginning of the shift with a stethoscope, so they get listened to at least every 12 hours. So when I’m performing my assessment, I use a Thinklabs One stethoscope that works with my cochlear implant. I personally connect it to my MED-EL AudioLink, and it streams directly to my cochlear implant with Bluetooth technology. If you want to learn more about how my stethoscope works and how it can be used, I talk more about it on my Nurse Alley YouTube channel in a separate video.

The Thinklabs One stethoscope is the only assistive device that I routinely use right now. I am a new nurse, so I kind of went through nursing school with just my cochlear implant and my stethoscope. I’ve been open to adding more assistive devices now that I’m actually practicing on my own. The MED-EL AudioLink is new to me, but it does have a feature where you can use a microphone, and it’s a close-range microphone. So if I’m talking with another nurse, I’m like giving a report or I’m sitting really close to them and it’s a loud environment on the unit, ICU units can be kind of loud, then I can hand this to another nurse and have them talk directly into the MED-EL AudioLink, and that will stream the Bluetooth directly to my cochlear implant. This is a close-range device so I can’t really pin it on someone and have them wander all around the unit, but it works really well if I’m sitting down close by with a nurse and they can just talk into it and relay good information when it gets pretty loud on the unit.

So as an ICU nurse, there’s a lot of listening. There’s a lot of collaboration with other providers. There’s a lot of keeping an ear out for devices to beep which usually alarm and tell me if something is wrong. I’m constantly thinking into the future and anticipating a critical event where maybe my patient’s heart rate slows down or their blood pressure goes down or up really high. There’s a lot of uncertainty in being an ICU nurse that you need to use your brain for a lot. So in those situations, I do plan a listening break in my day. Every nurse on the unit gets a uninterrupted 30-minute break. It’s very rare if we don’t get that. But I take my uninterrupted 30-minute lunch break, and I don’t spend it with other people. It’s very rare that I’m talking to somebody on my break. I use that time to kind of recharge my brain. Sometimes I’ll turn my cochlear implant off. I’ll still have my little cellphone, my little nurse cellphone with me so if someone calls me on my break, I can respond to that. It’s a very safe listening break that I can take to myself and recharge.

I think if you use a cochlear implant, it’s very important to take listening breaks whether you’re a nurse or not because we work three times as hard as everybody else to listen and respond to these hearing situations. We are working really hard to rewire our brain and really interpret that speech. So if you can take a listening break at work, whether you are a nurse or not, at home when you’re talking a lot with your family, I think that really helps you comprehend things better as the day goes on. So in my day of the life of an ICU nurse, I’ve taken you through waking up and getting to work and going through my first assessment, and then I’ve gone on break, and so now the one thing that has been a huge player in my day as an ICU nurse has been masks. Because we are in the middle of the COVID-19 outbreak, it is May 2020 as I’m filming this, there are masks everywhere.

There’s a policy in my hospital that everybody, whether it’s employees or visitors, has to be wearing a mask at all times when they’re on the premises, so everybody I talk to has a mask on, bar none. That’s just how it’s working around here. So I’m a lipreader. I know a lot of people are different, but in the scale of hearing loss and being deaf, I rely a lot on lipreading. So now all of that is gone, and the people I’m talking to look like this. And so it’s very important for me to take those listening breaks and work extra hard to understand people when they’re talking in their masks. So everyone on the unit wears masks, and everyone on the unit uses something called closed-loop communication. I talk a little bit more in depth about it in another video on my Nurse Alley YouTube channel, but this is not a thing that just I use.

This is a thing that everybody in critical care situations uses. It’s when somebody tells you to do something, someone gives you an order, and you repeat it back. For example, in a critical situation, a provider will look at me and go, “Alley, administer one milligram of epinephrine by IV push now.” If I’m using closed-loop communication, I will repeat the order back to them saying, “I am administering one milligram of epinephrine IV push now.” That way, if I misheard, and I have the wrong drug, the wrong dose, or the wrong route of administration, then I will know before I make any mistake. And so this isn’t just for people with hearing loss. This is for everybody, but I use it for the smallest things. I use it for almost everything now that people are wearing masks.

If someone catches me in the hallway and asks me to grab a few things for their room, a few supplies, then I will repeat that supply list back to them in closed-loop communication so they can confirm that’s what they need so I don’t waste my time running and grabbing things that I misheard. So that’s how I as a cochlear implant user keep it safe in my day as an ICU nurse, but I will put it out there that deaf people, hard of hearing people, are feeling very isolated with all these masks. And this is a new job for me. I’m a new ICU nurse, and so I feel like I’m also getting a little bit of that isolation feeling because if there’s a group of people just socially talking on the unit, they’re still wearing their masks, and if there’s more than two people talking, I kind of stop being able to follow the conversation. Every person with hearing loss knows this feeling when they realize they’re just not really picking up the conversation and that they kind of become a fringe person, an outlier on the conversation.

Because of the masks that are on the units now, that’s happening a lot more to me, and so it’s making it a little harder to make friends with the other providers on the unit, and just develop those professional relationships. Of course, I don’t use this as an excuse. I don’t just walk away. I push through that and I find other ways to make sure I’m hearing people, make sure I’m connecting with people, but I do understand those feelings of isolation that people with hearing loss are having right now. I’m right there with you. I’m also experiencing that as well.

At this point in time, I’m very lucky to have a cochlear implant that works so well for me, and I have been through the whole 20 years of MED-EL changing their devices, and each time it gets better. Each device works better for me, and the assistive devices are getting better so this is an awesome time to be a nurse with a cochlear implant. Thanks for coming with me through my day as an ICU nurse with a cochlear implant, as much as I can show you. If you’re interested in more content about being an ICU nurse or being a nurse with a cochlear implant, please subscribe to my Nurse Alley YouTube channel. Thank you so much for watching, bye y’all.