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A sound intervention

Engs, Samuel Franklin BA, BSN, RN

doi: 10.1097/01.NURSE.0000510743.47466.71
Feature: SHARING

A hospice nurse's innovative intervention delights a community icon.

Samuel Franklin Engs is a hospice nurse in Lake Mary, Fla.

The author has disclosed no financial relationships related to this article.

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I'VE ENJOYED working with so many of my hospice patients over the years, but one in particular I'll never forget. Miss Bee, as she was known throughout her community, was nearly 100 years old. She was a living legend in town. Her father was one of the town's founders and a local war hero. Miss Bee had served as the beloved grand marshal of several Memorial Day parades over the past 60 years, and she could always be found sitting on her front porch waving at the passing cars whose drivers honked in friendly salutation. People of all ages sat with Miss Bee on her porch seeking her counsel.

Miss Bee had cancer, but she also had an iron will and determination. Unfortunately, she also had significant hearing loss.

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An innovative solution

As with many proud, older adults, Miss Bee didn't like to complain or see a physician over “nothing”; she considered her hearing loss a normal consequence of old age. And with a cancer diagnosis front and center, her hearing loss seemed the least of her worries. One evening, I mentioned Miss Bee's hearing issues to my wife, who's also a hospice nurse. “I've always wondered if speaking into a stethoscope would solve that problem,” she said. “Nurses used ear horns in the old days.” She then took my stethoscope and we tested her theory. I could hear perfectly!

I could hardly wait for my next visit with Miss Bee. I always scheduled our visits after my lunch so I could bring a special little treat to make her smile—Miss Bee loved sweets. But this time, I also stopped by a pharmacy and purchased an inexpensive stethoscope.

When I arrived at Miss Bee's house, her daughter was there, too. I removed the new stethoscope from my bag and placed the tips in Miss Bee's ears. As I spoke to her at a normal volume, her eyes grew as big as saucers and she reported she could hear me perfectly. She exclaimed, “I can hear like I'm 20 years old!” Miss Bee and her daughter were jubilant.

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Not according to plan

I finished my visits and rushed home to report the success to my wife. As we talked, the phone rang. It was the night supervisor. After my intervention, Miss Bee apparently went completely deaf and her daughter rushed her to the ED! I imagined my nursing license flying off into the sunset.

Needless to say, I didn't sleep well that night and dreaded returning to work. Had I caused the deafness of a community icon? What was I going to do?

The next morning, my team manager received a call from Miss Bee's daughter. She now reported that I'd saved her mother from a life of deafness. The ED physician had determined that Miss Bee's apparent deafness had been caused by excessive cerumen. Apparently the stethoscope ear pieces had compacted years of cerumen accumulation, rendering Miss Bee temporarily deaf. After the ED physician irrigated her ear canals, she could hear perfectly. Her daughter now announced to all who would listen that I'd been “heaven sent to cure my mother's hearing.” Boy, was I relieved! And my visit to Miss Bee that day included a double scoop of her favorite ice cream.

Miss Bee never missed a day on her front porch until the last few weeks. During those final days, we moved her hospital bed to her front window where she could continue to see and hear her loving friends driving by honking their respect.

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