Tell us about yourself
Eyes are for us, but ears are for others. By this, we infer that a person will be the first to notice their vision has deteriorated, but it is often the people around them who will notice a loss in their hearing ability. In practice, this is often observed as their close ones becoming frustrated at their inability to maintain a conversation, instead, being asked to repeat themselves, causing frustration, tension and in some cases, hostility.
My name is Hamza Saleem, and I came to this conclusion whilst studying, and now working as an audiologist in South Wales, UK. “Service to others is the rent you pay for your room on earth,” remarked the late boxer Muhammad Ali. Thus, as far as I can remember, a career in healthcare has always piqued my interest. However, someone much closer to home affected my decision to pursue audiology. My younger sister was born with Down Syndrome and hearing difficulties. Seeing my mother take her to routine hearing check-ups and helping her to adapt to using hearing aids was a tedious affair. Fortunately, after she became acquainted with these, she progressed significantly both socially and verbally.
After witnessing first-hand, the disadvantages that can impact upon people, as well as the enormous value and social inclusion that hearing aids can provide, I took a leap of faith. Audiology is still a relatively young and nascent vocation, yet as I have found since the insception of my career it is tremendously fulfilling with every patient interaction.
What was it like being a student in the NHS during the Pandemic?
During my first week at University, I was told that we would spend 54 weeks in hospitals across Wales over the course of three years. That’s nearly a year of implementing our knowledge into reality with real-life patients, gaining valuable insight and understanding of life in the NHS.
Naturally, the pandemic reduced the time spent in the hospital, but it did not diminish my experience. When the pandemic first erupted (at the end of my first year), it was unclear if hospitals could accommodate students. Due to the social distancing measures in place, hospital resources being stretched, and hospital staff being redeployed on the frontline to help fight the virus, our placements had to stop temporarily.
My lecturers at University organised placements for us in the Health and Well Being Academy (a state of the art Private clinic on Campus) so that we could continue to practice our skills. We learned basic competencies like otoscopy, audiometry, and tympanometry. We also obtained an edge in skills such as earmould impressions, masking, acoustic reflex thresholds (ARTs), and otoacoustic emissions (OAEs), before we would resume our clinical placement in our second year. This fantastic facility on campus combined with the support of my lecturers was integral to my development during a very uncertain time.
How did working with different healthcare professionals help you to become a better Audiologist?
Attending appointments with several audiologists had a silver lining. It enabled me to create my own routine and approaches to provide the best possible patient care. It is so effective to learn from other people’s actions and achievements than to figure things out on your own. By seeing what audiologists performed successfully, I was able to take what they accomplished and incorporate it into my routine. When describing the hearing test result, for example, one audiologist would remark, “This is called an audiogram, and it’s where we record the outcome of your hearing test.” giving the patient a marker for future reference. Another would explain, “across the top you have the pitch, so if you imagine a piano, you have lower, deeper sounds on the left moving to higher, whistling sounds on the right,” providing a tangible real-life example. Another audiologist would remark, “We are aiming to measure the quietest sound you can hear at each pitch,” clarifying the goal of the hearing test to someone who was simply following directions at this point. This gave a comprehensive image to the patient, ensuring that they were on the same page and, as a result, involved and reliant on the audiologist’s recommendations.
What did you find most challenging about Clinical Placement?
To put it plainly, the clinical placement was essentially a prolonged job interview. It expanded on our theory and enabled us to put it into action. As we progressed through the years, the extent to which we were involved in appointments grew. In our first year, we mostly observed appointments to acquire a sense of how things work in the real world. In the second year, we were expected to be more hands-on with procedures, eventually leading appointments with supervision, and by the third year, we would be expected to lead appointments whilst always having that option of support from more senior members of staff about anything we were unsure about.
The most difficult element of my placement was adapting to the differences in the day-to-day guidelines at hospitals in different health boards. That, and the realisation that the slack the world used to offer me as a student as I meandered around the meadows of my mind was now a thing of the past as I attempted to conform to a 9-5 lifestyle. The British Society of Audiology (BSA) provide best practice recommendations for most of the audiological procedures we do. However, it is the responsibility of the health board to develop local protocols for their teams.
Some hospitals, for example, might carry out bone conduction (BC) at certain frequencies but not at others. Referral requirements for ear, nose, and throat (ENT) or MRI scans also varied per hospital. Furthermore, no morning or afternoon at a hospital felt the same. Just as no two ears are alike, no two audiologists are either. They do things differently. Thereby working with varied personnel kept us on our toes in several respects. Without your conscious present, it’s quite easy to make a routine mechanical, even habitual.
Any final remarks?
We are the product of the people around us, so I would like to thank my family, lecturers, peers, and all of the healthcare professionals I’ve met since being exposed to the world of audiology. I’m grateful for the patience, commitment, and guidance offered to me by staff throughout hospitals in Wales, all whilst navigating their own responsibilities within the NHS.