Nurse Overcomes Career-Limiting Disability With Openness, Ingenuity

Growing up with a disability taught Marissa Pusateri, BSN, RN, the empathy and compassion that would become the foundation for her clinical career. Pusateri, who has lived with profound bilateral hearing loss for most of her life, says the experience has given her certain gifts, including a sharp knack for problem-solving, that serve her well as an ICU nurse at Cleveland Clinic Hillcrest Hospital.

Pusateri explains that she chose critical care partly because the specialty allows her to work her shifts in the same area of the hospital, where she can focus on a limited number of patients – typically two at a time.

“I’ve learned that my hearing loss is more manageable when I’m in controlled environments,” she says. “I perform best when I have time to focus and acclimate to my surroundings.”

Pusateri began her nursing career in August 2021, at the height of the pandemic. Caring for gravely ill patients while covered head-to-toe in protective gear might be intimidating enough for any new nursing school graduate. But for a nurse with hearing loss, the pressure was staggering. Determined to succeed, Pusateri says she knew she would have to tackle her challenges head on. The first step required asking for help.

“My preceptor was a great advocate for me during my orientation,” she says. “Working as a new grad in an ICU was extremely nerve-wracking, especially with a hearing impairment, but my preceptor was very helpful in finding workarounds that would allow me to perform at my best.”

Transparency and perseverance

Pusateri was diagnosed with bilateral profound hearing loss at 9 months old. She received cochlear implants as a toddler and then embarked on several years of speech therapy and auditory training. Although she says her hearing loss was never much of an obstacle during her school years, “everything changed” when she began working in the ICU.

“Everyone has a hard time with masks, but it is even more of a challenge for someone like me,” she explains. “Masks constrict the sound of a person’s voice and obviously make it impossible to read lips. The stress was overwhelming at first, but I quickly realized that the best – and only – solution was to be open about my needs. Once I made it clear to my colleagues that they had to speak up, things instantly improved.”

Receiving a phone call or interpreting verbal instructions from a physician – especially one with an unfamiliar accent – can be particularly difficult, she notes. She has learned to manage the sounds in the ICU — the equipment and cacophony of voices — by positioning herself in locations that give her a clear view of the room and her fellow clinicians.

Pusateri explains that she initially had trouble hearing through the Vocera devices that the staff uses to communicate with each other. Always willing to find a solution, she discovered how to route Vocera calls through her cell phone, which is connected by Bluetooth to her hearing aids.

“That was life-changing for me,” she says.

Pusateri advises others who are struggling with a disability at work to be open about it.

“If I hadn’t told anyone about my hearing difficulty, they might think I was ignoring them or just not listening,” she says. “There’s no shame in asking your manager for the accommodations you need to do your job well. We all have limitations – physical, social, cognitive, financial – that we work to overcome. I’m no different in that way.”

She also encourages anyone struggling to never give up.

“I’ve had moments in which I doubted myself, but I’m so glad I didn’t give up,” she says.

“I think my hearing loss has made me more diligent – and I’m a better nurse because of it. It’s kind of been a blessing in disguise.”