ADA definition of "reasonable accommodations" at work


I work in the medical field as a respiratory therapist. Recently I attended a “Code Blue” (cardiac arrest) and there were 14 people in the room shouting, alarms going off and the patient’s television was on.

2 days later it was brought to my attention by HR that several of the nurses felt I wasn’t listening. My supervisor and many of the staff are aware of my hearing loss for which I am wearing hearing aids (Starkey Livio 2000). I feel like I am being groomed for termination.

I’m wondering what the ADA says about the employer making “reasonable accommodations” in a case like this.

I’m considering consulting with an attorney who specializes in disability law.


You might consider looking at this from other viewpoints, including the person that was in cardiac arrest if he/she survived.


First, talk to your Human Resources department. They likely have an ADA expert.
Get your hearing problem documented. I ended up getting a form filled out by my ENT.

My case was different from yours and basically resolved by moving away from a noisy conference room to a cubicle with high walls.

I think your employer initially determines what is “reasonable” If you have any ideas, discuss it with them.

Diaclaimer: Since you mentioned ADA, I assume you are in the US.


Don’t know the rightness or wrongness of anything but one would think if your employer is aware of a disability and your job description requires performance in certain situations, that in an annual review your supervisor would be required to evaluate your ability to perform in such situations line item by line item. So your supervisor might bear some responsibility if he/she had previously determined that you were fit for that item in your job description.

Apart from your role in what went down, one would think a code of any color someone by rank/position would be in charge and should have directed someone to do things like turn the TV off. I guess hospital responders do not wear body cams and perhaps for privacy reasons there are not security cams but perhaps someday for liability reasons vis-a-vis the patient’s family, etc., there will be body cams and maybe if there is now security camera audio and video, you can get a hold of it to document your experience.

Often “reasonable accommodation” may involve moving the person involved to a different position but equal pay. So “reasonable accommodation” if instituted might still mean that you end up doing something else in your institute that you may or may not like, not that you keep the job that you have now.


If your supervisor is of no help you should be free to go to your Human Resources department. That’s what I had to do.


Seems like another issue that might come up in some regard to the situation is why you are wearing 18-year old HA’s and whether you have had annual ear and HA checkups to evaluate the quality of your hearing.

Perhaps the 2000 is just the model #, not the year?

EDIT_UPDATE: Released by Starkey on August 26, 2018 the Starkey Livio 2000 falls under Starkey `s advanced technology level within the Livio family. Built on the all-new Thrive platform, Livio provide better sound quality than any other Starkey


I’ve been out of the ICU setting for almost 20 years now, but kind of doubt they have security cams for documenting codes. None of my friends who still work there have mentioned it. Depending on availability of staff, a physician would usually be in charge of the code. If no physician, an ACLS (Advanced Cardiac Life Support) nurse. Codes are chaotic and often one of the most important tasks of the person in charge is get rid of unneccessary “help.” I think how HR would respond a lot on how big of a hospital it is, but asking HR about ADA could be a good place to start. If no satisfactory answer, yeah disability lawyer may be in order. It doesn’t seem like it should be that difficult to resolve.


HearHere, I think you just diagnosed your own situation: in an emergency situation, there was simply too much chaos, noise and confusion for you to participate at an optimal level, such that several nurses noticed. This is not just a one-off, or setting you up for termination (per se!). It is the reality of what happened. The nurses were concerned enough to raise the issue with HR. So it obviously made an impact on them.

Now it could be that this is THE BEST you can do given your physical limitations - despite the Starkey aids! I TOTALLY feel for you. But I think we also have to be honest with ourselves and ask, “Is this a career or position that I can actually perform at a required level?”

It’s not about getting HR to defend you - no matter what - with ADA guidelines in mind. It’s about the reality: can you perform in an emergency situation with so much going on and a patient’s life at stake?

With your training, knowledge and experience, there may be related positions that can take advantage of what you can offer. Can you write procedural manuals? Even lead training classes? These are soul-searching questions only you can answer.

BEST of luck to you to find a comfort zone for your career, where you can be an optimal contributor.


This sounds like a few “personalities” on a shift. I know this nonsense can be shift dependant. I’m a paramedic and have been questioned as to whether I can still do the job by co-workers.

I have a stethoscope which works with my HAs and I believe you do to. Your job I know is focused on the airway and breathing. I don’t know how anyone including “normal hearing” people could hear everything going on in a code.

This looks like discrimination by a few bad apples. They would need volumes of proof
that you in any way could not do the job.

BTW my hearing loss was caused by sirens over a 20 year period.


I thank each and every one of you for your responses. To Jim_Lewis. I was led to believe my Starkey 2000 were not manufactured in 2000 - that is just the model number.

The small community hospital I work in was just bought by a larger hospital and lots of changes are in the works, I am ACLS and have attended more codes than I can count and they rarely run the ideal scenario of closed-loop communication , They are usually the every definition of chaos. Things are changing with the merger/takeover and the new guys are usually looking to to replace anyone they can if by doing so they save money by crowding out and older experienced worker with one less experienced but cheaper. Some of the code are run strictly by the book. That’s how I would want it if I were the patient but other are simply hit and miss and protocol goes out the wind and chaos is the rule


@HearHere, I think you should consult an an employment attorney or ask the question of one online–just to be prepared if HR tries to escalate this. I’ve been present at codes myself and know how chaotic they can be. Respiratory is supposed to be at the bedside but often gets pushed out of the way by the eager young physicians and RNs in the room. If your hearing does impair your ability to do your job on a code, they can rightly claim that this puts patients at risk. Therefore, you can ask for reasonable accommodations, such as limiting your assignments to less active units in the hospital. Perhaps you can be assigned to an outpatient unit that uses respiratory services, and, if there is a code, it could be understood that another respiratory tech on your shift would cover codes in your place. Since your hospital is small, they might look for ways to get rid of you, especially if you are on the high end of the pay scale. But I think EEOC law is on your side. It’s not much different than other hospital employees who have injured themselves on the job and can no longer lift heavy patients–they can ask to do no heavy lifting, and it usually accommodated. Just make sure that you claim a disability and a need for accommodation ,and that it is on record in your HR file. There are usually forms you must fill out. But check with an attorney who specializes in employment law, just so you are prepared. Good luck.


Firing without offering reasonable accommodation is illegal due to ADA.


I work in an ICU and also manage codes and emergencies. One of my main reasons for getting hearing aids was the difficulty hearing in just those situations. A number of years ago I went to a Critical Care Crisis Event Management Course. Some of the most important messages of the course were about:

  • Communication
  • Roll allocation and definition including quickly assessing each persons experience and utilization in the team
  • The importance of leadership.

Basically roles need to be allocated ahead of time according to the skills of the team member (14 is not a very manageable number). The team leader or whoever notices first should turn off the television/request that it be turned off or other unwanted noise to fascilitate communication. If you have that situation happen again then either turn off the tv yourself or ask someone to turn it off who can reach ( with that many people there should be plenty of spare hands ).

The best run codes I have been to were actually less loud because the person in charge communicated well. Allocating tasks then practicing closed loop communication is most important (this means that the team leader says “ Do this and tell me when it is done” then the person assigned the task does it and communicates that back to the team leader). This type of communication helps to avoid the confusion which tends to occur at such events. It is also crucial for there to be a clearly stated and acknowledged team leader. This may sound obvious but it is vital.

Does your organization do practice codes and have you had a chance to participate? If you have a regular role in an arrest team this would be very helpful. Also here we do debriefing sessions after codes where all those who were involved can sit down together and talk about what happened and how things could be done better in a non threatening way - no blame just opportunities to vent and to improve things for next time. These sessions can prove very useful. Many of the people at the code may not be aware of your hearing issues and this could have helped them understand.


It’s a very small hospital and we cover all the units. There are two of us on weekdays but they do everything they can to save money. For some reason there is only one person on during the weekends no matter what the census. We just got bought out by a bigger hospital that seems eager to fire people for any reason and replace them with newer and cheaper employees.
I’d be happ


If they fire you without trying to accommodate your disability, that is illegal in the US.


My thanks to everyone for their replies. I’ve been here for over 5 years and I’ve probably forgotten a lot. I’ve worked in labor & delivery but, with few exceptions, haven’t seen an infant in years!
I have ACLS (Advanced Cardio Life Support) but we no longer have live instruction. Everything is done online because it doesn’t cost the hospital a nickel. I believe you get what you pay for and I’m sure there are many of us who hold certificates who would be ineffectual in an actual code situation.

With few exceptions the codes are never as organized as they appear to be in the training videos. I’m also a private pilot and know the importance of closed-loop communication when reading back clearances, etc. Rarely done here.
In the 5 years I’ve been here I think I’ve only been to one or two debriefings such as when we have had a pediatric trauma/death.

My apologies if this reply sounds a bit discombobulated but I’m writing it on the fly. Thanks again!