April 2026 • Volume 19, No. #4
From the Editor
For this special Deaf History Month issue, and at the strong recommendation of our Chief Executive Officer, we are proud to introduce Lori Frisher — an entrepreneur born with severe hearing loss, who communicates through lip-reading and two cochlear implants. Her business is focused on pushing boundaries and revolutionizing the way disability is perceived.
We also present a young nurse named Mikaela Thepvongsa, BSN, RN, who posts on TikTok under the name Kaela|DeafRN.
Neither of these women works in the OR, but our conversations with them shed some light on deafness and hard of hearing (HoH) issues and opportunities in healthcare today.
In other news, did you know that NIFA’s Director of Hospital/ACS Surgical Education Relationships, James Stobinski, PhD, RN, CNOR, CSSM(E), CNAMB(E), has been publishing a monthly article on ORToday.com? Read below for a link to the April article on the evolution of ambulatory surgery.
Finally, in the Spotlight this month is RNFA Program Instructor Ashley Ferguson, BScN, RN, CNOR, RNFA, of Nova Scotia, Canada.
Take care!
Julie Lancaster, Editor
Photo by JK2507 on Adobe Stock
A Conversation with Lori Frisher
Lori Frisher is an entrepreneur living in Denver. Born with a severe hearing loss, she mastered lip-reading as a child and wore hearing aids. She excelled in the classroom and at sports but was constantly fighting battles against misunderstanding and limitation. Kids laughed at her hearing aids and the way she spoke. She decided, “If I couldn’t blend in, I would stand out, on my own terms.”
To this day, she says, “Every setback, every harsh word, every sideways glance pushed me to find my strength… I didn’t walk away from those early years broken. I walked away knowing how to fight for myself, how to lean on the people who love me, and how to believe in who I am.”
Lori earned academic and athletic scholarships to the University of Hartford and became that university’s first student commencement speaker with a disability. She went on to work in magazine publishing in New York City, survive 9/11 (she was on one of the last trains into the World Trade Center before the first plane hit), start an advertising agency, work in enterprise sales, battle cancer and other health challenges and, ultimately, launch her current business.
Her company, Ready or Not Media, promotes disability empathy and access through training and consulting. Among other services, they provide experiential and sensibility training for team leaders and staff.
“Empathy, I believe, drives awareness,” she says, “and awareness inspires people to become more actionable, to practice what they preach, and not just check a checkbox — to go beyond the checkbox.”
Lori’s memoir, Pieces of My Heart: A Woman’s Story of Family, Spiritual Growth, Entrepreneurship and the Strength to Keep Going, details her life experiences and the practical and spiritual growth they have prompted.
Photo courtesy Lori Frisher
Meet Kaela | DeafRN
Mikaela Thepvongsa, BSN, RN, lives in Seattle. As explained in this People magazine article, Mikaela was born able to hear but lost her hearing around the age of one, experiencing bilateral profound hearing loss and going on to have multiple chronic illnesses.
She became an expert lip reader, learned American Sign Language, was outfitted with hearing aids and eventually two cochlear implants, and went on to earn a bachelor’s degree in psychology from Washington State University Pullman. Then she decided to earn a nursing degree at Washington State University College of Nursing. Despite many obstacles, including an instructor telling her during her first clinical rotation that she couldn’t become a nurse because she was deaf, she graduated with honors in 2019.
After working in the ICU for more than a year, she transitioned to community health nursing. Her main job is with Neighborcare Health, an organization dedicated to serving low-income, uninsured, and underserved populations. She also has some per diem jobs in home health nursing and as part of the Health and Safety Team as a Registered Nurse at EDM (Electronic Dance Music) festivals.
And she has become an influencer, using her TikTok channel, Kaela | Deaf RN, partially to educate people about deafness and hard-of-hearing issues in health care. For example: How to communicate more effectively in healthcare. But topics about nursing are not all she posts about.
“People are quick to reduce us to our disabilities, expecting us to act as teachers on a daily basis,” she says. That’s why she posts about her dog, her family, her beach vacation, etc., on the channel as well. But she graciously acts as a teacher for us with the very useful tips below.
Photo courtesy Mikaela Thepvongsa
Tips for Communicating with a Deaf or Hard-of-Hearing Team Member
By Mikaela Thepvongsa, BSN, RN
There are a lot of sounds in the OR that can potentially make communication challenging, even for hearing staff. For those working with individuals with hearing loss, best practices include:
Communication should be direct, visual and intentional (not necessarily louder). It’s about clarity.
Closed-loop feedback. All staff should be using this method to ensure communication is clear, conveyed and received correctly. The request must be clearly stated, the receiver repeats it back (verification), and the person making the request confirms the receipt/action. This reduces errors for ALL staff, not just deaf/HoH staff.
Example:
Provider: “Draw up ** of etomidate and *** of succinylcholine.”
Nurse 1: “Drawing up ** of etomidate and *** of succinylcholine now.”
Provider: “OK, please push *** of etomidate and *** of succinylcholine now.”
Nurse 1: “Pushing *** of etomidate and succinylcholine now.” (This also makes it easier for the recorder to document in an RSI, code, etc.)
- Use names when communicating (such as: “Mikaela, hand me the ambu-bag.”) This ensures you are getting the person’s attention first and staff know who you’re talking to.
- Face the person when speaking (even if it’s brief) so lip-reading or visual cues are possible.
- Use clear face masks if possible.
- Write or type quick clarifications when needed instead of repeating the same thing louder.
Pre-briefing and shared communication plans before the case starts.
One of the most effective things a team can do is spend a few minutes prior to starting the case to:
- Review key steps of the procedure
- Clarify preferences (e.g., where to stand for best visibility, how to signal urgent needs)
- Confirm how intraoperative communication will work
Use hand signals/sign language for simple cues
Use clear hand signals or pre-agreed cues for common steps (e.g., instrument requests, suction, cautery) or for emergencies (STOP, all clear, etc.).
Verbalize actions at all times, especially prior to doing said action when hands are in the field.
Examples: “Passing behind you,” “Coming in with suction.”
Photo by Studio Romantic on Adobe Stock
Helpful Assistive Technology
Many deaf/HoH individuals are using assistive technology that can assist in workplace communication. For example:
- Mini Mic: a cochlear wireless mini microphone. It can either be clipped onto a speaker’s clothing — for example, the surgeon can wear this under their scrubs/gown to amplify their speech — or placed on a table to pick up multiple people talking from different directions. The sound is streamed directly to the deaf/HoH person’s sound processor.
- Real-time captioning that can turn speech into onscreen text that one can read on a phone, laptop, smart glasses or other wearables. Many apps are now available to do this. Read an article about the technology…
- N95 respirator masks with a transparent panel to make lips available for lip reading. These are available from several manufacturers, including Optrel and Safe ‘n’ Clear.
Ambulatory Surgery: How Things Have Changed
This month at ORToday.com, James Stobinski, PhD, RN, CNOR, CSSM(E), CNAMB(E), NIFA’s Director of Hospital/ASC Surgical Education Relationships, published an article about the evolution of ambulatory surgery: “My, How Things Have Changed.”
“When I began working in perioperative nursing in the mid-1980s,” he writes, “our total joint cases, whether knees or hips, had a lengthy inpatient hospital stay. In comparison, total knee arthroplasties are now routinely scheduled as outpatient procedures for healthy patients and outpatient hip replacements are possible for some patients.”
Read the whole article. . .
RNFA Program Instructor Spotlight: Ashley Ferguson
Credentials
BScN, RN, CNOR, RNFA
City & State
Nova Scotia, Canada
Current Position
I work full time as a registered nurse first assist specializing in plastic and reconstructive surgery, with additional experience in general surgery. In addition to my hospital role I operate a medical aesthetics clinic where I practice as a medical aesthetic injector.
How did you come to choose perioperative nursing?
Healthcare was always part of my world growing up. I was drawn to nursing because it offered the perfect balance of science, skill, and meaningful patient connection. I knew early on that I wanted a career that challenged me technically while still allowing me to make a tangible difference in people’s lives.
I chose perioperative nursing because I absolutely love surgery — the precision, the teamwork, and the complexity of it. The operating room is where I feel most focused and inspired. My mother worked in surgery for nearly her entire career and was one of the first registered nurse first assists in the Atlantic Provinces of Canada. She advocated strongly for recognition of the RNFA role within our healthcare system and demonstrated the impact first assists can have on optimizing surgical care. Watching her passion and leadership in the OR had a profound influence on my own path.
When did you first get involved with NIFA?
After 11 years working in the operating room as a surgical nurse, I felt ready to advance my role and step into first assisting. I chose to complete my RNFA education through NIFA and graduated in 2022. It was an excellent decision — the program was comprehensive, supportive and truly prepared me for the technical and professional responsibilities of the RNFA role. The strong educational foundation and continued mentorship through NIFA have been invaluable in my practice.
What do you enjoy about teaching the SutureStar™ Workshops?
The SutureStar™ workshops are such an energizing and positive learning environment. There’s something special about being in a room full of nurses who are passionate about surgery and eager to grow. I love the collaborative atmosphere — sharing knowledge, refining technique, and picking each other’s brains. Even as an instructor I am constantly learning new tips and perspectives from both fellow instructors and students. That shared enthusiasm for skill development and excellence in surgical practice is what makes teaching these workshops so rewarding.
What is one interest or ability you have outside of surgical skills that might surprise people?
Outside the operating room, I’m a dedicated horse mom. I spend most of my free time at the barn with my daughter and her horses. Being part of that world is incredibly grounding and brings a completely different kind of joy and balance to my life.
NIFA – Office Hours
Monday-Thursday, 8:00am – 5:00pm
Friday, 8:00am – 4:00pm
Practice Resources
Here are several of the most-in-demand sites for our students, prospective students and grads:
Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.
