Non-English speaking patients

[1Tulip]

I am just beside myself trying to take care of patients who speak NO English. I work in Neuro. Last night, fully 10% of our patients were Spanish only. It's driving me crazy, mostly because I can't do my job. I can't make assessments of subtle changes in language and understanding, word slurring, short term memory, any number of things that are just basic. I can't do an NIH stroke scale. I can't assess for receptive or expressive aphasia...

I can't explain to the wife that her little old demented husband with chronic renal failure will undergo a full code if his heart stops and does she want him to have a tube put in his throat and does she want us to shock his heart to make it start again and would she want her husband supported on a ventilator if it came to that.

I can't explain to a Latino man that I must put a catheter up his urethra and into his bladder, or why we're starting an IV, or putting an NG tube in his stomach.

I find out days later that the family thinks dad is unresponsive because we are giving him medicines that make him groggy. I can't tell them that it's his disease not his treatments doing this.

And on and on and on.

We get by (barely) because usually (but not always) we have a CNA who speaks Spanish.

I've tried the tapes. I've tried the books. I'm thinking about going to the local Community College and starting classes. It's so tedious, it feels so futile.

Why... oh, why can't people who come here make learning English a top priority? How is it that we have so many in the hospital who don't?

[PANurseRN1]

Depending on the situation, having a family member translate isn't always the best idea. Unlike professional translation services, a family member may also seriously edit information.

It's a sticky situation for everyone, that's for sure.

[1Tulip]

I understand your frustration 1Tulip. We have similar problems where I work - only our most Non-English speaking pts our Chinese - Mandarin or Cantonese.

Some things were have found that help - get an English speaking family member to write our a list of words - their language matched up with English. We use the most common things like Pain, toilet, cold, hungry etc. I can point to "pain" for example and they can nod or shake their head. Once little old lady has 'take me to my room" written on a card that she pulls out when she is tired of being in the hall or lounge. We get phone number for family members who can speak English and get them to help translate - this sometimes works better than other phone translaters because they are family and the pts will be more open with them.

Still, it is very scary to have a non-English pt that needs invasive care such as a catheter or IV!

Those are some great ideas, Pepper. I will get my index cards out and start making a "deck" my patients and I can use.

We still have the problem trying to figure out if the patient has receptive aphasia, or if we are not speaking his/her language or dialect.

Interesting story: We had a Chinese fellow who'd had a bad roll-over MVA. We tried to use the AT&T translation line. Unfortunately, the translator only knew Cantonese and he thought the patient was speaking... or trying to speak... Mandarin. Because the patient had a head injury, he was slurring his words. (At least the translator was able to tell us that... which was useful info. We actually found a Mandarin speaking student at our local university.)

Now I'm motivated to get out my Spanish-English dictionary and get to work.