Right thing? personal opinions needed.

fergus51 · Mar 23, 2004

I don't think there is anything that could have been done at that point. It should have been set out long before she ever came to the hospital (not by you, but as a hospital policy). Hospitals are required to provide care to all sorts of people with communication challenges, not just the hearing impaired but people who don't speak English as well. They should have a policy in place. I also think it is helpful if the patient or the OB plans things with the floor nurses long before the woman goes into labor. Having something on the chart that says "Please provide written material related to...." is an idea. They certainly don't have to do this, but it can be helpful.

Off topic, but I have never heard of patients routinely receiving antibiotic prescriptions on discharge.

PJMommy · Mar 23, 2004

My daughter is deaf so this really infuriates me. Bottom line? The hospital is obligated to treat ASL or Signed English or Pidgen ASL or whatever she signs with as a foreign language -- no different than when or how they get interpreters for Spanish or French or whatever speaking pt's. At a minimum, you or your sis need to check on the ADA (American Disabilities Act) guidelines. Also, check your state government website -- most states have agencies and/or commissions which deal solely with deaf or hard of hearing issues. Texas strikes me as a state that usually is fairly good about taking care of their deaf population. Also...contact the National Association for the Deaf (NAD) and ask about advocacy programs.

I'm so furious for your sis!! But here's the deal...she absolutely MUST do something about the treatment she received -- otherwise it will happen to the next deaf/HoH patient. PM me if you want more info -- I do a lot of advocacy work in my state and email with folks all over the U.S. I can definitely put your sis or you in touch with some advocates in Texas.

HUGS out to you both!!

P_RN, ADN, RN · Mar 23, 2004

That's HORRIBLE!!!! That poor mommie.

That kind of reminds me of my cousin (male) who was aphasic from a traumatic brain injury when he was 16. He was very intelligent, traveled all over, COULD HEAR, just couldn't speak. He had crohn's ds and was hospitalized frequently for hyperal.

He had doctors who YELLED at him (he wasn't DEAF), talked about him "behind his back"....in the room!(he could HEAR fine)

Stupid comes in all shapes and sizes and your poor sister got the whole crew. I hope they personally take this matter up with the risk manager of the hospital. The infection alone was terrible, but having all that pain and being separated from her newborn is unexcusable.

llg, PhD, RN · Mar 23, 2004

I have a mild hearing impaiment and have several friends with profound hearing loss. The key to handling the health care needs of those with hearing loss is to arrange things ahead of time and not to assume that all will be taken care of.

Yes, the hospital should have been better prepared to care for deaf patient. But a person with a hearing loss also needs to communicate their needs to the staff either prior to the hospital visit or ASAP after admission. As a family member, that is something you could help with. Some of us don't know sign language: some of us have a very low reading level: some of us read lips well: some of us do not read lips: etc. Each has preferred ways of communicating -- and these need to be spelled out to the staff ASAP so that the communication can be most effective.

Also, I recommend that people be careful about the use of friends and/or family as interpreters. The friend may not be sufficiently knowledgable to interpret some of the medical concepts well. Also, it may distort the natural relationship that does or should exist between the deaf patient and his/her friend or family member. It may be a violation of privacy to disclose the information. While the deaf patient may consent to the disclosure, he may give the consent because he feels he has little choice. A neutral, professional should be used whenever possible -- one that is familiar with medical terms and accustomed to giving and receiving medical information.

Just a few thoughts from someone who has seen a little from both sides.

llg

Trauma Columnist · Mar 23, 2004

How horrible - what should have been a joyful event - the birth of a baby - was a bad experience. Sorry! I am familiar with the ADA - American's with Disabilities Act because we have a deaf girl that comes to the ER frequently. She demands a translator upon coming in and she chooses to come in for non-emergent care in the middle of the night. We always make a "reasonable effort to accomodate" for ADA requirements. This is what the law actually states. It does not mean that the hospital or institution must provide a translator. We are usually successful though. However, this patient uses ASL and will now only accept a "certified" translator. Well -we still make many phone calls but in the middle of the night for a non-emergent complaint - we can't always get a translator. For hearing people that don't speak English we use the AT&T phone line with very good results.

missmercy · Mar 23, 2004

When i worked on OB, we had a large number of migrant help come in to deliver -- NO english -- we had one gal who ended up with a similar experience! Most of us felt it was inappropriate to use her 12 year old son as her interpreter (HE was 12 for crying out loud and embarassed out of his mind) However, the nurse who discharged her felt that the son was able to express all that was necessary for her. He failed to discuss the episiotomy care or engorgement care -- guess who was miserable for days. The nurse was disciplined (BIG) and there is now a sheet near the phone with interpreter numbers for forwign languages, mentally retartded patients (special ed specialist) and ASL!! Her husband was only able to come in occasionally, but he could understand us fairly well. Stilll, post partum discharge instructions are SO important and it's not THAT hard to get someone to interperet!

**canoehead, BSN, RN** · Mar 24, 2004

It sounds like they had the interpreter, but that they just didn't give the care they needed to. Sounds to me like a hearing person wouldn't have gotten the explanations either- after all, all they had to do was explain them like they normally would and the interpreter would relay the information. And giving her a script- how simple is that? They really dropped the ball- you could certainly write to administration, and I sure wouldn't be paying for that second hospitalization!

justjenny · Mar 24, 2004

This sounds like a very sad situation, indeed.

I don't think it is fair to "blame" anyone. The hospital obviously was not sensitive to her needs, and did not have protocols in place to care for a diverse population of patients (whether deaf, or cannot speak/read English)

It is also important for patients (all patients) to know their rights. She has a LEGAL RIGHT to an interpreter (not a friend/relative) at the hospitals expense.

http://www.captions.com/hospital.html

Had there been a professional interpreter present - I highly doubt that the interpreter would have allowed the nurse to speak in such a crude manner, and would have been sure to correct any misconceptions that the staff may have about your sisters intelligence.

I am a first year nursing student, who also knows ASL - with the hope that my patients will not have to go through the traumatic events that your sis did!

My ASL instructor is Deaf also, and she is not a "shrinking violet" type! LOL! In a way, she HAS to be assertive - that is the only way to make sure that what is happening is in her best interests. (whether shopping, etc...)

I think education is needed all around in this situation - with the hope that something like this will not happen again.

On a side note - because both parents are Deaf - that child is going to be forced to grow up very fast. Most CODAs (Children of Deaf Adults) wind up being the "translator" to the outside world starting at a VERY young age.

I suggest you learn ASL if you haven't already - and try to educate yourself and others about the d/Deaf community.

http://www.deafness.about.com/

HTH!

Jenny

gypsyatheart · Mar 25, 2004

Just wanted to post how appalled I am at the care your sister received! That really is inexcusable! Please, Please follow up with administration, get the patient advocate involved, your sis's insurance company, anyone and everyone. Like other's have said...don't let this go, because it will happen to the next patient...it sounds like horrible care anyway! Remember in today's world :the patient is the "customer", make sure admin knows how upset your family is!

dawngloves, BSN, RN · Mar 25, 2004

Policies in place or not, I think it is poor nursing care not to properly educate your pt.The first thing I thought of with the PCA was "Why didn't they write instuctions if the interpreter wasn't there?" and then follow up when the interpreter arrived?

And I only yell at my kids for not looking at me when I talk to them and not very often!usually because they are looking at the TV and I am POed about something.

Tsk, tsk, tsk!

elkpark · Mar 25, 2004

I'm sure that Texas has a state agency that licenses hospitals and investigates complaints about individual hospitals, because every state does, and I'm sure that they have a telephone number or mailing address for making complaints. I work for the agency in my state that does this, and we investigate complaints about poor quality care like this all the time, by going to the hospital and investigating whether the hospital violated any of the state and/or federal rules it is obligated to follow. My agency takes complaints from anyone, whether or not it's the person who was actually involved in the incident, and you can even complain anonymously if you wish. When we do the investigation, we keep confidential the identity of the complainant.

I would imagine the arrangement in TX must be similar. That is one option, and the hospital would be held accountable for the nursing care provided to your SIL. Best wishes --