About 6 years ago I was caring for a young Hispanic woman in the ICU who had become critically ill with some type of respiratory issue. She was about 30 or 32, an immigrant, and spoke no English. The docs were baffled at what had made her so sick since she appeared the picture of health and from the limited history we got from her friends, she had no medical history other than 3 pregnancies. She had no family in the states; her family, including her young children, were all in her home country. A slew of tests were ordered to try to figure out what was going on with her, one of which was an HIV test. Needless to say, it came back positive.
The first day I had her, which was about 4 or 5 days after she first came in, she was on a ventilator, but had significantly improved and was about ready for extubation. With the help of a Spanish-speaking respiratory therapist, I was able to communicate enough to let her know what I was doing, such as drawing blood, turning her, doing mouth care, etc, and ask if she needed anything. What I remember most is that she smiled a lot, despite the tube down her throat and lines all over the place. She couldn't talk, but her smile was almost constant when she was awake. It was that day that the results of the HIV test came back.
Early the next day she was finally extubated and able to talk. Fortunately, the same Spanish speaking RT was there and helped with a lot of the translation. But when it was just the two of us, with my limited broken Spanish and her limited broken English and a LOT of hand gestures, we actually conversated about her children and how much she missed them. All the while I kept thinking about that HIV diagnosis and how it would change her life. It may not be a life sentence anymore thanks to advances in treatment, but its still life altering. Plus, this was a woman with very limited resources who only saw the doctor in the past to give birth.
Later that day I sat in the room at her bedside while the physician and a translator informed her of the diagnosis. The wails that came from that woman were almost unbearable. The only thing I could do was rub her back and sit with her while she cried, and thats what I did for the next hour (fortunately my charge nurse was able to watch my other patient during that time). She sat there and cried and talked and cried some more during that time...I felt horrible that I couldn't understand most of what she said but it obviously wasn't the time to leave her to get someone to translate or use the translation phone, so I just stayed with her.
It seemed liked she just shutdown after that. She barely talked for the rest of my shift and the next day she was equally quiet. She wouldn't make eye contact and answered questions with a simple yes or no. I transferred her out to stepdown in the middle of that last shift and just felt helpless when I left her in her new room curled up in the bed facing the wall.
Sorry so long, but that is a patient that really sticks with me especially how she looked when I last saw her. I still think about her from time to time and wonder what became of her.