Hi, my name is AngelfireRN, I'll be your nurse tonight.
I am not a waitress, nor am I your slave.
Yelling and hurling obscenities at me will not get you your pain meds any sooner than they are ordered. Nor will having your family member or entourage do the same.
Threatening lawsuits and having umpteen family members camp out in the halls or hold up the nurse's station will not get you preferential treatment.
Physically grabbing me as I go down the hall is NOT a good idea.
I do not give the orders, but I do have to follow/enforce them. This is something that you should take up with your doctor.
No, I will not call him again to ask him for more pain medicine. He has been called twice and has said no both times.
No, I will not give you his number so you can "straighten him out".
No, you are not my only patient, and I highly doubt that you are single-handedly paying my salary. On the off chance that you are, let's talk about a raise.
NO, NO, NO, I most empahatically will NOT come get you when it is time for your next pain shot while you are having a smoke break. I also will not bring it to you in the smoking room. (Have actually said that, I am allergic to cigarettes. I did it once, had an asthma attack, desatted to 83, and turned blue, according to the patient and my charge nurse, after the patient had to help me back to the floor).
No, I don't really care if your family has not eaten all day, they drove here by themselves, they are not sick, and no, I will not call for 6 guest trays. (This of course, is if the patient in question does not need all 6 family members present, and is not at death's door).
No, you may not have 3 six-packs of soda from the kitchen, there are other people that would like a snack, too.
No, they will not open up the kitchen up just for you, at 1 in the morning, because you don't like the snacks we have on the floor.
I could think of hundreds, but those will do for a start. I know it sounds mean, but this is why I got out of bedside nursing. When a hospital becomes the Hilton, I'm gone!
Specializes in med-surg, psych, ER, school nurse-CRNP.
Well, I'll probably get slammed for this too, but Nocturne, hon, THINK about what you're saying. Yes, I speak Spanish. Why? I learned in high school, 12 years ago, because even then I could see the handwriting on the wall. I did it because I WANTED to.
However, I did not, and do not feel that it's my duty to learn a plethora of languages because the immigrants and transplants that choose to come over can't be bothered to learn English. I hate it, but my ability to treat and prescribe and NOT KILL YOU by giving you a med you're allergic to is severely hampered if you have made no attempt to facilitate communication. I left my little Star Trek doowhatcher at home, so no go on the body scan physical, either.
You plan to live here, learn the language. It's that simple. Well, along with getting your legal papers and SSN and a job and all that other not-politically-correct mess.
And I won't even go into the Death Squad thing. Suffice it to say I think they have a point to a degree.
OK, lets see, goggles? Check. Marshmallows? Check. Asbestos underoos? Check. Let the flames begin!
admittedly, i don't know any of that for sure. i'm just going from past experience with my ex-husband's family who brag that they've been in the country for 40 years and have never had to learn english. their grasp of the english language is proportional to how much they like what they're hearing. and they brag about that, too.
well, that would annoy me, i must admit. i think i'd have to ask them, "but why are you proud of not being able to speak the language of your country?" it could be that they're not really that happy about it, just pleased that they haven't been pushed to do something that they fear they wouldn't succeed at.
anyway, you've got to be careful about assuming that patients who don't speak english well are just being difficult. some haven't had the opportunity to take classes. most people don't learn a second language very well just through osmosis----they have to memorize vocabulary, understand at least the basics of grammar, and practice over and over. (especially adults. and even more especially, adults who have only a sketchy education to begin with, which is true of a lot of poor immigrants.) that can be difficult, for immigrants who are working long hours trying to get ahead. also, people who are unsure of their skills in a foreign language are often very shy about trying to speak it to a native. add to that the fact that it's harder to concentrate on listening and speaking in a different language when you're sick or anxious, and there are quite a few reasons an immigrant might prefer to have a translator present.
40-something year old morbidly obese patient with a [recurring] UTI and no pertinent PMH (during clinicals)...
"So, [patient], who changes your diaper at home?"
"Oh, no one, I just use the bathroom."
USE THE BATHROOM HERE TOO. IT'S QUITE OKAY.
And recently I heard a mother tell a young adult GI patient (I work on peds) that he could "just poop in the bed because the nurses will clean it up anyway".
Oh yeah, and meanwhile, you can lay in your own filth...
Well, I'll probably get slammed for this too, but Nocturne, hon, THINK about what you're saying. Yes, I speak Spanish. Why? I learned in high school, 12 years ago, because even then I could see the handwriting on the wall. I did it because I WANTED to.
However, I did not, and do not feel that it's my duty to learn a plethora of languages because the immigrants and transplants that choose to come over can't be bothered to learn English. I hate it, but my ability to treat and prescribe and NOT KILL YOU by giving you a med you're allergic to is severely hampered if you have made no attempt to facilitate communication. I left my little Star Trek doowhatcher at home, so no go on the body scan physical, either.
You plan to live here, learn the language. It's that simple. Well, along with getting your legal papers and SSN and a job and all that other not-politically-correct mess.
And I won't even go into the Death Squad thing. Suffice it to say I think they have a point to a degree
OK, lets see, goggles? Check. Marshmallows? Check. Asbestos underoos? Check. Let the flames begin!
I'm not going to slam or burn you, but I am going to talk turkey. I'm also going to point out that you're making a lot of assumptions about total strangers here, and that most of them are based more on emotion and political rhetoric than logic.
So you studied Spanish in high school? Good for you. If you have a good memory, then no doubt you'd manage quite well if you were to visit, say, Mexico or Spain. You could order in a restaurant, hold your own in a basic conversation, conduct a sales transaction at the local market and so on. As you said, you "speak Spanish."
On the other hand, that level of fluency might not be nearly enough for, say, a trip to the local hospital's emergency room. It's one thing to be able to say, "I'll have the chili con carne, please," or to comprehend "Are you enjoying your first visit to Barcelona?" It's quite another to be able to say, "I woke up with a throbbing pain that shoots right through from the right side of my forehead to the back of my neck. I'm also seeing double. I do get migraines, but this isn't like any migraine I've had before. I'm really scared, because my mother died of a cerebral hemorrhage two years ago, and her symptoms were very similar to mine." Or "I'm allergic to NSAIDS, and the only time I was ever given Dilaudid I went into cardiac arrest." Quick, now: can you say all of the above in Spanish without using a dictionary? Could you say it off the top of your head while you were coping with the worst headache of your life....and know for sure that you'd communicated it effectively?
That's the part that so many of the if-you-want-to-live-in-the-U.S.-learn-English-it's-that-simple crowd tend not to consider: that what might be a very adequate command of English in some situations can be terribly inadequate in others. And, when you throw in the fact that the patient is also dealing with cultural differences, and can't always tell by observing expressions or body language whether the doctor or nurse actually grasped what s/he's trying to say....well, why would anyone think it's unreasonable for a patient to ask for a translator?
(Trust me on this one: I lived abroad some years ago, and had plenty of opportunity to put it to the test. And I had much more than a high school command of the language in question.)
I'd also be interested to know how you managed to find out, at one glance, that this hypothetical patient (1) has lived in the U.S. long enough to become completely fluent in English, (2) had ample opportunity to take an English class, and could afford to do so, but (3) refused to do so because s/he "couldn't be bothered." That's an awful lot of blind assumptions to make, for a health care professional who's been taught to assess rather than jump to conclusions.
By the way, no one was asking you to learn a "plethora" of languages. AT and T has a perfectly adequate language line that's just a phone call away. (Yes, it costs money to use. So do IVs, medications and Xrays.) Is it really asking so much to provide that service for those who need it, and to can the stereotypical assumptions while you're at it?
I'd love to tell some of my patients that, "No, you will not die if I give you your medication 5 minutes later. Please stop ringing your call bell, your room mates call bell, sending your family members out to find me, and yelling out as loud as you can from bed!
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
i'd also be interested to know how you managed to find out, at one glance, that this hypothetical patient (1) has lived in the u.s. long enough to become completely fluent in english, (2) had ample opportunity to take an english class, and could afford to do so, but (3) refused to do so because s/he "couldn't be bothered." that's an awful lot of blind assumptions to make, for a health care professional who's been taught to assess rather than jump to conclusions.
by the way, no one was asking you to learn a "plethora" of languages. at and t has a perfectly adequate language line that's just a phone call away. (yes, it costs money to use. so do ivs, medications and xrays.) is it really asking so much to provide that service for those who need it, and to can the stereotypical assumptions while you're at it?
i work in icu, not er, and by the time they get to us we usually have a ballpark idea of how long they've been in the us. just visiting from india? or lived here for 35 years? i think anyone who has lived in the country for 35 years ought to learn enough english to ask for ice water, to go to the bathroom, or say they're having pain and pointing to the location. perhaps not for the scenerio you described above and certainly not for "your coronary arteries are blocked and these are your choices:" types of conversations. but even after living here for a few years, you ought to be able to understand "are you having pain?" and be able to nod yes or no even if you are embarrassed to speak english.
as far as the language line or providing interpreters, yes, it's a service that costs money. but unlike ivs, medications and x-rays, it comes directly out of our icu budget. the patient is not charged for these services. maybe the unit budget ought to cover the complicated "you need surgery" discussions", but i don't think it ought to have to cover an interpreter for a naturalized citizen who has been here for decades so she has someone at the bedside in case she wants to ask for a glass of water. i think that for those basic discussions, the patient ought to bring their own interpreter, pay for us to provide one, or crank up those english comprehension skills.
Specializes in med-surg, psych, ER, school nurse-CRNP.
OK, OK, let me clarify here. I said I LEARNED Spanish in high school. I was condensing for time's sake. What I did NOT include was the facts that I 1) also took 2 years further in college 2)have been to Mexico and Puerto Rico 4 times each and acted as translator and 3)worked with a Peruvian boss who understood me better in Spanish than in English. Now, no, I won't pretend that I could translate all the convo you listed above. Far from it, I'm a little rusty, but that's kinda my point. Add to that that I work in a clinic, and we don't have a language line. Nice thought, but not practical here. So, as long as we're canning things, here's a lid.
And as far as telling at a glance that a patient fell into each and every single category I brought up, I never said I could. It's called generalization. And it's proven by people such as Ruby who has firsthand knowledge of people who knowingly choose not to learn the language of the country they live in because they CAN NOT BE BOTHERED. Been there, seen it, dealt with it. So, yes, I know. I have seen it, been in the ER when an illegal immigrant was literally dropped at the door by his head contractor, after falling off a scaffold. No SSN, no ID, no CONSCIOUSNESS, no way to know what was going on except for a note from said head contractor that said he had fallen, his name was XXXXXXXX, and he had no insurance. The poor guy woke up and spoke no English, had no family, was disoriented, and hung up on the translator.
Flip side, I have also been in the psych ward when one of our favorites, who spoke only Spanish, was going ape. He just wanted a cigarette, and finally calmed down after I asked him (in Spanish) to sit on his bed for 10 minutes beforehand. Saved him a takedown and a hip full of the Holy Trinity.
As far as knowing a plethora of languages, well, how would I USE the language line, without knowing which language to select? I'm OK with some, but I'll be danged if I can tell Arabic from Farsi.
In the interest of time, and the patient I have to go see, I'll stop, but just wanted to point out, it's only stereotyping if you have no knowledge of what you're talking about. If and when I don't, I gladly can it. Since I kinda sorta DO, gobble, gobble.
I now return you to your regularly scheduled VENT THREAD, and hope that it can remain just that.
i work in icu, not er, and by the time they get to us we usually have a ballpark idea of how long they've been in the us. just visiting from india? or lived here for 35 years? i think anyone who has lived in the country for 35 years ought to learn enough english to ask for ice water, to go to the bathroom, or say they're having pain and pointing to the location. perhaps not for the scenerio you described above and certainly not for "your coronary arteries are blocked and these are your choices:" types of conversations. but even after living here for a few years, you ought to be able to understand "are you having pain?" and be able to nod yes or no even if you are embarrassed to speak english.
as far as the language line or providing interpreters, yes, it's a service that costs money. but unlike ivs, medications and x-rays, it comes directly out of our icu budget. the patient is not charged for these services. maybe the unit budget ought to cover the complicated "you need surgery" discussions", but i don't think it ought to have to cover an interpreter for a naturalized citizen who has been here for decades so she has someone at the bedside in case she wants to ask for a glass of water. i think that for those basic discussions, the patient ought to bring their own interpreter, pay for us to provide one, or crank up those english comprehension skills.
if the patient is in icu, it's very likely that he's both sick and stressed, both of which would make it harder to communicate in another language.
i agree that it's reasonable to ask the patient to have someone at the bedside to interpret for things like water and kleenex. that said, it isn't always possible for a family member or friend to be there around the clock, any more than it would be for you or me to get someone to stay with us around the clock. how do you handle the problem when the patient is just visiting from another country, doesn't have friends or relatives available, and speaks a relatively uncommon language? couldn't you handle it the same way, when the patient is a mexican immigrant (never mind how many years s/he's lived here) and doesn't speak english well?
what i'm getting at is this: when you make stereotypical assumptions about patients "not bothering" to get with the program, whose needs are you really meeting? the patient's need for clear communication, or your own need to vent frustration?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
if the patient is in icu, it's very likely that he's both sick and stressed, both of which would make it harder to communicate in another language.
i agree that it's reasonable to ask the patient to have someone at the bedside to interpret for things like water and kleenex. that said, it isn't always possible for a family member or friend to be there around the clock, any more than it would be for you or me to get someone to stay with us around the clock. how do you handle the problem when the patient is just visiting from another country, doesn't have friends or relatives available, and speaks a relatively uncommon language? couldn't you handle it the same way, when the patient is a mexican immigrant (never mind how many years s/he's lived here) and doesn't speak english well?
what i'm getting at is this: when you make stereotypical assumptions about patients "not bothering" to get with the program, whose needs are you really meeting? the patient's need for clear communication, or your own need to vent frustration?
i'm sorry. i thought i was on a vent thread. if i'm not, so sorry. i won't ventilate about my stereotypical assumptions if this isn't a vent thread. if it is a vent thread, it's impolite to step on our vents. just sayin'.
:yeah:
:smokin:
WoofyMutt80
158 Posts
I work in SMALL clinic, no interpreters, but the community is mostly Spanish, Portuguese, Cape Verdean, Haitian