Without Words

Shenanigans, RN

Oftentimes food and drink bought in so the patient doesn't have to suffer through the horrors of hospital gruel. Some are even lucky enough to have a family member bring in their own pajamas, clothes or toiletries. But Yin, well, Yin had nothing. Even patients from lower socio-economic backgrounds had something to remind them of home. As for Yin's home? I didn't even know the name of his country.

Yin had somehow found his way into New Zealand illegally, wanting freedom from whatever trauma or poverty so badly he would flout the laws of the nation he wanted to call home. On arrival in New Zealand Yin had made himself useful doing a job that most New Zealanders would shun their noses at, well, the educated New Zealanders at least. He was picking pumpkins. A rather labor intensive, thankless and probably badly paid occupation. Yin spoke no English and so when his "employer" had come running from the shed, screaming the cops had shown up with immigration officials, Yin really had no idea of what was happening. So when Yin witnessed his boss running with police officers in hot pursuit, he did what most illegals would do, he ran as well. Yin then became the target of a well-trained police dog, a large Alsatian that in all likelihood that afternoon had sat obediently in a classroom while over enthused school children patted him and asked questions about how many "baddies" he'd caught. Yin noted the closing dog, spun around awkwardly and fell over into a small ditch, in the process of escape Yin had sustained minor scrapes, bruises a sprained ankle, several broken fingers, a dislocated wrist and a painfully fractured calcaneus (heel bone). This event led Yin into my path.

At the time I was a year two nursing student. I had never worked in the hospital setting, having so far only worked placements in rest homes and elder care hospitals. I was looking forward to Orthopaedics with its promise of blood, gore and horrific fractures. A chance to do dressings, injections, prime lines, essentially just get some good hands-on experiences, albeit under the watchful eyes of nursing preceptors and lecturers. It was week two of my four week placement and so far having dealt with the messy results of a motorcycle gang vs. an SUV, a workman and his adventures with an unsteady ladder, a chap who had a rugby scrum collapse on him and a multitude of little old ladies slipping downstairs, in showers and in gardens, I was getting my fill. My meeting with Yin began when my lecturer learned I was caring for a gentlemen post his total knee replacement who's resulting came back as having MRSA in his wound, school policy was students weren't allowed to care for MRSA positive patients and so I was asked to take over Mr. Yin's care.

Handover from the nurse caring for Yin to me involved finding out about Yin's accident and his pre-op state, also that no one actually knew what Yin's name was, where he was from, how long he'd been in New Zealand if he had any other friends or family, nothing. Essentially, Yin was as faceless as a case in a nursing textbook. A human being with no name, no birthday, no family, no co-morbidities, no friends, nothing and no voice. I wasn't sure how I was going to deal with Yin; my nurse preceptor said it would be a good learning experience, as there would be many events in my career to come that would leave me in a situation with a non-English speaking patient. Why the interpreter service wasn't yet involved I honestly didn't know. All I knew was he was Asian.

My mind conjured up scenarios of where I subconsciously offended Yin; I had a waft of knowledge about different religions and cultures and their beliefs and opinions. I gave thought to the consideration of Yin being a Muslim; there were various Asian countries where Islam was the predominant religion. If this was the case, and he was Muslim, would be cared for by a female offend him? If he was Muslim, exactly how Muslim? Was he from a small village somewhere where women were below dogs on the scale of value? Where they were covered in some form of dress and they were stoned if they ventured out against their "master's" wishes? Maybe Yin was a Buddhist? I had just had a very meaty sandwich for lunch, weren't most Buddhists vegetarians? Maybe he was Hindu, and perhaps he'd believe I'd eaten a reincarnated relative of his? Perhaps he was a Protestant Christian and the crucifix I wore about my neck would draw his scorn. Perhaps just being a woman obtaining an education would anger him. Essentially all the knowledge of other cultures and religions passed through my mind and how it was I was going to insult him.

Entering the room I found Yin sitting in bed with no measure of comfort. Two heavy-set prison guards sat next to him. I smiled politely, introduced myself - and inwardly aware that it was of the only benefit to the guards as Yin just had no understanding of the words I spoke and the accent that they came with. The guards told me to go about my jobs and just pretend they weren't there, which was kind of hard to given the handcuffs that bound Yin's wrists and ankles and the rather nasty looking Trudgeon the sunglass wearing, tattooed guard was tapping against the cot side. It was a rather extreme waste of taxpayers' dollars, two muscle clad prison guards protecting New Zealand from the evil antics of an illegal immigrant with a busted foot! I explained to Yin the point of an MRSA swab, inwardly knowing it wasn't going to help, he nodded and smiled. Now was the part where I had to find a way to get Yin to swab his groin. I explained in English to a blank face. I made the motion a somewhat distance from the area of his body. I thought better to make the motion against my own body. The guards thought it was amusing and their laughter only served to make Yin a little more uncomfortable. This was going nowhere fast. I realized. If I had been a cartoon character a light bulb would have suddenly been animated above my head. I pulled a piece of paper from my pocket and drew the most G rated, non-gendered image of a smiling faced person. I indicated on the drawing where Yin was to swab himself. Yin looked somewhat horrified for a moment - an indication that he understood where he needed to rub the cotton bud on a long stick.

I stepped outside the curtained cubicle; the guards remained in case Yin was able to use the swab to pick the locks of his cuffs or something. When I returned the guards confirmed Yin had swabbed.

Yin spent the next three days waiting for surgery while politicians and police argued with doctors that he should be sent back to his own country - wherever that was. The politicians didn't see a point in him getting surgery; the doctors demanded that under various UN treaties and just common human decency that Yin should be cared for. All the while Yin lay in pain with no way of understanding the white men that argued about him. Yin was eventually operated on, I cared for him post-op and within 4 hours of his return to the ward, he was transferred to the nearby prison hospital.

I never found out the fate of Yin, if he was deported, if he found refuge, if he was given residency, and I never even knew his name. Yin had taught me a valuable lesson in cultural sensitivity. New Zealand often peddles itself as a miss match of cultures and welcomes them into our brood, with this society we are taught to be open to all ideas and worldviews. Yin, however, caused me all manner of concerns as he couldn't speak nor understand a word of English. Most of those from other cultural backgrounds arrived on our shores with at least some understanding or friends and family who translated. Yin left an impression on my life and on my nursing career; his pain filled time in New Zealand taught me there are other ways to communicate with those of another culture that don't involve words or semantics. He also taught me that a person isn't just a religion, a worldview, a country, culture or skin color. All the inward thoughts I had about how I was going to offend him, I think at the end of the day, even if he had been some extremist, he realized I was there to help, and the kindness I and the other nurses showed him was a welcome antithesis to the ignorance of others and the authoritarian arrogance of those guards.

names changed for privacy

strugglingnurse · Jan 11, 2009

Great story. However, why wasnt interpreter service activated immediately? Im confused.

Shenanigans, RN · Jan 11, 2009

Dunno why. That was part of the problem. I also think because he had no residency status or whatever, and that interpreter service is expensive, they didn't bother since they wouldn't get any money from him in the end.

SDChargersGirl#31 · Jan 11, 2009

You have great writing style. I found myself laughing at parts. You had brought to light some cultural differences that I had never even considered or though of. It was an enjoyable read, thanks.

Without Words

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