Wednesday, April 21, 2010

Language Barriers

It is not uncommon for us to have Spanish speaking, Polish speaking, or some other very foreign language speaking families in the PICU. We have a great interpreter program and can almost always get someone to give parents and families updates. However yesterday I had a "language barrier" I had never encountered before!

My patient was deaf...and so was her mom. I had meetings the first part of my day, so I came into the assignment at 3pm. As I walked into the room the mom had just arrived so I wrote down on a piece of paper "My name is Dana and I will be X's nurse until 7pm...." I wrote a short update on how the patient had done that morning and my plan for the evening....then I wrote "Can I get you anything?"

Very shortly after I walked in and introduced myself, Patient Relations walked in. Now, for those of you who don't know who "Patient Relations" is....they are the people who get called when parents are extremely upset with some part of their care, ie: the nurses suck- they never take care of my child, never bathe them, never turn them etc., or the doctors suck- they never come in to check on my child, they never communicate with me, they don't know what they are doing, or this hospital sucks- there is absolutely nothing good about it!! Now while a majority of these complaints come from extremely anal parents who are being over-the-top unrealistic (and not seeing the doctors and nurses who really are providing exceptional care for their child!) every once and awhile there is some truth in their complaints.

Enter deaf mom yesterday. I had a two and a half hour conversation with the mom, the resident (doctor) and the patient relations woman. And by conversation I mean the mom talked and yelled in a way that was very hard to understand (because she's deaf and can't speak well) and then we had to write everything down because she doesn't know any sign language (which we have an interpreter for by the way!). Try writing EVERY. LITTLE. DETAIL. about a patient you are changing the the patient is really doing...what her test results were...and then having to re-write it down in a way that is easier to understand.

This mom was also very upset about a lot of things because she simply was not understanding. Part of her misunderstanding is because we probably did not do a great job of writing everything down as it happened...part of it is because she is not there all that often so we don't have the opportunity to communicate with her...and part of it is because she is slightly delayed. So trying to calm a deaf yelling mom down by writing down words was difficult!

However, while it was really hard communicating in this way, I can't even imagine being deaf and having a child in the ICU, feeling like I have no idea what's going on! The poor mom just kept saying "I want my baby back" (by the way, her "baby" is 19 years old)..."I want to watch Twilight with her and fight over which one is cuter"..."I want her complain about my cooking again!"

As hard as it was, I learned the importance of communicating with every single parent that we have. No matter how difficult it may be, every parent just wants to know what's going on with their kid! Every parent wants to be reassured that their progress (or lack thereof) is ok. And the times that it's not "ok" the parents want to hear that too! So no matter the language spoken, I want to make sure the families feel like we are (I am!) truly communicating with them.

*Oh, and to validate the mom's complaints, she told the patient relations person that I was the first nurse that had written anything down for her! I was shocked but proud of myself for at least trying to communicate in the only way that I knew how with her!

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