Scene1 : Lost in Translation
Sometime in May 2011, I saw the reflection of my next patient from the privacy screen of my computer. A Hispanic Mom with her daughter patiently waiting until I finished entering data in the computer of my last patient.
Me: Hi, how are you?
Mom: Hola, habla espanol Senor? (Hello, do you speak Spanish Sir?)
Me: Poquito , necesita un interprete? (A little bit, do you need an interpreter? )
Mom: Si, por favor (Yes please)
Me: Un momento por favor, tome asiento. (One moment please, have a seat).
I was able to get more information with the help of our in-house interpreter. She brought her 6 year- old daughter that day due to swelling on the right side of her neck. Her daughter was diagnosed with ear infection 3 weeks ago, already changed her antibiotics twice but still with on and off fever. Her daughter has Down's syndrome. The Dad is the only working and was at home with their 3 other kids. They have no health insurance.
Through an interpreter I explained to the Mom the plan of care- placed an IV and send another blood. She was hesitant at first but after explaining what happened she agreed. It was less than an hour when I received a call from the lab. They usually call if you messed up a specimen, wrong label or it's a critical result. I was betting with a Resident that night- she's for another clotted specimen, I was for high WBC. Both of us end up wrong, her blood count was positive for BLASTS !
SCENE 4 : DYING YOUNG
Through an interpreter I learned she had lots of questions, so confused ,worried on how and what to tell her husband. Her greatest fear was the patient will not survive. I asked our ED Social work to facilitate calling her husband and talk about community resources and support group. I informed the ED Attending to talk again with the mother's concern and questions. My shift was over and they were still in the ED. I went to their room, the Mom was holding a rosary. She gave me a weak smile and said: " Mi amor va a estar bien" (My love will be fine).
Yesterday morning I was running late for our in-service seminar. I yelled on to whoever inside the elevator to hold the door. A tiny hand held it for me- she's wearing a cute bandana to cover her thinning hair and had a purple backpack with a familiar cartoon character. I remember her and the Mom and vice versa. The Mom introduced me to her husband and say something else I can't comprehend. Her husband gave me a firm and warm handshake : Muchas Gracias Senor !
a) using an interpreter for the Mom to relay information and answers the questions she can best understand well.
b) healthcare team availability for any questions
c) providing her with informations on how she can avail of resources : social work, community resources and support group.
3) Sensitivity to Self and Others
4) Helping-trusting , human care relationship
5) Expressing positive / negative feelings
6) Systematic use of Creative Problem Solving Caring Process
7) Promoting Transpersonal teaching-learning
8) Supportive, protective and or corrective mental, physical, sociocultural and spiritual environment.
9) Assistance of Gratification of Needs.
10) Allowance for Existential-Phenomenological-Spiritual forces.