Sunday, November 16

I am going to blog about my recent experience and I really don't want everyone to point out the mistakes unless you have a solution.

A friend of mine texted me that she was not feeling well and did not want to drive to PrimaCare alone. She is Deaf. I went with her and interpreted between the dr and her. They treated her for acute gastridus and sent her home. The next day, I tried calling her, texting her but she was not answering. Finally, 4pm she answered me that she just woke up and was still not feeling well. We went back to PrimaCare and she was severly dehydrated. We were sent to the emergency room. PrimaCare called ahead of time to inform them that she was Deaf and that I could interpret until a certified interpreter arrived. They got her right in, this was about 6:30 or 7pm. NOW - I am not a certified interpreter and I have only been signing since last October. I am doing pretty well, but would definately not call me fluent.

The choice for me was do I leave, do I interpret, or what do I do. I did request an interpret and they kept telling me that they were looking for someone. She was REALLY dehydrated and they thought it was her appendix or gallblatter. Her appendix was removed back in the 70s, so we were left with gallblatter. They ran a series of tests and decided she would need to stay overnight until the surgeon came in the morning. Her sister arrived and we finally got a room at about 5 in the morning. I stayed with her all that time. Her sister is relearning sign language, they were apart for many years and she just recently moved close to her sister 2 years ago. They only see each other once, maybe twice a week- so she is learning slow and I can sign better than she can.

I stayed until we got the room and they finished the initial testing. I went home, told her sister to call me in the morning when the surgeon came - I work right across the street and can come if an interpreter has still not arrived. I get home about 5:30, I need to wake up at 7 to get my daughter up for school. I get home in time for Rebecca to leave, say bye to her and go to bed. I wake up and get my other daughter ready for bed. I call my friends room and did not get an answer. I thought maybe they were asleep or out for more testing. I tried again about 8:15, still no answer. I tried again about 8:30, still no answer. I called the hospital after the 3rd time and asked if anyone was in my friends room with her - NO, NO ONE WAS IN THE ROOM WITH HER. I am a person that always wants someone with me in the hospital because nurses can make mistakes - and then add to that, my friend who was drugged up if she was asleep would not know what they were giving her.

I left my work and went straight to the hospital, the surgeon was already there, but wanted to wait for an interpreter to arrive before going over everything with my friend. When I arrived, the nurse told me that they were still not able to find an interpreter. She called the surgeon and told me that someone was there who could interpret for my friend. I told her I was not a certified interpreter. She did not seem to care. My friends sister finally arrived and then the surgeon came. I interpreted the operation choices and the risks involved with each one. Her gallblatter was going to need to be removed. My friends sister asked if an interpreter would be able to go into the operating room with her sister and the surgeon said that he would take care of that and got on the phone - I never stopped interpreting what everyone was saying. The surgeon said (on the phone), "Is there anyway that we can have a family member come in and interpret for _____?" My face fell, but I continued interpreting. I reminded the surgeon that I was not certified, but again I don't think he cared. They said that she would have surgery the next day at 7:45am. I informed my work that unless an interpreter came, I would need to stay with my friend for another day. I had my laptop so in between nurses coming in when my friend was asleep, I was working.

I will not go into all the things that the nurses did that I felt were wrong, but I had a set several nurses straight and educate them on how to work with the Deaf, for example - talk looking at her - NOT ME!! She is a person and deserves that respect. Anyway, I called some of the interpreters from church and together we took shifts. Both of them work in the school system, so could only come at night. They releaved me for about 4 hours, so I could come home and get a couple hours of sleep, say goodnight to my girls and take a shower. In 3 days, I got about 6-7 hours of sleep. Surgery day, her surgery was delayed until 1pm. Can you imagine if no one was there to tell her how worried she would have been??!!

Anyway, the whole thing was very frustrating, but I was happy that I could offer my hands to help. I went into the operating room with her until she was totally out and then I ran to the cafeteria to get something to sleep really quick. I could also only eat if someone brought me food or like this instance when she was in surgery or when a friend releaved me at night. The nurses were very nice and happy that I was there to help facilitate communication. They were never ugly to me and always asked me if I needed anything - I wanted to SHOUT - YEAH, a certified interpreter would be nice. My friend never asked for another interpreter. She was fine with me interpreting and was familiar with my hands - but I still felt that it was just wrong - she deserved better than my hands. God definately spoke through my hands the entire 4 days that I was there and I learned a lot. An interpreter from church brought me an ASL medical dictionary and I studied that at night and especially right before the surgery.

NOW - here is what I wish, and I would like your opinion or advise on this: can the hospital have a video relay phone where they could reach a certified interpreter when they needed one? I know that this is not a replacement for a live interpreter in the room. But I keep thinking what happens when someone is just traveling through our town and has a car accident. What would happen to that Deaf person - none of their family is here. There has to be a solution. I was happy to help my friend. I realize there was a HUGE risk involved with me interpreting, but I really did not see another way. They could have written notes back and forth, but that just seemed wrong too. Her sister wanted me to interpret and I feel like I did a great job. It was scary but also a great learning experience. Makes me want to get my certification and volunteer at the hospital. I heard that they reason that no interperters ever came is because several were never paid by that hospital. I am writing a letter to patient relations of the church and I am also going to make a flyer for the hosptial on how to better work with Deaf or hard of hearing patients.

My friend is doing great and is staying with her sister for the time being and my family is very happy that I am home. Please do not "bash" me for my decision. I felt and still feel like I did the right thing. I would like solutions however for future hearing impaired patients.

16 comments:

Deaf Pixie said...

Hi,

I know How much so frustrated with Doctor and nurse knew nothing about how to reach ASL agencies.

Late 1987 I end up appedectomy surgery and tried to get ASL interpreter for 2 days and End up to get ER surgery for struggle to get interpreter Agencies. After surgery I was out of recovery. I asked my sister to get water. I cough.. she wont able to help me because of no interpreter. I was kind of drownesy by medicine.

I know it is hard for everyone deaf frustrated with hosptial. I am now file complaint against Hospital. Your friend should suing Hospital and Where you lives location?

I am correct your spelling of Gallbladder.. Smile. It is not correct earlier you wrote one of most difficult spelling for medical Vocubarly. :) Don"t feel gulity for not right spelling gallbladder. Wink

Deaf Pixie said...

One things I forgot to say something..

Getting ASL intepreter business card and put it in your purse and remind to save your life.
OR, I always save ASL interpreger's business address and phone number of list in the kitchen. Make a copy it for the future in your purse. I always gave doctor office each I visit. they dont know where they could find ASL interpreter or Go looking at Translate in yellow page. It often dont put their 24 hours phone number. it is very negative issues.

I always put in my cell phone ASL Agencies in cell phone. Much easier.

You should try to tell your friend about put address their ASL interpreter. Often Hosptial doesnt want to pay for interpreter. it is too expensive. They refused to call ASL interpreter, Instead they can call forgein language Agencies so they can itnerpreter. Most of intrepreter are not certificate. I warning you about serious medical which interpreter doesn't qualifited interpreter!

That's scary issues about my bad expereniced.

Anonymous said...

I understand you felt the need to be there while they were looking for interpreter. What the hospital did was wrong, they violated the ADA. Here's what you need to do, go to the Department of Justice page online...and locate ADA and there is a form you can fill out online and submit. Let them investigate this and they will make sure the hospital does what they're supposed to to.

This is not a lawsuit (I do not think), but more of DOJ following up. You can, however, contact a lawyer to file a lawsuit to make sure the next deaf person does not have to go through what your friend did. I personally don't like suing everyone that messes up, but, even so, sometimes doing it and not getting any gain from it helps in the long run for all the future deaf/hoh patients that goes into that hospital. Do you want deaf/hoh people to go through what your friend had to go through?

Normally, I'd be ok with no interpreter in a regular doctor's office visit. But, when we're talking about someone cutting you open! Geesh! You'd need to know everything before you sign that paper to have a surgeon cut you open.

Candy~

Robert Alfred Hawkins said...

You faced a common dilemma but as was the case in many cases you handled with poise so extraordinary.

I have no clear answer for this. Regardless, you did your very best and that's what matters. This doesn't absolve the provider of their obligations.

Can't please everyone. The ADA was designed with no clear predictive. Not as simple as it appears as numbers of interpreters are in so severe shortage thanks to several trends going on lately.

Keep your head up and stay strong.

MB said...

I would definitely send them an invoice for every second you were there. They may not pay it, but it will send a message that they need to get their act together.

You might also want to provide them with this handy article so they see what a legal liability they are risking (not to mention possibly losing their accreditation).
http://tinyurl.com/6p64mc

Mother of Bilingual Deaf and Hearing Children said...

Thank you for staying with and helping your friend communicate with the hospital people, because that is what she wanted. Be persistent with your follow up with the hospital, interpreters, and interpreter agencies in your area. The hospital should have in place policies and procedures to ensure that interpreter services can be and are provided when needed. Many hospitals have obtained video conferencing equipment and contracted for video remote interpreting services, to provide interpreter services quickly and when interpreter services are scarce. You may want to contact the NAD or look on their website for information about access to health care, and video remote interpreting services, and share this information and NAD's contact information with the hospital.

Jamie said...

Candice,

I am so horrified by your experience, and indirectly, your friend's, that I don't know where to begin.

First, I think you were a great
Second, sounds to me like the hospital really messed up and is facing a possible lawsuit! There ARE options if a live interpreter is not available, such as video remote interpreting (http://deafness.about.com/od/interpreting/qt/videoremoteterp.htm). By LAW your friend is/was entitled to a certified interpreter. If that hospital has not paid interpreters, all the more reason the hospital could face a lawsuit.

Third, you are not a certified interpreter, and if you had made any serious mistakes, you could have been liable (I could be wrong on this, but that's my hunch).

Fourth, you are absolutely right in your concern about what could happen to a deaf patient who got hurt passing through your area. All the more reason the hospital needs to get its act together.

Get in touch with Elizabeth at her blog, Mishkazena. She knows better than anyone else how to handle these hospital and interpreter situations. Her blog is at http://blog.deafread.com/mishkazena.

mishkazena said...

You were very helpful.

However, the hospital was blatantly neglectful, disregarding the laws of ADA and Section 504. This shouldn't be tolerated. I am sorry for your friend, your friend's sibling, and you because none of you deserved to be put in this position. That hospital is asking for a major lawsuit.

Sad

Anonymous said...

I skimmed the post, and I may have missed if you already did this, but you could have a list of local agencies and their phone numbers handy to give to the hospital staff. If they say they "can't find anyone", you can call the local agencies and find out if they really did contact the agencies or not.

Anonymous said...

You did a very dangerous thing. You are not an interpreter. You do not in any way possess the skills neccesary to interpret for surgery. You really have to understand how DANGEROUS this is, this mindset. You knew better. Your time would have been better used calling every interpreter agency in town. I guarantee they have people who explain the need for interpreting services to the hospital all the time. In a medical emergency, no agency is going to deny to send an interpreter because of non-payment.

If you were an EMT would you volunteer to perform surgery if a doctor wasn't available? No, you would wait until a doctor could be found because the damage you could do can't be undone. The hospital was wrong. You thought you were doing the right thing, and I sympathize with that. Please understand that not every signer is an interpreter, especially not one who has only been signing for one year. What you did was just plain DANGEROUS and irresponsible. I am sure this was not your goal, but please never ever do this again until you are a certified interpreter.

Amy said...

that last anonymous post was awful. its completely a different situation. As long as the deaf person understands and says yes, you can tell me what they're saying, I trust you not to leave things out. I have interpreted at hospitals, police stations and voting polls. As long as the deaf person and all parties involved know the limitations of your skills and qualifications they can say ok. You did a wonderful thing helping our friend and i know how hard it can be to struggle through things like that,

Make sure paper is always around when communication is needed even when you are present that way if clarification is needed, white boards are also awsome for this reason that way everyone can write what they need. Like some other ppl said keep numbers with you and the hospital should allow you to call someone for them if you believe you can make the call and the interpreter available faster. Nurses would let hearing patients know what they were given and so should deaf patients which is where the paper/marker board would come back in to play. It can be very hard to find equality in emergencies when people are trying to provide care and fix things and deafness can appear a 'road block' as they need extra care where communication is involved. Im sure you did a wonderful job and that your friend is very thankful, it must have been nice to have a face and hands she trusted as she was sent off to sleep in the OR. Keep strong, you did the right thing!!

Martha said...

Wow...I feel very bad for you and your deaf friend and I completly understand how you feel. I am in a unique situation because I can understand this from all sides.

My parents are both deaf (my mom has usher's and is deaf and blind). I am constantly shocked by how people in the field of CARING for others (healthcare) can show such utter disregard for the emotional comfort of the deaf.

I interpret for my parents. I DEMAND to be allowed to stay with them at all times no matter the rules of the hospital or doctors office. I have tried to explain the laws and that I am only trying to help all involved to facilitate better communication (which is what everyone should want). Unfortunatly this usually is not enough. I have found getting very loud and sometimes angry has better results. I know that sounds bad but my parents are my priority not the feelings of those around us.

I am fluent in sign language BUT I am not certified. I have interpreted for anyone and everyone because I feel I have a moral obligation to help those who cannot hear. God gave me the tools to help them. Anyone who wants to say I shouldn't because I'm not certified? I guarantee I can sign better than most certified interpreters. I've been talking with my hands longer than I've been talking with my voice.

HOWEVER I understand why certification is SO SO important and the deaf do deserve the best they can get.

Now the important part. I work in healthcare and I also understand their point of view. The people you are asking to provide an interpreter simply don't have the time or the knowledge to do this for you.

Hospital staff is not trained to deal with this situation. They don't know who to call OR that they are required to call someone. Most of the time they will simply put you off by telling you they are still working on getting an interpreter...hoping you will just wait.

The first thing you must do is ASK EVERYONE. Tell everyone you see every time you see them that you are still waiting for an interpreter and that ADA requires they provide one.

Do not offer to interpret or give phone numbers to contact you to interpret if no one is available. They will stop looking for an interpreter because YOU become the solution.

Complain to your doctor(s). Mention it is against the law for them to refuse to get an interpreter. Most doctors want to keep their money and integrity. Lawsuits look bad.

Complain to the HOUSE SUPERVISOR. This is the top nurse in the hospital It's who we call when we can't handle things ourselves. DEMAND to speak to this person. DEMAND they get an interpreter. Require them to update you HOURLY on the progress. Stay on them.

In hospitals the squeaky wheel gets the oil. The more you ask (and you can do this nicely) the more you annoy them. When you are busy and overworked (like most hospital staff are) you want the annoying people to stop annoying you...so you do whatever has to be done to get them to stop. In this case...they stop everything and get an interpreter.

Unfortunatly...until things change, this is what we have to do.

Anonymous said...

I don't think that last anonymous post was awful at all. It IS dangerous to think you can do the work of an interpreter when you are not an interpreter. This is how horrible things happen. You should not be learning signs from a medical dictionary while you are interpreting for surgery! Fight fight fight for a real interpreter. I am not saying you should abandon your friend, I am just saying that giving the illusion of a competent interpretation is worse than having nothing at all. OF COURSE the hospital was doing nothing if you enable them to have a free interpreter and even organize interpreting services! They have no idea what certified means, but YOU do. By all means, be her advocate, but DO NOT be her interpreter in a medical setting. It is extremely high risk, there is so much at stake. How are your voicing skills? Have you ever taken interpreting classes?

I am not saying this to be mean, but to make you aware of the inherent danger of playing interpreter. Code of Professional Conduct Tenent 2: "Interpreters possess the professional skills and knowledge required for the specific interpreting situation." That means you do not bring a medical dictionary when you are interpreting for surgery.

If you were "interpreting" in the line at Starbucks or even for a school play or parent-teacher conference, it wouldn't be such a big deal to have limited skills, but MEDICAL is serious stuff. Please understand.

Ashley's Mom said...

You could also contact your state's protection and advocacy organization. That was the group in Virginia that took hospitals to task over this very issue, and things changed.

Mary said...

My husband and I have this kind of problem all the time. He is Deaf I am not. A lot of people said things about ADA we do something a little different. We just tell them that because of ADA they have to have an interpreter. If they don't get one then they will be reported. It eve worked when I had my baby. First they said they couldn't find one. After we told them that they had one there in less than an hour.

Anonymous said...

While I do agree that interpreting when you're not certified can be dangerous, I am much more upset by the fact that the hospital did not ever get a translator for your friend. If this ever happens again, please let them know that they are legally required to provide a certified translator to anyone who needs one. Many in the medical field are unaware of this, and for non-emergency office visits, the patient is required to alert staff ahead of time, and may be requested to come at a certain date/time. However, a hospital should have a list of certified interpreters...and if they don't, the earlier suggestion of carrying a list of local interpreters is a good one. Also, I agree that you should bill the hospital for your services. The hospital should pay for it, as it is included in the fees that your friend's insurance company paid.