This is a guest post by Steve Lercari BA/BS, EMT-P. If you want to guest post on this blog, check out the guidelines here.
Spanish Speaking Patients in the South Bronx
Depending on where you work, language barriers may not be much of an issue for you. This is not the case for me as my primary employment finds me based in the South Bronx, NY. The area is predominately native Spanish-speakers who are usually only first or second generation in this country. Given that the patient Bell-Curve is statistically skewed to the right which makes sense since the older you get, the greater your chances for a decreased-immune system, chronic conditions, etc. Follow the above information and you begin to realize that the older the patient is from within this population, the less chance there is that they will have any ability to communicate in anything but their native language.
I have been counting my blessings over the last year that I was “forced” to take a language in school. Luckily for me it was 8 years of Spanish, albeit 8 years of Spanish I hadn’t used during the following decade. Since having started working in this area my Spanish has returned to college proficiency and I tend to shock even my coworkers, most of who could not fathom that this Irish-Italian from the suburbs was all of a sudden able to engage in fluent general discussion, complete with the proper accent.
Spanish Speaking Paramedic
This last part was also where my trouble begins. Like my peers, most of my patients do not expect me to engage them in Spanish when I arrive and there is always a sign of relief on their faces when I do. I like to think I can hold my own through most of the basic demographics, history taking and presenting problems. However I become increasingly lost when specific details leading up to their complaint begin emerging and I start losing my ability to get “the gist” of my question across when I have to start discussing specific issues. In my mind two things are now occurring; the first is that they are slowly losing the initial high elation they had when we communicated and thus there is a slow breakdown in the patient-provider relationship, and the second is that I am now missing potentially vital but seemingly insignificant pieces of information. The latter is a big problem for me since I am a firm believer in what an instructor once told me… “85% of your diagnosis comes from the patient history”. It would be easy to fall into the trap of pushing the blame off on the patient for not learning English like I hear so often on the streets, but I cannot fathom finding it acceptable to lose a patient because I may have missed the one or two words they said (or didn’t say because I couldn’t ask) that may have led to that extra thought in my differential diagnosis that may have saved a life.
BEIKS Paramedic’s English-Spanish Voice Translator has been an amazing addition to my daily equipment and finds itself being used as often as the scope & cuff. The dictionary data is sorted in two ways. You can either search through an alphabetical listing of 800+ words, phrases, and sentences until you find what you want (good for studying by the way), or you can enter a filter word to narrow your search. For instance, I can enter the word ‘hospital’ and be directed to the actual word, but on that list is also: Do you want to go to the hospital?, Have you ever been in the hospital?, etc.
Additionally, the sentences are all designed to elicit a simple yes or no response because there is no point asking the question if you still can’t understand the answer. I’ve found that the added bonus is the trust level that you can elevate the patient-provider relationship to; both the patient and their families appreciate that you are going way past their expectations of what a person will do to help them, and the mental note that gets filed that even when you aren’t communicating with them, they can rest assured that you are going to do everything you can do to help.
I obviously love this product and have nothing but positive things to say about it but who am I to be believed when we haven’t even met. Luckily Beiks is offering a free trial program so you can “try before you buy.” At $24.99 for this program, it is not something that most people are going to add in their “just in case/Buff” folder. However if any part of my story resembles a part of your normal day, you may want to give this product a shot. My one caveat is that this product will work great (to the limitation of your phone speakers) in most patient interview scenarios, but if you can’t hear your own phone ring when you have the radio blasting, don’t expect this product to meet the needs of a medic hanging upside down off the roof of a car waiting for the extrication evolution to begin.
Learn more about BEIKS Paramedic’s English-Spanish Voice Translator for BlackBerry from www.beiks.com
Let me know how your experiences go. Safe Travels
Steve Lercari BA/BS, EMT-P, has worked in the EMS field for the past 11 years, 8 of those as a paramedic. For the last year he has been stationed in the South Bronx, NY and also works as a FF/Medic for a Fire District on Long Island. Additionally, he is a skills instructor and guest lecturer at several EMT Schools in Queens, and a Authorized Trainer for the Center for Domestic Preparedness. His interests in EMS include specialized operations/technical rescue for which he is a Certified Rescue Swimmer and trained in Confined Space Rescue