Poquito Espanol.

Yesterday one of my Spanish-speaking-only patients told me I was a good nurse because:

1. I am very nice.

2. I have very nice hands.

3. I speak Spanish.

....I speak Spanish? What beautiful, beautiful words. Poor lady had no idea that, had she not been a pain patient, I would have had nothing to say.

Do you have pain? Where is the pain? Is the pain better or worse? Does it hurt when I press here? Do you need medicine for the pain? I have your pain medicine.

Aside from that, my Spanish is limited to a few other key phrases.

I'm a nurse, I speak little Spanish. I don't understand. Do you need anything? Water. Nausea. Food. Bathroom. Pee-pee.

As we stray farther and farther from the pain assessment, my Spanish vocabulary becomes increasingly caveman-esque. Language is rough when you don't know any verbs. Or nouns, really... adjectives... etc...

Yesterday I had 5 patients all day, and only one of them spoke English. 3 of them only spoke Spanish. One of them only spoke Vietnamese. We have this phone number we can call that reaches some language-translation hot-line. After you wait on hold, tell the operator your language/name/hospital/unit/patient's name, and put your phone on speaker, you can have an awkward conversation in which you yell into the phone, the translator yells what you said while the patient strains to hear them, the patient yells back, the translator asks them to repeat it a few times, then the translator tells us what the patient said.

This is not ideal.

We used to have a live Spanish translator that would come up when we called her Monday through Friday 9-5 type hours, but her hours have since been cut back to part-time. I think she now is in the hospital 3 days a week for a shorter amount of time. She's really helpful, she helps us consent our patients for procedures, she translates our discharge instructions into Spanish, and she'll go over the discharge with our patients.

But there is one of her. For the whole hospital. Part time.

So what the crap do we do when she isn't there? Use the translator phone line? Yes. But what do we do when we need things explained in writing? The ER has their own Spanish translator 24/7, understandably so. The ER is incredibly busy, the Spanish-speaking population at Brackenridge is huge, and they often need information quickly. Fair enough. But on the weekends/days of the week that the rest of the hospital has no live translator, we have to ask the ER translator to write out our discharge instructions (etc) for us. We don't dare ask them to come help us discharge or consent our patients - we know they're busy - and sometimes it has taken hours for them to send back the translated short instruction forms. Our patients don't like this, we don't like this, and the busy ER translator really doesn't like this. Sometimes when I call them, they are understanding and accommodating, and other times my head is bitten off as soon as I say "this is Kristin up on 9..."

I think my favorite part about all of this is - after some complaints were thrown out from the ER translators - we were recently told that the ER translator can and will refuse to translate our forms for us when we don't have a live translator. Instead, we have to call the language hotline, ask them what the Spanish translation is and how to spell it, and write our own Spanish translations.

Did you laugh? Because I certainly did when I got this news. I cannot, cannot, cannot imagine how long it would take to write even the easiest of discharges. I'm picturing dictating an essay to a first-grader where full words can't even be dictated; each one has to be spelled. As if we don't have other patients that might need us during that hour we'd be spending on the phone writing out discharge instructions for a basic lap appy. As if even thirty minutes of uninterrupted time is something that we can count on when we need it. On a busy day, even the fifteen to twenty minutes of uninterrupted time necessary to hang a new unit of blood on a patient is somewhat of big request.

Bottom line is that I need to learn Spanish. I wish the bottom line was that we ought to have better resources in this department. Actually I guess that is the very bottom line, but apparently not the realistic one.