I was recently on a cardiopulmonary placement in the area of intensive care and had to treat a large range of patients. I treated a 60 year old water polo player from Romania who had a cardiac arrest and had undergone a coronary artery bypass. I had seen this gentleman, day 1 post op and this man spoke no English and was very agitated because he did not understand what was going on around him and did not have any family or friends in this unfamiliar environment. A translator was present when gaining consent from the patient for the surgery but due to the priority of other patients, the translator could not be with the patient at all times and was only called on for important decisions that needed to be explained.
When gaining a subjective assessment from this patient, even when I used gestures and facial expressions, he seemed lost and confused. At first he seemed agitated and was speaking in Romanian. As I kept trying to explain my questions, he seemed to give up and just nodded in agreement with everything I tried to explain. I had never experienced this before in any of my other placements and was at a lost on how to get my message across.
It was hard to communicate to this patient and it made me feel helpless because I knew how alienated he would have felt and I could not give any comfort or ease his anxiety because I did not know what was the issue. In the end I simplified my treatment and got him to copy my actions. I tried to draw out some of the instructions and gave that to him to take with him to the ward. The more complicated actions I tried to communicate but in the end could not be understood.
According to the nurse, a lot of patients that are admitted into hospital cannot speak English and this is an issue that physiotherapists would have to overcome. It is important to develop a better method of communication with the patient, especially because they would be feeling worried in an environment that they do not understand what is happening. I understand next time that I encounter a non English speaking patient, that I have to use my body language and tone of my voice to help calm the patient. Also the use of flash cards or pictures are useful but I have to work on drawing more legible pictures.
If anyone has methods of communicating to a patient that does not understand English, please let me know because I am eager to discover more ways.
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4 comments:
Wow, that sounds like a very tricky situation. I've done some work in aged care, in which many of the residents are immigrants who have dementia and revert back to their first language. It's difficult to communicate with dementia patients even when you're speaking the same language! But I noticed that the carers put up notes around the room with lists of common words used, with a translation into the patients preferred language. I'm not sure how well it worked with dementia patients, and whether it would work on an inpatient ward but i thought it was a great idea!
I completely understand how you feel! I have had a number of patients with limited English in my first two pracs. It only gets easier as you encounter more and more patients that are difficult to communicate with. I think flash cards is a great idea... one that I didn't think of myself!
I found it useful to use common one word commands often, such as "good", "bad", "lots", "little", "up", "down", etc.. These can usually be accompanied by hand signals. I also found it extremely useful to use demonstration wherever possible.
Sounds like you did very well in the situation though.
^^ I think I am totally understanding the situation because sometime I have same problems with English native speakers due to my English skills. Here is my way to deal with the situation. Firstly, trying really hard to learn the language, I think for you, you can find some useful words to translate English to patient's language in internet. Secondly, trying to talk with a patient as much as you can. From my experience, sometimes some people cannot understand 100% what I am talking about. But as people are getting used to for my accent, gesture, and facial expression it was getting easier for me to communicate with.
I think you can find your own way to deal with this situation soon.
I think it is not only frustrating for the patient who cant understand but also for the Physio. Treatments can end up less effective due to inability to communicate effectively. I have treated two patients this year where a translator has been involved. It can be very frustrating and a lot of patience is needed when a translator is involved. The treatment can take a very long time with less being achieved over all. I think it is great experience to treat patients where there is a language barrier. It makes you appreciate the ease of treating patients where there isn't one.
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