Emergency Room FAIL

[trouble]

I had to take Don to Emerg last night (A&E, I think, in UK & Aus). He's (relatively speaking!) okay. (You can read it here, but the key thing is that he was injured enough that we headed straight for Emerg, but not so much that we didn't walk the five or so blocks, rather than call someone to get us there.)

During construction, they've taken out parts of the sidewalk.

So, to get to Emerg, one needs to notice (in a stressful situation) that the sidewalk has been taken out, preferably before taking a wheelchair all the way to that point, which is a good... 30ish feet from where one can take a wheelchair safely off the sidewalk.

One then needs to go into the road - the road used by ambulances and cars trying to get to Emerg, so people who may either be driving quickly, or who are also very stressed - down those 30 feet, and then turn into an area we couldn't see.

There is no indication anywhere coming up that the sidewalk is out. The way the site is setup, I assumed there was another way around, because there's another sidewalk that meets this one, but it just leads to a set of stairs going someplace else.

An alternate entrance is not marked, or at least not clearly.

When reporting this to the Security Guard, I guess we weren't nice enough, so we were basically told to call the Health Authority, because making a note, apologizing for the inconvenience, and ensuring that such complaints would get to the proper people is obviously too much to expect.

(I'll be calling the security company about it, too.)

When I talked to the paramedics about it, they *begged* us to call the Patient Representative because their complaints about this are going nowhere. The guy made sure I knew who to call, and when to call them, circling their name and number, and confirmed I still had the pamphlet later.

They aren't in today, but I'll be calling tomorrow.


Slightly unrelated, but what's the state of 'terps in your area? There was no signage anywhere indicating that terp service was available, but I'm not sure if that means there isn't or not. (I'll be asking this when I call Patient Services.)

When I was working in Australia, there were strict rules about not letting a family member interpret unless it was impossible to get an interpreter wthin a certain period of time, and even then they'd be still trying to get someone not-related while they dealt with what had to be done. It's because it's a stressful situation.

Comments

[willow]

Is this the place to ask how 'stressful situation' ties into not letting a family member interpret?

PS: I am glad Don's alright and that you will be kicking administrators in the butt who should really have thought things through. Really, how hard is a plyboard ramp at the point of construction? Plus a bit of the road turned into a walkway via cones?

[azurelunatic]

If I were to guess, my guess would be that it's a good idea for an interpreter to be perfectly level-headed and stress-free to accurately understand the patient, understand the staff, and do the interpretation, and the stressful situation could potentially mean that a family member would be distracted and might miss things. It's an assumption, to say that someone might not be capable of translating under the circumstances, but it's one that's aimed in a direction of less danger to the patient.

It's only a guess, though.

[lacey]

What I was thinking.

[lauredhel]

Using professional interpreters isn't just because it's a stressful situation. I can think of three main other reasons:

- Accuracy. Firstly, the interpreter typically needs to correctly interpret complex medical information and put it in a form that people can understand. Medical interpreting is a specific subspecialty because this is more difficult than it appears. There's also the issue of completeness; untrained family translators sometimes (often?) don't transmit all of the information in either direction; they 'interpret' in ways that can be unhelpful or harmful, and insert their own perspective; they can omit or change information because of taboos or embarrassment or fear or lack of knowledge or belief that they know better. (Some don't, of course, and some medical interpreters aren't perfect either, but these are generalisations and risks.)

- Confidentiality. People may well have medical issues, risk factors, questions that are not appropriate for some of their family members to hear about. Compromising confidentiality by using family interpreters means that people sometimes won't get the medical care that they need.

- Appropriateness. Sort of related to confidentiality, but when for example children are interpreting for parents, it can be inappropriate for that child to be interpreting details of, for example, sexual issues; or for some family members to be present during some physical examinations.

[background: I'm not a terp myself, but I've worked with medical interpreter course teachers and students to help develop their skills.]