View Webinar ppt slides here
Replay Webinar here
This webinar was first delivered on December 19, 2014, and we repeated it on January 9, 2015 due to the numerous requests we received. You can view the webinar ppt slides here.
Our guest presenter was Linda Golley who managed the innovative Interpreter Services program at University of Washington Medical Center in Seattle. She teaches interpreters and health care professionals on topics such as cultural competence at end of life, medical terminology, barriers to care, and non-print-based patient education methods. Linda’s B.A. is in International Political Economics. Her Masters is in Organizational Management. She builds content for the NCIHC Home for Trainers webinar work group, and is an active trainer for NOTIS and TAHIT.
Healthcare interpreters have long been considered language workers. While it is true that their expertise lies in communication, medical interpreters must also be considered part of the healthcare workforce. And as healthcare workers, interpreters must acquire the specialized knowledge to be safe members of the healthcare team.
I was holding an iPad over the face of a Deaf patient lying face up in the Interventional Radiology unit. The patient was communicating with her care team about the abdominal procedure in process via an ASL interpreter on video. My arms were aching. Not only did I have to hold the iPad still so that the patient and interpreter could see each other clearly, but if I moved half an inch southward my elbow would be over the sterile field.
We had started the conversation before the procedure began, and once it became obvious that someone would have to hold the iPad over the patient, my coworkers in full surgical garb had been wrapping me in hair covers, layers of gowns, and gloves. After this experience, I have purchased a tall iPad stand that will hold an iPad over a surgical patient’s face, and which can be properly disinfected between patients.
Every interpreter present on the units finds himself in the middle of germ warfare and industrial hazards. I will share some of my learnings from my last 35 years working in direct patient care. These learnings inform the webinar presentation.
Health care is dangerous! The nurse running the Urgent Care pod at a clinic where I worked died of HIV/AIDS, back in 1990.
She was ready to retire, super competent. Her patient required an injection for something innocuous like a flu shot before he was discharged from the Urgent Care pod to go home. When he received the injection in his upper arm, he involuntarily spasmed and flung his arm out. The syringe and needle flew out of his arm and poked the nurse, who was standing next to him. He was HIV positive. Back then we did not have any way to deal with the virus. The damage was done. Patients as young as 3 or 4 can react unpredictably to injections and to procedures which involve cutting implements, or “sharps.” All health workers in the room have some risk of being punctured by an instrument or needle flying through the air or dropping off of the counter. Wearing proper clothing and standing well back from where sharps are being used is essential.
Many of our interpreters, and I, have been injured on the job over the years. Most of these injuries involve mechanics: Slipping on a highly polished floor with rain on it from people coming out of the weather with wet umbrellas. Descending internal stair wells quickly to get to the next assignment, and missing a step or catching a toe in a dangling garment. Slipping in water left by a janitor mopping. Falling in a hallway outside of the pathology lab due to a film from wax from specimens. We also have had several interpreters break their toes or feet by banging into equipment in narrow hallways. These injuries resulted in many surgeries, long and painful recoveries, and in one case permanent disability. Protective shoes, but even more importantly, slowing down to a safe pace and being alert to hazards, are the best prevention.
One of our female staff interpreters was accosted in the elevator while accompanying an elderly male patient to his clinic. The patient pressed up against her and kissed her on the mouth. This was very shocking and distasteful to the interpreter, who reported it right away. The consequent investigation and meetings with security and other agents of the administration were very uncomfortable for her. We now counsel interpreters to maintain space or some unknown person between themselves and their patients when in confined areas. Mirroring patterns of domestic violence in families, all of the complaints made to me over the years by staff interpreters about unwanted advances on the job involved their own assigned patients, not random members of the public!
Many of our staff and agency interpreters have been exposed to patients with latent or active TB, before these patients were known by their care team to have the disease. Although TB is a very scary disease once it gets a foothold in a person or in a population, not one of our hospital staff, doctors, or interpreters has gone on to develop TB from his/her exposure at work. The follow-up protocol involves a quick symptom check by a nurse, who asks the exposed worker questions about his health right after the exposure for a baseline, and then every 3 months to make sure that he has not developed symptoms. I have had interpreters who were terrified, others who have gone through the exposure process numerous times and don’t worry about it now. Some interpreters tried to avoid interpreting for patients with TB even when protected by respirators and masks. Part of the infection control training is to remind interpreters that as health care workers, they do not get to choose which patients they see. If they DO stay in healthcare, they must use precautions properly and see all assigned patients.
One of our Vietnamese interpreters is 5’2” and weighs 120 lbs. She is 50 years old and wears charming, feminine outfits. She is one of the bravest staff at the hospital. A male inpatient had been deteriorating in mental mood and function over his stay for a medical condition. His medication was being changed frequently to try to find a good combination to reduce the mental side effects, but he had made a number of lunges toward nursing staff, along with yelling at the care team frequently, and thus was put into 4 point restraints. Our interpreter knew this patient well, and when she found out that he was in restraints, she went to the unit and requested to be allowed to speak with the patient to calm him. She told the security officers to wait outside the door rather than accompanying her in. She spoke with patient calmly, respectfully, chatting with him about the situation. The patient was able to relax, agree to not yell or lunge at people, and to focus on getting better. He was taken out of restraints, and did well. I like to tell this story NOT because it is a normal interpreter activity to calm down violent patients, but to show how interpreters are truly an amazing part of the care team.
Please get trained in infection control and industrial safety to keep yourself and your patients healthy!