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A 62-year-old Hispanic male was admitted to the ICU after having an irregular EKG. Before his transfer, the documentation stated that he spoke very little English, and Spanish was his primary language. His wife remained at the bedside during the stay.

Soon after his transfer into ICU, the patient required mechanical ventilation. The sedation used prevented any attempt at communication with the patient. The different diagnostic tests created a picture of acute hepatic failure, acute myocardial infarction, acute respiratory failure, and renal failure. Communication was challenging with the patient’s wife due to language barriers.

The decision makers included the patient’s wife, on the patient’s behalf, the primary nurse, and the primary care covering physician. Resources used to address the challenges included the use of an interpreter.

Although interpreter services helped overcome the language barriers, the cultural barriers were still in place. According to the wife, the husband is the primary decision maker, and she did not feel that she was able to speak on his behalf. Support family members were contacted to help the wife with decision-making.

The situation illustrated the need for a detailed patient interview on admission as a practicing nurse. The wife did not feel that it was her place to make any care decisions for her husband, which caused a delay in care. The interview could help the spouse fulfill her husband’s wishes, especially if she were present during the interview. The language barrier may have been an impacting factor on the patient’s decline before ICU admission.

SCIENCE
HEALTH SCIENCE
NURSING
NR 527

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