No Hablo Ingles: Emergency Department Lived Experiences of Spanish-speaking Patients
Arleen Steckel, PhD, RN, CPNP; Danielle Bellucci, BSN, RN, CEN; Julie Mount, MS, RN, FNP-BC, CEN, CPEN, email@example.com; Dawn Hueber, RN; Eileen M. Dowdy, RN; Erin Zazzera, MPH, RN, CEN; Mary Feiler, BSN, RN, CPEN; Susan Masciello, BSN, RN
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Purpose: Few studies have specifically targeted the experience of Spanish-speaking patients in the Emergency Department. Studies have shown that patient populations are growing more diverse. This presents challenges to the Emergency Department staff working in a fast-paced chaotic environment where vital information must be communicated accurately to best assess and treat patients presenting for care. Communicating with a patient who only speaks Spanish creates an obstacle for health care professionals trying to provide appropriate and timely care. The aim of this study was to obtain information to guide change in Emergency Department practice and promote more effective communication and respectful care for Spanish-speaking patients who come to the Emergency Department.
Design: A qualitative design using a phenomenological approach was used to explore the lived experience of Spanish-speaking only adult patients treated in the Emergency Department.
Setting: A 571-bed teaching hospital with a Level One Trauma Center in the northeastern United States.
Participants/Subjects: A purposive sample of 22 patients identified by registration staff was obtained with 13 interviews completed. Spanish-speaking only patients greater or equal to 18 years of age treated in the Emergency Department were consented. The following patients were excluded from this study: those less than 18 years of age, medically unstable, chemically impaired, recent history of domestic/sexual abuse, major psychiatric illness or severely hearing impaired. Approval for the research proposal was obtained from the Institutional Review Board and Committee on Research Involving Human Subjects (CORIHS).
Method: A demographic form was completed by the patient after consent was obtained. Face-to-face interviews were conducted within 24 hours for patients admitted to the hospital from the Emergency Department. Patients discharged directly from the Emergency Department were interviewed via telephone within 24 hours after discharge. All interviews were conducted by an Emergency Department research nurse who spoke Spanish or used a hospital-approved real-time language-assistance-device. Interviews were audiotaped and transcribed verbatim by a professional bilingual transcriptionist. Thematic analysis of data to identify common themes was completed using Colaizzi’s phenomenological method.
Results: Three overarching themes emerged during the preliminary thematic analysis: wait times, communication, and patient satisfaction. Patients stated that waiting for an interpreter or assistance-device prolonged their Emergency Department visit. Patients frequently addressed the difficulty communicating with a language discordant staff and language-assistance-devices. They also preferred a Spanish-speaking health care provider during their emergency department visit. Overall, patients stated they were satisfied with the care they received while in the Emergency Department compared to other local hospitals.
Implications: This study generated an emic perspective from Spanish-speaking-only patients regarding their lived experience during their Emergency Department visit. This study identified the need of having Spanish-speaking interpreters readily available 24 hours a day. The information obtained from this study can be useful to guide change in Emergency Department practice to promote effective communication and respectful care for the growing population of Spanish-speaking Emergency Department patients.
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