During a clinical rotation there was a particular patient that remains embedded in my memory, where his physical health became priority only because his mental health and other holistic components were not addressed prior to his admission to the hospital.
This patient was a middle aged male immigrant from Cuba, who recently moved to Maine. This gentleman spoke little to no English and was admitted to the med-surgical unit for alcoholic liver cirrhosis. This particular patient was not my assigned patient but the nurse I was paired up with for the day was taking care of him. When I walked into the room I introduced myself in Spanish (since that is my primary language) and asked him how he was feeling. His face lit up and replied back in Spanish. I informed him of the tasks my nurse and I would be performing, i.e. assess his vital signs, perform a head to toe assessment, and administer his morning medications the provider came in to gather information for rounds. He agreed and then went on to ask me where I was from and how I got to speaking Spanish fluently. I answered him and then inquired about his life to attempt to build rapport and find out more about his social determinants of health.
While in the process, the provider walked in to gather information for rounds. She did not speak any Spanish and I was happy to see that she called the phone interpreter in order to communicate effectively with the patient. During her assessment and conversation with the patient, I found out that the patient had been drinking excessively due to the stress of moving to another country. He specified that he moved here alone and had no support system nearby. He admitted to feeling helpless at times. The provider went on to discuss his drinking habits and how that is affecting his overall health. He admitted that on occasion he drank excessively until he couldn’t remember anything which ultimately led to his hospitalization where his coworker brought him to the emergency room, where he was diagnosed with liver cirrhosis. The provider went on to explain the plan of care and how she would get an interprofessional team involved (social worker etc.) asked him if he had any questions. The patient denied.
This made me reflect on my experience as an EMT where I primarily served a district in south San Diego, consisting of homes lacking fluency in English and with adverse socioeconomic factors. Most calls were from households living in poverty, people who expressed inequitable access to preventive-health care services, and immigrant families who were unfamiliar with the U.S. healthcare system. The reason I am drawn to help these communities is because they remind me of my own family and community. Most of my family refuses to get medical attention because they are afraid of the medical bills that will follow, despite suffering serious symptoms. Situations like these lead to health disparities experienced by many other immigrant families like this patient who deal with higher health care costs and perceptions of injustice.
I believe Maine Medical Center and those directly taking care of the patient did a great job. They offered him the necessary resources and spoke to him in the language he felt most comfortable without making it seem like a hassle and I believe that speaks volumes. In the long run, I think there should be education regarding the health care system in their new state and hopefully in their language so they can feel more comfortable accessing care. There is still a lot of outreach and community work that should be done but I feel the health care team did a great job.
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