Uncle Dale’s, You Probably Should Know: The Hospital ER Script.

ASLized courtesy of Delawaredeaf.org

Last night there was a town hall meeting at the Deaf Center discussing the failure or refusal of hospitals to give primary consideration to the request of the patient who is Deaf when they ask for a Live In-Person Interpreter and are told they have to use VRI or get nothing at all. I was in the audience and suggested a script for making such a request.

Several people who are Deaf in the town hall asked, “why should we have to go through all that? Shouldn’t they just respect our request?”

Yes, of course they should. But if they did or would there would be no need for this town hall meeting. Hospitals are businesses and as such will not change just because the Deaf community asks. They will only change if they are forced to.

This script will help build a factual basis for future lawsuits which is the only thing hospitals will respond to.

THE SCRIPT

(If you are in too much pain or stress whomever is with you can follow this script for you)

I require a live in-person ASL Interpreter for effective communication.

Let’s use VRI until we can get an interpreter here for you.

VRI is not effective for me because (pick the one that fits):

I am in pain/stress/destress and I can’t follow the three dimensional language of ASL on a two dimensional screen;

I’m not ordering a pizza, I’m trying to get medical care;

The screen is too small;

The picture keeps freezing;

Your staff does not know how to hook it up;

The VRI Interpreters can’t see or hear what is going on off screen and so I miss half the message;

My eye-sight is not good enough to see ASL on a VRI screen; or,

Your reason here.

Please make a note of the reason that VRI is not effective for me in my medical records so that we don’t have to have this discussion every time I come to the hospital.

But it’s after 5/it’s the weekend and there are no live Interpreters available.

That is not true. Interpreter referral agencies are open 24 hours a day 7 days a week. Please make a note of that in my medical record so I don’t have to explain this every time I come to the hospital.

VRI is the same as a live interpreter.

It is not. VRI and Live In-Person Interpreters are listed as separate accommodations under federal law. The Affordable Care Act in Section 1557 says that Section 504 of the Rehabilitation Act requires you to give primary consideration to the specific accommodation I request and I request a Live In-Person Interpreter. Please make a note of that in my medical file so I will not have to have this conversation every time I come the hospital.

Well, it could take a long time for the interpreter to get here so let try VRI until then.

I will use VRI until the Live In-Person Interpreter gets here if AND ONLY IF you provide me with the following information:

1. The name of the hospital staff person who requested the interpreter on my behalf;

2. The exact time that staff person called to request the interpreter for me;

3. The name of the agency the hospital staff person called to request an interpreter for me;

4. The name of the specific person the hospital staff person spoke to at that agency to request an interpreter for me; and,

5. The time the agency estimates the interpreter will arrive at this hospital.

Provide that to me in writing and make a note of it in my medical file and I will use VRI until the interpreter arrives.

Why do you need to know all of that?

Because I need to know who has ownership of my request.

We are not allowed to give you that information.

Yes you are. None of it is protected by law. If you refuse to give me the information I request please provide me with the specific law that forbids it and also make a note in my medical record that I requested it and you refused to provide it.

We don’t put things like that in medical records.

You put all kinds of things in medical records and this is my medical record and you will put whatever I tell you to put in it.

There is not an interpreter available.

I will now call the interpreter referral agency that you told me the hospital called and verify the time you called and that there is no interpreter available. If there is in fact no interpreter available I will require you to call a different referral agency. Make a note of my request in my medical records.

We can’t call another agency, we only contract with this one.

Who this hospital does and does not contract with is not my problem. I am the patient and have a right to effective communication and if the hospital cannot provide it with the agency it uses it needs to contract with a different agency. Make a note of that in my medical records.

Do that each and every time.

If they refuse to document it then as soon as possible make a request by email to the hospital’s Office of Customer Service or Risk Management Officer that you made the request I explained above and that your nurse/doctor refused to document it in your record. Use the names of the specific people you spoke to as often as possible.

One last point, and I can’t stress this enough. Never say “I prefer a Live In Person interpreter” or “I don’t want VRI” or “I don’t like VRI.” That says to the hearing people that is just a choice you are making. The magic words are, “I need” or “I require a Live In Person Interpreter for effective communication (that comes right from the law).

Rule 703

Nurse: “Ok, we just need you to sit in the room and make sure she keeps breathing….”

UD: Again, I’m sure they haven’t given me a complete list of the things they don’t want me to do as a contractor. But I’m pretty sure that would be on it.

(Pirate voice) Means no.

More wit and wisdom of Tyler Forsgren.

Rule 686

Sometimes your job is to sit quietly and be there while a Client’s life implodes, explodes or even ends. It’s not something they teach you in an ITP. It’s not in the fine print of any job description.

It’s just a part of the job.

Rule 679

The floor of an Emergency Room is disgusting.

Do not set your bag or coat on that floor!

In fact if you drop something on the floor in an Emergency Room don’t pick it up! Consider it gone, mourn its loss, and buy another.

Note from Uncle Dale: Those Moments When the Student Loans Are Totally Worth IT!

Recently, an interpreter posted the following to a discussion group on FaceBook:

“I heard this quote today at a conference:

“If you treat me like a number, I will treat you like one, too.”

Interpreters: May your 11:15a appointment tomorrow be with “Susan who is experiencing pain and facing knee surgery.” or with “Tony who is nervous about his upcoming History test.”

Consumers: May interpreter 2518 on your VP call be “Jennifer who is worried about her sick child at home.” or the interpreter for your 3:30p staff meeting be “Joe who is anxiously awaiting NIC test results.”

We don’t have to bear each other’s burdens but we can certainly respect the person behind our daily “numbers”.”

Rebecca Sipe Buchan

I love that!!

I read it and it rang like a bell in my soul.

It also got me thinking of the times when I have been the problem and others when I have been the solution.

Anyone who imagines they have not played both roles while taking the stage in this ongoing melodrama we call “interpreting” lies, first to themselves, then to others.

Mostly though it made me smile. It reminded me of my favorite “right place, right time, right question” moment.

Just to steady hearts-before I posted this I contacted the Deaf Client and sent a copy of this Note for their approval before I published it.

****

A Doctor came into the Deaf Client’s hospital room, surrounded by medical students, and the entire time this “murder of crows” was in room the Doctor never once referred to the Deaf Client as anything but their illness. NOT ONCE.

No name. No gender. No eye contact.

It was as if the Deaf person was no more than a prop to be used to teach a lesson to medical students.

The Doctor, still ignore the humanity of the Deaf Client, began quizzing the medical students on the “next steps.” The medical students began shouting out tests that could be administered to the “illness in the bed” and each were met with a gruff but approving nod or a decimating head-shake of disapproval from the Doctor.

When all of the tests had been discussed, they left- without so much as a backwards glance.

The Deaf Client looked at me and asked, “are they doing all those tests today?”

I just sort of shrugged and replied, “it sounded like it.”

The Deaf Client’s brow furrowed and they asked, “are you staying to interpret for them.”

“No,” I replied. “I have an appointment in less than 40 minutes.”

The furrow deepened. “Will they have an interpreter for me?”

Again, I shrugged, “I’m not sure, do you want me to go get them so you can ask?”

The Deaf Client sighed, “I will tell you honestly, I’m too tired to have that argument,” then the Deaf Client looked at me, “will you go ask and if they are jerks about it find my nurse?”

I told the Deaf Client I would ask and get the nurse if needed, and I stepped out of the room.

The cluster of Doctor and med-students were just outside the next door down the hall. The Doctor was zealously berating one of the students for mispronouncing the name of a medication (I remember that specifically). When he finished I cleared my throat and his eyes zeroed in on me.

“Excuse me,” I said, “I am interpreting for [I made a point to say the Deaf Client’s name] and they were wondering if you planned on running all of the tests you discussed today?”

“Of course.” The Doctor snapped and, one hundred percent true, physically waved me off.

“If you are planning on doing those test,” I persisted, “you will need to schedule an interpreter as soon as possible to make sure one is available at the time you plan to run them.”

I had busted the Doctor’s groove and he did not like it. Not one little bit. “Well go ahead and do that then.”

“I am actually not allowed to schedule from the field,” I answered, “that is both the hospital and the agency’s policy. There are steps that the hospital follows,” I put on my most helpful tone of voice, “If you can give the nurse’s desk a time frame when you will be conducting the test then they can…”

That was just a bit too much for the Doctor. “I don’t have time this,” he snarled, “it’s just some tests and I really don’t see why we would need you in the way waving your hands.”

I smiled as warmly (as I could), “well, you won’t get me. I have another appointment, but you will need someone. Specifically you need to consider if any of these tests require ‘informed consent.’ There is also the ADA and Section 504 to think about. [I said the Deaf Client’s name again] has a right to effective communication…

“OH,” The Doctor’s eye narrowed as he prepared to administer, what he expected to be, a devastating blow, “SO WE’RE A LAWYER NOW?”

I smiled again and replied, “I realize that you were being facetious when you said that, but as it turns out I AM.”

You could taste the awkward silence.

“Um, really?” The Doctor finally stammered.

“Really, really,” I said a little too shortly.

There was another pause, during which I observed the best moment of the medical students’ lives play out on all their faces.

The Doctor composed himself in a flash. “Well,” he stated openly to any audience who happened to be nearby, “well, of course we will get an interpreter for…”

I said the Deaf Client’s name.

The Doctor sent one of the medical students with me to the nurses station to make sure it was all arranged.

I went back to the room and reported back to Deaf Client.

We have chuckled about it ever since.

That. That right there made the hardest parts of law school worth it. Every. Last. Minute.