Spanish Speakers with COVID-19 Left in the Dark About Their Care
Illustration by Hans Yparraguirre, Filipino student from Amundsen High School
By Leslie Hurtado
Understanding the effects of COVID-19 can be challenging especially when medical professionals use complex medical terminology.
But patients whose primary language is not English face extra barriers in hospital rooms. Some patients are receiving medical treatments without fully understanding them, they must navigate complex communications despite a lack of adequate interpretation and interact with staff who lack cultural sensitivity, according to several nurses and families that spoke with Cicero Independiente.
Daniel Ortiz, a COVID-19 care nurse at the University of Illinois Hospital, expressed sadness that for some patients he is the only bilingual nurse that they have contact with. He says patients are already terrified as is and not having someone that is bilingual to explain the medical process can add to the discomfort.
“The majority of the patients speak Spanish, and the majority of the staff do not speak Spanish,” said Ortiz. “Even with proper translation a lot of stuff is lost during translation. It's a huge barrier for the health and education of the patient... in cases of emergency you really need to know what the patient is telling you.”
Black and non-Black Latinx communities in Chicago and surrounding areas like Cicero have been disproportionately impacted by COVID-19. In May, majority Latinx zip codes, for example, had the fastest growing number of people who tested positive for COVID-19. In Cicero, 83% of the population speaks a language other than English at home according to the latest available Census information.
Ortiz is concerned about medical staff not providing interpreters before asking Spanish-speaking patients for informed consent to receive donated plasma from individuals who have COVID-19 antibodies, which some hospitals are using to treat COVID-19.
While it is rare to receive a negative blood transfusion reaction, there is a low chance a patient may contract HIV if given the wrong blood sample, according to Ortiz. Some people may also experience itching, rashes, or, although rare, a hemolytic reaction where a person's immune system attacks the transfused blood releasing a substance that harms the kidneys .
Ortiz explained that some non-English speaking patients in the COVID-19 unit have agreed to blood transfusion tests without understanding the negative effects of receiving a blood transfusion. In some instances, Ortiz said patients found it difficult to understand why they were receiving blood from a donor.
“So, with blood products, you have to take it very seriously,” said Ortiz. “You have to inform [patients] of the risks and benefits. And what I've been seeing is, patients aren't having enough information to actually give informed consent.”
Ortiz brought the issue up to his manager who reminded staff of the need to call in interpreters so that patients can make informed decisions about blood transfusions.
Rafah Abuinnab, a University of Illinois Hospital representative said the hospital’s policy is to have interpreters available even if a family member decides to translate for a patient.
“Each clinic and unit is responsible when they schedule their appointments with the patient to schedule an interpreter as well,” said Abuinnab.
Abuinnab says on-site interpreters are available to University of Illinois Hospital patients in the COVID-19 unit through telehealth (phone or video). The COVID-19 unit has access to 65 tablets that have access to 40 different languages using video and 240 different languages for audio. Despite this, Ortiz still believes staff and interpreters have not adequately interpreted for patients.
“The patient can visually see [the interpreter on the tablet] but even so, the patients are not comfortable with a random person on an iPad talking to them in Spanish,” Ortiz said. He describes the interaction as a “complete mess” as nurses try to understand the interpretation coming from the iPad.
Jorge Camacho, a Spanish medical interpreter who works at a Chicago area hospital, agrees with Ortiz.
“Telehealth is particularly challenging,” Camacho explained. “Because it is video remote interpreting you're not there with the patient and so you lose all the nuances and visual clues that you would otherwise see. Sometimes you can’t hear what is being said or they can’t hear you...sometimes elderly patients can’t really relate to the idea of talking to a computer so they feel really alienated.”
For patients seeking advice on how to address their concerns to medical staff, Ortiz recommends that someone they know help make medical decisions on their behalf and ask what could go wrong during a medical procedure.
Yuri Guzmán, another registered nurse from Cicero, said her hospital incorporates the use of Zoom calls for family members to connect with patients directly and communicate with medical staff around a patient’s care. Guzman did not want to name the hospital where she works at for privacy purposes.
“I think the best way to [communicate] is via Zoom because families can talk directly to [the patient],” said Guzmán. “If you want to ask the nurse questions when you're in the room and [the nurse] doesn’t speak Spanish, it's really difficult because you need an interpreter, and interpreters are not working in the hospital right now.”
At MacNeal Hospital in Berwyn, one of the closest hospitals for Cicero residents, family members who call to inquire about a patient must follow phone menu options that do not include language preferences. If a non English speaker does not select an option from the menu, they are directed to an operator who will usually answer in English.
Ernesto Perez, a Humboldt Park resident whose Spanish-speaking mother contracted COVID-19 and is now in a rehabilitative hospital in downtown Chicago, believes that in areas most affected by the virus, it is still hard for people to understand COVID-19 prevention methods and how the virus is affecting their health. He also says that his mother has difficulties communicating with medical staff despite his constant interventions.
Perez said hospital staff told him that he would have to call once a week using a laptop to communicate with his mother but Perez prefers using an iPad to speak to his mother regularly, so medical staff allowed him to bring that in.
As the medical guardian for his mother, Perez says he contacts the hospital daily to check in with her, but there have been cases where the iPad is disconnected, or medical staff do not communicate with him before they proceed with medical treatments.
“There was a time where about two weeks ago [hospital staff] overdosed [my mother] with a sedative and she became unresponsive. And they called me like an hour later about that happening,” described Perez.
His mother has asked him to bring her home because she is not comfortable at the hospital and cannot understand medical staff.
“She gets very anxious because there's only one staff member that speaks Spanish and they’re not there all the time. There are times where [my mom] gets frustrated and cries,” said Perez.
“Right now, she mumbles some words, and we cannot understand what she is saying. It's kind of hard because there are times where I call staff to see how [my mom] is doing, and they say, ‘Oh, well, she's doing fine,’... but then I asked them, ‘You don't even speak Spanish. How do you even know what she said?’”
The rehabilitative hospital where Perez’s mother is receiving care did not return several requests for comment.
Martha Mendoza, a Cicero resident, says that in mid-May her entire family contracted the virus except for her and her sister. According to Mendoza, while her mother was in the hospital the virus affected her kidneys. Mendoza's mother was asked by medical staff to authorize dialysis but she could not grasp what staff told her.
“If [hospital staff] used a translator, then translators did not do a good job because they didn't explain why [she was receiving kidney dialysis] until I called them,” Mendoza said.
“One of the challenges we are seeing right now is doctors routinely trying to speak Spanish disregarding interpreters like, ‘Hey, you know, we don't need you right now. I can carry on,’ but they will say things that can cause further miscommunication,” said Camacho, who interprets for patients in the ER room. He says it is common for providers to use their limited Spanish to communicate important medical decisions leaving patients confused.
Miscommunication can pose different problems in the COVID-19 unit, as stated by Camacho, especially because family members are not allowed inside. He also said while working in the hospital, some medical staff are culturally insensitive to patients.
“What I see is just this lack of cultural sensitivity too,” said Camacho. “Sometimes providers do not know or understand their culture. And sometimes I'm sure, without [medical staff] wanting to, they might say or do things that are deemed offensive.”
Camacho has had to step-in to clarify what patients are saying when describing the pain they experience in certain body parts or to ask questions.
6 in 10 Latinx adults consider speaking to a medical professional difficult, according to a 2018 study conducted by the Associated Press-NORC Center for Public Affairs Research.
“Sometimes patients don’t feel confident enough to ask specific questions regarding COVID,” says Camacho. “[They] feel a little bit embarrassed to ask questions because they may not want to look like fools or they think they are going to be demeaned or not taken seriously.”
“It’s not right that because you're not born here or because you don't speak fluent English that your medical treatment should suffer because of that,” said Ortiz.
Leslie Hurtado is a community reporter who works on COVID-19 coverage for Cicero Independiente. You can send her questions or suggestions at reporter@ciceroindependiente.com
