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Frustrated and Upset


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#1 Tired Mom

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Posted 11 May 2012 - 05:49 PM

How do you work through them?

There were three extremely frustrating incidents this week, and I need to figure out how to get around this.

1 - A surgery was booked (on short notice) but agreed to and fully explained what it entailed to a patient via a family member that was bilingual, and we didn't have a consent already filed, they had to come in after agreeing on the phone to the surgery and what it required. Pre-admission called them yesterday to get them in for their pre-surgical appointment and got an earful because they said they didn't know what they were going in for, that they couldn't have the surgery Monday, etc. With the english speaking relative I asked if they understood everything, and if there were any questions and they said they understood and didn't have any, but they tell the hospital they weren't told, and it reflects on me, and one out of three surgeries for Monday was cancelled.

2 - Another surgery, also booked for Monday, where I spoke with them, went over everything slowly, walked them through it, they agreed and said they didn't have questions. Pre-admission called them, they go in today, and pre-admission called me because the medication the patient was supposed to stop taking last Wednesday for the surgery was still being taken, meaning the surgery could still happen but it would be a risk, and what did we want to do. Obviously, the Dr. didn't think it was worth the risk, the family said they didn't know (again, I KNOW I went over this), and asked to reschedule, and now say they are aware of the deal with the medication. They said they were only told about the insulin, not this other one. Again, I booked the surgery, it's bad on me. We're down to 1 surgery out of three, my a$$ is on the line.

In both these cases, because they both told me they understood what I was telling them, and not asking questions to clarify what they weren't clear about, I'm very very frustrated. 1, they did not have to agree to set the surgery dates for next week. I stressed that it was available to them if they wanted it and could work with the requirements. Why say yes for a surgery, if you don't want it x day or can't for x reason? This is so unnecessary, and creates a huge problem for me. 2, Why not tell me they didn't understand? It feels like they were agreeing to it to shut me up, but if this keeps happening I'm going to be out of a job.

Then, before leaving today I was trying to get through some referrals, and one of them was from the ER. With other Dr's offices they send us the referral, we set the appointment, fax it back, and they call the patient to notify them of the appointment. We have to follow up with the ER ones. I set the time for the patient to come in, and call the number on record. The person (happily) was honest about not being able to understand me, and asked me to call their relative who was a previous patient of ours to take the message. I call the former patient to give them the appointment info for the new patient, and she had no idea who I was talking about. I feel so bad for this woman, we spent a half hour on the phone trying to get this appointment set up, because she had a hard time understanding what I was looking for too. We got it worked out eventually, but this is insane!

What are some ways to circumvent language barriers? Does this happen to you at your job? How do you deal with it? It's stressful on both sides, which only makes it worse. Short of taking classes on Arabic I don't know what to do. And I can't afford to put in my hours and take classes on other languages and still see my kids.

Help!

#2 Mama2Gracie

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Posted 11 May 2012 - 07:46 PM

Dr. Ling sent out an appt sheet that clearly states the rules for his appts and one of them is that if you dont speak, write and understand English you are to bring a translator with you or your appt will be cancelled.

Edited by Mama2Gracie, 11 May 2012 - 07:48 PM.


#3 mom2nico

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Posted 11 May 2012 - 07:57 PM

There are parents of my students who don't understand enough English to have a conversation. In these cases I've been lucky that I can speak with an older sibling and get my message across. If I need to, we do have a service for translators. I think each school has a rep who helps set up the appointment between all parties and the translator. Like I said, I haven't had to use this, but it's an option should I ever need to. Does the hospital not have a service like that?

#4 Outnumbered

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Posted 11 May 2012 - 10:16 PM

Sometimes people with foreign backgrounds will tell you they understand in order to save face and avoid seeming ignorant. The hospital does have a phone interpreter program, would it be possible to tap into that?

#5 Danielle

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Posted 12 May 2012 - 05:59 AM

Sometimes people with foreign backgrounds will tell you they understand in order to save face and avoid seeming ignorant. The hospital does have a phone interpreter program, would it be possible to tap into that?

Yes this. I think it's also that they want to escape discomfort of the situation ASAP and will say 'yes yes yes' until they are blue in the face just to get out of there.

I have lots of experience with language barriers with my inlaws. It drives me insane when they say they understand, answer questions etc and it comes out later that they really didn't understand. I've often had to repeat important instructions over and over until I'm satisfied that they understand, and/or ask them to summarize back to me in their own broken English.

#6 Tired Mom

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Posted 12 May 2012 - 11:50 AM

Do both hospitals have that option? I only work with Hotel Dieu, and I wonder why the pre-admissions lady didn't use that when she called me upset that she couldn't book the pre-admission appointment for the first cancelled surgery because the english speaking person I spoke to wasn't home and they kept telling her "No No No! No english! Arabic!" lol. I had to call them, say "Phone (my office number)" and they had the english speaking one call me back, at which point I had to get her to reach that lady in pre-admissions, and when she did, she ripped that lady a new a$$hole. She called me back in tears warning me the lady was being very, very nasty to her.

I know I can't tell people how to feel, but I really wish they wouldn't be so embarrassed, because that isn't going to fix anything lol. I need them to be willing to work with me with what little we have to go on, or I can't do anything for them. And they can wind up getting me fired if this keeps happening.

I'm debating looking into seeing if there is a reputable language on tape option. Although I doubt that would cover a lot of medical speak. And the Dr. I work for is Arabic, so I don't want to ask him if he'd be ok with insisting people are (or bring) a strong english speaking person to appointments and be available for all phone calls.

I want to send flowers to the ones who actually try to work with me LOL.

#7 Mama2Gracie

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Posted 12 May 2012 - 11:55 AM

Then maybe he should be taking the time to explain things to them then.

#8 Jill

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Posted 12 May 2012 - 04:11 PM

The phone interpreter thing is for in-patients only, I think. I am not sure that any of the other departments have access to it when handling outside calls...

This is a very difficult situation, because in theory, if they don't understand what they are consenting to, then their consent doesn't even count. It needs to be with the pretense that they fully understand risks, procedures, etc.

I wish there was a better way, I know it can be very frustrating. That being said, you'd have to learn quite a few languages for this to never be a problem, and like you said, those courses don't really teach in medical terminology, which tends to be a language of it's own! We need an interpreter for explaining medical stuff to laypeople in ENGLISH, when they speak ENGLISH! lol

Edited by Jill, 12 May 2012 - 04:12 PM.


#9 Tired Mom

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Posted 12 May 2012 - 04:20 PM

The phone interpreter thing is for in-patients only, I think. I am not sure that any of the other departments have access to it when handling outside calls...

This is a very difficult situation, because in theory, if they don't understand what they are consenting to, then their consent doesn't even count. It needs to be with the pretense that they fully understand risks, procedures, etc.

I wish there was a better way, I know it can be very frustrating. That being said, you'd have to learn quite a few languages for this to never be a problem, and like you said, those courses don't really teach in medical terminology, which tends to be a language of it's own! We need an interpreter for explaining medical stuff to laypeople in ENGLISH, when they speak ENGLISH! lol


M2M needs a like button! LOL

So far arabic has been the only barrier presented, but I'm sure you're right and it will come up with others too.

Grr :(

#10 Claudia

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Posted 12 May 2012 - 04:24 PM

Can you ask whoever you work for to start giving out a written agreement/statement with everything they need to know when booking appointments/surgeries? This way they can have someone they know translate or bring it somewhere to have it translated if they don't understand.

#11 JeepMom

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Posted 12 May 2012 - 08:43 PM

Maybe a new rule that if you book a surgery and cancel withing x numbers of day you pay a fee....or if english is not your first language then they cannot book an apt over the phone, they have to come in and fill out the forms and then book the apt....or a two step program...set up an apt time to fill out the forms and then book the apt for the surgery on that day..that would probably be the best considering everyone should be filling out paperwork for surgeries.

#12 Tired Mom

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Posted 12 May 2012 - 09:57 PM

We have a binder full of signed consents from before I worked there, and that was what I was working with (with the exception of the first scenario in the OP.)

I'm going to compile a list of ideas given in this thread to take to my boss, thanks ladies!

I feel bad, but we've got to do something. We're finally almost done straightening around the office itself, and getting caught up with moving over to the EMR's from the piles and piles of paper everywhere. And we've been having to call every office in town because the last girl in there booked appointments then threw away the referrals before scanning them in. In other cases (more than 20 times in three weeks) we've had people walk in and get upset that they won't be seen that day when there was no listed appointment for them. She'd call them and tell them when to come in, and not put anything into the system.
We have to go ahead to every booked appointment in the computers because both our Dr's were booked wrong, double or triple booked, and has patients scheduled through holiday's and vacations lol.

I'm anxious for things to be running smoothly. Although it feels great to get a whole weekend off :) This is the first time I've been out of the office for more than 24 consecutive hours since I started lol.

#13 tabbs

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Posted 18 May 2012 - 12:41 PM

What do other similar sectors handle this?

#14 cbarker78

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Posted 18 May 2012 - 01:02 PM

We have this problem as well (( call centre based insurance))... Legally, they have to understand the product & coverages, and have to be able to respond to our questions. In training, I teach the brokers that just because there is a language barrier does not mean the client is deaf (don't yell!) and they're not stupid! They are having as hard a time understanding you and you are of them.

The best thing to do is speak slowly & clearly, use as simple language as possible, and get the client to paraphrase back to you. It doesn't hurt, when you are giving a lot of information over the phone, to ask if they have a pen and paper so they can take notes. It just takes a world of patience!!

Best wishes!!

#15 tabbs

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Posted 28 May 2012 - 08:33 PM

any update on how you ended you handling this???

#16 Tired Mom

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Posted 28 May 2012 - 10:15 PM

Having to book everything while they are in the office, so I can see what they do and don't understand. And I ask that they bring someone english speaking to help bridge the gap.

I feel bad, I know they are as frustrated as I am. But they don't have the job on the line, and I do lol.