Megan Foltz exceeded expectations by proactively responding to a patient and wife's needs in a very personal meaningful way. She displayed an outstanding demonstration of patient advocacy and compassion for a patient who spoke no English. She discovered the patient and his wife had arrived to LGH the previous week having come straight from JFK airport to the emergency room accompanied by a medical escort. The couple was unattended this day by any support or sponsors and were not able to communicate what organization or individual was supporting them. Because neither spoke any English, it required the use of the ODI. The ODI translator spoke a slightly different language and felt it better to get another translator if possible.
Meg was very concerned that the patient did not fully understand what procedure he was having done or if he fully understood the implications and possible complications of the surgery and his post-op course. Meg immediately contacted the Anesthesia provider and Surgeon about her concerns. The Surgeon was ok because the patient has agreed to the procedure, and had no questions that it was good to pursue. Meg was not comfortable witnessing the surgical consent if her patient did not have a full comprehension of the surgical expectations. Because of Meg's personal experiences having traveled to several third world countries she understood that many times it is an acceptable response in some cultures to agree with what is being said. Through the ODI translator, Meg was able to learn that the patient knew he was having a procedure to permit dialysis. Meg continued to voice her concern that although he had received dialysis in his home country, it may be a different process in this country. Meg was not satisfied that the surgeon wanted to pursue without her knowing this patient was well aware of what was about to take place.
Meg contacted language services who was able to find an interpreter who fortunately was available within 10 minutes. The surgery was delayed until the interpreter arrived. Through the interpreter, Meg was able to determine that the patient had a good understanding of what the plan was and what to expect from having dialysis. When the OR team escorted the patient to the operating room Meg turned her attention to the patient's wife asking her when was the last time she had anything to eat. The wife (through the interpreter) told her last evening. Meg gave the patient's wife $10 from her personal funds and asked the interpreter if she could assist the wife to the cafeteria especially after noting the wife's response when looking at the money and obviously not knowing what or how much the money was worth.
Meg was still a bit unsettled regarding how follow up care would occur so she placed a nursing consult to case management and left a detailed voicemail message. In addition, she researched the patient's chart to learn more details that had occurred prior to his arrival to LGH and she updated the patient's story in the EMR to reflect this information.