SARAH HEXEM HUBBARD: This is At the Core of Care. A podcast where people share their stories about nurses and their creative efforts to better meet the health AND healthcare needs of patients, families and communities.
I’m Sarah Hexem Hubbard, executive director of the Pennsylvania Action Coalition and the National Nurse-Led Care Consortium.
As part of our special COVID-19 coverage, we’re going to spend this episode hearing from Ana Pichardo. She works full-time as a certified Spanish-speaking medical interpreter at Temple University Hospital in North Philadelphia and is about to earn her second degree this summer with a Bachelor of Science in nursing from LaSalle University. The pandemic has hit especially close to home for Ana.
ANA PICHARDO: Having my grandfather in the hospital and with my background in, you know, just being an interpreter or a case manager and now a nursing student, I had to step up for the family.
SARAH: Ana will share with us the impact that the pandemic has had on her nursing education, her work as an interpreter and the ways she’s now thinking about healthcare.
ANA: Everything changed with the coronavirus. Everything first changed with school. We were all going in person for school and then I don't know where we're like, OK, we have to finish your last two classes online. So that was a change at first. Just going from being in person and doing our clinicals in person to now everything having to be online. During my last semester, unfortunately, we're not able to go to the hospitals to do our clinical work. So we are able to do it online, doing virtual simulations. And then another thing that happened, unfortunately, is my family lives in Lawrence, Massachusetts, and unfortunately my grandfather contracted the virus and that was very difficult on the family. And all of this was happening right as my semester had just started. He got hospitalized end of April...having my grandfather in the hospital and with my background in, you know, just being an interpreter or a case manager and now a nursing student, I had to step up for the family. I was the main primary contact for my family in the hospital. Even though I was far away. I would do phone calls with my aunt all the time. I had to help her not only with the language that most of my family doesn't speak English, but I also had to help them with the medical lingo, with helping them communicate with the providers there and to explain everything to them. So I served many different roles during this time.
As an interpreter, I'm used to interpreting for different families and I'm able to take myself away from that role. But it was very difficult, like one of the things that I had to tell my grandfather was asking those end of life questions that you have during the palliative meetings. I had to ask him if your breathing were to stop or if your heart were to stop. Would you want to be intubated? Would you like to receive CPR? Or how long would you like to be intubated? That was a very difficult conversation to have with a loved one. I had to push back the tears and had to toughen up at the time and I had to be there for him and interpret that for him in Spanish. And that was very difficult…One of the things when the pandemic first started, you weren’t allowed to go see your loved ones or to be there for them in their last moments as they took their last breath or passed away. And with my grandfather, it was similar. We weren't able to be there in person for him, most of the time before he was intubated, we were able to zoom and talk to him and see how he was doing. So that was a little bit of relief for the family just being able to see him, even if it was just through video.
My grandfather passed away on May 29th... A couple days later, we had his funeral but we drove back that same night to Philadelphia you know just to lower the risk, not being around too many people... But it was very difficult, thinking I had an exam that night. My professors were very accommodating. They were able to push the exam back a couple of days later and it has been hard, going through this loss, and this grief, and going through school. And my boyfriend James, he’s been my biggest support, along with my family...And I would want to finish my degree now, become a nurse, so I can also be a support system for other families now dealing with this, because most likely with this pandemic, I will probably end up working with COVID patients. When my grandfather was hospitalized, I talked to the nurses almost every day and they made me feel part of the team.
I work at Temple University hospital currently. My department has been really good with trying to keep us away from patients who have the virus. And in the emergency room, honestly, at this point, we don't know who has the virus. So at this point, we have to just be ready that any case is a possible case that could have the virus. So we just have to wear all of our PPE, our surgical masks, or when we know the patient, it's possible to wear N-95 masks. But our department has been good at giving us the equipment we need to be protected, such as the face shields. But another thing also is that we started doing is in the emergency room, we now started doing like a face time call with the providers and the patients. So we don't have to walk personally into the E.R., one of our staff interpreters or we are able to call in, call the provider and we are able to interpret that way. The patient and the provider have an iPad setup where they can see us clearly and hear us. And we're able to be there, present and to be able to provide these patients with the language, communication that they need. But, you know, also while protecting ourselves and being in the office and not coming face to face or in contact with the patient just in case.
I guess now that I'm so close to graduation, I hope that I can stay working at Temple Hospital as a nurse just because I grew up around Temple and this is my community here in Philadelphia working with the Hispanic community and minority communities...I still keep going back and forth between being a med-surg nurse or ICU nurse like working in an intensive care unit, just because that's the population that needs the most help with an intensive care unit similar to where my grandfather had to be in...It was nice to see how well the nurses took care of my grandfather first hand and without those nurses, I feel like the family members would be out of the loop because they’re not able to go in person to see their loved one. So that was very helpful for me to see. Just seeing how much the nurses care. And I guess with this pandemic, one of the things that has come up is how important nurses and the nurse field is during these times. Because they serve as many different things. They’re there as a caregiver, they’re there to support you as well as a family member. So I’m thinking maybe of going into the intensive care unit and in the long run, I would like to go back to school to become a nurse practitioner eventually.
I've always been interested in health care. I used to go with my mom to her medical appointments. We moved here when I was two years old to the US. So my school has been all in the United States, but my mother's from the Dominican Republic and she had a hard time learning English. So I would go with her to her medical appointments so she can have at least someone to help her interpret. And I would be very interested in what the nurses were doing, the doctors. And that's what first sparked my interest in medicine, to see my mom go through like all that hardship. That bridge between not knowing the language and not being heard. But then being in school, I went to school originally at Temple to be a nurse. But I got very scared because of anatomy at first. I didn't pass it the first time I took it, but I didn't give up. And then I saw that I took one class, intro to Public Health and I loved what public health stood for. What was all about, it was all about preventing disease. And pretty much focusing on primary prevention, which is trying to catch people early with education and knowledge before they get sick and try to have them live a better quality of life. So I was really interested in that, so I switched my major to public health and I loved it. I worked two years in the field as a case manager for people with HIV and AIDS. I worked one year at Congresso Latinos Unidos and another year at Action AIDS, they’re known now as Action Wellness, and I loved just helping people and meeting them where they are.
As a provider and an institution, we have to recognize that there's sometimes inequalities in health care with different groups. So it's very important to try to build that bridge. Whether it is through my department, the linguistics department, we bridge the gap of communication with patients. We try to provide health care in the language that the patient is most comfortable speaking in. So the care can be the best quality as possible... helping them with their needs and also involving the family. I’ve noticed going through all this, involving the family in the care is very important. So we have to do more as health care providers to educate our communities as well. So they don't end up in the hospital and don’t end up sicker than they could be.
Recently, everything going on with the protests...Everything has been very difficult. But it's also showing me that everything going on around the country with these different inequalities or, you know, racism, it's something, it's not being political, it’s just recognizing that racism still exists. And basically, we have to show as health care workers and institutions, we need to recognize that racism is a public health crisis, it’s something that we need to address in order to build a bridge in the health care inequalities that are going on every day that we see.
CREDITS
SARAH: Special thanks to Ana Pichardo for taking time to talk with us.
Funding for this podcast comes from the Center to Champion Nursing in America, which is a joint initiative of the Robert Wood Johnson Foundation, AARP, and the AARP Foundation…along with the Pennsylvania Action Coalition.
Stephanie Marudas of Kouvenda Media is our producer and we had production assistance from Brad Linder.
I’m Sarah Hexem Hubbard of the Pennsylvania Action Coalition.
Thanks for joining us.
