Escuche Me: Why We Must Research

Currently, I’m staring at a stack of interviews that my wonderful FNP (that’s Family Nurse Practitioner) research partner and I have conducted with primarily Spanish-speaking women about their childbirth experiences in the United States over the past 6 months for our scholarly project. I have done my fair share of whining, complaining, and general moaning about how much work doing your own research is, but as I come to the finish line of a completed, possibly publishable paper, I am struck with a sense of awe at how much this research, and the research conducted by my peers could mean to the field of health care. 

We research for a huge number of reasons, many do research about what treatment is the best for a certain disease, what is the most effective test for diagnosing, what will ease the pain better. This kind of quantitative research is important, and a majority of what makes up health care related research. I, instead, fell in love with qualitative research. Ever an anthropologist at heart, I want to talk to people, listen to their stories, tie together themes, and help come up with universal truths and meaning. 

In order to explain why I arrived on the scholarly project that I did, I have to jump back to my first year of nursing school. I was doing my OB rotation at a local hospital, and had a patient who was one day postpartum, had a significant hemorrhage, and was in an immense amount of pain. She was also Spanish-speaking, and there was no interpreter available. I walked into the room and tried to do my assessments. She was exhausted, we couldn’t communicate, and her husband was so scared after her hemorrhage and no one had explained to him that his wife would not, in all likelihood, have another bleed. He was terrified it might happen again at any second. 

She was in too much pain to breast feed, and the nurse handed the patient’s husband a bottle. When leaving the room I asked the nurse if maybe this patient needed some pain medication. Her answer nearly knocked me to the ground. “No,” she said, flippantly, “She’s Hispanic. Hispanic women are stoic. They never want pain medication.”

This was when I knew I had to intervene. I went to get my lovely clinical instructor, and in no time, we had given Mom pain medication (that she did, in fact very much want but didn’t know how to ask for), and gotten her set up with a supplemental nursing system that could help the baby learn how to latch. 

This experience impacted me significantly. On the one hand, I almost couldn’t believe what I had seen, and then on the other hand, knew that the scenario I had witnessed must take place a thousand times a day across this country we now label “post-racial.”

So, my FNP friend and I got to work. What is the experience that many Hispanic women face birthing in America? What are translator services like? How do we use this opportunity to create a project that could really mean something, could really be published, and influence how hospitals provide interpreter services? 

There have been many themes that have come out of our research, but, one of the most striking, heartbreaking, and infuriating things to hear women say over and over again when asked what they would change about their experience interacting with the American medical system is this: “Escucha me” 

Listen to me. 

Many of the women I spoke with were so terrified by their childbirth experience that they switched hospitals, providers, or even wish to never have children again. They are forced to sign consent forms in English, they are provided with phone interpreters at best, or no interpreter at worst. They are left in cold pre-op rooms wondering if the nurse heard them ask for a blanket. They are unsure of what is being done to them during their labors and why. Some women feel so defeated that they even stop asking for an interpreter because they know they will not receive one in time for their birth or appointment, or that it will be the uniformly hated phone interpreter. 

The term “Evidence Based Practice” gets thrown around a lot in nursing and nurse practitioner circles, and for many, I know that means looking up the latest evidence on UptoDate (a medical reference cite that literally allows me to do my job and not keep every single detail in my brain all at the same time), but when it comes to patient care, when it comes to the qualitative, real, lived experiences, how do we make sure we’re providing evidence based care? 

I want to live in a medical world where evidence based care means that we review research from sociology, anthropology, and ethnic studies. Where we view the evidence of people’s lives and experience as just as valid, just as true, just as important to medical practice, as anything that is conducted in a lab.

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