Being on the other side of a hospital visit gives you a different perspective about a few of the important issues that are present. I am by far no expert, but by talking to the nurses on staff in the Emergency Room and by interacting with patients, I have began to notice common issues and concerns. The hospital can be a confusing place to navigate, and one of the biggest challenges is that patients sometimes have misunderstandings about what resources they should be utilizing and what assistance is available to them.
One time there was an elderly man who could not read or write very well and he spoke only Spanish. He had been given instructions about his treatment before he came to see us, the Health Advocates, for help on health insurance. While we were helping him, he expressed concern that he was confused about how to proceed with his treatment after he left the hospital because he didn’t understand the instructions that were given to him. Because he was able to communicate his confusion to my partner in Spanish, we were able to get him the proper translations he needed instead of leaving the hospital without asking any questions.
In a different situation, we assisted a man who did not have health insurance and was under the impression that he was not eligible for Medi-Cal because he did not have a job. He was relieved to discover that he was eligible for HPE (the Hospital Presumptive Eligibility program) and in the future, Medi-Cal as well. It is because of situations such as the two that were just described that I believe Health Bridge’s mission is so important. The health care system when you’re an uninsured patient and/or a patient with limited English proficiency can be extremely confusing, and with Health Advocates' assistance, we can help sort out situations that might have been overlooked.
Sometimes the most important way we can help the patients are in intangible factors. When my fellow Health Bridge advocate works with a Spanish patient, I cannot understand their conversation but I observe the conversation and watch the patient’s body language. The patient relaxes and the conversation is more fluid. Their initial desperate and contorted expression is exchanged for a relieved one as they are able to clearly express their concerns. The hospital is a nerve-wrecking, tense place for some and being able to lift the language barrier is key to the patient getting the care they need.
Maryann Zhao is a sophomore at Pomona College from San Diego, CA. She is a Molecular Biology major and wants to become a doctor in the future. On campus, she is a TA for Computer Science, involved in Molecular Biology/Chemistry research, and a member of the Pomona-Pitzer Women's Varsity Tennis Team. In her free time, she enjoys developing her coding skills and exploring the outdoors.
One of the challenges that many healthcare providers face today is learning to adequately provide care to a diverse set of patients. This is a problem that the hospital Health Bridges has partnered with, Pomona Valley Hospital Medical Center (PVHMC), also faces. One of the largest demographics that PVHMC serves is immigrants. Many of these immigrants are limited English proficient (LEP) patients, setting them up for confusion and frustration in a healthcare system dominated by the English language. To address this issue, Health Bridges has placed Health Advocates, such as myself, in PVHMC's ER to help uninsured LEP patients learn more about their health insurance options in their native languages.
Being a Health Advocate has been a rewarding experience. I have the opportunity to work directly with the LEP patients who speak Spanish. In particular, I help patients who are uninsured enroll for HPE, an emergency medical insurance that gives qualifying patients enough time to enroll in full coverage programs. Many of these patients do not know what options they have for health insurance. Patients are concerned about the costs of their ER visit, which adds to the stress of the medical emergency they are already facing. The service that Health Advocates provide offers a sense of relief to patients who qualify for HPE because they can focus on convalescing rather than on the financial burden they would otherwise have to confront. Thus, Health Advocates have the potential to make an already stressful experience at the hospital more bearable for patients and their family members.
In addition to helping uninsured LEP patients, as a Health Advocate we also help nurses with other small tasks around the ER such as changing beds or helping visitors find their family member's room. This has been an eye-opening experience because as Health Advocates, we are directly immersed in the ER's fast-paced environment. Health care providers have many responsibilities in the ER, but they also want to make the patients feel comfortable. With their already packed schedules, nurses and doctors cannot always afford to give each patient the attention that they would like to. That is where volunteers come in. They can provide the smaller touches to ER visits that makes patients feel welcomed at the hospital. For instance, as a Health Advocate I have been asked to show visitors to their friend's or family member's room, get water and coffee for visitors, change beds, and help patients to the bathroom. These seemingly insignificant tasks help create a friendly and encouraging environment for patients and their families alike.
So, whether Health Advocates are helping LEP patients learn about their health insurance options or bringing a cup of coffee to a father who has spent the night in vigil at the bedside of his son, Health Bridges is making a difference at PVHMC.
Joana Perdomo is from Inglewood, CA. She is currently majoring in Mathematics at Harvey Mudd College. She enjoys reading, dancing, listening to music, watching movies, and sharing her love for science and history with others! She hopes to pursue a career in quantitative public health in the near future and ultimately become a physician.
Last weekend, Hong, Sophia, and I drove to the home of the Wu family. For our fundraising campaign video, we spent the past week interviewing and filming nurses, hospital administrators, and Health Bridges coordinators to highlight the importance of what we do at Health Bridges. What we (and our intended audience) needed the most, however, was testimony from the patients themselves, so that’s why we were going to interview the Wu’s.
When we entered the house, we were greeted by a chorus of screams. The Wu’s had four little boys with boundless energy. They ran around, jumped on the piano, and climbed onto anything that was climbable. Since they couldn’t sit still by themselves while we interviewed the mother and father, I babysat the boys and made sure they didn’t injure themselves. As I watched them run, I was hit by a wave a nostalgia. The entire atmosphere reminded me of my childhood, from the rapid fire Chinese being spoken, to the aroma of Chinese spices in the kitchen, to the boys who looked and acted as I did.
During our interview with the Wu’s, we learned more about their situation. As recent immigrants from China, they spoke limited English. They met Hong in the emergency room in the midst of a family emergency. From their emotional accounts, it was clear that the anxiety from their emergency was exacerbated by the difficulty of navigating the American healthcare system. It was, simply put, frightening when you have trouble understanding what the doctor is saying and not knowing how much you will be charged. Thankfully, Hong was able to alleviate some of that burden and the Wu’s were grateful for our help.
My experience with the Wu’s reminded me why I was a part of Health Bridges. As students, we are so caught up in our schoolwork and our own problems that we sometimes can’t fathom the frustrations that arise from inadequate access to healthcare. But that is their reality. I hope that as Health Bridges expands, we are able to help more families like the Wu’s.
Jerry Lee, a senior at Pomona College from Irvine, California, is currently pursuing a major in Molecular Biology. He is a Community Engagement and Relations Coordinator for Health Bridges. He is also an active scientific researcher at Pomona studying the biochemistry of extreme microbes. He is interested in science and healthcare, and intends to pursue a career as a physician.
Working as a Health Advocate for Health Bridges has really made me realize how much of a barrier language is to access to quality healthcare. To illustrate this point, I want to tell you about an experience I had at the end of one of my shifts.
It was 11:30 am on a Tuesday morning and my shift was winding down. My usual shift partner, the Spanish-speaker for our shift time, was getting ready to leave early in order to make it back to campus on time for another obligation. After she had left, a family came to the registration window with a small child. It soon became evident that neither parent felt comfortable speaking in English and that Spanish was their primary language of communication.
After struggling to communicate with the admitting staff, the family expressed that the child who needed care did not have health insurance. Panic began to set in as I realized that I would have to handle the HPE sign-up with my limited Spanish-speaking ability. (HPE, or Hospital Presumptive Eligibility, is a program offered through Medi-Cal that allows health care providers to sign patients up for a temporary Medi-Cal service that not only covers the cost of their visit but also covers them for an additional month. )
Now granted, I have been taking Spanish ever since 7th grade and grew up in Miami—a city where you hear just as much Spanish being spoken as English. But unfortunately, my Spanish abilities are limited strictly to academic functions—reading literature and writing essays, which are useful in school but not in a practical setting like a hospital.
Quickly, I began to run through phrases in my head in Spanish. Soy voluntario, puedo ayudarse. ¿Tienes seguro medico? As I approached the family I could feel my heart beating in my chest. To my relief, as I explained the HPE sign-up process in my broken Spanish, the family seemed to understand me. While filling out the sign-up form online, I paused as I thought about how to pose my next question.
Although I am quite sure I messed up many times, the family was patient and understanding while I struggled to communicate to them. Because she was so stressed about her son’s illness, the mother cried as I went through the HPE process and I tried my best to console her with my limited Spanish vocabulary. After the child had been approved for HPE, the mother thanked me profusely and said she was so grateful someone could communicate the process to her in Spanish.
Interacting with this family taught me an important lesson about how a language barrier can make seeking quality healthcare so difficult. When I could not communicate to the family exactly what I intended to say, I felt greatly frustrated. And I felt equally frustrated when they said something to me I could not fully understand.
I imagined what it would be like if this was my only interaction with a healthcare provider and I could barely speak enough English to get all my questions answered and understand the doctor’s instructions. I think this experience really drove home to me the importance of the work Health Bridges is doing.
Zoe Zhou is a Health Advocate Coordinator for Health Bridges. She is a sophomore at Pomona College and is majoring in Molecular Biology. Besides being involved in Health Bridges, Zoe is also an intro genetics and writing TA and a sponsor. She is passionate about medicine and healthcare and wants to become a doctor.