In today’s ever more diverse world, language – and the ability to communicate – will become even more critical to providing people the health care they need.
Two current College of Saint Benedict students not only discovered this truth, they’re using critical and creative thinking skills to solve problems and enhance communication with patients in health care settings.
Emily Kieke and Lauren Dueland, both seniors from Cold Spring, Minnesota, spent this summer in 10-week internships with the Hospital Elder Life Program (HELP) at St. Cloud Hospital. They also found roadblocks for patients who weren’t able to communicate – and ways to work around them.
They were involved with HELP last year as students in a creative writing course taught by Chris Bolin, an assistant professor in the English department at CSB and Saint John’s University. The course, titled “Clinical Encounters” (English 206/207) provided weekly interactions with patients. The students practiced active listening skills and explored creative writing as a way to stimulate and prevent at-risk patients from developing hospital-acquired delirium. From May until August, thanks to support from a Fleischhacker Fellowship (Kieke) and a Jackson Fellowship (Dueland), their roles expanded. They also received a grant from the Office of Undergraduate Research & Scholars that funds creative work efforts of students, just like this one.
“We have a patient list of about 30-40 people we interact with, and we decide how we want to split that up,” said Kieke, who with Dueland visits surgical units 1 and 2, medical unit 2, oncology and neurology. “I was on one of the medical floors early in our internship and we kept seeing patients on our list who had language barriers – like Somali, Vietnamese, Spanish – and we didn’t want to just cross them off because of a communication barrier.
“We approached a nurse to see if we could find a way to be with the patients,” Kieke added. “She said if we were open to it, we could use this Martti app that the hospital uses for online interpreters. The resource nurse was able to communicate with a Spanish-speaking patient enough to determine whether they were interested in having a general conversation. The patient agreed and so we connected through the interpreter app, and I got to talk to them with the interpreter. We went through a generic HELP exercise to see if they were oriented and then we had a conversation about their life … they went home the next day and the charge nurse told me that they were so appreciative of the experience and beyond grateful. It was nice to see how much of a benefit we could be.”
Kieke, an exercise and health science major on a pre-occupational therapy track, said she knows a little Spanish. Without the iPad and app, her limited knowledge of the language wouldn’t have been enough to serve the purpose of HELP – which is to interact with patients and engage patients mentally. Originally developed at the Yale School of Medicine, HELP has shown to reduce incidences of delirium by as much as 30%. And, in an intensive care setting, statistics have shown delirium can be a threat to 80% of patients. It also helps maintain a regular sleep schedule.
“It’s important to break up the mood because, when you’re in a hospital, you’re talking about your diagnosis a lot,” Kieke said. “It’s nice to break up the day with something else. If you’re a farmer, I can talk soybeans with you. We try to take their hobbies and make conversation about them. Sometimes we’re in these patients’ rooms for an hour or more just chit-chatting and doing creative writing.”
Sometimes it doesn’t even take a high-tech solution to solve a communication problem. Dueland had a similar experience with a patient who had undergone a tracheotomy.
“I noticed a loud noise coming from a room and I assumed there was some kind of machine going,” Dueland said. “I checked with the certified nursing assistant, and she notified me that the patient couldn’t speak, but they could gesture and mouth words, so that presented a barrier to conversation. I tried to offer what help I could through yes and no questions but after that we got to brainstorming about how this will happen and what can we offer. We thought of whiteboards and were able through a grant from the College of Saint Benedict to purchase those items. It's not exactly high technology, but it helped bridge a barrier.”
Dueland, also an exercise and health science major, plans to go on to get her doctorate in physical therapy. She and Kieke will occasionally volunteer between the end of their internships and the start of school, after which they will help arrange opportunities for the CSB and SJU students coming up behind them.
The outlook for occupational therapists is robust. And considering a 2021 median annual pay of $85,000, the future could be rewarding in more ways than one.