WAKE UP

Of mid-western blood, I was schooled as a registered nurse in Fargo, North Dakota. Three years into my working career, my husband and I packed our few belongings and moved south, to Fort Worth, Texas.  My initial job was in a Post Anesthesia Surgical Care Unit. It was an exciting change from my neuro?orthopedic experience and my clinical skills adapted smoothly. Despite this blanket of comfort, there existed a neoteric aspect of patient care Fargo had not prepared me for.

Fort Worth was largely populated by persons of Hispanic decent. Fargo was not.  In Fargo, the Norwegian dialect asks, “How ya doin?” Whereas, in Fort Worth you hear, “Como esta?” And, the days of “Uf da” were now but a dear sweet memory.  Soon, my fingertips scrambled through the pages of the Spanish?English  dictionary close at hand in my locker. Fortunately, many of my nursing colleagues were already armored with conversational Spanish; at least enough to manage a patient through the recovery room process. I was assured that I too, would soon gain such competency.

One afternoon, Mr. Mendoza was wheeled into recovery, still lightly anesthetized. I was given report: “Fifty-one year old Hispanic male, married wife out in the waiting area, non-English speaking…right inguinal hernia…general anesthesia…extubated without difficulty…”

I engaged myself in the care of my new patient, dressing Mr. Mendoza in the standard patient attire of EKG, blood pressure, and oxygen monitors. His physical assessments were normal: vital signs checked out normal sinus rhythm;  blood pressure stable; respirations non?labored; breath sounds clear; oxygen saturation at 99%; good capillary refill in all four extremities; abdomen soft with bowel sounds present; surgical dressing was clean and dry.

But his neurological status remained in question, “Mr. Mendoza, Mr. Mendoza.”

Not a stir. Not a flinch of a response to my voice or to touch.

His wife came in to see him. Mr. Mendoza didn’t respond to her either. I continued closely monitoring my sleeping patient, charting, “clinically stable, assessment unchanged…remains non-responsiveness to voice or touch at this time…” Definitely, it was not prudent to chart, “Responds like a brick wall to voice and touch.” I continued to engage every effort to waken him.

“Mr. Mendoza. Mr. Mendoza,” I called over and over again. Soon I had an uncomfortable sense of an audience. The other half-dozen or so semi?conscious patients and their nurses were clearly annoyed with the echo of my persistent badgering.

Yet, I was determined to get any elicited response — a groan, a hand squeeze, a batter of an eye. Art, my trusted and bilingual colleague, finally came to my aid. He suggested I ask Mr. Mendoza to “wake up” in Spanish. I nodded my head as Art repeated the Spanish phrase I was to repeat to my patient. Art assured me it would elicit a response.

Trusting my rescuer, I didn’t question Art for the English translation of his tutorial. As I repeated it in my head, I was comforted by the cohesive support I felt from the other patients and staff looking on with eager anticipation. I assumed they sensed the emergent need for Mr. Mendoza to respond, lest he fail his neurological assessment.

With my hands on his shoulders, I leaned over the side rail, twelve inches from his face. In my mid?western dialect, I articulated the Spanish words in a desperate cry, “Beso mi, Senor Mendoza, Beso mi!”

To this day, I am not sure what startled me more: the chorus laughter of my colleagues or Mr. Mendoza, eyes wide open, shooting up in bed! Dazed, I turned to question my instructor, Art, who was buckled over in laughter.

In between breaths, he provided me the English translation: “Kiss me, Mr. Mendoza, Kiss me!”
By Kathleen Dahle
(chicken soup for the soul)

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