This is part 3 of the series on the healthcare system in Nicaragua discussing the language and my role in the clinic.
The LanguageAll of the intake and the visit was completed in Spanish as most of the patients reside in rural areas where English is not spoken often. Even the physicians working in the clinic and the other staff understood very little English, which made it a challenge for me to communicate with them as my Spanish level is minimal. I did have an interpreter with me some of the days, which helped, but it is very limiting as a person let alone a doctor to not be able to communicate with my patients to the full extent that I wanted to. At the end of my time there I was able to complete an intake with the patients, completely in spanish, but I was not able to understand all of their responses. It made me more appreciative of patients who come into the clinic or hospital here in the USA who do not speak English fluently, because it is challenging and frustrating at times to not understand during a medial visit. Luckily all the medications in the clinic were from the USA, so I was able to catch onto the treatment fairly quickly. Most Commonly heard Nicaraguan word in the clinic… “chistata” which is their way of saying urinary symptoms (UTIs and chronic kidney disease are very common in the country).
A note on Nicaraguan Spanish… Nica spanish is different from Mexican spanish or other dialects. There are certain words that mean certain things there that do not exist otherwise. Also, they do not pronounce the “s” at the end of words, so their sentences flow together much quicker and it makes it that much more difficult to understand for someone who is not a native speaker.
My Role in the Clinic
As a medical student I was unsure of what my role was going to be while in the clinic in Nica. When I arrived to the clinic on the first day, the physicians there told me that in Nicaragua I am Doctor Emma, so that is who I was, but it was not the only role I held.
Some days I was pharmacist Emma… working in the pharmacy counting out medications for patients, explaining dosages and side effects, and making sure that the medications fit the conditions they were being treated for.Other days I was triage nurse Emma… working at the front desk in triage hearing the patient’s chief complaint(s), taking their vitals, and getting basic medical information from them.
Then I was phlebotomist and laboratory technician Emma… taking blood draws, looking at specimens under the microscope, and interpreting basic lab results.
Lastly, I was Doctor Emma… a role I was the most comfortable with. Hearing the patient’s medical concerns, doing basic physical exams, interpreting and discussing lab results, and providing basic treatments and follow up.Some of these roles were easier to assume than others, but it was difficult to jump in between roles in a single day. The physicians in this clinic and others like it have to be prepared to assume multiple different roles at any time, which only increased my respect for them and all that they do.