A deaf Fresno mother says Valley Children’s excluded her from custody of her child. “It was horrible”

A deaf Fresno mother who accompanied her teenage daughter to Valley Children’s Hospital in Madera for emergency surgery said what should have been a two-day stay stretched into more than a week because that staff had left her out of important conversations.

Rosemary Wanis said the frustrating nine-day hospital stay left her daughter, Rashelle Diaz, “traumatized by the experience.”

“It was a horrible experience for me. For her, she will never trust another doctor and will never be willing to go to the hospital for another exam,” Wanis, 50, said through an American Sign Language interpreter .

The case highlights the difficulty the deaf and hard of hearing community in Fresno and the San Joaquin Valley faces in obtaining interpreter services during hospital visits, even when a health care facility has several options.

Wanis, a professor at Fresno State and Ohlone College in Fremont, said his requests for communication from Valley Children’s were ignored and met with hostility from some staff members while his 16-year-old daughter was transported from emergency for two surgical procedures in 2022.

Wanis said the hospital was willing to meet with her to discuss a settlement after her complaint, but she rejected that offer. Instead, the mother wants the hospital to improve access to interpretation services and train employees to interact with deaf patients and their loved ones.

Two years later, Wanis and Diaz say their frustration has only grown.

Valley Children’s Hospital and Communication for the Deaf

Diaz, who is fluent in American Sign Language but is not hard of hearing, was taken by ambulance to Valley Children’s Hospital on Sept. 4, 2022, with intense stomach pain, Wanis said.

The mother and daughter had already gone to Kaiser Permanente Fresno Medical Center that day when the pain first appeared, thinking it might be food poisoning. Their stay at Kaiser was relatively short, but Wanis said she was happy with the performance.

Doctors referred both men to Valley Children’s for an appendectomy, and Wanis said she believed Kaiser informed Madera Hospital of its interpretation needs.

Wanis said the ambulance crew informed Valley Children’s of its interpretation needs when they arrived at the hospital. But, she says, the hospital only provided these services after she herself repeatedly requested them.

The hospital used video remote interpreting, commonly known as VRI, which is essentially an electronic tablet hung at approximately eye level and connected to a remote interpreter. The service can interpret many languages, but American Sign Language (ASL) requires additional accommodations.

While many languages ​​must be relayed only audibly, ASL requires that the interpreter and the deaf person can see each other on the video screen. It was difficult, Wanis said, because the tablet computer’s spotty connection made it impossible to keep it working consistently.

Wanis said the nurse in the room also stood between her and the screen, making communication difficult.

“She pushed me. She actually pushed me when I tried to access the equipment,” Wanis said. “So I gestured, I pointed my eyes, and I pointed at the VRI screen, and I gestured, please. I didn’t touch her, but gestured if you could move so I could see the screen, and she very deliberately pressed her against the machine and pushed me away.

Staff members repeatedly failed to speak to the mother, Wanis said, and spoke directly to Diaz while she was in pain.

Diaz, who is now 18, said she was in extreme agony and repeatedly told nurses that her pain was a 10 on a scale of one to 10. The nurses gave Diaz medication and ignored his mother’s questions about dosages.

Diaz said she tried to replace Wanis, who had been cut out of the communications chain.

“I’m in terrible pain, you know?” Diaz said. “She doesn’t have the insurance she needs. She has no confirmation of what is happening.

Nurses would wake Diaz, who was still recovering from surgery, and have her interpret for her mother, the mother and daughter said.

On the third day of their nine-day stay, an ASL interpreter entered Diaz’s room, they said. The hospital had an interpreter in the building but did not call him into the room. The interpreter arrived only after learning from another deaf patient on another floor of the hospital that a deaf family member needed help, Wanis said.

Diaz underwent a second surgery on the eighth day of his visit to clear a blockage. Wanis later learned that some of the information nurses collected from her daughter was incorrect, which she said could explain why the hospital stay was extended to nine days.

Valley Children’s Hospital Response

Valley Children’s declined the Fresno Bee’s request for an interview, emphasizing that the Health Insurance Portability and Accountability Act protects patient privacy.

Hospital spokeswoman Zara Arboleda said in a statement that the hospital values ​​and respects the deaf and hard of hearing community and is “dedicated to providing exceptional care and support to these patients.” .

“For nearly 45 years, our interpreter services department has been committed to meeting the needs of our diverse region with qualified bilingual and bicultural healthcare interpreters,” Arboleda said in a statement. “We offer support in more than 100 languages ​​and represent 37 distinct cultures, providing language assistance 24/7 through face-to-face, telephone and video interpreting services. »

The hospital also works with families to address areas that need improvement, Arboleda said.

Limitations of remote interpreters

Many deaf and hearing people will avoid hospitals to their detriment because lack of communication is a barrier, according to Michelle Bronson, executive director of the Fresno Center for Services for the Deaf and Hard of Hearing.

Bronson, who described Wanis as a friend and mentor, said deaf people want to be able to understand the care a hospital provides to them or their loved ones just like anyone else.

But video interpretation has its limits, its defenders say.

“The hospital needs to ask each patient: ‘What do we need to communicate effectively?’ They do not decide for the patient. Bronson said. “They have to ask the patient. Each of us is different.

Federal law requires hospitals to have an accessible means of communication, according to the National Deaf Association, a national nonprofit organization that advocates for the rights of the deaf.

While VRI can be helpful, it must be broadcast without interruption and hospital staff must be trained in its use, the association’s interim executive director, Bobbie Beth Scoggins, told The Bee in an email.

“VRI should not replace in-person interpreters when the nature of the medical interaction requires a physical presence for effective communication,” she wrote.

Hospital negotiations

Wanis said that after she complained about her experience, hospital representatives began negotiating with her and an attorney. She said the hospital offered her money, but she was only interested in making changes.

Wanis sent a formal complaint to the hospital in late 2022, and negotiations began in the summer of 2023 but broke down early this year, she said.

Zeenat Hassan, an attorney with the advocacy group Disability Rights California who represented Wanis, said the hospital “wants to throw money at Dr. Wanis to make all this go away, but she’s not interested in the money.” .

“She wants them to change the way they serve deaf patients and visitors,” Hassan said. “They’re not willing to do that.”

Wanis said the hospital should better train employees to work with deaf patients and their family members, connect all VRIs to the Internet using a wired Ethernet connection rather than Wi-Fi, and work with a consultant from the deaf community who will perform routine examinations and make recommendations on hospital policies and training regarding interpreting for the deaf.

“I don’t want our story to become someone else’s.” Without communication, we cannot have good quality health care. The two go hand in hand,” Wanis said. “There is a direct relationship between communication needs, between me as a mother advocating for my daughter and what she needs so that we can get the best health care possible for her.