Spanish for PACU nurses: the patient who woke from his first general anesthetic not knowing where he was and pulled at his IV, the patient who kept saying she was fine through three doses of ondansetron because she needed to be home by three o’clock to pick up her son from his first day of middle school, and the patient whose knee replacement pain score was two but whose heart rate was a hundred and one and whose blood pressure had climbed thirty points

Miguel Santos had the last clear memory of counting backward from ten. He had reached seven. He remembered seven with reasonable clarity — the ceiling tiles, the anesthesiologist’s voice, the cold spreading up his arm from the IV site — and then there was nothing, and then there was everything at once: a brightness that was wrong, a pulling sensation in his left hand, voices speaking English in a register that arrived as ambient noise rather than meaning, and a cold that seemed to originate somewhere inside his chest rather than on his skin.

He was sixty-four years old, a retired postal carrier from San Bernardino who had driven the same route for twenty-seven years and who had never had surgery before. He had agreed to the inguinal hernia repair because the hernia had grown to the point that he could no longer lift his grandchildren, and the surgeon had explained the procedure in English with a diagram and Miguel had nodded and signed. He had understood perhaps forty percent of what was said to him. He understood the important things: that a small incision would be made, that he would be asleep, that he would go home the same day. He had not understood what it would feel like to be asleep and then suddenly not be asleep, in a room that was not the room from before.

He did not know where he was. He pulled at the thing in his hand.

Three PACU conversations that arrive as a hand pulling at an IV line, and as “yo estoy bien, de verdad, no se preocupe, ¿cuándo me puedo ir?” from a woman who has not moved in forty minutes and whose lips are the color of concrete, and as “dos,” from a seventy-one-year-old woman with a new titanium knee whose blood pressure has climbed thirty points since she arrived and who takes a short involuntary breath when the nurse rests her clipboard on the bed rail: Miguel Santos, sixty-four, a retired postal carrier from San Bernardino waking from his first general anesthetic after inguinal hernia repair, disoriented, agitated, pulling at his peripheral IV, every English reorientation attempt landing as noise rather than information because he is semiconscious and does not speak English in the way that helps him decode words in a semiconscious state; Elena Rios, forty-two, a medical assistant from Riverside who had a laparoscopic cholecystectomy this morning and who has severe post-operative nausea she is actively concealing because she works in healthcare and understands exactly what nausea means for her discharge timeline, and her son’s first day of middle school ends at three o’clock and there is no one else who can pick him up; and Guadalupe Reyes, seventy-one, a retired seamstress from Pomona who had a total right knee replacement this morning and who has reported two out of ten at every fifteen-minute assessment since arriving in the PACU, whose heart rate is 101 against a baseline of 78, whose blood pressure is 158/94 against a baseline of 122/78, who has not shifted position in forty-five minutes, and who takes a short involuntary breath every time anything makes contact with the rail of her bed.

The patient who woke from general anesthesia not knowing where he was, and why the English reorientation was not working

The specific nursing challenge of emergence confusion in a Spanish-speaking patient is that reorientation works by verbal anchoring — you repeat a small set of orienting facts until the patient can hold them — and verbal anchoring in a language the patient cannot decode in a semiconscious state does not anchor anything. It produces sound without content.

Miguel had been told, in English, that surgery was over and he was in the recovery room. He had been told this twice before the Spanish-speaking PACU nurse came on at the start of the next shift rotation. The information had not landed. He was pulling at his peripheral IV again, his eyes moving without focusing, his breathing rapid and shallow.

The nurse moved to the left side of the bed — the side without the IV — pulled the stool close, and leaned toward his ear. She did not raise her voice.

“Señor Santos. Señor Santos, soy Marisol, soy su enfermera. ¿Me puede escuchar?”

His eyes moved toward her face. Not all the way — but toward it.

“La cirugía ya terminó. Usted está en la sala de recuperación. La cirugía salió bien. Está seguro.”

She had learned to lead with terminó before anything else — not because patients were consciously afraid that surgery was ongoing, but because the first orientation fact that resolves the alarm in an emerging patient is the confirmation that whatever was happening has stopped. You are not in danger. Whatever was happening before the counting is over.

“¿Su esposa se llama Gloria?”

She had checked the chart while she was walking to his bay.

“Sí.”

The word came out of him before he had fully understood he had said it. Something about hearing a specific name — not his wife’s title or category, but her name — activated a kind of attention that the generic reorientation facts had not reached.

“Gloria está en la sala de espera. Ella sabe que la cirugía terminó. Va a poder venir a verlo cuando usted esté un poco más despierto. Estamos en contacto con ella.”

The pulling at the IV stopped.

“Tiene una aguja pequeña en la mano izquierda — es el suero que le da los medicamentos y los líquidos que necesita. No la tiene que sacar. Yo la cuido para usted.”

He looked at his hand. He looked at it the way a person looks at something they can now categorize. Not with alarm, but with the deliberate attention of someone filing information.

“¿Dónde estoy?”

“Está en el hospital — en la sala de recuperación, que está al lado del quirófano donde lo operaron esta mañana. La cirugía de la hernia ya terminó. El cirujano dijo que todo salió bien.”

The second telling landed differently than the first. He had been told the surgery was over when he could not hold the information. Now he could hold it. The same words — la cirugía ya terminó — functioned differently at seven percent orientation than they did at fifty.

“¿Cuánto tiempo pasó?”

“La cirugía duró unas dos horas. Ahora son las doce y cuarto.”

“Yo contaba hacia atrás. Me acuerdo del siete.”

“Así funciona la anestesia — se va muy rápido. No va a recordar nada entre el siete y ahora. Eso es normal. A muchas personas les sorprende que no hay ningún sueño — solo el número siete, y después este cuarto.”

He was quiet for a moment. Then: “Tengo mucho frío.”

She already had the warming blanket ready. The OR had been cold — it was always cold — and Miguel had been in it for two hours. She opened the blanket and placed it over him.

“La sala de cirugía es muy fría para prevenir infecciones, y eso hace que el cuerpo llegue aquí con mucho frío. Esta cobijita tiene calor. Va a sentir la diferencia en uno o dos minutos.”

He closed his eyes. She waited.

“Tengo la garganta rara.”

“Eso también es normal. Durante la cirugía usamos un tubo pequeño en la garganta para ayudarlo a respirar mientras estaba dormido — el anéstesiólogo lo pone después de que uno se duerme y lo saca antes de que uno se despierte, entonces no lo va a recordar. Ese tubo deja la garganta un poco irritada. Mejora sola en unas pocas horas. Si quiere, en un momento le doy unos sorbitos de agua.”

“Sí. Por favor.”

She gave him water in small sips. He held the cup without trying to remove the IV. He was oriented. He was not comfortable — his groin ached, his throat was irritated, the room was still too bright — but he knew where he was and he knew Gloria was in the waiting room and he knew the surgery was over.

The nursing note from the English-only assessment period had read: patient agitated, pulling at IV, attempting to sit up, not following commands. The nursing note from fifteen minutes after the Spanish-language reorientation read: patient oriented x3, cooperative, sipping water, reported pain 4/10 at incision site, warming blanket applied with good effect, wife notified of patient status.

The intervention was not complex. It was reorientation in the language the patient could process at fifty percent consciousness. The complexity was only in understanding that the English version of the same intervention, delivered to a patient who does not speak English, is not a partially effective intervention. It is no intervention at all.

The nurse made a note in the chart for future reference — and for the pre-operative team: Miguel Santos had been assessed, consented, and prepared for surgery entirely in English. He had nodded and signed. The nod and the signature had been the indicators that consent was obtained. But the preparation for what emergence from anesthesia would feel like — the cold, the sore throat, the confusion, the IV in the hand — had been delivered in a language he could not reliably decode even at full consciousness, let alone at semiconscious emergence.

The PACU nurse had been the first person in the entire surgical episode who spoke to him directly in Spanish. She was also the one who found him pulling at his IV.

The patient who kept saying she was fine because she understood that not being fine meant she could not go home

Elena Rios was forty-two years old, a medical assistant in a family medicine clinic in Riverside, and she had worked in healthcare long enough to understand the discharge criteria for a laparoscopic cholecystectomy from the inside. She knew that you had to tolerate oral fluids. She knew that nausea was a reason to stay. She had, in fact, prepared the discharge paperwork for patients with exactly this procedure, in this hospital, and she knew what went on the line that said discharge delayed pending.

She also knew that her son Lucas was starting middle school today and that the bus dropped him off at two forty-five and that his father was in Sacramento until Friday and that the neighbor who sometimes helped had a doctor’s appointment today of her own. She had taken a half day from work. She had told the scheduler she would be out by noon. She had arranged everything around the assumption that she would be fine.

She was not fine.

The laparoscopic cholecystectomy had gone well by every surgical metric. The gallbladder was out. The ports were closed. She had arrived in the PACU at ten forty-five and received ondansetron 4 mg IV pre-emptively per protocol. By eleven twenty she was reporting nausea of two out of ten and had received a second dose. By noon she was still at two, she said, but the nurse checking on her noticed that she had not touched the water cup on her tray, that she was lying with a particular quality of stillness that experienced PACU nurses learn to distinguish from actual comfort, and that she was breathing through her nose in short measured increments.

“¿Cómo se siente, Elena?”

“Bien. Estoy bien. ¿Cuándo me puedo ir?”

“¿Ha tenido náuseas?”

“Un poquito al principio. Ya se me pasó.”

The nurse set down her clipboard. Elena was a healthcare worker. She knew what she was doing. She was not confused about her symptoms — she was making a rational choice about which symptoms to disclose based on her understanding of the consequences of disclosure. That meant the standard nausea question was the wrong question. The standard nausea question asked about the symptom. The symptom was not the obstacle. The fear of the consequence was.

“Elena, antes de preguntarle sobre las náuseas, quiero preguntarle algo diferente. ¿Hay algo que le preocupe sobre quedarse más tiempo en el hospital?”

A pause.

“Tengo que recoger a mi hijo. Es su primer día de middle school. El autobús lo deja a las dos y cuarenta y cinco. Si no estoy —”

“Entiendo.”

She did. The information changed the conversation completely — not because it changed the clinical decision (Elena needed her nausea treated before she could be safely discharged) but because it revealed what the nausea question had been unable to find: the specific competing obligation that was generating the false reports.

“Quiero ayudarla a irse a tiempo. Por eso necesito que me dé el número real de las náuseas. Porque si le doy el alta con náuseas de siete y sale al estacionamiento y vomita en el carro en la calle, eso es peligroso para usted — y hace imposible llegar con Lucas a las dos y cuarenta y cinco. Lo que me permite ayudarla a irse rápido y seguro es el número real.”

Elena was quiet. Then:

“Siete. Son siete.”

“Gracias. Ahora la puedo ayudar bien.”

The nurse ordered droperidol 0.625 mg IM — a second-line antiemetic that works through a different mechanism than ondansetron and was appropriate given that two doses of ondansetron had not controlled the nausea. She also asked the question she should have asked before the first dose of ondansetron was given.

“Elena, ¿ha tenido náuseas con anestesia antes?”

“Sí. Cuando me sacaron las muelas del juicio. Estuve mareada todo el día.”

“¿Y se marea en carros o en barcos?”

“Siempre. Desde niña. No puedo ir en el asiento de atrás de un carro.”

Prior PONV history. Motion sickness. Female. Under forty-five (well, forty-two). Non-smoker. These were the risk factors that predicted high PONV risk — factors that, if identified in the pre-operative assessment, would have changed the prophylaxis protocol. They had not been identified because the pre-operative questions had been asked in English and Elena had answered them in English and the English exchange had been technically adequate and had missed everything that mattered.

The nurse did what she could from where she was. Repositioned the head of the bed to thirty degrees — «La posición ayuda a que el estómago drene mejor.» Applied a cold compress to Elena’s forehead — «El frío en la frente reduce la sensación de náusea para muchas personas.» Brought ginger ale in small amounts.

“El medicamento que le acabo de poner actúa diferente al primero — trabaja en una parte diferente del cerebro. Muchas personas que no responden al primero responden bien a este. Vamos a esperar quince minutos y ver cómo se siente.”

At twelve forty-five, Elena reported nausea at three out of ten. She sipped ginger ale without difficulty. Her color was returning. She had shifted position twice — a sign that the stillness of concealed nausea was releasing.

At one fifteen, she was at two out of ten and meeting discharge criteria. The nurse went through discharge instructions in Spanish — including the specific foods to avoid for the first week, the signs of bile leak or infection to watch for, and the PONV risk-factor pattern Elena should disclose at every future pre-operative assessment.

“La próxima vez que la vayan a operar, dígale al anestesiólogo o a la enfermera que usted tiene un historial de náuseas con anestesia y que se marea en los carros. Eso va a cambiar el plan que usan antes de la cirugía para prevenir las náuseas. Si nos lo dicen antes, podemos hacer más.”

“¿Por qué no me preguntaron eso esta vez?”

It was a fair question. The nurse did not have a good answer that was not also a system indictment, so she answered honestly: “Deberían haberle preguntado. Esas preguntas son parte del protocolo, pero las respuestas a veces no se consiguen bien cuando la conversación es corta o en otro idioma. Por eso lo estamos documentando ahora, para que esté en su historial.”

Elena was discharged at one thirty-five. She picked up Lucas at two fifty-one. He had three pieces of homework, one of which he had already done on the bus.

The nurse added to Elena’s chart: Patient minimized PONV during three assessments due to discharge anxiety related to childcare obligation. True nausea score 7/10. Droperidol 0.625 mg IM added with resolution to 2/10 and successful discharge. Patient has multiple unidentified PONV risk factors (prior PONV history, motion sickness, female sex) that were not captured in pre-operative assessment. Recommend pre-operative PONV risk screening in Spanish for patients with limited English proficiency.

The chart note was accurate. The more accurate version would have been: the patient was a medical assistant who knew the discharge criteria and gamed them for ninety minutes because no one asked her what she was actually afraid of. The question — ¿hay algo que le preocupe sobre quedarse más tiempo? — took seven seconds to ask and two minutes to answer and produced the real clinical picture that two doses of ondansetron had not addressed.

The patient who reported two out of ten while her blood pressure was rising and she had not moved in forty-five minutes

Guadalupe Reyes was seventy-one years old, a retired seamstress from Pomona who had sewn quinceañera dresses for thirty-two years and whose right knee had been limiting her work, her church attendance, and her ability to walk to the corner store for the past three years. The total knee replacement had not been a decision she made lightly. She had prayed about it. She had discussed it with her daughters. She had asked the surgeon three times whether it would hurt more than it hurt now, and he had said yes, at first, and she had accepted that answer with the particular composure of a woman who has been managing pain quietly for a long time.

She arrived in the PACU at eleven fifteen. The anesthesiologist had placed an adductor canal nerve block before surgery, and it was working — the immediate post-operative period was more comfortable than it would otherwise have been. At eleven thirty, she reported pain at two out of ten. At eleven forty-five, two out of ten. At noon, two out of ten. At twelve fifteen, her heart rate was 101. Her blood pressure was 158/94. She had not shifted position in forty-five minutes.

The PACU nurse looked at the trend. Baseline heart rate had been 78. Baseline blood pressure had been 122/78. The nerve block was still nominally active but would begin diminishing in the next one to two hours. The pain score was two. The vitals said otherwise.

She went to Guadalupe’s bedside and rested her hand on the bed rail. Guadalupe took a short, involuntary breath.

“Guadalupe, ¿cómo está calificando el dolor en este momento?”

“Dos.”

“¿En la rodilla?”

“Sí. Dos.”

“Guadalupe, noto que su pulso y su presión arterial han subido un poco desde que llegó. El pulso está en ciento uno y la presión está en ciento cincuenta y ocho sobre noventa y cuatro, cuando llegó estaban en setenta y ocho y ciento veintidós. Esos cambios pueden ser una señal de que el dolor está más alto de lo que el número me dice. ¿Puedo preguntarle algo antes de seguir con los signos vitales?”

“Sí.”

“¿Hay algo que le preocupe sobre decirme cuánto le duele la rodilla?”

A pause. The kind of pause that means yes.

“La última vez que me operaron — me sacaron la vesícula hace diez años — me dieron morfina y estuve vomitando dos días. No podía ni moverme de la cama. Pensé que si les decia que me dolía mucho me iban a dar morfina otra vez.”

There it was. The entire clinical picture in one sentence: a woman who was choosing undertreated pain over the memory of two days of opioid-induced nausea, who had organized her disclosure strategy around preventing a specific treatment she had experienced as worse than the pain it was supposed to address, and who had been successfully deceiving the pain scale for forty-five minutes while her blood pressure rose.

“Gracias por decirme eso. Es exactamente lo que necesitaba saber, y cambia todo lo que le voy a ofrecer. No le voy a dar morfina. ¿Me permite explicarle las opciones que tenemos que no son morfina?”

Guadalupe looked at her. “¿Hay opciones que no son morfina?”

“Sí. Varias. Y para una cirugía de rodilla, la mayor parte del control del dolor se puede hacer sin morfina.”

The nurse explained the multimodal analgesia protocol in patient language, piece by piece:

“El anestesiólogo le puso un bloqueo nervioso en la pierna antes de la cirugía — un medicamento que adormece los nervios alrededor de la rodilla. Ese bloqueo todavía está activo, pero va a empezar a disminuir en la próxima hora o dos. Lo que podemos hacer es agregar otros medicamentos antes de que el bloqueo se acabe, para que el dolor no llegue de golpe.”

“Tenemos ketorolac — un antiinflamatorio fuerte que va en suero, igual que el ibuprofeno pero mucho más potente y que actúa rápido. No es narcótico. No da náuseas.”

“También tenemos acetaminofén en suero — el mismo que el Tylenol pero en suero es más efectivo porque va directo a la sangre sin pasar por el estómago. Tampoco da náuseas.”

“Y vamos a poner una compresa de hielo en la rodilla. El frío en una rodilla recién operada reduce la inflamación y el dolor de forma significativa.”

“Con estas tres cosas juntas — el ketorolac, el acetaminofén en suero, y el hielo — podemos controlar el dolor de rodilla de forma muy efectiva sin narcótico. Pero necesito el número real para saber si lo que estamos dando es suficiente. Si me dice dos y en realidad es ocho, le estoy dando la dosis que corresponde a dos — y eso no es suficiente, y el dolor va a seguir subiendo.”

Guadalupe was quiet for a moment. Then: “¿Y si el dolor empeora mucho, me tienen que dar morfina?”

“Si llegamos a un punto en que estas opciones no son suficientes, tenemos otras opciones que son narcóticos pero que no son morfina — algunos que dan menos náuseas que la morfina. Pero primero vamos a ver si llegamos a ese punto, porque para muchos pacientes de rodilla no llegamos. ¿Puedo preguntarle el número real?”

“Siete. Tal vez ocho.”

“Gracias. Ahora la puedo ayudar bien.”

She ordered ketorolac 15 mg IV, confirmed the acetaminophen 1000 mg IV was due in thirty minutes and administered it, and applied an ice pack to the knee with the dressing covered.

“Una cosa más. Esta noche y mañana temprano, el fisioterapeuta va a venir a trabajar con usted — van a practicar cómo doblarse y estar de pie. Para poder hacer esa terapia, el dolor tiene que estar controlado. Si aguanta el dolor esta tarde, mañana la terapia va a ser mucho más difícil — porque el dolor mal controlado hace que los músculos se pongan en guardia y no se puedan relajar. El control del dolor no es para estar cómoda — es parte del plan de la cirugía. Es lo que le va a permitir caminar bien.”

Guadalupe heard this and received it the way people receive information that rearranges something they had misunderstood. She had believed pain after surgery was to be endured. She had not understood it as a clinical target, and she had not understood that undertreating it had consequences beyond discomfort — that it would impair her physical therapy the next day and extend her recovery.

“Nadie me había explicado eso.”

Thirty minutes later: heart rate 84, blood pressure 136/82. Guadalupe reported pain at three out of ten. She had shifted position twice. She asked the nurse if she could see a menu — she was starting to feel hungry.

The physical therapist who came the next morning noted that Guadalupe was cooperative, achieved thirty degrees of flexion in the first session, and reported pain during PT at four out of ten — managed with pre-PT ketorolac and ice, no opioids required. The chart note from the PACU said: Pain underreporting identified via vital sign discordance. Underlying driver: opioid avoidance secondary to prior morphine-related PONV experience. Intervention: multimodal non-opioid protocol explained in Spanish with mechanism; patient consented to accurate pain reporting. True pain score 7-8/10. Managed without opioids to 3/10.

What these three conversations have in common

Miguel pulled at his IV because he did not know where he was and the only reorientation reaching him was in a language that arrived as noise rather than information. Elena said she was fine because she knew exactly what “not fine” would cost her. Guadalupe said two because she had made a clinical trade — underreported pain was better, in her experience, than the morphine that would follow accurate reporting.

None of these are rare PACU presentations. They happen to Spanish-speaking patients with the specific additional layer that the standard PACU interventions — verbal reorientation, verbal pain assessment, verbal nausea screening — all depend on two things the standard protocol does not guarantee: that the patient understands the question, and that the patient believes the honest answer will produce something useful.

Miguel could not understand the English reorientation even at the level of vocabulary, let alone at the level of the semiconscious state in which he was receiving it. Elena understood every word of the Spanish nausea question and had decided the honest answer would not produce something useful — it would produce a delayed discharge. Guadalupe understood the pain scale and had decided that answering it honestly would produce morphine.

The three interventions that worked were: a name close to the ear in Spanish followed by a family member’s name; a question about the fear beneath the nausea report rather than the nausea report itself; and an explanation that honest pain disclosure leads to non-opioid options rather than morphine.

None of these are complex. They are the logical responses to what was actually happening in each bay. The complexity is only in recognizing that what is actually happening in each bay requires a conversation in the patient’s language to discover.

The PACU nurse who speaks Spanish is not a translator. She is the person who can get the real answer. In a unit where the real answer is the only thing standing between a patient and a complication, getting it is clinical.

Related conversations that build on these patterns: the pre-operative conversations that set expectations before Miguel arrived in the PACU are covered in depth in Spanish for perioperative nurses. Post-operative pain assessment, including the specific dynamics of pain underreporting in orthopedic patients, appears in Spanish for orthopedic nurses. The pain scale conversation itself — how to introduce the 0–10 scale and what to do when the number given does not match the presentation — is the subject of pain scale in Spanish for nurses. Discharge instructions for the patient leaving the PACU on the same day as surgery are covered in discharge instructions in Spanish, including how to explain warning signs to patients who have been medicated and may not retain verbal information. Post-operative nausea and other surgical complications in a different post-operative context appear in Spanish for bariatric surgery nurses, including the patient whose dumping syndrome she was convinced was a cardiac emergency.

Clinical Spanish for the conversations in this post

For emergence reorientation:

• «La cirugía ya terminó. Usted está en la sala de recuperación. Está seguro.» — The surgery is over. You are in the recovery room. You are safe.
• «Soy [nombre], soy su enfermera. Voy a estar con usted.» — I am [name], I am your nurse. I will be with you.
• «[Gloria] está en la sala de espera y va a poder venir cuando usted esté un poco más despierto.» — [Gloria] is in the waiting room and will be able to come when you are a little more awake.
• «Tiene una aguja pequeña en la mano — es el suero con medicamentos. Yo la cuido para usted.» — You have a small needle in your hand — it is the IV with medications. I will take care of it for you.
• «Le traigo una cobijita caliente — la sala de cirugía es muy fría.» — I will bring you a warm blanket — the operating room is very cold.
• «La garganta irritada es del tubo que usábamos para respirar durante la cirugía. Es normal y mejora.» — The sore throat is from the breathing tube we used during surgery. It is normal and it improves.
• «No va a recordar nada entre el número [siete] y ahora. Así funciona la anestesia.» — You will not remember anything between the number [seven] and now. That is how anesthesia works.
• «Respire despacio. Así. Así.» — Breathe slowly. Like this. Like that.

For PONV assessment:

• «¿Ha tenido náuseas desde que llegó?» — Have you had nausea since you arrived?
• «¿Hay algo que le preocupe sobre quedarse más tiempo en el hospital?» — Is there anything that concerns you about staying in the hospital longer?
• «Necesito el número real de las náuseas para ayudarla a irse rápido y seguro.» — I need the real nausea number to help you leave quickly and safely.
• «Tenemos medicamentos que actúan en diez minutos para las náuseas.» — We have medications that work in ten minutes for nausea.
• «¿Ha tenido náuseas con anestesia antes? ¿Se marea en carros o en barcos?» — Have you had nausea with anesthesia before? Do you get motion sick in cars or boats?
• «La posición con la cabecera levantada y una compresa fría en la frente ayudan mientras el medicamento hace efecto.» — The position with the head of the bed elevated and a cold compress on the forehead help while the medication takes effect.

For post-operative pain assessment:

• «¿Hay algo que le preocupe sobre decirme cuánto le duele?» — Is there anything that concerns you about telling me how much it hurts?
• «No le voy a dar morfina. Hay opciones que no son morfina.» — I am not going to give you morphine. There are options that are not morphine.
• «Tenemos un antiinflamatorio fuerte en suero que no da náuseas.» — We have a strong IV anti-inflammatory that does not cause nausea.
• «El control del dolor es parte del plan de su cirugía — no es opcional.» — Pain control is part of your surgical plan — it is not optional.
• «Si aguanta el dolor ahora, mañana en fisioterapia va a ser más difícil.» — If you hold back on the pain now, tomorrow in physical therapy it will be harder.
• «Noto que su presión y su pulso subieron desde que llegó — eso puede ser una señal de que el dolor está más alto de lo que me dijo.» — I notice your blood pressure and heart rate have risen since you arrived — that may be a sign that the pain is higher than what you told me.