Co-workers acting as translators

bagladyrn, RN · Nov 20, 2007

I can't see how this would be a HIPAA violation. Information is restricted to those employees who need to know it in order to care for the patient. The employee translating needs the information in order to translate to and from the patient, thereby facilitating patient care - part of the job. This might be a different case if you were using a family or community member to translate.

Altra, BSN, RN · Nov 20, 2007

classicdame, can you elaborate on why you believe this to be a HIPAA violation?

How is this different from any other scenario - helping co-workers with a patient when needed?

If you have a non-English speaking patient with bilingual family present, do you really not utilize them for translation?

CraigB-RN, MSN, RN · Nov 20, 2007

I feel this is a HIPAA violation, although the practice is VERY common. We have translator phones, but we also have a lot of bilingual employees (in every department). What is your take on using co-workers as translators? Does it matter about the topic (such as asking teaching versus asking are you too cold)?

A lot depends on hospital policy. I'cve worked places were only certified medical translators were allowed to translate. Otherwise I'd say it's appropriate. Now I'm not sure I would have the housekeeper or mantence person act as interpreter, just out of not being sure that the medical stuff was being translated correctly.

classicdame, MSN, EdD · Nov 20, 2007

I believe it is a HIPAA violation because the co-worker, who might be from Dietary, has no need to know anything about the patient. Also, I have no way of discerning that the interpretation is correct or that the translator understands what I am asking and will translate correctly. When I do consents or discharge teaching I get the licensed translator on the phone. But for other interactions I am not sure what to do. If my patient spoke the same language as I but did not seem to comprehend what I was teaching I would not get someone from another discipline to explain for me. I would get another nurse. Am I being too pig-headed?

Altra, BSN, RN · Nov 20, 2007

When I posted my reply I was picturing a scenario of utilizing another clinical co-worker - another nurse, nursing assistant, physician, etc. However, I have called upon a unit clerk fluent in American Sign Language for help and would not heistate to do so again. Most bilingual (or multi-lingual) people are happy to help when needed, and anyone working in healthcare should be able to comprehend the frustration & the danger of a patient in need of care who cannot communicate with care providers.

When you utilize the phone-based translators, do you know whether or not they have any clinical knowledge, any more so than housekeeping or dietary staff? No. You put what you have to communicate into the simplest language possible and hope for the best. The same applies even if you & the pt. speak the same native language. There is always room for miscommunication between any two individuals.

Don't let HIPAA get in the way of common sense.

happydays352 · Nov 20, 2007

Don't let HIPAA get in the way of common sense.

Amen sister

CritterLover, BSN, RN · Nov 20, 2007

when you utilize the phone-based translators, do you know whether or not they have any clinical knowledge, any more so than housekeeping or dietary staff? no. you put what you have to communicate into the simplest language possible and hope for the best. the same applies even if you & the pt. speak the same native language. there is always room for miscommunication between any two individuals.

actually, the phone-based translators are supposed to be certified medical translators -- it it their job to be able to translate the medical info accuratly.

that would be my reservation about using a coworker as a translator -- not hipaa. i agree that the translator is performing a function where they "need to know" whatever information they are translating, so hipaa would not be violated (even if their hospital job is non-clinical).

however, i would be concerned about accuracy. i worked with a paramedic once who was hispanic. we were taking a spanish-speaking patient to the hospital, and he was having a tough time trying to figure out how to explain something in spanish. afterall, he learned how to be a paramedic in english, not spanish, and he had lived in the us so long, he was no longer sure what phrases to use. his job was to be able to care for the patient. his job wasn't to be able to explain the information in spanish. it isn't so much the translation of nouns/verbs/adjectives that are problematic -- it is the translation of idomatic phrases that are the issue. certified medical translators specialize in how to get the information accross, idoms and all.

(and remember, we have to document the translator number when we use the translator phones -- this is why -- "quality control," so to speak, for the information that is being relayed.)

RNperdiem, RN · Nov 21, 2007

My own conversational-but-not-fluent Spanish gets me through basic patient care.

I would only use a coworker-another nurse, aide, or RT on my small unit for more complex communication about daily care. No, I would not ask some random person who I don't know to do translation.

I would use the hospital translator, and nobody else for legal and very important communication like surgery consents, discharge instructions,admissions etc.

Elvish, BSN, DNP, RN, NP · Nov 21, 2007

As a bilingual staff member, I certainly don't mind helping out in a pinch. Sometimes I'll do a 4hr stint just doing discharge teaching (mother-baby). However, when I've got patients, they are my priority. I don't mean that to sound unhelpful, but I've got a license I'd like to keep, lol. So if a coworker asks me to help translate and it's not an emergency, I usually say, "I'll help you with your patient about ABC if you'll help me with mine doing XYZ." Keep that in mind, that if you can offer to something in return, please do. Otherwise, I don't see the HIPAA violation. It's up to you whether or not you want to put your trust in someone's ability to accurately translate something. That's my personal opinion. You can share information for treatment, payment, or healthcare operations under HIPAA law.

SummerGarden, BSN, MSN, RN · Nov 21, 2007

OP: It is my understanding that translators can be considered apart of a patient's treatment team. If someone is translating I think he/she would fall under collaborative care and thus is not a violation of HIPPA. In fact, in my hospital some of the "housekeepers" are designated translators. My hospital has a training program to ensure that the person with the translator designation is able to translate properly. However, those that are not designated as translators are also used in an emergency because if you cannot speak to the patient, you cannot provide safe effective care!

As an aside to all posters: Some of the housekeepers in my hospital are CNAs, MAs, technical students, medical students, nursing students etc. but choose to be housekeepers for personal reasons (one told me she makes more then she did as an MA). So I would not make assumptions that housekeepers don't know what you are trying to translate even if he/she is not designated; if I were you I would ask first. GL.

TazziRN, RN · Nov 21, 2007

i have used the att language line, very acceptable to the hospitals i worked for. those operators have no medical training whatsoever, but they are acceptable.

at one hospital the official translators were the women from admitting. they have no medical training but it was part of their job description.

in a pinch i have snagged housekeepers, even a transporter.

even when you're speaking to a pt in your own language, do you use medical terminology to teach/obtain consents, or do you simplify it so the lay person understands? you do the same with translators. you tell that person what you would tell the pt, and the interpreter repeats it in the other language.