English As A Second Language

[Santa Monica]

Hi. I am a nursing student in second year. I came here 15 yrs ago. Spanish is my native language. I know English, but I have a strong accent. I am doing good in school and clinicals. However, a medsurg nurse told my instructor that I have issues with pronunciation and that makes me less competent as a nurse. My instructor got into an argument with her about me. I cried because I really try to do my best in school. I feel depressed and so insecure now. I need to grow thicker skin.

The nurse was so friendly with me. However, she turned out to be so hipocrite. I haven't work with her, and she just decided to tell my instructor that about me. I understand that sometimes I have a hard time pronouncing medication names and medical terms. But, she doesn't know me enough to make that statement. How can I improve my pronunciation? Thank you!

[NurseCard, ADN]

It's a tough argument. I would never advocate discriminating against anyone based on their accent. Furthermore, I have worked with many foreign born nurses with very thick accents, and I personally cannot

remember ever having trouble understanding any of them, myself. I work with one right now with a rather thick Scottish accent, and SOME words go straight over my head, and her patients' heads but for the most part, I don't think anyone has any trouble understanding her.

I was doing some research just now on the internet, regarding language discrimination. If I read correctly... it is legal for some employers to deny employment to non-English speakers, or speakers with accents that make it difficult for them to be understood... IF, not being able to speak English, or clear English, would be detrimental to the performance of that job.

Wouldn't nursing KINDA fall into that category? Maybe?

Should a nurse who cannot speak clear English be able to work with mostly English speaking patients? When being able to communicate is so vital?

As opposed to just, I don't know, not hiring someone from India because, you just don't like foreigners. Or, issuing a blanket rule that all new employees must be native English speakers from Kansas.

[klone, MSN, RN]

I repeat I have been re educated. That is language discrimination.

Your posts in this thread are a little weird.

[KatieMI, BSN, MSN, RN]

NurseCard said:

I REALLY do not see anything wrong with a native English speaking nurse, helping a non-native speaker with their pronunciation of medical terms and various other terms, especially when receiving that help is going to be vital in their nursing practice, or any other career.

Think about it.

You're the patient. You're sick. Really sick. You've never been in the hospital before. You're scared. Overwhelmed.

In your room, comes nurse Florence. She's from France but moved here with her family about 10 years ago. Speaks English well but with a very very heavy accent.

You know she's speaking English, and you know she's giving you instructions, but darn it if you can understand much of what she is saying.

But, you are scared and overwhelmed, and with that, you are afraid to ask this nurse, who is rather intimidating, to repeat what she just said.

---------------------------------------------------

I'm not saying anything bad about foreign born nurses, and I know that just learning English is a huge accomplishment, let alone pronouncing much of it correctly. I'm just saying that there's nothing wrong with pointing out that their pronunciation is very difficult or flat out wrong, and helping them to use better, clearer pronunciation at LEAST when working with

their patients or clients.

I'm also NOT saying that it is okay to shame or bash some-one for their accent. Maybe what I pointed out above is shaming. I don't know. I had just read Ruby Vee's account and didn't find anything at all wrong with what she was doing with her coworker.

Now, imagine that.

You are just hired as a nurse. It may be your first job, or may not be, but it is still a big transition. You know that you MUST fit in the existing camaderie, and you better fit with everyone there, and quickly. You only have those 6/8/11 weeks of orientation to prove yourself, and with just three days a week you have even less time. So, naturally, you jump outta your pants trying to be as friendly, helpful, nonobtrusive, polite and generally an epithome of all things known for "an exceptional nurse professional".

For a week or so, things run smoothly. Then, it starts. One nurse seems to follow you as a tail and every time you're within her hearing circle, corrects you. She does so with no malice, seemingly, but constantly. Say it again. No, we say "th" like "th' ", not like you said. Stop, what did you just tell me? Say it again... no, this way... no, c'mon, girl, WE SAY IT LIKE THIS HERE!

And so forth, for 12 hours straight. Then, suddenly, you're callen in that manager hole, and told that "someone had a concern" about your communication. That mysterious "someone" thinks that when you call doctors for something you might mispronounce something, misunderstood and the sky will fall down. And, BTW, that "someone" also noted that you did not share with her that the patient's temp increased from 97.6 to 97.8, you did not aplogize for speaking with an accent when introducing herself in the morning to the patient, his family, surgeon and PA (yes, I was forced to do so) and you were breathing 0.6785463 times/min more than WE ALWAYS DO HERE when you realized that the patient was spiraling down toward code fast.

And then you know that it is the end of your story there. You'd got a target on your back. You'd angered one of those old school gals. Rubbed her wrong. And the only one thing you did was speaking with the accent. You just cannot pronounce that "th' ". It doesn't matter that you're a clinical whiz, that you put that IV in first attempt and that 95 to 97% of other people have no problem understanding you. You cannot pronounce "th' ".

I went through this TWICE. TWICE I was humiliated, isolated, rejected, sabotaged with - simply because I was speaking the way I was speaking, with my voicebox maimed by 20+ tubes and a trache. I am sorry, but I cannot just forgive those so-called "nurses". What they did, in the name of Holy Patient's Safety, has different names in my book.

And yes, I believe that only those who went the lond road or immigration and integration can discuss it. Without all those "what ifs..." and such, because, somehow, huge hospital complexes in NYC and many other places are run just fine with pretty much everyone there speaking with some sort of an accent. If they can do it in NYC, I do not see what can be a problem in Omaha, NE, or Pleasant Lake, KS, except for the vices that still penetrate all layers of society of the country which deems itself as the World's beacon of freedom and democracy - namely, rasism, xenophobia and discrimination.

[KatieMI, BSN, MSN, RN]

This was one of the assignments within "nursing ethics/professionalism" segment of an MSN/DNP cluster programs (not my former, but I was one of "subjects" and naturally wondered about results):

Solve the puzzle, give direct answer with no reasoning (circle 1, 2 or 3):

You are a new manager in a med/surg unit in (middle of Midwestern nowhere). You were hired 2 months ago and are just starting to get hands onto things.

Three new nurses were hired in the unit three months ago:

1). - middle aged, white female who has characteristic fresh-looking scar on her neck. She was working mostly in home care and some step down, had 6 months medical leave for some kind of severe disease and then decided to get back to work. She speaks like if she has some weird, but easy to understand accent and has clear "voice tiredness"

2). - young African American female who just moved from Louisiana to be near her family and help them with "some issues". She was working in a large teaching hospital there. She speaks with deep Southern acccent, which is unusual for the area. She is not the only one African American nurse in the hospital, but there are not many of them, and she is only one who speaks this way.

3). - middle aged, dark-skinned Asian female who received her BSN in USA years after immigrating from India long time ago. She was working in "acute" LTACH and private care for several years. She speaks with strong but easy to understand accent.

All three nurses have BSN degrees from well-respected US universities.

You know that neither of these three nurses has any ground for concern about their clinical abilities, decision making, attendance, "fitting in the unit", etc. During their employment, each of them had 3 instances when someone (hospital employee or patient) complained about their accents. A few patients state that they wanted "American" nurse caring for them, you do not know for sure which nurse was assigned for them as the last episode happened before you were hired in the unit. The summary reached the ears of administration, and you are now urged to "do something immediately". You are busy like crazy and short as always, and there is only one nurse you might devote your time to, knowing that this can expose the nurse to disciplinary actions and ultimately firing.

Which out of these three nurses you'll choose? You are on the phone with your boss, and you have to tell her something. You have 30 sec to decide, no more additional information will be given.

This puzzle was given to students to challenge nurses they encountered (not necessarily management, but many of students were from DNP Nursing Leadership program and so had contacts with management). The results were collected and analyzed but no reasoning for the decision was asked.

Overall, >75% of "subjects" would "sacrifice" Indian-origin nurse (if anyone interested, my answer was #1)

Does it tell anything to anyone?

[Ruby Vee, BSN]

Ruby, I believe from what I've learned from my gracious Allnurses is that is language discrimination. Please re read the posts.

Beverage alert!

[Ruby Vee, BSN]

Your posts in this thread are a little weird.

I think it's sarcasm. That's the way I took it anyway.

[klone, MSN, RN]

I think it's sarcasm. That's the way I took it anyway.

I sure hope so.

[TriciaJ, RN]

I think I might have told this story before. I worked on a surgical floor with a nurse who was from Poland and spoke with a heavy accent. One day the charge nurse asked if I would swap a patient with this nurse, because one of her patients wanted "an American nurse". I reminded the charge nurse that this particular nurse is a US citizen and I'm not. She rolled her eyes and said in a tired voice: "Yes, I know. Just please swap."

[amoLucia]

I am almost always in envious awe of those persons who are multilingual, and even of those who have limited English speaking ability, but enough to make themselves generally understood by the listener.

I note when foreigners are interviewed on TV, they most always have enough English skills to be understood. How I envy that!!!

I don't know a single word of Swahili. Or Tutsi. Or Finnish. Or native Eskimo. Chinese. Filipino/Tagalog. Et al. You wouldn't be able to have me speak to a Finnish audience in Finland UNLESS they knew some English. I can't even say 'thank you' to a Filipino nurse coworker.

The borders of the world are shrinking and English-only speaking folk are missing out and they are pretty much becoming the equivalent of the techno-dinosaur (computerly challenged!).

The problem lies not with speakers, but with listeners.

[blackmamba123]

Ok, unfortunately that med surg nurse seems like a jerk. Issues with pronunciation alone certainly isn't grounds for being deemed incompetent! However, when it's time to practice, communication is going to be key in any position you have. You can waste your time labeling it as language discrimination, or you can put some effort into improving your pronunciation to better communicate with your patients. Like it or not, this is America, and the primary language spoken here is English. Suck it up buttercup and get better at it. In the course of my career, I worked a year in a hospital where our patient mix was 85% Spanish speaking. I got sick of the translator phone and how impersonal it could be at times. So, I stepped it up and learned the language more and more to be able to communicate better with Spanish speaking patients, because that is where I chose to work. I would have to do that for sure if I moved to a country whose primary language is something other than English. A huge part of nursing is being flexible and adaptable, especially when it comes to dealing with the melting pot that is America. On the flip side, you have an advantage for positions that require or prefer bilingual candidates, and those positions tend to pay premium salary/wages, depending on the state, need, etc.

[canoehead, BSN, RN]

You are learning new words and in a new environment. There are only so many brain cells in your head, so maybe she could be a bit more patient.

I think that with your education you'll be getting lots and lots of practice in English. It's too soon to decide that you can't speak well enough to practice. And there are tons of Spanish speaking positions.

I think she was mean to draw a conclusion after one shift, but you may need to speak slowly in the future for the accent impaired listeners.

[Sour Lemon]

This was one of the assignments within "nursing ethics/professionalism" segment of an MSN/DNP cluster programs (not my former, but I was one of "subjects" and naturally wondered about results):

Solve the puzzle, give direct answer with no reasoning (circle 1, 2 or 3):

You are a new manager in a med/surg unit in (middle of Midwestern nowhere). You were hired 2 months ago and are just starting to get hands onto things.

Three new nurses were hired in the unit three months ago:

1). - middle aged, white female who has characteristic fresh-looking scar on her neck. She was working mostly in home care and some step down, had 6 months medical leave for some kind of severe disease and then decided to get back to work. She speaks like if she has some weird, but easy to understand accent and has clear "voice tiredness"

2). - young African American female who just moved from Louisiana to be near her family and help them with "some issues". She was working in a large teaching hospital there. She speaks with deep Southern acccent, which is unusual for the area. She is not the only one African American nurse in the hospital, but there are not many of them, and she is only one who speaks this way.

3). - middle aged, dark-skinned Asian female who received her BSN in USA years after immigrating from India long time ago. She was working in "acute" LTACH and private care for several years. She speaks with strong but easy to understand accent.

All three nurses have BSN degrees from well-respected US universities.

You know that neither of these three nurses has any ground for concern about their clinical abilities, decision making, attendance, "fitting in the unit", etc. During their employment, each of them had 3 instances when someone (hospital employee or patient) complained about their accents. A few patients state that they wanted "American" nurse caring for them, you do not know for sure which nurse was assigned for them as the last episode happened before you were hired in the unit. The summary reached the ears of administration, and you are now urged to "do something immediately". You are busy like crazy and short as always, and there is only one nurse you might devote your time to, knowing that this can expose the nurse to disciplinary actions and ultimately firing.

Which out of these three nurses you'll choose? You are on the phone with your boss, and you have to tell her something. You have 30 sec to decide, no more additional information will be given.

This puzzle was given to students to challenge nurses they encountered (not necessarily management, but many of students were from DNP Nursing Leadership program and so had contacts with management). The results were collected and analyzed but no reasoning for the decision was asked.

Overall, >75% of "subjects" would "sacrifice" Indian-origin nurse (if anyone interested, my answer was #1)

Does it tell anything to anyone?

It tells me that the "puzzle" is stupid ...but if I were forced to play along for the sake of my grade, I would sacrifice the Indian nurse, too. The first person is suffering from an obvious hardship and it's suggested that the second person (or her family) may be, as well. The third seems well-off and capable in comparison. There's no suggestion that I'll be sending her further into a downward spiral. But what did you conclude? It seems like the person who came up with this garbage had quite the agenda.