What is your opinion on adding more Spanish-friendly tools to the ER?

[angiebelle]

So, i am a nursing student in the last semester, and it's "change paper" time!!! (i write a paper about a change that i see a need for). i have noticed that, besides the translator line, there are no other tools to assist a nurse in helping a primarily-Spanish speaking patient. The paper requires that i am specific in what changes to implement, and i am kicking around ideas: dual-language triage forms, bilingual picture boards, a translator on staff at all times, maybe even offering medical-centered Spanish classes offered by the hospital. So, i was just curious what other nurses would think, maybe what change would be plausible, as i am still the doe-eyed nursing school student.

And i get that there are tons of other languages that a person could learn to assist patients, and i also am including counter-points about how this is an English-speaking country, so if y'all could please refrain from rehashing these points, that would be great. :)

Thank you!!!

[Ellekat2]

I would like to have access to the translator program referred to by Fromthesea. Our patients speak many languages; it only makes sense that we use technology to help us discern what the problem is and explain adequately what is wrong and how we propose to treat the problem. While we do have many who speak Spanish, we also have Chinese, Vietnamese, Korean and a number of other nationalities. And perhaps our older patients whose native language is German, French or Hebrew would like to hear their native language spoken in times of stress and pain.

Some of our nurses use the Google translator to "speak" with their patients for simple requests like a comb or a specific type of food. It would be advantageous to have the hospital provide some sort of service like that for basic requests, but a more sophisticated and medically-oriented translator such as Fromthesea described would be a much better option when answering medical questions and obtaining medical consent. It needs to be accessible to the floors as well as to the Emergency Department. To cater to only one foreign language is biased and unacceptable in a multi-cultural country.

[emtb2rn, BSN, RN, EMT-B]

Picture boards are good for adls.

In the er i use the "emergency medical spanish audio" app on my iphone often. It asks "si or no" questions that allow me to get a glimmer of a clue.

Next to an in-person translator, the next best thing is cyr-a-phone (sp?) where you have 2 handsets and the medical translator interprets in real time. No handing the phone back and forth. I am bad with languages but am learning very rudimentary spanish to get the gist. Dolor?

[KayRN910]

Absolutely not. Why should we accomodate those who come to this country and do not speak the language? (many of them choose not to learn the language at all)

..

Well, I say we "accomodate" them because I need to get an accuate history!! Do you know how dangerous taking care of a patient in ther ER (or any other field of nursing...) is if you dont know the history. Are they diabetic? That makes a difference with CT scans with contrast. God forbid they have METAL in their body and we need to do an MRI. (and imagine if it's an EMERGENCY!) I dont think it's us "accomodating" them as much as, we need to know things when people check in.

Also, it's dangerous if we can't get an accurate description of what they are there for. Abd pain? Where? When did it start? Chest pain? Pressure or sharp? Worse when you take a deep breath? All these things are important when I'm doing my assessment

[angiebelle]

Thank you everyone!! i was trying to keep my paper more simplistic, so i chose the most frequent language barrier we run into in our local community.

i didn't want to start any debates, but i do realize this is a subject that a lot of people have very solid views on. i actually have to address this "resistance to change" in my paper as well; i'm not trying to get every nurse to accept the language barrier, but just trying to find ways to make OUR jobs easier, such as medical history information, etc. Would keeping the change less intrusive help with that? That real time webcam sounds amazing.

Our current ED has one telephone translator for 19 rooms. i feel like there is a need for something more. i am, however, also one of the people that is personally learning Spanish to assist myself (and my resume ) in my nursing care, so i might be a bit biased.

Thanks again for everyone responding: it's good to hear from all points of view!!!!

[angiebelle]

That is a good point; i have witnessed a few situations like that in OB on out-rotation.

[heartflutter, ADN, BSN]

I'm not thrilled with the illegal immigration situation either (the law should be followed and immigrants should learn English so they can succeed here), but I'm disappointed with some of the responses here. Would you say that to a patient, guys? Come on.

You're supposed to be helping someone in need; leave the politics at home.

Anyways, OP. It seems like you're considering a lot of short term solutions which seem viable and great, but it may be worth mentioning in your paper that many technical and community colleges offer "Spanish for health care workers" classes that may benefit nurses in largely Hispanic communities over time. The two at my local tech college are $100 each, which isn't bad compared to the cost of Rosetta Stone or language courses at a university. Education is the long-term solution, in my opinion.

Good luck on your paper!

[HouTx, BSN, MSN, EdD]

PP's for the most part have provided excellent information.

However, I just wanted to jump in and remind everyone about the new (as of January) Joint Commission standards re: Patient and Family centered care. These standards require us to determine each patient's preferred language & other cultural-specific demographics as part of the admission process. THEN, we have to utilize a certified medical interpreter to communicate any 'non casual' information for patients that are not fluent in English.... REQUIRED, not optional. This excludes using a family member, housekeeper, or other apparently bi-lingual person - they must be certified. Of course, participation of the interpreter will have to be documented somewhere -- more paperwork.

In addition - if >5% of an organization's patient population speaks a certain language, we have to provide written materials in that language. This would include not only consent forms and such, but all patient education materials and discharge instructions. Sheesh.

This is a huge new can of worms. If anyone is interested in finding more about how your organization is dealing with it, you check with your JC gurus.