Diversity.. at what price?

Nurses Relations

Published

I am working in a large inner city facility. Corporate expounds the benefits of a diverse working culture.

I understand the benefits of a large pool of talent. There is every nationality on Earth represented in this medical center.

Recently, I took report from the recovery room. The nurse had such a thick accent , I had to ask her to spell some of the words she was saying. During the shift, I "worked" with a resident that was also very difficult to understand. He is also from a culture that expects women to walk 3 feet behind them. Needless to say.. the communication was difficult and time consuming.

At the end of the shift, I gave report to a nurse from another culture, that had never heard of the procedure the patient had undergone. Another language barrier ensued as I tried to explain the case.

I find it interesting that they can understand my mid-west American accent, but not vice-versa. The communication effort is time taking away from patient care.

I have seen a Chinese nurse, trying to describe a (emergent) patient's condition, over the phone to an Indian doctor, with a nursing assistant yelling in the background trying to interpret for them.

Is there a solution?:uhoh3:

I have also worked with a wide variety of colleagues- with varying degrees of accents. It is not racist or inappropriate to be concerned with how easy it is to communicate with one another. I am living in a cultural mosaic- no melting pot here. However- I have worked with nurses that were impossible to understand on taped report, telephone, and face-to-face verbal report. They spoke their mother tongue, to eachother, during shift, and sometimes on report. I was an agency nurse who would work the odd evening shift and I would have to call management of both facility and agency to get clarificiation. In the end, the facility was taken over by the government for various infractions (including difficulty communicating with staff). There were lessons to be learned by all:

1. These nurses were not supported to learn better english; their employer was required to offer classes (free of charge) to all nurses

2. The licensing body required appropriate language skills, and no longer allowed Graduate License to be held for as long as these nurses were allowed. As it turned out, the employer found a loophole to allow these nurses to work for a very long time with only a graduate license and not a full RN license.

3. The health region was much more stringent in their interviewing of foreign trained nurses, and would often panel them to ensure that they were understood by a group of managers (subjective, but arent all interviews?)

As nurse, we must uphold ALL of our requirements and ethical standards. We cannot decide that thick accents and questionable functional English skills are okay as long as we EVENTUALLY figure out the situatin and the actions that need to be taken. I for one prefer to work with colleages who are able to share their knowledge freely and easily. It allows them the respect and dignity that we all want.

Its amazing how unprofessional one can sound if they are always searching for words and repeating themselves. If your colleages do not want to give or take report from you, or if you are afraid to call a physician because you do not want to have to guess what he said, then there is no way this system is working. If you do not want to give report or get paged for the same reasons, you have a problem.

I do not care if you are Quebecois in British Columbia or a Saskatooner in rural Moncton, if you are not understood or cannot understand- you have a problem. Let us not pretend that foreign trained nurses and doctors and allied health professionals are not helping with staffing shortages- but let us not forget that clear and concise communication is the cornerstone of any professional relationship.

Bottom line? Its not racist. Its wanting to work on a level playing field where communication barriers are smaller due to our professoinalism, not larger due to our political correctness.

Specializes in none.

It's not about accents or dialects, it's about saving lives. If the Nurse, or doctor can not be understood or are not patient with our trying to understand them, People, in my 40+ years of nursing, have died.

Specializes in Infectious Disease, Neuro, Research.
If you're frustrated by a colleague's accent or style of expression, they're twice as frustrated as you. Give them a break. No nurse sets out to be incomprehensible.

Generally, but not always true. Its the ones that push their paradigm on the society that are the problem.

"Diversity", as a concept, has the difficulty of carrying the fundamental message that others must love and accept you, regardless of what you do or say. Politically, that has a lot of juice, socially, not so much.

Blatantly dysfunctional paradigms cannot be tolerated, "because its right for them..." If that's tha argument, I need to take a loan to go buy some yard boys. Its okay, I can let them sleep in the garage...:eek:

Being rather tongue-in-cheek, but that really is the point.

Most of us are willing to work with people willing to work with us, and its fairly universal. Is one "way" better than another? That's why a cogent philosophy is important...

Specializes in none.

I've work with a nurse who wore tin foil on her head to keep the people from her home planet from knowing where she is, I have worked with witches, Born Agains, and fellow Atheist, all races, and sexual orientations. No Problems because they worked as hard as I. It's the ones that try to push their beliefs on me, the ones that say because "I am a (fill in the blank) I am better then you are "or the ones that insult The Three Stooges in front of me that usually hear some of my old colorful Air Force phrases hit their ears.

Specializes in School Nursing.
Talk about communication breakdown: there is a redneck, a frenchman, and a deaf guy running a department in my lab.

Hey, I think I know them. Didn't they all walk into a bar.... :clown:

Ithink that it is best for you to seek employment where you dont have to worry about dealing with accents . Your patients deserve a nurse who is open minded, and non judgemental.

Ithink that it is best for you to seek employment where you dont have to worry about dealing with accents . Your patients deserve a nurse who is open minded, and non judgemental.

There are very few medical environments where nurses don't have to deal with accents, and I think most of us are okay with that if we can still understand what's being said. I actually enjoy hearing accented English most of the time. But if it jeopardizes patient safety because I can't understand the message, then, not so much. At least with the patients we can use the Language Line or call for an interpreter. We shouldn't have to do that with co-workers.

To imply that that because a nurse wants to be able to communicate safely and effectively with her colleagues she is somehow being judgmental and close minded, well, that's kind of judgmental and close minded.

Specializes in Infectious Disease, Neuro, Research.
:D What more can I say...
There are very few medical environments where nurses don't have to deal with accents, and I think most of us are okay with that if we can still understand what's being said. I actually enjoy hearing accented English most of the time. But if it jeopardizes patient safety because I can't understand the message, then, not so much. At least with the patients we can use the Language Line or call for an interpreter. We shouldn't have to do that with co-workers.

To imply that that because a nurse wants to be able to communicate safely and effectively with her colleagues she is somehow being judgmental and close minded, well, that's kind of judgmental and close minded.

A small amount of sincere understanding and willingness to learn and appreciate another culture can go a long way. If the OP is of the mindset that diversity is an option, which in many locations it is not, then she clearly would be better off where s/he viewpoints on diversity is welcomed.

No amount of appreciation of diversity and sincere understanding will render an unintelligible accent understandable.

I think you are equating any resistance to a thick, nearly-impossible-to-figure-out accent to xenophobia, racism and bigotry. It may be for some. But for many of us it's flat out fear that mistakes will be made and patients will be harmed. It's naive and, irony of ironies, prejudicial to lump all of us into one category and label us as racist because we have a difficult time communicating with some people whose spoken English is poor.

I would suggest that sincere understanding is best when it goes both ways.

Specializes in Peds/outpatient FP,derm,allergy/private duty.

rn/writer's post made the same points mine did. No need to duplicate them!

All Im saying is that if you work in a highly diversified place where you cant understand your coworkers, it is best to find another job. Yeah, the defensive replies brought a nice smirk to my face.

+ Add a Comment