Diversity.. at what price?

[Been there,done that, ASN, RN]

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?

[OhioCCRN, MSN, NP]

:sofahider

[ChuckeRN, BSN, RN]

Pantomime?

[PhoenixTech, LPN]

:sofahider

Yes, exactly!

[TheCommuter, BSN, RN]

There are benefits and drawbacks to everything in life, including workplace diversity.

[johwiklundRN]

retire?

[Spydered]

:sofahider

Yup, I'll sit in the sidelines and watch this unfold...:)

[Been there,done that, ASN, RN]

All posts so far by newbies...Interesting.

[brownbook]

In the words of the infamous Rodney King...."Can we all get along?"

Thick accents are difficult to deal with, it is frustrating to not be able to communicate. I am somewhat hard of hearing from too much rock and roll, childhood illness, and old age. That can really interfere with my ability to communicate with co-workers and patients. In medicine it is important to communicate well.

No solutions from me, just lets cut each other some slack, and try to all get along.

[Been there,done that, ASN, RN]

retire?

Why would you respond with that ? Why bother even answering?

[NRSKarenRN, BSN, RN]

from

bmj careers - mind your language

it’s important to set a minimum level of english language proficiency for all relevant roles. this benchmarking approach, which is successfully used in other industries, would provide health service managers with a reliable way to define the level of english language needed by doctors or nurses to work effectively across a range of contexts. the common european framework of reference for languages, a guideline developed by the council of europe in 2001, is often used to define and describe language ability and helps employers and educational institutions understand what it means in terms of real life performance. the framework describes different levels of language ability in three broad stages (table ): a (basic user), b (independent user), and c (proficient user).

the scale ranges from a1 for beginners to c2 for those who have mastered or are considered fluent in a language. this is an invaluable tool that can easily be integrated into a working environment.

level / description

a1 can understand and use familiar everyday expressions and very basic phrases aimed at the satisfaction of needs of a concrete type. can introduce him/herself and others and can ask and answer questions about personal details such as where he/she lives, people he/she knows and things he/she has. can interact in a simple way provided the other person talks slowly and clearly and is prepared to help.

a2 can understand sentences and frequently used expressions related to areas of most immediate relevance (e.g. very basic personal and family information, shopping, local geography, employment). can communicate in simple and routine tasks requiring a simple and direct exchange of information on familiar and routine matters. can describe in simple terms aspects of his/her background, immediate environment and matters in areas of immediate need.

b1 can understand the main points of clear standard input on familiar matters regularly encountered in work, school, leisure, etc. can deal with most situations likely to arise whilst traveling in an area where the language is spoken. can produce simple connected text on topics which are familiar or of personal interest. can describe experiences and events, dreams, hopes & ambitions and briefly give reasons and explanations for opinions and plans.

b2 can understand the main ideas of complex text on both concrete and abstract topics, including technical discussions in his/her field of specialisation. can interact with a degree of fluency and spontaneity that makes regular interaction with native speakers quite possible without strain for either party. can produce clear, detailed text on a wide range of subjects and explain a viewpoint on a topical issue giving the advantages and disadvantages of various options.

c1 can understand a wide range of demanding, longer texts, and recognize implicit meaning. can express him/herself fluently and spontaneously without much obvious searching for expressions. can use language flexibly and effectively for social, academic and professional purposes. can produce clear, well-structured, detailed text on complex subjects, showing controlled use of organizational patterns, connectors and cohesive devices.

c2 can understand with ease virtually everything heard or read. can summarize information from different spoken and written sources, reconstructing arguments and accounts in a coherent presentation. can express him/herself spontaneously, very fluently and precisely, differentiating finer shades of meaning even in the most complex situations.

when setting a level, consider how linguistically demanding the role is. if it is for a frontline healthcare role, such as a doctor or a nurse, then c1 is probably the minimum level for this demanding professional environment. to help explain this, it’s essential to look at what an individual can do. at c1 level, users can converse effortlessly in english and are easily understood by native speakers and learners from other countries. they can understand complex verbal discussion and read long documents, all of which are crucial skills for healthcare professionals who need to deal with people and information in their working environment.

improving language skills among existing staff

with a benchmark on language proficiency set for new staff, it is equally important to ensure that all foreign medical professionals currently in employment meet this level too. exams such as the ielts test are suitable to verify an individual’s language proficiency at the c1 level.

it is also critical to provide learning support to staff whose knowledge of english falls short of the required standard. this is not always easy when you consider the demanding lives that people lead; learning solutions must be flexible and tailored to an individual’s needs.

whatever means of language support you provide to staff, ensure that it helps each person to achieve the required level of language proficiency through a series of attainable goals that target the minimum acceptable level required. successful language learning is not just about understanding grammar and vocabulary—it is about knowing how to communicate in real life working situations. therefore, any english language programme that is used must align with the environment in which workers operate and must cover all the language skills they are likely to need.

increasing the linguistic competence of the nurse with limited english proficiency..

[Nascar nurse, ASN, RN]

We have evolved into a world...or at least a nation...of political correctness. Even though it hurts the very people we are paid to help (the patient and the potential errors that result) it will never be OK to admit it doesn't work. There was another recent thread on the same topic.