Spanish speaking patients in labor

[gravida]

I need some advice on a problem that is new to my area. I live in a small Kentucky town and a local food processing plant has recently began a new program of recruiting workers from Mexico. In the next couple of months it is expected that as many as 400 families (Non-English speaking) will be in our community. My problem is this.......since I work at the closest hospital they probably will be coming to our facility to deliver. None of the nurses speak Spanish, and I have been told that a large majority of the patients are also unable to read Spanish. So the communication gap will be huge. I am sure that many of you in larger areas with Spanish-speaking communities are familiar with this situation, but here in Ky it is new for us.

I am searching for a website that I can find some literature on common medical phrases, and hope to be able to educate the nurses in at least some basic ones......push, don't push, Where do you hurt, etc..... Plesae help!

Many of the local churches are concentrating on having Spanish speaking services and English classes. But no one is really prepared for the health care aspect or how best to bridge this gap.

Please help, any suggestions will be appreciated.

Thanks

[bagladyrn, RN]

i worked l&d in a small florida community hospital for 9 years where we had an enormous mexican migrant population who work the orange groves. probably 3/4 of all our patients were from this group. the posts above list some great points and suggestions. please remember not to use family members as interpreters for health information. as easy as it may seem to you at the time, you have no idea what information they are translating to the patient or what they are translating back to you from the patient. we also used the at&t interpreter line and although it is time consuming, it is a great service. another point i wanted to make is that just because a patient speaks spanish, you need to take into consideration there are many different spanish dialects and the at&t interpreter line can assist with the right interpreter for the patient's individual language needs.

i wanted to point out something else about this population of patients. i've worked with many types of patients in my career, but my mexican mamas continue to be my absolute favorite patients of all! you will not find a more grateful, appreciative group of women. they are good mamas and do their best for the babies....very loving.....way different than your "princesses"....who i'm sure you've seen as well! many of them were dropped off at the hospital by a friend or cab and they labored and/or delivered alone because dad could not afford to take the day off due to their measly wages they are paid. it was very sad. so, i just want you to know a little about this type of patient beyond their language. i hope you grow to love taking care of them as much as i did!

i agree with you qt! i've done multiple contracts at a small fl rural hospital that serves the migrant worker population and loved the patient population there. (wonder if our paths have crossed?). i prefer these hospitals to the yuppie community "hotel" hospitals any day!

i have found that when i am willing to "look foolish" by trying my few mangled words of spanish, the patients, and family, are much more willing to try what english they know.

the at&t line works well for almost all patients, but there are some dialects (in particular some of the native tribes from down near the southern border of mexico) that even they don't have translators for! those patients have strained my pantomime skills to the limit.

[JentheOBRN]

At the last hospital I worked at, we have access to a "CyraCom" phone-which is a phone used specifically for translation. Anyways, it has 2 receivers. You plug it in to the phone jack in the patient's room, pick one receiver up, access the service (MANY different languages are available), and you are connected to a translater. They give you an ID number which you then write in your notes ("Admission H+P completed, as translated by cyracom rep#..."). Then, you give the second receiver to the patient. And you actually have an official translation session going! I like it, other than the extra time taken-figure it will take twice as long as it would for you to do for your english-speaking patients. Usually, when I admit a pt, I will cover EVERYTHING that I can think of in one translation-from admission paperwork to consents to plan of care (including possible use of pitocin, ivs, etc.) and pain management.

The service really is handy. Maybe you can suggest it to your manager??? The do have a website: http://www.cyracom.net. I'm sure there are probably other companies out there as well.

This is what our hospital uses. That and a PT interpreter that floats to all floors. I work nights so I try to request the interp. right away and get all my teaching etc. done at the start. Then I use the phones for the rest of the shift. We are not allowed to use any non-approved interp. because especially family members (like children) could be embarrased by some of the things we need to ask.... STD's, GBS, Drug use etc.

[JentheOBRN]

my mexican mamas continue to be my absolute favorite patients of all! you will not find a more grateful, appreciative group of women. they are good mamas and do their best for the babies....very loving.....way different than your "princesses

same for me in central ca. i love my mexican mama's! i wish i knew more spanish.....

[morte, LPN, LVN]

Here's another thought. Maybe the employer who is recruiting all these folks can provide a certified interpretor as well as English classes which the workers are required to take.

over the years that you and i have been here, i cant think of too much we have agreed on....but this is def one!

and i will go you one better....since this is a scheduled move, i think the english language lessons should be commenced at home in mexico, and a basic level be met before immigrating....i have a hearing deficit....and try very hard not to make that anyone else's problem and i see the language issue in the same light.....maybe if the company were required to do this, hiring these workers wouldnt be so appealing. In the current economy they cant find any one here to do these jobs? highly unlikely....so they get the tax payer to pay for all sorts of things for them.......geesh

[tntrn, ASN, RN]

over the years that you and i have been here, i cant think of too much we have agreed on....but this is def one!"

Not even one little teeny tiny thing? That's really too bad.

and i will go you one better....since this is a scheduled move, i think the english language lessons should be commenced at home in mexico, and a basic level be met before immigrating....i have a hearing deficit....and try very hard not to make that anyone else's problem and i see the language issue in the same light.....maybe if the company were required to do this, hiring these workers wouldnt be so appealing. In the current economy they cant find any one here to do these jobs? highly unlikely....so they get the tax payer to pay for all sorts of things for them.......geesh

We do indeed agree on this one. And it would extend to any immigrant who wants to come here: learn some English before you come at the very least, or get into some classes the second you get here. Show some initiative. Some of us taxpayers are tired of paying for it all.

[futuremombabynurse]

Coming from South Texas, I'm in the minority of people who don't speak Spanish with some level of fluency, and I can offer a suggestion...

While yes, the hospital should definately look into getting interpretors, there are two things that can be invaluable. First, even though a lot of the mothers may not speak English...if they have older children, nieces, nephews, etc, the children may. During Holy Week, a lot of families who come here to shop use their children as interpretors and almost every family I've encountered has at least one child fluent in English and Spanish. Not 100% guaranteed, but something that can help in a pinch.

Also, get a book of Medical Spanish. There is a good one by Lipincott in the Made Incredibly Easy series, as well as a pocket version. There are specialty-related phrases and common answers laid out, and it pays to have a couple of basics under your belt. (¿Con qué frequencia vienen las contracciones? ¿Cuánto duran los Dolores? Un minuto / dos / cinco...¿Tiene historia de un problema medico?¿Tiene alergias a las medicinas?Respire lentamente por la boca...etc.)

http://www.123teachme.com/learn_spanish/labor_delivery_gynecology

Has some good phrases to start out with.

One more suggestion...learn about the culture as well. An inservice on cultural aspects of Mexican families during pregnancy and birth can cut down a lot of frustrations with things like entire extended families piling into delivery rooms, etc. (Someone could also present some useful Spanish phrases )

[QTBabyNurse, BSN, RN]

one more suggestion...learn about the culture as well. an inservice on cultural aspects of mexican families during pregnancy and birth can cut down a lot of frustrations with things like entire extended families piling into delivery rooms, etc. (someone could also present some useful spanish phrases )

the post above brings up a good point regarding the culture. many mexican mothers need education regarding early breastfeeding. although they eventually do breastfeed their babies, they are reluctant to nurse them for the first few days until their milk comes in because previous generations have taught them that the colostrum is bad for the baby. the mexican culture looks to the older women in the family to teach them how to care for their infants. consequently, some of that information is outdated and/or dangerous...such as sleeping with the baby next to you in bed and also placing the infant on his/her tummy for sleep. there is alot of teaching that needs to take place!

[SmilingBluEyes]

Ask your management and admin about getting language line access YESTERDAY. You are required by law, to provide translation services to such people, and this will be your answer 24/7. Remember, family members and friends are not always suitable translators and you will be held liable for misunderstandings in such critical issues like consent to treatment, etc.

We have a language line for that purpose, and access to many languages for translation 24/7 and it works!

Do this soon!!!

Good luck. I am glad I learned Spanish; it's not a hard language to learn and I use it often.

[morte, LPN, LVN]

i think my first post is still the best solution.....

[SmilingBluEyes]

OF course, a solution for us would be to have all people learn English. However, there are barriers that exist that prevent this. ESL classes are great but waiting lists are long in many areas. English is a difficult language to learn for anyone; just look at us. We take English comp/literature classes all the way through high school, and into college, and we are native speakers. As tough as you might think it is to learn Spanish for us, English is even harder. And not all Latino folks lack initiative. Most of the ones I speak to are in one way or another trying to learn, but like I said, barriers exist, be they transportation, culture, waiting lists or family issues. Often, they pretend not to understand or speak English when they have some level of competency and fluency, for fear of looking "stupid" or uneducated. Don't assume no efforts are being made, however; that is unfair.

And yes, learning culture is a very important idea. Not even all Mexicans share the exact same culture. It's a big country, and mores and beliefs do vary by region and family. Also, Spanish is a second language for many of them, their first being an Indian dialect of some sort. So we are asking them to learn, now, a third tongue. This does not happen overnight and so few of us in the USA even speak a second, how about a third?

We can argue all day long about what "should be". But the reality is, we have people from all over the globe coming here who do not share our culture, mores and language. And it's also a fact we are required to provide translation services for non-English speakers. The best way I know is to have 24/7 reliable services you can count on. The liability we share as care providers demands it, whether we agree with this or not.

Ask about the language translation service line. It's a lifesaver. And yes, learn a bit about the culture of the people who will be coming into your care; it does help everyone, not just our patients.

[SmilingBluEyes]

A bit off topic, just want to share one of the most beautiful phrases I was ever taught in Spanish language:

Dando (or dar) la luz (for giving birth)....

Literally translated, this means, "giving light". Says a lot to me.

[morte, LPN, LVN]

OF course, a solution for us would be to have all people learn English. However, there are barriers that exist that prevent this. ESL classes are great but waiting lists are long in many areas. English is a difficult language to learn for anyone; just look at us. We take English comp/literature classes all the way through high school, and into college, and we are native speakers. As tough as you might think it is to learn Spanish for us, English is even harder. And not all Latino folks lack initiative. Most of the ones I speak to are in one way or another trying to learn, but like I said, barriers exist, be they transportation, culture, waiting lists or family issues. Often, they pretend not to understand or speak English when they have some level of competency and fluency, for fear of looking "stupid" or uneducated. Don't assume no efforts are being made, however; that is unfair.

And yes, learning culture is a very important idea. Not even all Mexicans share the exact same culture. It's a big country, and mores and beliefs do vary by region and family. Also, Spanish is a second language for many of them, their first being an Indian dialect of some sort. So we are asking them to learn, now, a third tongue. This does not happen overnight and so few of us in the USA even speak a second, how about a third?

We can argue all day long about what "should be". But the reality is, we have people from all over the globe coming here who do not share our culture, mores and language. And it's also a fact we are required to provide translation services for non-English speakers. The best way I know is to have 24/7 reliable services you can count on. The liability we share as care providers demands it, whether we agree with this or not.

Ask about the language translation service line. It's a lifesaver. And yes, learn a bit about the culture of the people who will be coming into your care; it does help everyone, not just our patients.

my comment only applied to this particular circumstance.....they are, it appears, being recruited en masse, ahead of time.......why not make rudimentary English a deciding factor? partly because the company then will lose some degree of control, i would think....and, again, only in this particular circumstance, are not USAers being hired?