I have entered a National speaking competition and have chosen a subject that we nurses experience on a daily basis; people being spoken to or treated differently because of the way they talk.
Im touching on a range of people; people with disabilities, aged, mental illness & English as a second language where, because of an accent or way of talking, are spoken to condescendingly, excluded from conversations, yelled to instead of spoken to and spoken about in front of them.
For example, I know a man with cerebral palsy who uses a foot controlled wheelchair. He had recently written his memoirs and worked at the hospital. Acquaintances would sometimes approach him with sympathetic smiles and high pitched "Hiiii! How ARE you!? You look cute in that shirt! I hope you're not giving your carer a hard time!" (I am his friend, not carer).
Or my colleague from Nigeria who has things read out to her like a story book "See here? This says 'No return policy applies after 60 days' so you can't return it after 60 days".
What I would absolutely adore is input from you; your personal experiences, if colleagues, friends, family or patients are treated differently (and how) and what you did or would have liked to do in that situation.
Particularly, what suggestions do you have to increase more dignified and respectful conversations?
I understand that many people who speak differently to another person under the belief they may not understand is not always meant maleficently and often has good intentions but I want to highlight this issue.
Specializes in Psych, Peds, Education, Infection Control.
Or, someone being described/charted as not completely oriented, when the reality is the nurse simply doesn't want to take the time to listen past someone's speech impediment. That happened with a patient recently. I discovered that he was perfectly fine regarding orientation and mental status. Others acted like he was mumbling nonsense. He was very difficult to understand, but once I adjusted my ears, he made perfect sense.
Oh, my goodness – this one rings especially true! I had a pt years ago that was labeled as confused and hostile, and a mumbler. She did have a marked speech impediment due to no front teeth – and at first I thought she WAS confused because she kept calling me Nurse Penny†despite several introductions and she would scream PENNY!†down the hall when she wanted me. I very quickly discovered, after taking the time to get to know her:
1.) She was not remotely confused. Actually, she was quite brilliant.
2.) She was, in fact, hostile because she thought it was funny to see people's reactions. She was that kind of person.
3.) She kept calling me Penny because she wanted to. She smirked one day when I came in and told her to be nice†to a new nurse and said, Whatever, Nurse Audreysmagic.â€
4.) She refused until the day she left my unit to tell me where Penny even came from.
Specializes in MCH,NICU,NNsy,Educ,Village Nursing.
I really find I have to watch the "sweetie" and "honey" because I'm both from the South originally and used to working with kids...it's become a part of my normal speech, and in the Midwest, I have to check myself because I don't want to unintentionally offend. People who do it anyway and then insist "it's just how I talk" when something is known to be condescending or offensive irritate me. It implies to me they don't care enough to consider their audience.
That's my main peeve about the use of "sweetie". I use that with a child, not a peer or older adult. I understand the South and its speech---grew up here. But, even then, those words were reserved for close family members or others we loved. Of course, if I'm out of it and in great need, and someone calls me "sweetie", I probably couldn't do anything about it....then :-).
There is also this type of discrimination in the reverse. It isn't only minorities who deal with it. How about the Spanish speaking people who speak Spanish because they KNOW others don't know what they are saying, or in the nail salons the Asian people (mostly Vietnamese but others too) speaking about customers in their native language? I work in an inner city public school and I constantly deal with having to call parents only to hear on the other end of the phone, "No speak a English." Well, I don't speak any other language and your child is sick. I was a floor nurse and one of the CNAs had to translate for the Spanish speaking patients quite often. One day, after apparently being tired of it, she said, "This is ridiculous. The nurses should be able to communicate with their patients. Speaking Spanish should be a requirement of the job!" THAT bothered ME! And I said to her, "EXCUSE ME! This is the United States! English is our primary language. You are saying that in order to get a job in MY OWN country I should have to speak another language so that I can communicate with people who refuse to learn the language of the country they are visiting or living in? I don't think so." She said, "I never really thought about it like that." If I went to/moved to Russia, Germany, Poland, or wherever (many of them speak English) I would either learn THEIR language or realize that if I ended up in the hospital, I probably wouldn't understand too much of what is going on. I guarantee, you won't be able to get "all up in arms" over the fact that they aren't providing interpreters 24hrs a day. They would tell you, "we will provide one if/when we can" and you would be lucky if one ever showed up. We cater to people way too much here. You all can be upset with me about this, but I feel speaking English should be a requirement of citizenship. It is for their own wellbeing as well as that of our own citizens.
There is also this type of discrimination in the reverse. It isn't only minorities who deal with it. How about the Spanish speaking people who speak Spanish because they KNOW others don't know what they are saying, or in the nail salons the Asian people (mostly Vietnamese but others too) speaking about customers in their native language? I work in an inner city public school and I constantly deal with having to call parents only to hear on the other end of the phone, "No speak a English." Well, I don't speak any other language and your child is sick. I was a floor nurse and one of the CNAs had to translate for the Spanish speaking patients quite often. One day, after apparently being tired of it, she said, "This is ridiculous. The nurses should be able to communicate with their patients. Speaking Spanish should be a requirement of the job!" THAT bothered ME! And I said to her, "EXCUSE ME! This is the United States! English is our primary language. You are saying that in order to get a job in MY OWN country I should have to speak another language so that I can communicate with people who refuse to learn the language of the country they are visiting or living in? I don't think so." She said, "I never really thought about it like that." If I went to/moved to Russia, Germany, Poland, or wherever (many of them speak English) I would either learn THEIR language or realize that if I ended up in the hospital, I probably wouldn't understand too much of what is going on. I guarantee, you won't be able to get "all up in arms" over the fact that they aren't providing interpreters 24hrs a day. They would tell you, "we will provide one if/when we can" and you would be lucky if one ever showed up. We cater to people way too much here. You all can be upset with me about this, but I feel speaking English should be a requirement of citizenship. It is for their own wellbeing as well as that of our own citizens.
Thanks for your POV. I see the thread has branched off into languages rather than the initial intent of identifying the way we communicate rather than who speaks what.
Accents, particularly strong accents, can make some people initially assume little English is known.
I worked at a place where the the two managers spoke Turkish in front of me sometimes dropping my name in the conversation, it is a form of workplace bullying. In australia, it is taboo to speak in another language in front of customer's and you can lodge a complaint with the business. It once happened to me in a shop where two employees were speaking to each other in Tagalog. I asked what they were talking about which surprised them; they answered 'school' then proceeded to speak in English.
My mother is hard of hearing, but she is able to understand you find if she can see your face and read your lips. We recently went on a cruise together and were seated at a table for dinner with six strangers. The entire week, they would talk almost exclusively to me, including asking if my mother was enjoying her dinner. At which point I would turn to her, and say "Mom, they are asking if you like your dinner".....because she can answer for herself, and she can hear you too! The very sweet waiter was much better at interacting with her, and he would always touch her shoulder to get her attention first, so that she could look at him when he spoke. She understood him just fine. And he always brought her coffee without her needing to ask. :)
That is a HUGE problem I have witnessed. It takes a near family member to truly explain how their elder loved one "communicates". Shoulder shrugs, eyebrow movements (think intubated), hand "gestures", are all a part of this, too. Were they ever a technical person in their working years, per-retirement, do they still work, education level? All of these play crucially into understanding each other. Watch the new film, The Arrival - at mid-point (and there is no spoiler here) there is a simple communication break down of the simplest sentence - remember sentence diagramming in Junior High and High School?
This level of analysis and synthesis for communication is essential for patent and patient patient communications. (The previous sentence has been diagrammed with big data and I deem it grammatically correct).
Then, there are the "difficult", always questioning (or just, realistically, with the questions), "second guessing" (at least it is perceived this way), family and friends of the pt. \
Most possibly one of the rudest introductions to someone you have never yet met on the ICU or ENT floors, but have been "cautioned" about through the grape whine, is to barely introduce ones self (doctors have been known to do this, generally not surgeons, most surgeons tend to be more forgiving in this regard), and then start with , "this is where I talk and you listen....". It does NOT save time, sets up an ill will for the duration of the pt stay and That merely sets the hospital up for a bad "Yelp" review - and one can only hope for a 'fair' negative Yelp review at best, as Yelp will not pull down reviews based on business owner requests, regardless of perceived "libelous" remarks, as those are generally impossible to prove, and Yelp is not in the legal libel proving business (is that a thing?).
At the risk of being verbose (and I believe I have succeeded in that risk), I think y'all know what I mean.
Couple that with: The Internet and all of it's Google Glory! These days, after every encounter with an RN, an RT, Dr. and Surgeon, you can bet every dollar in your change purse or murse that at least one family member is online (and has most likely been assigned the duty), fact checking your every statement. Ya, the job gets harder.
Now add the layered, time suck of floor communication. Family member of PT A has a question, RN A is with PT B (you know, the usual 2:1 RN to PT ICU ratio!), the Case Team has concluded their initial PT A assessment, and is sending the rest of the team all the pertinent info, via email or vmail, etc? RN A has been with PT B for at least 20 minutes, is then found by PT A's daughter, and asked a question, "Nurse A, is my A going to need a rectomy?", well the last RN A heard was, "yes, scheduled tomorrow".
"Oh, OK".
5 minutes later on the floor, the NP, from the earlier meeting, stops the Family member briefly and informs them, "Oh, good news, your A doesnt need that rectomy after all, it has been cancelled, we found a new approach, and will be administering that in an hour - quite NIV!".
Family member now is infuriated, as now they have two opposing bits of info and a piece of jargon on the floor: "Well why did the RN just tell me the opposite?". NP: "That;s odd, we just sent all the team emails - I have no idea why she wouldn't know this - I'll straighten this out, very sorry".
We know why.
And, "Quite NIV!" What? Dont do that, lose the jargon, even IF 'your' family members use jargon with you - correctly or not - dont fire back at them, unless you have a clear indication that they indeed will understand you on that educational level, dont assume it, please. You know, "we demand a PICC line in our old mum!"
Have I been burned? Yes. Have I burned? Yes.
Let's put out that kind of fire on the floor.
(PS, Instant Messaging is THE ONLY way to communicate these days on the floor, lets do it! Lose the vmails and emails, no one has the time nor should they be forced to take the time to read in-house emails, just use IM, please). All the kids are doin it!
That's interesting. That was drummed into us as a big NO-NO in nursing school. I would never dream of referring to a pt. with a term of endearment. Especially a pt. older than I am. We were taught that it can be offensive, and unprofessional. First names are ok to use, but only with permission.
(Sorry, meant as a reply to LovingLife123, must note have clicked "quote")
I was born in England, so yes, English really is my native language...but I can't even begin to count how many times I've either a) had to put on a fake American accent to make certain words understood ('Fall' 'Respiratory' and 'Water' being the most common), or b) Have been asked if I am from France, Germany, Australia...what am I doing here and the most irritating 'when did you become a US Citizen' and then the insulting 'Why not' when I explain that I'm a Green Card holder and do not choose to take citizenship, (My home will always be England, the same as an American's home will always be the USA, and one day I will be hopefully spending equal time in both countries, or going back to live in England), and then the most offensive 'Don't you like it here?'...yes, I love this beautiful country but I also love my own country. (In my head I'm screaming "I'm proud to be English, the same as you are proud to be an American dammit! Why can't you understand that!"
...then, sadly, there are all the attempts by people to imitate a British accent, something that would be considered extremely offensive with any other 'foreign' accent...and it happens SO MUCH and it makes me cringe, but I have to pretend that it's original and funny. I've even been asked "When did you learn to speak English?" Gah...
BTW, NaDaNurss is absolutely right. If a "functionally illiterate" person (that meaning someone who has difficulties to read on Grade 4 level and unable to understand what is written in an ordinary restaurant menu) is talked with an average health care worker, it looks for me like a discrimination of a sort. These people do not understand anything at all except concepts "is it good?" or "is it bad?", and only if "good" or "bad" is applied to the current present time at that. The idea of "your BP is 145/90 now; it was 160/100 last month, so today it is good but we need to work more on it because having it so high would bad for you on the long run" takes at least 15 min talk for them.
I was born in England, so yes, English really is my native language...but I can't even begin to count how many times I've either a) had to put on a fake American accent to make certain words understood ('Fall' 'Respiratory' and 'Water' being the most common), or b) Have been asked if I am from France, Germany, Australia...what am I doing here and the most irritating 'when did you become a US Citizen' and then the insulting 'Why not' when I explain that I'm a Green Card holder and do not choose to take citizenship, (My home will always be England, the same as an American's home will always be the USA, and one day I will be hopefully spending equal time in both countries, or going back to live in England), and then the most offensive 'Don't you like it here?'...yes, I love this beautiful country but I also love my own country. (In my head I'm screaming "I'm proud to be English, the same as you are proud to be an American dammit! Why can't you understand that!"
...then, sadly, there are all the attempts by people to imitate a British accent, something that would be considered extremely offensive with any other 'foreign' accent...and it happens SO MUCH and it makes me cringe, but I have to pretend that it's original and funny. I've even been asked "When did you learn to speak English?" Gah...
Oh my gosh, I'm also a Brit living stateside and I have experienced this, too. :/
"Which boat did you come over on?" "Are you a citizen? Why not" (also a GC holder and will always be)
I am sick to my back teeth of people saying "'Ello guvna!" or asking if I want a spot of tea; it wasn't funny the first time, certainly isn't funny the 500th. Oh! And mocking the chav type accent too... and cockney rhyming slang... ugh x_x'
People faking a British accent is super annoying; as you said, it'd be really offensive if I started imitating an Indian accent, or Chinese for example... So I'm not sure why people think it's okay to do it for British folk too. :/
I also had to fake an American accent while at work - a lot of the older people in the rehab center that I worked at couldn't understand my British accent, but I noticed that as soon as I started dropping my native accent, the mockery went down - I still let it slip if I say words like 'water', 'awful', or mention 'tap water' haha (seriously, it's not faucet water... what the heck!) My inlaws have asked why my British accent isn't heavy anymore and I tell them "Well, it just fades over time, I've been here 10 years." but the truth is, every time someone mocks the accent it gets harder and harder to hide my annoyance. People don't realize that this kind of stuff builds up, so the general reaction I'd get is "Jeez, don't over-react." (uwotm8.) So really it's just easier to hide it if I can, which takes a lot of conscious effort.
I've had to deal with this a lot in college - thankfully not the professors, but definitely from the students... I am also royally sick of being asked if I like Dr. Who, Downton Abbey etc. and then when I say no, they look at me like I have 3 heads. "But why not? It's British TV!"
Specializes in MCH,NICU,NNsy,Educ,Village Nursing.
I was born in England, so yes, English really is my native language...but I can't even begin to count how many times I've either a) had to put on a fake American accent to make certain words understood ('Fall' 'Respiratory' and 'Water' being the most common), or b) Have been asked if I am from France, Germany, Australia...what am I doing here and the most irritating 'when did you become a US Citizen' and then the insulting 'Why not' when I explain that I'm a Green Card holder and do not choose to take citizenship, (My home will always be England, the same as an American's home will always be the USA, and one day I will be hopefully spending equal time in both countries, or going back to live in England), and then the most offensive 'Don't you like it here?'...yes, I love this beautiful country but I also love my own country. (In my head I'm screaming "I'm proud to be English, the same as you are proud to be an American dammit! Why can't you understand that!"
...then, sadly, there are all the attempts by people to imitate a British accent, something that would be considered extremely offensive with any other 'foreign' accent...and it happens SO MUCH and it makes me cringe, but I have to pretend that it's original and funny. I've even been asked "When did you learn to speak English?" Gah...
Great post! Us Americans can be cheeky, can't we ? ;-). Seriously though, sometimes I am amazed at what, in the mind of the person speaking, seems so original/cute/just trying to make conversation, is actually really rude. I used to be "one of those Americans"...until I had the privilege of living outside of the USA and realized the rest of the world really isn't like us in a lot of ways (all ways?).
Also---my condolences on the losses in London this past week. My heart hurts for all affected. I remember meeting a police officer last July in Windsor (I, ahem, got scolded by one of the UK's finest as the Queen's Guard was approaching our location as they were marching to barracks.) I apologized to him after the crowd was allowed back onto the street. He was a delightful young man, former Navy, who loves his Queen and his country and counted it a privilege to be on the force in Windsor. We chatted for about 10 minutes. Anyway, as I read of the loss of the police officer in London, I thought of that young man and all the others who put their lives on the line daily.
Specializes in Pediatrics, Women's Health, Education.
The act of inquiring about an accent is not offensive by itself. Rather, it is the manner in which the person asks that can come across as offensive or rude.
One time I was told, "You sound funny, like a Valley girl. Where are you from?"
Let's flip the script. The woman who made the comment probably wouldn't like it if I said, "You sound funny with that thick southern drawl, like a country bumpkin. Which state in the South are you from?
I'm from Queens and live in Florida. My NY accent gets mocked all the time. Most times I don't mind and I own it. But sometimes people think a person with a NY accent is dumb because of stereotypes of NY in movies and on TV. I have friends who have purposely lost their accent because of it; I'd feel fake if I did that.
audreysmagic, RN
458 Posts
Oh, my goodness – this one rings especially true! I had a pt years ago that was labeled as confused and hostile, and a mumbler. She did have a marked speech impediment due to no front teeth – and at first I thought she WAS confused because she kept calling me Nurse Penny†despite several introductions and she would scream PENNY!†down the hall when she wanted me. I very quickly discovered, after taking the time to get to know her:
1.) She was not remotely confused. Actually, she was quite brilliant.
2.) She was, in fact, hostile because she thought it was funny to see people's reactions. She was that kind of person.
3.) She kept calling me Penny because she wanted to. She smirked one day when I came in and told her to be nice†to a new nurse and said, Whatever, Nurse Audreysmagic.â€
4.) She refused until the day she left my unit to tell me where Penny even came from.