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:

Why is it Kay to say "suck it up and listen harder" but not Kay to say the speakers should "suck it up and take more classes/practice your English skills". Some of both should go a long way.

I know a lovely lady who is originally Spanish speaking. When I first met her on a contract she could barely get vital information across. We spent much time guessing at what the other was saying. The next time I came back for a contract she had enrolled in ESL classes. We had a lot of fun laughing over trying to say the tongue twisters assigned by her instructor to improve pronunciation. By the last time I saw her she was able to converse fluently on just about any topic. All because she made the effort. Oh, and not young - she's a grandmother.

THIS. Communication between health care providers, by its very nature, cannot and should not be one-sided. I agree that there must be patience taken on the side of the listener; however, the speaker must also put forth the effort to speak clearly so that they can be understood.

Because this is particularly true in a health care setting in which lives are at stake, not having the time or resources to do so is not a valid excuse.

This is a touchy subject. I could reply by saying the foreign nurses with thick accents need to take English pronunciation courses or I could also reply that you need to listen a little better. I don't know what to say but hey, it's life

Also don't confuse a thick accent and lack of knowledge. Those are two totally different subjects. The nurse who didn't know the procedure didn't know because she was t educated well, not because of his/her country of origin. A laparotomy in Somalia is the same laparotomy in San Diego

Specializes in Spinal Cord injuries, Emergency+EMS.
:sofahider

it there room on / behind that sofa if i bring the popcorn ?

Specializes in Float.
Exactly. The newbies haven't 'been there' or haven't been nurses long enough to have worked in a large city where you are the only native English speaking person around.

Also if someone posts a cartoon of ducking under a couch just after you post your valid vent, it tends to sway posters to think what you said is shameful.

You have a valid vent/issue/complaint that many veteran nurses have dealt with. I'm glad you're not afraid to post something that some think isn't "pc" enough for their tastes.

I liked Karen's post/suggestion.

Excuse me...this so called newbie also works in a large inner city hospital that also conforms to diversifying our workplace. I work with Filipino's, Native Americans, Portuguese, etc., not to mention most of our patients are of Hispanic origin. All I do all day long is go from one Spanish speaking patient, to one Filipino nurse, to one Native American resident, to one Haitian tech and the list goes on and on. I don't have the limited scope of just a few patients to care for, being a tech, I come in contact with all of them as well as all other disciplines in health care.

Being a float, I go from department to department throughout the facility and have had to make more than a few adjustments regarding the language barrier. And it is a barrier, no doubt about it. So much so that I've taken it upon myself to incorporate Spanish courses, (not just one), into my college curriculum.I took that action because I want to communicate more effectively with my patients. It troubles me when I don't understand how to help a patient because I don't understand what they are saying and vice versa. It would be nice if other professionals in health care felt the same discomfort and took steps to communicate more effectively.

I disagree with the poster who said you can't make someone improve themselves, I believe that it can be mandated as part of a curriculum or licensing process to pass a certain level of proficiency in speaking English. Just as the article Karen posted outlines.Now, my reason for wanting to hide behind the couch as ohiostudent did is because this is definitely an issue that we all face daily, the OP had the guts to bring it up and there were going to be some fiery responses because of it. Not because I think her post is shameful, on the contrary, it was bold. I certainly didn't have the guts to address this issue. I really wanted to sit this one out but your assumption of my lack of experience demanded a response.

Specializes in Float.

Please allow me to apologize about the appearance of my previous post. I had three paragraphs but I'm having trouble with my browser. I have tried to edit the formatting 3 times and every time when I hit the save edit button, my paragraphs pop out and the result is the hard to read post above. I do apologize and appreciate the effort of all those who read it.

Specializes in ICU.

I agree with the OP. I work with people from all around the world, in fact in most cases I am the only native speaker present for the entire shift. I have noticed a breakdown in communication that has cost a life in one case. I have had a staff member unable to adequately describe an emergency and this left the nurse at a real disadvantage, unable to figure out the reason for the patients distress, while the staff member just kept repeating the only English word she knew to describe the situation. ( Which turned out not to be close enough to help at all) I have seen this to lesser degree's almost continually with staff unable to tell me what is wrong, asking always to " show me." I am not really sure what can be done to solve this problem.

Specializes in Community, OB, Nursery.

We have a great mix of diversity at my workplace. I might have a Filipina coworker, a Nigerian coworker, a Kenyan or Pakistani lab guy, an Indian med student, and a Brazilian resident. And you know what? There is way more miscommunication between native English speakers than when there is English as a second language involved.

I'm not completely discounting the issue in OP....just saying (as another poster did) that miscommunication is miscommunication. Can't blame it all on the folks with thick accents.

I don't think anyone expects someone to completely lose their accent, I think the expectation is for them to be able to communicate clearly..a person can "listen hard" but if the words the speaker is speaking are not clear then "listening harder" does no good. This isn't about not liking one culture etc. it's as several have posted..this is about safety - of the patient, the nurse and whomever else is involved in caring for a patient. If someone cannot understand the directions that are being given or the report, how can proper care, correct care, for this patient be ensured or potential problems identified? Passing a test on paper is not the same as speaking - obviously - if I am caring for a patient and cannot understand them, how can I meet their needs adequately and appropriately? Same goes for the caregiver - if the nurses can't understand one another there IS going to be a major issue at some point in patient safety. As far as if I were a patient or a family member was, I can tell you, if I am uncomfortable for any reason with whomever is providing care I have NO problem, politely but firmly, asking for someone else to be assigned. I am NOT going to take instructions from someone I cannot understand for myself or my family member simply because someone may get their feelings hurt - its too dangerous. Those w/thick accents absolutely can take classes to help lesson the accent and learn to speak clearer for this country. Speech therapy helps. When in Rome do as the Romans do. Yes, we need patience and tolerance, of course, but when a nurse is having to spend an extra 45 minutes at the beginning or end of a long shift to get report from or give report to someone that has communication barriers - somethings got to give.

Exactly. The newbies haven't 'been there' or haven't been nurses long enough to have worked in a large city where you are the only native English speaking person around.

I'm a newbie at an urban hospital in a predominantly Spanish-speaking neighborhood within a large city that has a large population of immigrants in varying stages of English acquisition. We don't all start out at Corn-fed American Hospital in Podunk, Middle America, ya know.

As a newbie, sometimes I get instructions in perfectly clear American English that I don't understand, and thankfully, my coworkers will patiently clarify with me when I ask questions.

I can assure you this was not an exceptional day! It is the rule of thumb.

Maybe physicians need to pass tests., however nurses, assistants, ancillary staff do not.

I have the patience of a saint, that is why the communication in all of those scenarios was successful.

Things are working quite well on my end, I was asking for suggestions regarding the bigger picture.

Totally subjective.

Specializes in I like everything except ER.

The longer you work with people who have thick accents the easier it becomes to understand what they are saying. I too have worked in large NYC hospitals and have no trouble with comprehension. If you pay attention you can learn a lot of words in numerous languages.This can come in handy when working with patients. I once had an MD accuse me of hiding the fact that I knew Chinese. I told him to spend some time with our Chinese patient and he would also know Chinese!

+ Add a Comment