Diversity.. at what price?

[Been there,done that]

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?

[DeLana_RN, BSN, RN]

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.

What I don't understand - who hires people who are unable to clearly and safely communicate? Don't they have to interview with their manager and/or HR?

DeLana

P.S. Just to clarify - I'm a non-native English speaker myself, having learned it in school starting in 5th grade (which is why I wasn't able to totally get rid of my foreign accent; however, others tells me it's very slight). If, however, I had any trouble speaking English, or had a heavy accent, I would have never decided to study nursing (in the U.S., BTW), or entered any other profession where clear communication is important.

[subee, MSN, CRNA]

DeLana , there's no need to totally get rid of your accent. I love listening to people who are able to speak English well but still have an accent. Believe me, it charms most people. I'm not gifted with the ability to speak languages and I know how hard it must be to master English well enough to have a position which requires lots of public communications. Having an accent is not the same as being unintelligible. A friend of mine was having chest pain on the night shift in an ICU and her nurse couldn't detect what the patient was saying. The friend-patient, fortunately, was an RN and was able to get a phone and call 911.

[C287]

I'm not sure where you guys got that one of the little face peeking over the couch--but, that one's great.

Hide. No, seriously...where I work we have a lot of cultural diversity because of the university and once I gave up trying to interpret what a doc was saying to me and I picked up the phone and dialed the language line ...after he got over the initial shock that I did that to him and was able to fix his problem, he was fine...we laugh about it now.

[nursel56]

. . .My advice to you is patience. learn to listen without bias. you may find that communication carries on without much hassle.

Oh, I see. If your language in unintelligible, it's my problem. I need to be more evolved. It's a sure sign that I must be biased! I hope nobody would be tempted to pretend such a transcendent state has been reached when the words "Pardon me?" or "I'm sorry, I didn't hear what you said" are the same as saying "I don't like your kind" and are actually a barometer of your feelings about that person's cultural identity.

What would happen if all you needed was to be patient and "listen without bias" and you really did have bias against people from one foreign country and really liked another, and both had thick accents? Would you be able to understand the latter but not the former?

Maybe I just couldn't understand you. Maybe it really is just that simple. Not everyone is capable of reaching the proper mental plane of tolerance that would actually make a change in their auditory system in just a few minutes. It could take quite a while. Somebody might get hurt while I''m striving to be ever more patient because they aren't getting something they need -- that you know about and I don't.

Talk about communication breakdown: there is a redneck, a frenchman, and a deaf guy running a department in my lab. ALL HIGHLY EDUCATED AND COMPETENT! But you can't understand a word they are saying. They go at it HOURLY like cats and dogs! You would think a fight was breaking out at the way they scream at each other.

Sounds entertaining!

[fuzzywuzzy, CNA]

Understanding accents can be very difficult. But you know what else is difficult to deal with? Lazy people. And dopey scatterbrains. And we all have to deal with them too. If the person with the accent is a good worker I'd gladly accept them as a coworker.

It's pretty insulting to have others imply that the reason for not being a jerk about accents is just because it's not politically correct. And this:

Would it be OK to admit it doesn't work if a communication breakdown led to the demise of your loved one?

seems just a little dramatic to me.

[anotherone, BSN, RN]

The"listen harder/ better" camp is NONSENCE. I can undersand spoken english perfectly......... It is not my fault someone else can't speak english well enough for me to understand. if he/she has a big accent, it is not my fault either............... i will ask them to repeat it a billion times if necesary.

[PhoenixTech, LPN]

Thank you Commuter for the edit.

[johwiklundRN]

All posts so far by newbies...Interesting.

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.

... AND THAT MAKES YOU GUYS OLDBIES...?

JUST MAYBE... YOUNG PEOPLE ARE MORE USED TO A MORE INTEGRATED AND DIVERSE WORLD WE LIVE IN TODAY.... AND HAVE LESS OF A PROBLEM UNDERSTANDING PEOPLE... AND USING COMPUTERS ...

OLDBIE

[TheCommuter, BSN, RN]

Thank you Commuter for the edit.

It's my pleasure. :)

[Poi Dog]

Understanding accents can be very difficult. But you know what else is difficult to deal with? Lazy people. And dopey scatterbrains. And we all have to deal with them too. If the person with the accent is a good worker I'd gladly accept them as a coworker.

Hello, hammer meet nail.

I would give this 50 kudos, if possible.

[Trekfan]

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?

There was a story in japan about this there to become a nurse if you are from another place you have to take a test in that language . I think we need the same thing hear I just posted about my dads ade becoming a nurse but she can not even understand english and shop that well in the store . today she almost put deasel in the car because she could not read the pump . I do not know about you but that in scarie to me ?

[carolmaccas66, BSN, RN]

Some peope can't pick up thick accents as easily as others - like me. And it doesn't matter HOW hard I listen; over the phone it's impossible. I've had to pull other nurses aside to listen as well so we don't get phone medication orders wrong.

It IS a problem, and no matter how others try to sugarcoat it, there have been deaths from this.

There was a case here at our women's hospital in our state capital where a youngish doctor could not understand what the mother was saying re her sick baby brought into the ED. The mother was apparently saying something was wrong with her baby's lungs and the doctor thought she was saying 'lings', and that it was just some sort of slang word. The baby was not checked thoroughly by this doctor, was sent home, and died. The mother ranted on TV that foreign doctors especially should HAVE to pass intelligible and strict English tests.

It is all well and nice to say 'just get along', but sometimes when patient safety is at risk, and you are asking someone to CONSTANTLY repeat themselves, and you are trying to be polite saying: I just can't understand you, it gets highly irritating, annoying and extremely frustrating. We shouldn't HAVE to ask someone to repeat themselves 10 times!

I have known lovely foreign doctors in my time, who I've been friends with, but they just couldn't speak or dictate English to save anybody's lives, let alone their own. One Chinese doctor I worked with tried really hard to improve her English, and though she was only partly successful, at the very least she tried.

And I have never understood why foreign people think other people are being prejudicial against them due to not understanding their accent. What are we supposed to do, realistically? Sit there for 20-30 minutes trying to decipher what you are saying? Nobody has time for that.

As the saying goes: When in Rome, do as the Romans do. When in an English speaking country, learn better English. But I've found many, many foreigners VERY resistant to this when you suggest it - they even find it offensive, for some reason I don't understand.

They are all people just like you and me, but if someone says I really can't understand your English, go and learn it better, please! It saves a lot of frustration in the end for everybody.