I worked with a medical resident yesterday, needed to get orders on a patient who was having issues. He was from a foreign country. His English language skills were poor. I had trouble understanding his rather broken English. I had to clarify several times, he didn't even seem to be aware of the fact that it was very difficult to understand him, both because of his heavy accent and the fact that his grammar was poor and his vocabulary seemed limited. He sounded like he had just gotten off the boat, frankly.
How is it that this is somehow acceptable? I find this to be a detriment to the good communication required for safe care. How is it that someone can be accepted into a medical residency program in the United States who hasn't mastered English? We have many residents from foreign countries who do appear to have a good command of English and are easy to communicate with.
Good Communication is the foundation of everything else we do in healthcare. Healthcare workers in America should all have a good command of English in order to communicate well with one another.
AND WHEN THERE IS TIME, THIS IS COOL........but not all communications in healthcare have that possibility.these persons need to take responsibity for learning the language, if i were to practice in another country i wouldn't dream of expecting them to understand me if i didnt learn THEIR language, and well.
If it is that much of an issue, where the doctor is in an acute care setting such as an ER, then I'm sure there must be a whole slew of people complaining, right? If it's just one person or a small group of people that can't understand someone, then I think the issue might lie elsewhere.
I will admit that most of my experience thus far is not in an acute care setting, so I can understand when decisions must be made quickly that it is frustrating if you can not understand someone. But again, it would seem to me that were this truly an issue on the scale which some here describe, that this person would be getting complaints from all over, no?
In this case, I had difficulty understanding what fluid the Dr wanted the patient to have and he seemed to be saying that he wanted to draw a serum potassium before hand, but I repeated back several times, and still his English was too broken to understand and he couldn't clearly communicate whether the fluid should have potassium or not. I finally brought the IV fluid in front of his and asked him "Is this the fluid you want and do you want it now, and what rate do you want it to go?" That was the only way I could understand this resident.
It was difficult to understand this doctor, and I didn't want to embarrass him, but I had to make sure what he wanted.
I think it's ridiculous to tell someone to get another job because another person doesn't speak English very well and is difficult to understand. My point is that if you want to practice medicine in the United States, you need to have a good command of English in order to speak with other healthcare workers.
it shouldn't have to be that much of a struggle to understand another's orders and/or directives.
of course there are situations that etiquette commands trying to understand.
yet there are more situations that we are not afforded the extra time it takes.
If it is that much of an issue, where the doctor is in an acute care setting such as an ER, then I'm sure there must be a whole slew of people complaining, right? If it's just one person or a small group of people that can't understand someone, then I think the issue might lie elsewhere.
So how about it?
edit: perhaps some bias is showing. I live in a very multicultural place, and with a little understanding and "give a crap" I can understand just about everyone. I guess I forget that there are some places that are not as diverse or multicultural.
edit: perhaps some bias is showing. I live in a very multicultural place, and with a little understanding and "give a crap" I can understand just about everyone. I guess I forget that there are some places that are not as diverse or multicultural.
You may want to avoid implying that other people here at allnurses don't 'give a crap'
As I mentioned in my opening post, there are plenty of foreign doctors at my hospital who speak English well. There is also a large Hispanic population and we have translators in case they are needed.
Look, when I go to Mexico and South America. I speak very understandable Spanish. Yeah I may sound like a 'gringo' but no one has trouble understanding me and I always make it a point to learn more.
Same thing goes in other places. Having been to places like Syria, Saudi Arabia and Morocco I've made it a point to speak Arabic as best I can. Some times I was told to speak English as I sounded horrible but I made the effort. Now I am very understandable.
The least ANYONE can do when they go to a new country is learn the language and learn how to speak it properly.
Especially a doctor. If they are smart enough to be a doctor they are smart enough to learn proper English.
ETA:
I exclude new people. They gotta have time to learn English.
edit: perhaps some bias is showing. I live in a very multicultural place, and with a little understanding and "give a crap" I can understand just about everyone. I guess I forget that there are some places that are not as diverse or multicultural.
listen sweetie...
i live in an extremely multicultural neighborhood and work in the same kind of environment.
we're not talking about those w/a thickened-yet-somewhat-intelligible accent.
rather, we are focusing on those who beg us to question, "how in hell did you ever make it as a doctor/nurse in america???"
their english is that muddled and incomprehensible.
true, these folks don't last long r/t excessive complaints.
but for the months they are employed, it makes for a whole lot of frustrating interactions...
often, where someone else has either had to interpret or act in their place.
and i refuse to play a guessing game as to what s/he is ordering.
i've had pts extremely upset r/t their inability to understand what the doc told them.
danged if i can help them.
thankfully there haven't been a whole lot like this.
oh, and that "give a crap" sentiment?
not cool at all.
most of us DO give a crap...
so much, that it affects our sleep, our health, our days off.
Exactly Stanley. Now, we have some housekeepers at the hospital who speak broken English like this doctor, which is good enough to communicate which room to clean, and other aspects of their job.
A physician, on the other hand, needs to communicate much more complex things, and sometimes there may not be the time to dilly dally in the interest of multiculturalism
The least ANYONE can do when they go to a new country is learn the language and learn how to speak it properly.
Especially a doctor. If they are smart enough to be a doctor they are smart enough to learn proper English.
Kudos to you for learning other languages! I myself only speak two, but am always trying to learn more. Anyway, I'm sure the docs in question are trying to learn english as best they can. As you are aware it can be extremely distressing to be in a new country and trying to learn the language on top of medical school and everything else. I'm sure they are trying.
true, these folks don't last long r/t excessive complaints.
but for the months they are employed, it makes for a whole lot of frustrating interactions...
often, where someone else has either had to interpret or act in their place.
If it's so bad that they don't last long, then yes I agree that is a problem! I've been fortunate so far because I've never worked around anyone with that much difficulty. Not yet at least.
oh, and that "give a crap" sentiment?
not cool at all.
most of us DO give a crap...
so much, that it affects our sleep, our health, our days off.
Maybe I am just annoyed by people who despise anyone with an accent. (I'm not saying that is you, or even anyone here) but I do see people like that quite a bit, and most of them won't even make the effort to try. It's sad really because I honestly believe that most people can be understood if true effort is given. I do agree with you though that if it is so bad that a doctor is dismissed, well that is a real shame. I hope I never see a situation like that but maybe I will at some point. I didn't mean to imply that you or someone here doesn't give a crap.
I think I'm a very understanding person, and tolerant too, and I don't give a rat's hind end WHERE someone is from...if a person is gonna practice in ANY branch of healthcare in this country in which they will come into contact with patients, that person should have a reasonable grasp of English. I don't think that's an unreasonable expectation, particularly when people's lives are at stake.
Specializes in NICU, PICU, PCVICU and peds oncology.
I work on a PICU at a major university hospital and we have a revolving door of residents and fellows from other countries. Many of them speak reasonably passable English, but a significant number of them are VERY difficult to understand. (And this group includes one physician from Quebec whose French accent was so thick and her English so rudimentary that I, who speak fair basic French, had trouble understanding her. My French isn't nearly good enough for me to work as a health care provider in Quebec, but someone thought her English was adequate to work here...) It's one thing to have them ask me what the patient's fluid balance is and quite another to interpret their orders. We're still using paper and pen for orders so having them write them down isn't even a solution. One of our clinical assistants came here three years ago from South America as a fellow. Her English at that time was very iffy and I can remember being in a code situation with her where we were all repeating her orders aloud, hoping that our PALS knowledge was going to be enough. Even now, after working with her regularly for three years, during which her English has really improved, there are times when I have to ask her just what it is she wants. Communication is a HUGE part of what we do and the most important safety factor we have. So I too believe that health care providers working in North America need more than basic English skills to function safely.
Koyaanisqatsi-RN
218 Posts
If it is that much of an issue, where the doctor is in an acute care setting such as an ER, then I'm sure there must be a whole slew of people complaining, right? If it's just one person or a small group of people that can't understand someone, then I think the issue might lie elsewhere.
I will admit that most of my experience thus far is not in an acute care setting, so I can understand when decisions must be made quickly that it is frustrating if you can not understand someone. But again, it would seem to me that were this truly an issue on the scale which some here describe, that this person would be getting complaints from all over, no?