when to ask patient if they need an interpreter.

[futurenaijaRN, BSN, RN]

Recently I went to a hospital for an observation. Long story cut short, I met the lady that introduced herself as my nurse. She asked me my name and DOB, I told her. To my surprise, the first thing she asked me was if I needed an interpreter. Of course I got offended by that because she already assumed I needed an interpreter without getting to know me first.

I paused for a while thinking of what to say to her. I finally replied her no, and we kept going with my admission assessments. At the end of it, she asked how long have I been in the country (I think is none of her business to know), and I answered her. And she kept going on and on, and of course I maintained my calm.

Now my point is dear nurses, that your patient(s) doesn't have American accent doesn't mean they don't speak and understand English. English might not be my first language doesn't mean my country's lingua-franca isn't English. Get to know your patient first before you jump into conclusion or assume wrongly.

[Sour Lemon]

That actually should be one of the very first questions a patient is asked.

[RiskManager]

Ooh, sorry, futurenaijaRN, but you are incorrect about this. As noted above, this is one of the very first questions we have to ask. https://www.dli.mn.gov/WC/PDF/interp_2_2.pdf is an excellent summary of the Federal requirements around limited English proficiency and some states have additional requirements.

[Pepper The Cat, BSN, RN]

I see nothing wrong with the question. Just answer yes or no.

Its better than spending time asking questions and getting incorrect/wrong answers because the person doesn't understand everything.

[HouTx, BSN, MSN, EdD]

Don't shoot the messenger. New (strict) rules for the use of medical interpreters is making the nurse's job even more difficult. Just like all the other regulations that roll downhill to the bedside.

Initial assessment/admission should include determination of the patient's preferred language & learning methods. If preferred language is not English, then the patient MUST be asked whether s/he wants the services of an interpreter. Determining language proficiency/literacy is not within the nursing skill set. Aside from English skills, the issue of 'health care literacy' is a whole 'nother kettle of fish that affects native English speakers as well.

We've discovered that wanting an interpreter it doesn't always mean lack of spoken English proficiency - we've had patients who seem to be highly English fluent, but still request one. Spoken language skill does not automatically mean literacy... so maybe the patient wants someone to help them read and interpret written documents. It's not our place to judge or determine. We just honor the request.

[Oh'Ello, BSN, RN]

Whether or not someone needs and interpreter is like the 4th question on our admission assessment, lol. I promise you, that nurse probably didn't give any kind of ****. She's just asking the questions that the computer prompts her to.

[Meriwhen, ASN, BSN, MSN, RN]

You have the right to take offense at whatever you please; your feelings are important to you.

However, as others have told you, it's a question that we have are required by Federal guidelines to ask almost immediately. In fact, asking such questions is how we "get to know the patient."

We need to know upfront whether a patient needs an interpreter. It's far better to ask and risk offending the patient, than to not ask and discover halfway through the admission that they're having a problem communicating with us or that they don't understand half of what we're telling them. And can you imagine the liability if we assumed that someone could understand English (not just speak but also understand, because there's a BIG difference between the two) but in reality they didn't and as a result, some misadventure happened to them? Let's face it, the society we live in is very lawsuit-happy.

As nurses, we need to provide the best care possible for our patients. And this means that at times we have to ask questions that the patient may not like...but in reality, they are asked in the best interest of the patient.

Of course, you as the patient can choose not to answer the question(s)...but by doing that, you could potentially compromise the care we can give you. The less we know about you (or the more misinformation you give us), the tougher you make our job.