Hispanic patients

[RNfromMS]

The unit I work in deals with a lot of non-english speaking patients and their families, mainly hispanic (just so you know, they are my very favorite patients...I could work in a hospital with only hispanic laboring women all day long.) Our hospital employs translators to help with these patients and one of them brought up an interesting point the other day that I am trying to find a way to deal with. I was working in our triage department and had a young hispanic patient who miscarried her 8 week fetus while I was trying to get information. It was all very sad and confusing (for her). After I had done our customary discharge paperwork, I asked the translator to let her know the particulars, especially since she would need to take her methergine on schedule. The translator asked later if we could do the discharge instructions in spanish. I let her know that we did not have the tools to perform that, but have thought of it continuously since then. I discussed the issue with one the RNs who manages our computer charting and have even worked in Microsoft Word to translate the document myself. The only problem with that is that some is write in (i.e., discharge diagnosis, allergies, etc) and there are too many to have them available for a nurse to write on or type into the document.

Any one have any thing they can share from their experience with this? Anything will help. Most of these women in our area don't seek medical care during their pregnancy and I think this is a big reason why.

[SmilingBluEyes]

I have spoken to many Hispanic people living here many years whose grasp of English is minimal. I have asked why this would be ( I speak Spanish). First, understand, many come from countries in Central America and in Mexico, where Spanish is already their 2nd language, having first learned a native Indian dialect as different from Spanish and English as you can imagine. So they are already bilingual, unlike most American people. Also, many DO speak some English, but are afraid to look "stupid" to us so they won't speak in English to us in the hospital. Pride is a huge issue for them. They really do not want to look stupid or made to appear so.

I encourage them to go to the ESL classes and tell them where they are. Sadly, many of these have waiting lists a mile long. Transportation is also an issue. There are a lot of barriers to overcome to learning English------but 10 or 20 years living in the USA is a long time, I do tell them. I always use my (need to be improved) Spanish skills to encourage folks and help them find a way to overcome limitations without ever coming across as judgemental or rude. This, I feel, does the most good.

As always, JMHO. Culture, not just language, can be a huge barrier to communication. And situations are always different. By talking to the people, and more importantly, listening----I have learned a lot.

[BlueRidgeHomeRN]

also, wouldn't you want to understand what was going on if you were visiting a foreign country and needed care?

.

yup..but these aren't "visitors"..

[Elvish, BSN, DNP, RN, NP]

I have spoken to many Hispanic people living here many years whose grasp of English is minimal. I have asked why this would be ( I speak Spanish). First, understand, many come from countries in Central America and in Mexico, where Spanish is already their 2nd language, having first learned a native Indian dialect as different from Spanish and English as you can imagine. So they are already bilingual, unlike most American people. Also, many DO speak some English, but are afraid to look "stupid" to us so they won't speak in English to us in the hospital. Pride is a huge issue for them. They really do not want to look stupid or made to appear so.

I encourage them to go to the ESL classes and tell them where they are. Sadly, many of these have waiting lists a mile long. Transportation is also an issue. There are a lot of barriers to overcome to learning English------but 10 or 20 years living in the USA is a long time, I do tell them. I always use my (need to be improved) Spanish skills to encourage folks and help them find a way to overcome limitations without ever coming across as judgemental or rude. This, I feel, does the most good.

As always, JMHO. Culture, not just language, can be a huge barrier to communication. And situations are always different. By talking to the people, and more importantly, listening----I have learned a lot.

Thank you, SBE. Could not have said it better myself.

[HappyNurse2005, RN]

Our triage discharge form, we have one in english, and another one in spanish. Also, consents are in spanish (not that anyone reads those...).

[SmilingBluEyes]

Well, we actually read through our d/c forms with our patients.

[bagladyrn, RN]

SBE - I find that trying my few Spanish words (and poor pronunciation), risking making myself sound foolish, usually encourages my patients to then try their English. (Or perhaps they just don't want to hear me mangling their language anymore!)

I do find that many of the women speak a lot more English when their husbands are not present - not sure what the dynamics of that are.

I tease some of my patients that I can always tell when the laboring woman starts cursing in Spanish - that's when the family stops translating (and the women start giggling)!

[SmilingBluEyes]

ROFL Baglady. I hear you. I find my Hispanic patients some of the most gracious, giving people I ever encounter. I have had many a homemade meal brought in just for me----and many a home offered open to me and my family just for caring for them. Many of them so poor, they hardly have anything to give, yet would still give me what they do have. I find that refreshing. And they are so glad for my efforts at communicating with them----even if at times,they are feeble. And they are tend to be the hardest-working folk, too! I really do enjoy them. I love the phrase they use to express "giving birth"---------------"dando la luz" literally in English, means "giving light". Says a lot to me.

[33-weeker]

I have spoken to many Hispanic people living here many years whose grasp of English is minimal. I have asked why this would be ( I speak Spanish). First, understand, many come from countries in Central America and in Mexico, where Spanish is already their 2nd language, having first learned a native Indian dialect as different from Spanish and English as you can imagine. So they are already bilingual, unlike most American people. Also, many DO speak some English, but are afraid to look "stupid" to us so they won't speak in English to us in the hospital. Pride is a huge issue for them. They really do not want to look stupid or made to appear so.

I encourage them to go to the ESL classes and tell them where they are. Sadly, many of these have waiting lists a mile long. Transportation is also an issue. There are a lot of barriers to overcome to learning English------but 10 or 20 years living in the USA is a long time, I do tell them. I always use my (need to be improved) Spanish skills to encourage folks and help them find a way to overcome limitations without ever coming across as judgemental or rude. This, I feel, does the most good.

As always, JMHO. Culture, not just language, can be a huge barrier to communication. And situations are always different. By talking to the people, and more importantly, listening----I have learned a lot.

Now come on... I'm 40-something, took 2 years of basic Spanish my freshman and sophamore years in high school and haven't really used it since, yet I have managed to pick up enough Spanish with very little effort that I can introduce myself, tell them I'm their baby's nurse and ask basic questions like, "when did your baby eat... how much... breast or formula... do you want your baby to stay here... your baby is doing well...etc..." I can also understand their answers if they keep it simple and don't talk too fast.

If I can do that with two years of school (many years ago) and a few minutes (yes, minutes) of reading here and there more recently, then they can bother to learn the basics of the English language with a little effort.

(Just to clarify - I am not advocating getting rid of medical interpreters - that will always be necessary for emergencies at least. But I do think the spoon-feeding in other areas, such as US schools, government offices, etc. needs to be greatly reduced.)

If the ESL classes are full, then let them pool their money and share an English language program or Spanish to English book. Where there's a will, there's a way. If they really wanted to learn, they would find a way. The problem is - with all the bi-lingual spoonfeeding - there is little or no incentive.

[33-weeker]

I just read the post above my last. I agree. The Hispanic people are some of the most patient parents around. Even the young fathers have endless patience when dealing with toddlers in the waiting room. The new mothers often room-in with their babies, breastfeed and care for them without much help. There are a lot of good things about their culture.

[SmilingBluEyes]

Maybe I am unclear , and for that I apologize. I can only say what I have learned by communicating with people. Many people from many regions, not just Mexico, but Central and South America as well. I promise: Most do try----and they do speak English, many of them, but poorly. They really are afraid of sounding and appearing stupid. Someone here said "there must be something more to it", and they were absolulely right. Cultural issues do come into play. And I, for one, applaud the efforts of the folks I have met and taken the time to listen to, because I know they are trying hard. Sure, there are "bad apples" among them. There among any of us. But I do understand the barriers they are up against and I appreciate their efforts. Because I do know how hard they are working, the (often dangerous) journeys they have taken to get here, and and how hard it can be to learn a new language any place. I also know some tend to "assimilate" more easily than others do. At least most are trying. I am, too. That is all I can say.