How have you dealt with language barriers?

Specialties Educators


I am a new instructor and my college (LVN and CNA/HHA) seems to draw many students from the African nations...who speak very poor English.

They tend to smile and nod, and parrot what I say when I ask them if they understand, but then are unable to demonstrate learning and are doing poorly on skills and tests. I have vented my frustration to administration and they tell me they are considering a test of sorts to ensure appropriate language skills prior to admission, (they are even considering a GED) but in the meantime I have to deal with this current class of students. 5 of 14 speak poor broken English only...difficult to understand them.... and they comprehend only basic phrases (not enough to qualify for a medical program IMO)

So...any instructors in my shoes out there? How have you coped? What has worked for you? I will appreciate all responses!

One thing I have decided to do is keep a documentation log of communication problems observed with each of these students as a CYA measure, and share it with my administrators regularly. ;)

Thanks, guys and gals for any advice you can offer!:roll


4,516 Posts

Hmm. I guess the lack of responses tells me my school is possibly more interested than they should be in increasing their $$$/enrollments...and are accepting students who probably should not be there at all...which is what I suspect is happening.

And they're dumping the language problems on instructors...several of us new instructors are really bucking this as we did NOT sign up to be ESL teachers.

I plan on continuing my documentation and sharing of problems I encounter with misunderstandings, poor test/quiz grades, inability to perform in skills lab, etc. I am ready to take a stand as I cannot take another student to clinicals if I do not feel they are safe, for whatever reason, language issues included.

I may lose my job over this but I guess that will be OK... ethically I cannot let what I've seen this last few months continue...not when it becomes my class and my responsibility. (I'm still orienting with an experienced instructor) These people will be caring for our mothers, fathers, grandparents, etc and they deserve good care by people who can speak and understand basic English, IMO.

I will watch this thread for any advice from the more experienced nurse educators...or if you feel more comfortable you may PM me as I need all the advice I can get with this...LOL!


577 Posts

Mattsmom, I know what you're talking about!

Just don't have much time at the moment to answer you question.

The only thing I can say, it not the problem of a nursingprogram to teach your students English (or mine German), they have to take care of that themselves.

We test our future-students (all of them, not just the immigrants) on their language skills and when they fail that test, they can't start nursingschool, until they improve the language.

(Different system here of course, since our students get pays, insurance etc.)

We help them find a language institute where they can study for not so much money and they can try again the next year.

This is it in just a few words, I'll tell you more about the testing, when I have more time, ok?

Take care, Renee


4,516 Posts

Thank you for your response Renee! I appreciate the support. I have tried to help these students but there is only so much we can do when the basic language is not there...I have even tried some translating with other students more fluent...but that is not sufficient to gain the students a thorough understanding, pass the written and skills tests or the communication portions of their tests.

There is too much info to translate...and many of our words will not even translate, I have found!

I hope our school goes to a stricter test soon. I will keep the lines of communication open with my bosses. :)


593 Posts

Hi Mattsmom,

Living in FLA, we have a large Hispanic population, many of whom have difficulties with the English language. The technical school that teaches the CNA and LPN requires taking an entrance exam with reasonable requirements. It would probably be in the best interests of your school that they have a pre-CNA/pre-LPN course that can address these issues. Your job is to teach them the clinicals.


4,516 Posts

Thanks for your response, 2Banurse....I am glad to hear other technical colleges offer a pre-entrance exam and I am pushing for the same at my school.

I agree it's in everyone's best interest. The last class I worked with had 4 students whose comprehension was too poor...and it came out in clinicals when we observed multiple instances of unsafe practice and had to fail them.

My goal is to catch the problem earlier than fact I was supported by management yesterday when I suggested these unsafe students should never have gone to clinicals (it wasn't my call...I was following another instructor)...too risky for the school , the patients, and my license...and not fair to anyone including the student...who is dropped in their last few weeks of the course after paying (or their sponsor is paying) the full fee.

The problem should be evident and well documented long before that and it's unfair to keep students strung along if the language skills are not there.

Thanks for your reply! It's nice to hear from other instructors!!


221 Posts

Over the years I have worked with many ESL pts., families and CNAs, as well as living in a neighborhood of many languages [75, counting dialects, in my parish church]. The main help I can give is the realization other cultures are often not nearly as comfortable with the word 'no' as ours. People sometimes will not disagree or shake their heads 'no'. This makes checking understanding difficult because we expect people to be forward and up front. It takes specific questioning and avoiding yes/no situations. good luck.


4,516 Posts

Thanks Maureeno for your response. I agree they do not seem to be comfortable with replying 'no' to my direct questions. I will try to be more specific in my questioning but don't know if it will be enough to help in the time constraints we have... it would take 4 to I instruction or so and we are staffed 15-16 to 1 instructor...not time for much personalized instruction in today's fast paced courses. I'm already way over my allotted hours trying to offer remedial help to them and then (as in the hospital) I am being reprimanded for unauthorized OT I'm between a rock and a hard place I'm afraid. So I'm documenting...:(

I've been offered a chance to teach pharmacology and think I will take the school up on it.....a qualifying pretest has been given to the nursing students so I know they have a baseline understanding of our language and culture even if they are ESL students..

It is amazingly hard to teach someone how to do personal cares and make beds, etc. when they come from a village where they slept on grass mats and have never seen these 'luxuries' of showers, etc.......and this is what I am encountering. I think the culture shock they are experiencing is a big part of the problem too.

I also do feel badly for them as they are desperate to stay here...and are here with the understanding they will learn a skill and work.....but they must be able to demonstrate competent personal care skills to pass the state exam. I could pass the problem students in my program, but the state tester will surely not pass them. And the poor pass rate will harm the school's another hard place.

My coworkers tell me not to sweat it so much....I guess I'm trying too hard as a new instructor, but I want my students to succeed if I can help it and I hate to see them so discouraged....they are nice people in a tough spot.

Thanks for letting me vent, ya'll. :)


221 Posts

with the problems in staffing for direct care, and the emphasis from university schools on always furthering the career ladder away from direct care [my own nsg. alma mater being a big example] Mattsmom81 is highlighting a problem which will be growing ever larger. I hope she can keep working hard to communicate, the situation sounds horrible. We all depend on competent care.

Maybe community organizations have available ESL classes, or maybe your employer could get you a teaching aide /translator.


4,516 Posts

Thanks Maureeno. This was my first suggestion as well... to utilize my students with better English as translators to assist those with poorer skills...the school completely discouraged me. The school policy states 'Enlish speaking only allowed during school hours' and it is grounds for dismissal, I was told, to be speaking foreign languages in school. So..I am frustrated as I feel they could understand some basics if only we could translate some...

Soo...unfortunately, I am left with ' document well and communicate with administration' ....but I can't help but feel it's unfair to both me and my students to be in this position. :(

I suggested the school may wish to contract a language teacher and/or find additional community resources to try and help. All of these immigrants have group and individual sponsors in the organizations..who are paying for their schooling and support, I've discovered.

Thanks for listening, ya'll. I'm finding myself really looking forward to the pharmacology class (I can't believe I'm really saying that...LOL!!) :chuckle


221 Posts this a for education or a for profit school? sounds unconcerned about teachers and students! good for you for laughing at the absurdity.


4,516 Posts

Private school...for profit. Guess that explains a lot doesn't it. ;)

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