This is the second time this has happened to me. Last night I was taking a patients vital signs. She had an interpreter with her that seemed to be very helpful. A little too helpful. I had just come on my shift and I took her blood pressure. I let her know through the interpreter that her blood pressure was very good however it was vastly different than what it was 4 hours ago and that I would let her nurse know and I may have to retake it. The interpreter interpreted and then turned to me and was telling me that "Well obviously she needs her blood pressure medication and should have it immediately!" Since he phrased it in the 3rd person and my patient was half asleep, I asked if that is what she said. He said "no, but I start medical school in the fall and I know a little bit.". I informed him that I am not an R.N. but I will let her nurse know and that it is good "you will be going to medical school in the fall because you clearly have a lot to learn." I let the nurse know and we had a good laugh over his behaviour but I have to wonder how ethical is it of the interpreter to tell me what to do?
A similar thing happened to me about a year ago. I was taking a set of vitals on a patient with an interpreter. When I was finished I asked "Is there anything you need right now?" and through the interpreter he said no and he would just take a nap until dinner came. As soon as I walked out of the room, the interpreter followed me down the hall and told me "You need to get him into a gown right now. He wants to go to sleep!".
Have any of you been in similar situations and what do you do?
Specializes in Addiction, Psych, Geri, Hospice, MedSurg.
An interpreter is supposed to be (basically) invisible. They are the mouth and ears of the patient only. While interpreting, they can NOT add their own spin to either you or the patient. They can be fired for that... especially in a medical situation, where one slip could cause a life and death situation. He needs to be reported. (He should not even be discussing her medical issues i.e. about her bp meds...)
I had an interpreter that would have a long involved conversation with the patient and when I asked about the answer he would say "Oh the answer is no" I don't want his opinion . I just want the facts and then I will figure out the answer.
I've seen interpreters let staff know about cultural differences in order to help staff be more culturally sensitive, but never seen one tell staff what to do.
The interpreter stepped outside of his scope of practice.
I have worked as a medical interpreter and that is a big no-no. It is reportable and cause for discipline and I suggest you follow up with your interpreting supervisor.
I had a similar situation in which a sitter made a comment about me not medicating a patient enough.
I wanted to say Sorry, but you a) have no idea what the patient was ordered b) the balance between sedation and keeping this person alive and a million other factors that go into my decisions as a REGISTERED NURSE.
"whispera, in both instances the interpreters were employed by an outside agency that my hospital contracts with."
i have worked with many, many interpreters, both hospital employees and agency employees. if this is the case, your hospital mgmt needs to have a talk with that agency, because they have not appropriately oriented their employees (at least not these two) to their role and scope of practice. you did exactly the right thing by reporting it to the rn in charge, and now s/he should follow up with management to get to the agency management.
if there is a form for reporting things like this to risk management, that would be a good thing too; if harm comes to a patient because the interpreter (hired by the hospital via the agency) has overstepped bounds, then the hospital is at risk, and the risk manager wants to know about it stat. there is a national council on interpreting in health care code of ethics, and the agency should adhere to them and so state in writing. (http://www.ncihc.org/mc/page.do?sitepageid=57768)
Interpreters are inserviced and trained on this issue in much the same way that nurses are trained on HIPAA, abuse, and blood-bourne pathogens and the like. It really is a very big deal. And as someone in the profession it really ticks me off to hear stories like this. It is completely unprofessional and agency supervisors are very sensitive to these kind of complaints. It makes everyone look bad.
In some ways the profession isn't regulated very well since the supply of interpreters hasn't caught up with demand. A lot of times health care facilities are flying by the seat of their pants, they just need someone who can help with communication and in a pinch they make do with what they have. But if you are dealing with an agency they should be adhering to certain professional and ethical standards, so please, complain to them if you can. They have no way of knowing that this stuff is happening if no one says anything.
I would have told him to come back and talk with me in four years if he makes it through med school.
I would also remind him that his job is to interpret. I would request a different interpreter if possible and talk to the charge nurse or manager. He is telling you things that are not from the patient. He is adding his own two cents, and quite frankly I wouldn't trust anything he said from that point on.
demylenated, BSN, RN
261 Posts
An interpreter is supposed to be (basically) invisible. They are the mouth and ears of the patient only. While interpreting, they can NOT add their own spin to either you or the patient. They can be fired for that... especially in a medical situation, where one slip could cause a life and death situation. He needs to be reported. (He should not even be discussing her medical issues i.e. about her bp meds...)