Is this discrimination?

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Hello haven't posted in a while. quick background before the meat. So I work at a fairly large health system, they currently own 95% market share so options here are not many. If you look at the pictures of the board of directors, they are all white. All my charge rn, the dept director, and her four clinical supervisors are all white. I happen to not be white, and I am bilingual. I have heard comments from physicians like: "they get off the plane and want us to fix all their problems". "That pt doesn't pass the smell test, hispanics are too emotional." The second comment was about my pt who came in with acute head pain worst of her life. History of Htn among other things and geriatric. I wanted to get her cleared for a stroke...the md never even came to the room. Waited and hour. Cat wouldn't take her stat cause it wasn't ordered stat. Well I gave report went home. Next day was told she ended up having a bleed. Now md won't even make eye contact with me. So I'm asked to translate all the time and now I'm told by triage and the charge and the clinical sups that I get certain PTs cause they only speak Spanish. My one year review is coming and I'm thinking of asking for a nice raise because speaking Spanish and translating are not in the job description...I checked. If they don't give it to me is it discrimination? Should I keep my minority mouth shut and just be happy I'm getting a paycheck? I was born in the USA. Technically I'm not a minority...right?

Specializes in ICU.

One patient who had a bleed and a few off-hand remarks is not enough to claim discrimination, in my opinion. If doesn't sound like YOU are being discriminated against. I, along with others, speak Spanish and do not get compensated for it. To me, its just part of my job. We do have an interpreter who gets paid to be on-call, but this person does nothing else but interpret for us on the rare occasions we need him. He is not a healthcare worker.

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I understand what your saying apple however I'm of the mindset, it's prolly not the first time this happens just the first time it bite the doctor in the @&$?!...and in regards to compensation. Of course you should, maybe it's on your job description but not on mine and I do not work for free for anyone.

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Translating is a duty covered in the job requirements as "other duties as required." As a charge nurse of many years, it would be most effective, and provide the best patient care, to assign nurses to patients that speak the same language.

You have a giant chip on your shoulder, good luck with that.

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Well I've pretty much decided I'm going to keep my mouth shut about all the racist comments I hear all the time. The two I posted were just two. The next nearest hospital system is about an hour drive and I have a family and a mortgage so I will make sure my patients get the right care the rest is someone else's problem. In terms of the raise yea I can ask they willl say no and we will go from there if I want to pursue it more. And for the person that posted about communication. Yes it is our job to communicate but it's not a rn job to be bilingual. If that was the case we wouldn't have many nurses.

The most disheartening thing I hear is when people say your in America learn English. That has to be the most ignorant comment I've ever heard. I guess racism is alive and well.

If hearing a colleague state that everyone should learn English is the most ignorant thing you have ever heard you have led a very sheltered life. Strangely enough my husband, a now naturalized citizen, did not consider learning English a horrible expectation.

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Specializes in Nephrology, Cardiology, ER, ICU.

Here is the CMS (Medicare rule):

45 CFR PART 92-NONDISCRIMINATION ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, SEX, AGE, OR DISABILITY IN HEALTH PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE AND HEALTH PROGRAMS OR ACTIVITIES ADMINISTERED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES OR ENTITIES ESTABLISHED UNDER TITLE I OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT

§ 92.201 Meaningful access for individuals with limited English proficiency.

(a) General requirement. A covered entity shall take reasonable steps to provide meaningful access to each individual with limited English proficiency eligible to be served or likely to be encountered in its health programs and activities.

(b) Evaluation of compliance. In evaluating whether a covered entity has met its obligation under paragraph (a) of this section, the Director shall:

(1) Evaluate, and give substantial weight to, the nature and importance of the health program or activity and the particular communication at issue, to the individual with limited English proficiency; and

(2) Take into account other relevant factors, including whether a covered entity has developed and implemented an effective written language access plan, that is appropriate to its particular circumstances, to be prepared to meet its obligations in § 92.201(a).

© Language assistance services requirements. Language assistance services required under paragraph (a) of this section must be provided free of charge, be accurate and timely, and protect the privacy and independence of the individual with limited English proficiency.

(d) Specific requirements for interpreter and translation services. Subject to paragraph (a) of this section:

(1) A covered entity shall offer a qualified interpreter to an individual with limited English proficiency when oral interpretation is a reasonable step to provide meaningful access for that individual with limited English proficiency; and

(2) A covered entity shall use a qualified translator when translating written content in paper or electronic form.

(e) Restricted use of certain persons to interpret or facilitate communication. A covered entity shall not:

(1) Require an individual with limited English proficiency to provide his or her own interpreter;

(2) Rely on an adult accompanying an individual with limited English proficiency to interpret or facilitate communication, except:

(i) In an emergency involving an imminent threat to the safety or welfare of an individual or the public where there is no qualified interpreter for the individual with limited English proficiency immediately available; or

(ii) Where the individual with limited English proficiency specifically requests that the accompanying adult interpret or facilitate communication, the accompanying adult agrees to provide such assistance, and reliance on that adult for such assistance is appropriate under the circumstances;

(3) Rely on a minor child to interpret or facilitate communication, except in an emergency involving an imminent threat to the safety or welfare of an individual or the public where there is no qualified interpreter for the individual with limited English proficiency immediately available; or

(4) Rely on staff other than qualified bilingual/multilingual staff to communicate directly with individuals with limited English proficiency.

http://ostiweb.org/federal-regulations-for-translation-and-interpreting-in-medical-settings/

No - they should NOT be using you for translation services. I'm a provider in a rural area. I have multiple pts who speak Spanish and I do not speak Spanish. I use an employer-provided language line where the conversation is completely recorded and transcribed (if needed) for the medical record. I also must document the translator's ID number as well as the time/date of the use of the language line. This protects both myself and the pt.

I've used this for years (12) and have always had positive experiences and the pts are happy also as we don't have to play the "guess what I mean" game which is counter-productive as well as dangerous.

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The second comment was about my pt who came in with acute head pain worst of her life. History of Htn among other things and geriatric. I wanted to get her cleared for a stroke...the md never even came to the room. Waited and hour. Cat wouldn't take her stat cause it wasn't ordered stat. Well I gave report went home.

eacue10,

Since you felt your patient should have a STAT CT, how did you handle that? What did you do about the physician not coming in the room?

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Specializes in ER.

The most disheartening thing I hear is when people say your in America learn English. That has to be the most ignorant comment I've ever heard. I guess racism is alive and well.

I think you're confusing language with race with this comment.

I do believe if a person is serious about immigration to the United States, some attempt to learn English is appropriate. Of course, it's not always practical, depending on age, ability, or living circumstances.

I do detect a big chip on your shoulder, and maybe some stereotyping of 'white' people that I don't think is helpful to discussion and bridge building. Don't go through life feeling like a victim!

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Specializes in Adult and Pediatric Vascular Access, Paramedic.

I am so sick of anyone who isn't white trying to play the discrimination card for EVERYTHING!!! STOP, no it isn't dicrimination! You have the option of refusing to act as a translator, so if you feel strongly about it then stop doing it and stop crying discrimination.

I have had it with this!!!

Annie

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Specializes in Adult and Pediatric Vascular Access, Paramedic.
Well I've pretty much decided I'm going to keep my mouth shut about all the racist comments I hear all the time. The two I posted were just two. The next nearest hospital system is about an hour drive and I have a family and a mortgage so I will make sure my patients get the right care the rest is someone else's problem. In terms of the raise yea I can ask they willl say no and we will go from there if I want to pursue it more. And for the person that posted about communication. Yes it is our job to communicate but it's not a rn job to be bilingual. If that was the case we wouldn't have many nurses.

The most disheartening thing I hear is when people say your in America learn English. That has to be the most ignorant comment I've ever heard. I guess racism is alive and well.

I have to say if someone is living here, and plans to be here permanently then yes they DO need to learn English!!! It is unfair that we have to constantly find translators because they don't want too! It's one thing if they are really elderly or have other special needs and can't, but otherwise learn to speak English if you are staying here!! I think it's unfair that a lot of them expect me to learn their language!!

Annie

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eacue10,

How can you automatically assume everybody is "white" on your board? If you are judging them just based on their skin appearance, perhaps what you are accusing them of, is also what you are doing a bit of as well?

I am 100% Mexican and while yes, I know nobody is ever 100% any ethnicity, both my parents were born and raised in Mexico and migrated here to the USA back in the late 60's. I am very fair-skinned with golden brown/reddish hair. In fact, I burn if I"m out in the sun more than 15 minutes on an 80 degree day. My cousins are also very light skinned with green eyes! There are many other Latinos who are blonde, blue-eyed, and only speak Spanish (Spain, Argentina, etc.) People always assume I"m "white" as well, until I start speaking fluent Spanish.

You cannot automatically assume everybody is "white" above you. You may be basing it on names and appearances, but you never know. My other cousins are Japanese-Mexicans and they only speak Spanish! We also have a family friend with the last name of Johnson, the reason for her last name is due to marriage.

I just want to caution you about being quick to judge the board of directors and everybody above you with a blanket statement of "they are white," because in this day and age you would be surprised of people's background! It's not easy to look at somebody and their name and know immediately their backstory.

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Specializes in Pedi.
I have to say if someone is living here, and plans to be here permanently then yes they DO need to learn English!!! It is unfair that we have to constantly find translators because they don't want too! It's one thing if they are really elderly or have other special needs and can't, but otherwise learn to speak English if you are staying here!! I think it's unfair that a lot of them expect me to learn their language!!

Annie

There's no national language in the United States of America and no one is required to learn English to live here. It's not "unfair" to have to find an interpreter, it's the law. It's not limited to healthcare either- the US census is provided in many languages, schools are required to provide interpreters for meetings with parents/guardians in their primary language, courts are required to provide interpreters to non-English speaking people. It's also not particularly difficult at the large urban hospital for which you now work- Spanish and Arabic interpreters are readily available, I rarely had to wait more than 10-15 minutes for one when I was liaising there, and every unit has an iPad through which you can easily dial an interpreter for dozens of languages and have a video conversation with a parent/guardian.

xkcd: National Language

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Well I've pretty much decided I'm going to keep my mouth shut about all the racist comments I hear all the time. The two I posted were just two. The next nearest hospital system is about an hour drive and I have a family and a mortgage so I will make sure my patients get the right care the rest is someone else's problem. In terms of the raise yea I can ask they willl say no and we will go from there if I want to pursue it more. And for the person that posted about communication. Yes it is our job to communicate but it's not a rn job to be bilingual. If that was the case we wouldn't have many nurses.

The most disheartening thing I hear is when people say your in America learn English. That has to be the most ignorant comment I've ever heard. I guess racism is alive and well.

I am pretty pro immigration but yes, if you come to america you should learn english. Not sure why this offends you? People (with clear records) should be welcome in our country but again if you are coming here, feel free to keep as much of your previous culture as you want but to say people should not have to learn english pretty much shows us this entire post is probably malingering and I can now safely assume you go out of your way to look at comments made at work as "racist."

It benefits the person coming to america more than others to learn the native language since there is a plethora of data showing not knowing english leads to problems in many areas of life. Not saying it should be a law to learn it but somebody SHOULD learn it.

Saying to learn english racist? lol give me a break. If you do not get a raise it will be more likely due to attitude than skin color. But it is 2018 and playing the race card is now fashionable so whatevs.

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