language barrier- weird situation

[JSlovex2]

Sooo...I had a patient the other day who spoke NO English. At least she didn't let on if she did. You'll understand why I say this in a moment. I used the phone translator to communicate with the patient and while it was extremely helpful, it was also extremely awkward! I would look at the patient and talk to the translator as if I were talking directly to the patient. For example, instead of saying, "Can you ask her if she needs anything?" I would say (while looking at her) "Do you need anything?" I was just trying to make a tough situation a little more intimate. It didn't work. She didn't look at me EVER. Whatever...I made it through the shift A-okay.

Fast forward a couple of days....I had another patient who I didn't even need the phone translator for. It was a little difficult to communicate, but not so much that I couldn't do my job. She understood simple questions and I used gestures, etc. At one point her family was there and they would say "thank you" and usually "gracias" at the same time. When this patient was alone (and when her family was there) I would walk in and ask her questions like, "Do you need anything? Would you like me to get you a toothbrush?" or more important questions like, "Are you having any pain? How would you rate it from 0-10?" She had NOOOO PROBLEMO anwering my questions. She would say, "No, I'm okay," or "Not bad. 3-4 maybe." heavy accent, but it was clear she understood and I had no trouble understanding. Fast forward....her daughter shows up. It's a little girl (maybe 12) who speaks perfect English along with fluent Spanish. From the moment the daughter arrived, all of the mother's English/communication STOPPED. I would ask, "are you having any pain?" and the girl would start speaking in Spanish to her mother. The mother in turn would respond to the girl who would then speak to me. I found that SOOOO weird!! I can understand translating obviously when it's necessary, but being as though this lady clearly understood and communicated with me half of the day, I fully expected that she would answer me directly and instruct her daughter of her ability to do so that she would stop translating for and IMO hindering her mother. Here's an example...I mentioned earlier that I had asked the patient when she was alone (and when her adult visitors were present) "how would you rate your pain" and she would answer immediately, "not bad. 3-4 maybe." I asked the SAME question with the daughter present and the daughter spoke up, "are you talking about the board?" because we have a board with the smiley faces to help patients rate their pain. She then pointed to the board and started speaking in Spanish to her mother and then her mother responded to her in Spanish. Then her daughter told me, "she said it's the second one on the board." Okay, so when she was alone she was able to understand and without hesitation say "3-4" but now she needs a translator to use gestures and translation to say "the second one on the board"? What happened to 3-4 without all the back and forth? I don't get it. Why do you think this mother would stop communicating with me and allow this unnecessary translating once her child was present? It was truly odd to me as a mother. I almost felt it was rude and expected her to say to her daughter (even in Spanish) that she could speak for herself because she COULD and DID. By the way, she and her family spoke to each other in Spanish the whole time I was in the room (which I also found a little rude) but they never attempted to speak or translate for her and they were adults. What am I missing?

[GiantJerk]

If English is her second language it might actually have been easier for her and better for her to have someone interpret. Also, it might comfort her daughter to feel like she's helping. Just go with what the patient likes best.

[caliotter3]

Have encountered somewhat similar situations. Reminds me of one that, looking back, is now a little humorous. When on the job, military, there was an individual who couldn't communicate in English throughout the day, but when word went down the line that work was over for the day, oh boy, did he perk up and understand. There is a payback of some sort for not exhibiting understanding of the language.

[linearthinker, DNP, RN]

I think it is cultural. And I wouldn't expect them to refrain from speaking their native tongue in front of you. That's silly, why would they? Don't take offense where none is intended.

[JSlovex2]

If English is her second language it might actually have been easier for her and better for her to have someone interpret. Also, it might comfort her daughter to feel like she's helping. Just go with what the patient likes best.

Well, I did go with it. It's not like I yelled "STOP!" and gave a lecture or questioned why she was doing what she did. BUT I don't think it was easier for her to not respond to me asking the same exact questions I had asked every single time, all day long which she could/did respond to without hesitation. She could've answered me, "3-4" before her daughter even had the chance to point and speak, wait for her to respond, and then translate for me. It would be different/understandable if I were asking something different or something complicated, but I was asking the same things I had been asking which she had no trouble nor a moment's hesitation responding to. While her daughter was asking me, "are you talking about what's on the board?" her mother already knew that's what I was talking about, knew the answer, and was capable of answering me in English. It was weird.

[JSlovex2]

I think it is cultural. And I wouldn't expect them to refrain from speaking their native tongue in front of you. That's silly, why would they? Don't take offense where none is intended.

I wouldn't really say that I "took offense," but I do think it's rude to speak in a different language and laugh openly in a room where only one person doesn't understand - especially in a professional setting. If I were visiting France would I speak to my family in English in front of a French person? ABSOLUTELY! Would I laugh in front of them? Yes. However, I'm pretty sure if I was in a setting such as the hospital and a French speaking doctor/nurse were speaking to me and I could understand/respond I would do so. In addition, I would expect my family to refrain from chatting/laughing in their presence. BUT if that were to happen meaning if my family did speak in English and laugh/joke in the French speaking doctors/nurses presence with my knowing they didn't understand English, I would probably say to them, "Oh, he was just saying that I've been here so long that I should have my mail forwarded" or whatever the joke was. That's another topic though and has more to do with morals than the original point.

If you were visiting Mexico and you understood Spanish well enough to communicate with the nurse without trouble throughout your stay would you suddenly start ignoring them and allow your child to translate for you in English which is not only a waste of time, but unnecessary? It was just extremely odd because it was like once her child arrived she pretended as if she didn't understand English at all.

[Orange Tree]

I work with a lot of Spanish speaking patients and they often are able to communicate enough to get by....but there are also times when I realize after three hours (or three days) that they have no idea what's going on- even though it seemed like they did.

I wouldn't let this behavior make you feel too offended. The patient may have even let the English-speaking daughter take over because she thought it would be easier for you. :)

[JSlovex2]

I work with a lot of Spanish speaking patients and they often are able to communicate enough to get by....but there are also times when I realize after three hours (or three days) that they have no idea what's going on- even though it seemed like they did.

I wouldn't let this behavior make you feel too offended. The patient may have even let the English-speaking daughter take over because she thought it would be easier for you. :)

True, and maybe she wanted to show off the fact that her child was bi-lingual and did understand English well. I'm not saying that she should be (although I think it would make sense for immigrants to learn the language) but maybe she was embarrassed that she didn't know English well so she wanted to show that her daughter does. good point. thanks for the response.

i just want to add, the lady was as sweet as she could be. furthermore, i'm certain that she did understand me so that wasn't the case, but i get your point.

[Marie_kaye]

hei.. same experienced i encountered.. i worked sometimes in home for the aged and definitely they are naturally citizen so they uses their language so much and not even know how to complete one sentence for english., very difficult to communicate.. i tried so much to learn from their language to help them and myself to have a nice working relationship even with my co-workers doesn't know so much of english.. i almost repeat my nursing course with their language, so tough.. language is really very important for us nurses=))

[shhhh]

The exact same thing has happened to me countless times. I've had many Spanish-speaking patients in their 30's or 40's who have an okay grasp of the English language, but they have children who speak both Spanish and English very well. As soon as the kid comes in, they just let the kid translate. I never thought it was odd because I understand that it's kinda exhausting trying to communicate in language that's not your first. These people already feel miserable and tired from whatever brought them into the hospital, and then they're being inundated with all this health information that they may not really be too knowledgeable about. I'm sure she was speaking broken English with you because she thought it was convenient for you. I'm sure when her daughter arrived she took advantage of her kid being bilingual and gave herself a break. And like OrangeTree said, she probably thought by doing this, she was giving YOU a break, too.

[chicookie, BSN, RN]

I was in the little girls shoes at one time. Anytime we went anywhere my sisters and I did all the speaking. It's not to be rude or anything but its because my parents felt more comfortable knowing that with us translating there was no miscommunication and it was easier to say what they meant in Spanish then trying to come up with the right English word. To some extent I think my parents were ashamed that they weren't learning English as fast as my sisters and I were which is perfectly normal if you ask me, some things are harder to learn as adults.

As to the family members speaking Spanish while you were in the room. Its not on purpose. I've done it lots of time myself without meaning too. You have to remember at their home that is the language they communicate in so in public whether its at Wal-Mart or a hospital setting that kind of what you fall back on.

Though being in both places I always make sure to turn around to the non-Spanish speaker and say she is thinking this or they are wondering about this. I don't like leaving people in the dark.

PS if I am speaking English to my parents now, even though they understand it and speak it pretty well too, I always feel awkward. :/ I'm not use to them speaking English.LOL

[Whispera, MSN, RN]

If English is a person's second language, up to a point lots of translation happens in his or her brain in order for communication to be possible. Speaking in the second language can be tiring.

In some cultures, people will agree, on the surface, anyway, with anything a professional caregiver asks, because it's seen as disrespectful to disagree. That doesn't mean they actually agree--it just means that they feel it's disrespectful to seem to contradict the person of authority.

Also in some cultures women are not supposed to speak for themselves. It is more acceptable to have a family member do the talking, even if the family member is a female child. I wonder if either of these things was involved in the situation you wrote about.