Language barriers - what actually helps?

[Avery Beck]

Hi everyone, genuine question. I've been seeing how often language barriers affect patient understanding and care, especially when interpreters aren't immediately available. For those working in general nursing settings, what strategies or resources have you found actually work in practice? What do you wish systems did better to support you?

I'm involved with a community nonprofit focused on language access, but I'm here mainly to listen and learn from nurses' experiences.

Thanks in advance.

[bluescoop, BSN, RN]

You can try learning the language 

[hppygr8ful, ASN, RN, EMT-I]

WHY BELITTLE THE QUESTION, "learn the language" Easier said than done. While I can pigeon my way through a bit of Spanish all hospitals (at least in California) Translations are mandated  to be by a certified medical translator. Simply find out which service is used by your facility and uses it. One can't use housekeepers, coworkers for official translations.

[bluescoop, BSN, RN]

hppygr8ful said:

WHY BELITTLE THE QUESTION, "learn the language" Easier said than done. While I can pigeon my way through a bit of Spanish all hospitals (at least in California) Translations are mandated  to be by a certified medical translator. Simply find out which service is used by your facility and uses it. One can't use housekeepers, coworkers for official translations.

I didn't mean to belittle anything. My point is less about the legalities of medical translation and more about the quality of patient care and connection. While I completely agree that certified translators are necessary for medical stuff, I've always advocated for nursing schools to incorporate languages like Spanish into their curriculum because learning a language is a gateway to understanding the culture. Cultural competency is obtained by speaking the patient's language. I'm not even suggesting we replace official translators. My clinic has language translators, but we also need to our linguistic knowledge to be more inclusive of different cultures. 

[DavidFR, BSN, MSN, RN]

bluescoop said:

I didn't mean to belittle anything. My point is less about the legalities of medical translation and more about the quality of patient care and connection. While I completely agree that certified translators are necessary for medical stuff, I've always advocated for nursing schools to incorporate languages like Spanish into their curriculum because learning a language is a gateway to understanding the culture. 

I take what you mean and I am personally all for language learning, however your initial quip did come across as being just a little glib. 

I speak two languages fluently and am learning a third, but I get it that not everybody is a natural language learner. 

I work in a Paris suburb where the local population speaks a wide range of languages. Not to mention the fact that we are a big international cancer centre taking patients from far and wide. In addition to already having fluent French and English, and intermediate Spanish, you'd be asking me to learn Arabic, Portugese, Fon, Yoruba, German, Chinese, Italian, Russian, Ukrainian, Romanian and possibly others. Not really feasible to get myself to fluency in all these languages is it? I'm not that gifted.

I think the OP was looking for more practical advice. 

Agree, official registered interpreters for the really official stuff.

On a more informal level, my hospital has a regularly updated list of staff with foreign language skills and their internal department phone numbers for on the spot language problems. I have been used for my English.

Some churches, mosques, community centres etc. have volunteers that will come out to interpret for their compatriots. When I worked in London there was a Ukrainian church,  a Polish community centre and a Gujurati speaking Hindu temple that would often help us out with those languages.

Yes if you work in an area where you have a lot of speakers of ONE foreign language, it's reasonable to say take classes in that language. However that's a personal choice, not a professional obligation. It's also time consuming and a medium to long term goal.

 

[traumaRUs, MSN, APRN]

I work in the midwest in a rural area. We have a huge population of Spanish-speaking pts along with a second population of Asian immigrants who speak a variety of languages. We are required to contact a language line and record the number of the interpreter as they can provide a transcript of the conversation should it ever go to court (and believe me....it CAN go to court). We do not use volunteers or co-workers. 

[DavidFR, BSN, MSN, RN]

I think that fortunately, in European countries it's a lot less frequent for patients to go to court. Of course it can happen, though a patient suing is actually quite a rarity. I'm aware it's apparently different in the US.

Of course I'd advocate official interpreters for breaking bad news, important announcements etc. However there are times I've been grateful for the help of co-workers or volunteers when a patient just couldn't tell me they haven't used their bowels in five days or they'd like a coffee.

I once had an elderly Moroccan gentleman who refused his meds and couldn't tell me why. Having no Arabic, I called on a Moroccan colleague. She was able to ascertain from him that since in Morocco everything has a price attached, he thought I was going to ask for money if he accepted his meds. A simple explanation from her that here health care is free and me asking for money would be illegal and he got it. Accepted his meds no problem for evermore after that. I see no harm in using a colleague or a volunteer for that since I think the possibility of any comeback is virtually nil.            

[traumaRUs, MSN, APRN]

I've lived in Korea, Japan and Spain for multiple years as part of the military. Healthcare is quite different overseas. In the US unfortunately every action has the potential for a lawsuit which will then drag on for years and years and years.