This past 2 weeks, the patients i have opened up cases for in HH speak not a work of English. They have social security numbers, Medicare benefits, and Medicaid benefits. Live in the U.S. But do not speak a word of English. Getting a family member who does or a translator at a certain time, or even to make a simple phone call and to get someone to answer the door is an utmost challenge.
I know this topic is controversial, but why am I struggling to hard to understand some Spanish so I can do my job in America?
Most are quite lovely patients. Some are just shocked that I don't speak Spanish!
My rant of the day. And these days, there are a lot of rants for me in this field, I admit it.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I can see both sides of this debate. At this point, we do not have an official language. English is our unofficial language, and it would be nice if everyone who moved here would attempt it, but it's not required. I have been debating learning Spanish in order to help me with being a nurse. I would LOVE to move to Florida when my son heads off to college. I will then NEED to speak Spanish. It won't be an option. Why? Because the majority of people speak it.
Florida is still part of the United States. You shouldn't have to learn another language to get along in part of your own country.
Florida is still part of the United States. You shouldn't have to learn another language to get along in part of your own country.
Right. Don't get me wrong. In an ideal world, we would all have this ability to absorb and learn new languages. When we get a patient speaking a foreign language, we could just magically know what they were saying and could answer them.
However, its not an ideal world. I can't learn to speak Mandarin, Spanish, German, Japanese, Russian, Greek, Italian, Portuguese (you get my drift) just because people can't bother to learn the language being spoken in the country they CHOOSE TO MOVE TO!!
I think it is pretty disrespectful to move somewhere, whether it is just because you feel like it, or to get a better life, or whatever reason, and expect THEM to bend over backwards for YOU. THEY should know your language. THEY should be respectful of your culture. I mean, if I took a job in the Middle East, I would A) Bust my butt learning whatever language I need to B) Wear a hijab or whatever piece of clothing I need to. Not because I want to. Not because it is easy for me. Not because it fits with MY ideology. But because it is THEIR home and I need to respect THEM.
Regarding being shocked that you don't speak Spanish, I dealt with that very well. When a family member or patient would say, "Don't you speak Spanish?!" I would reply, "No, but I'm trying to learn Scottish Gaelic!"
I remember taking a compulsory cultural sensitivity class my first year at uni (NZ) which ended up being a bashing fest for any non white student to blame the white students for every single bad thing that has ever happen to them race wise. Oh and the assumption that white people have no culture. This seems to come up time and time again. Also I can't stand when people aren't sensitive to MY culture either. I'm not singly responsible for slavery. My country did not have slaves. My ancestors did not have slaves. Yet some how I seem to get accused on being racist before I even get to open my mouth (and I may very well be but let me prove that to you first)
Anyways if we all have to start learning other language I demand that someone learn how to make a decent slice of pavlova.
Yes, yes, yes, and yes. MY family was forced to come to this country after the Battle of Culloden, and they came as indentured servants. They were forced to work for someone else, they were not free to leave. None of my ancestors ever owned a slave, and even if they had, that's nothing to do with me. I actually had a teacher in Constitutional Law make the statement in class that the whites were always the oppressors, never the other way around. I raised my hand and said, "Talk to the Welsh, the Irish, and the Scottish." I got no response.
I know that I am very late in the game with respect to posting here, but I felt the need to help clarify a few misconceptions about medical interpreters (since I hold a Certificate in Medical Interpreting!). I do not mean to hyjack the thread, but this is relevant to previous posts.
On July 26, itk3838 wrote “Medical terminology alone is very hard to translate into certain languages and sometime there are no equivalent translations.”
You are absolutely correct, and that is why it is important for medical interpreters to be trained in medical terminology in both English and their non-English language, and it is especially important that they understand the direct translation of terms. However, at this point in time, most Medical Interpreter Training Programs to do teach medical terminology in both working languages.
Itk3838 also wrote “Professional interpreters have 2-5 years of special linguistic education, not just one simple medical terminology course at the community college (not enough!).”
While I agree that one simple medical terminology course at the community college level is certainly not enough, I regret to inform you that many professional interpreters do NOT have 2-5 years of special linguistic education, particularly medical interpreters.
The truth is that the current standard for medical interpreter training is a 40 hour course (as per testing requirements of both the National Board of Certification for Medical Interpreters aka NBCMI and the National Council on Interpreting in Healthcare aka NCIHC). Many of these courses do include a medical terminology component, with medical terminology training IN ENGLISH.
The level of medical terminology training in most Medical Interpreter Training Courses does not guarantee that a trained/professional/certified medical interpreter has the medical terminology background necessary to adequately interpret medical terminology. In fact, a Medical Interpreter who has taken Medical Terminology at the community college level likely has a far better understanding of medical terminology than many of their colleagues.
I took the required foreign language courses in college and high school, but I took Latin in both cases, so my BSN has been of little help to me there, although a good base of Latin will help in any Romance language. I won't say I'm thrilled to have to learn Spanish, but I have tried, if for no other reason than to make MY life easier. So, I can now get someone through a precipitous delivery without the translator phone (because no woman in transition can hold a phone and talk to some faceless person on the other end. It's just not happening). Translation services aren't infallible, though. I will never forget the night I asked, "Did your water break?" and the translator, after speaking to the patient, said, "Yes, she would like a glass of water." I've also had to explain to the translator on the special little phone what a circumcision was. It doesn't exactly instill confidence. Using the translator service, I have asked a question, listened as the translator spoke with the patient, then listened as the patient speaks several sentences to the translator only to have the translator tell me, "She says 'yes'." Umm, I know she said "yes," because I understand that much, but what else did she say?
And no one has brought up the issue that drives nurses in my unit the craziest. We have a large Guatamalan population, and 9 times out of 10 you cannot get a translator for them. The translation service can usually come up with someone who speaks the most-spoken dialect in Guatamala, but there are many dialects and these people often don't speak Spanish OR English. Informed consent is an absolute joke in this case. Many times, I've had the male in the room on the translator phone with me. I speak English to the translator, who speaks Spanish to the dude. Dude then turns around and speaks in the indigineous dialect to his wife and then translates what she says to Spanish and then I get the English version of that. Once again, informed consent is a joke.
Unfortunately many interpreters are not well trained in medical terminology in either language, much less their non-English language. I have trained Medical Interpreters and always tell them to ask the healthcare provider for clarification if they do not know or understand a term. It is best to describe the medical term in your own words so that the interpreter can interpret your words directly to the patient.
At the end of the day, we are responsible for our patients EVEN IF an interpreter misinterprets something. It is better to take the extra time to explain something rather than have the interpreter guess. While I can see how the interpreter's need for you to clarify what circumcision is can leave you questioning the ability of the interpreter to render your message accurately to the patient, I can assure you that your patient had a better understanding after you clarified the term for the interpreter.
Another tip when working with an interpreter and a limited English proficient patient is to ask them to repeat back to you what they understand as opposed to simply asking if they understand. Some limited English proficient patients may be embarassed to tell you that they didn't understand the instructions. . .or perhaps some of the instructions got lost in translation.
This will help assure that the patient understands your questions/instructions/etc, will help increase patient compliance, and will help protect you from malpractice on account of a poor interpretation. As I said, at the end of the day we are responsible for our patients even if an interpreter misinterprets something. Very scary but true.
I believe that there are new CMS regs that speak to this. The patient's primary language has to be taken into account as part of the planning & implementation of health care services. Language abilities must be assessed as part of the admission process and if an organization cannot meet the needs of non-English speakers, they should not be accepting those patients - must refer to another provider.
The US does not have an "official" language, so all arguments about America=English are moot - at least until we change the Constitution.
Thank you!
People thinking America has an official language is a huge pet peeve of mine.
I wonder how many of the people who do that are the same people who will travel to countries that do have offical languages with out learning even the most basic phrases and act annoyed that no one understands them?
Lets face it, most people in America who do speak English do so poorly. How can we expect someone to be fluent in two languages when we can barely speak our own?
Thank you!People thinking America has an official language is a huge pet peeve of mine.I wonder how many of the people who do that are the same people who will travel to countries that do have offical languages with out learning even the most basic phrases and act annoyed that no one understands them?Lets face it, most people in America who do speak English do so poorly.How can we expect someone to be fluent in two languages when we can barely speak our own?
Visiting another country and deciding to *move* to another country are two very different things. And, yes, most Americans use poor grammar, but we can still understand them.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Thank you!
People thinking America has an official language is a huge pet peeve of mine.
I wonder how many of the people who do that are the same people who will travel to countries that do have offical languages with out learning even the most basic phrases and act annoyed that no one understands them?
Lets face it, most people in America who do speak English do so poorly. How can we expect someone to be fluent in two languages when we can barely speak our own?
Before I travel to another country, I make sure I can say "Please," "Thankyou", "Where is the rest room?" and other simple phrases in that language. I also have a good idea of the words for "Beef", "Chicken" and "Fish" so I'm not totally off guard looking at menus, although being surprised is part of the fun of travel. If I were to move to another country -- as DH is urging me to consider -- I'd make sure I learned at least the basics of the language before I moved there and continued to work on improving my language skills after I did. Because my rural school had no language requirement beyond the semester of Latin that everyone took, I've never learned a foreign language -- although I did attempt to learn some Spanish to communicate with my Mother-in-Law. (When I figured out that DH was the only one of her children who actually knew any Spanish and that there were advantages to NOT knowing -- I'm pretty sure "Puta" isn't a compliment -- it dampened my enthusiasm for studying the language.)
I'm comfortable with the idea, though, that English is the language spoken in the United States. It's the language in which the majority of our schools are taught and our business is conducted. It was my first generation American husband who told me that even though it's possible to get by in this country without speaking English, it's impossible to get AHEAD. His mother knew that and made sure all five of her children could speak English.
Someone who moves to this country ought to learn the language, rather than expect everyone around him to accomodate his refusal to do so. Or would you have all of the US residents learn to speak Spanish, Mandarin, Cantonese, Japanese, Korean, Tagalog, Russian, Swahili, German and every other language under the sun just so they can speak with any immigrants who move here and expect to maintain their "culture" without accomodating to ours? My ancestors who moved here learned to speak the language, even the ancient grandmothers who came with their children and grandchildren. All except for the one ancestor who spoke Kickapoo. I'm told he refused to learn English. I can sympathize with him.
Why assume they're immigrants? They could very well be Puerto Ricans (US citizens since 1917), or Hispanics who were born here.
Yes, they should learn English, but for whatever reason, they haven't. Or they've learned some English, but they would rather operate in their mother tongue to make sure they don't miss anything important. They're not going to become fluent in a hospital stay. I'd rather make sure I'm understood, even if that means using a translator or Frantic Gesturing for everything, than get mad over something I can't change.
Again, I made this mention not just for the hospital stay. I am in home health. After the hospital stay you need to be able to manage your illness beyond having translators. Trying to teach a patient to manage their illness without someone else like a nurse managing it for them is dangerous. Then again, if they chose not to learn the language in the country they live in ( official or not official). They should be aware that it is a danger to their health. It's like ruby said, they most likely aren't going to get ahead. Maybe barely manage. But that's their choice I guess.
Ruby Vee, BSN
17 Articles; 14,051 Posts
Florida is still part of the United States. You shouldn't have to learn another language to get along in part of your own country.