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.
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 MIL speaks only Spanish. She has lived here since the 1960's. The area where she lives makes it easy to not learn English and her children will translate for her when necessary. It's a comfort thing. To learn to speak English would be uncomfortable for her and why should she when she can get by without it.
She expected me to learn Spanish but I did not. It does not make sense for me to learn to speak another language just to talk to one person once in a while. It would have made a lot of sense for her to have learn to speak English 40+ years ago.
Unfortunately I'm going to have to learn Spanish eventually because of the above situation.
I am fortunate enough to speak 4 languages, two of them fluently, including Spanish. I enjoy speaking to patients in Spanish that are more comfortable speaking it. I know in the long run that it will lead to better patient outcomes knowing they can speak comfortably in their own language, especially with someone who is also of their ethnicity. I do however follow my hospital policy in using dual-handsets or certified translators even though I know the language of the patient.
If someone comes to this country as an older person (age 65+) and does not speak English, I personally would not expect this person to sit down and start learning it, how could anyone expect that? My grandmother was one of these people. She did manage to pick up a few key words and phrases along the way, but she was always comfortable dealing with professionals in her home language. When English is your 2nd language (or any other language for that matter), you're almost always going to prefer dealing with people in your home language, that's just a fact. However, anyone younger than that I feel should morally make a concerted effort to learn English. It should not be something mandatory because one never knows what educational handicaps exist.
With the increase of individuals entering the medical profession that speak many languages, I don't see why this would be an issue. Do English-only speaking healthcare workers feel that they will somehow be sidelined out of a job for not being biligual/trilingual? It's so funny though. I may speak 4 languages but Chinese is not one of them -- so if I encounter a Chinese-only speaking patient I don't get all bent out of shape about it. How come people English-only speakers get so frustrated over the same scenario? This is the USA, we're always going to have people that speak other languages and only that language, and there is nothing that will change that in our lifetime. If this was just an English-speaking country, I think it would be kinda dull to live here, JMHO!
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.
I think you are talking about this, which I just pulled from the Department of Health and Human Services website:
OCR guidance recommends that plans conduct a four-factor assessment to help determine what language access services to offer. These factors are (1) the number or proportion of Limited English Proficient (LEP) persons eligible to be served or likely to be encountered in the provider’s service population; (2) the frequency with which LEP persons come in contact with the provider; (3) the importance, nature, and urgency of the program, activity, or service to people’s lives; and (4) the resources available to the provider and costs for offering language access services.
OMH’s CLAS standards can help plans become responsive to the cultural and linguistic needs of diverse populations. Four of the fourteen CLAS standards focus on the provision of language access services. These standards are (1) providing language access services during all business hours, (2) providing verbal offers and written notices of the right to language access services, (3) assuring the competence of language assistance provided by staff, and (4) providing written materials and signage translated into appropriate languages.
I found the exact same language I quoted above on two other "org" sites, aside from the DHHS site.
I didn't do a thorough search, but I would like to see the text of the regulations that you are referring to. You imply that if a facility cannot meet the needs of an LEP patient, regardless of the language the patient speaks, the patient must be referred to another provider.
If you are referring to the same standards that I quoted above, I don't believe it can be interpreted the way you are interpreting it. As you can see in the first paragraph, part of the assessment of a facility's compliance with language access standards includes demographic data of the people most likely to use the services of the facility. If, let's say, Chinese is a language spoken by many people who use a facility, 24/7 language access services in Chinese need to be offered. Notices must be offered in Chinese, and signage should be in Chinese.
24/7 language access services can be met through subscription to a "language line" off hours, with in-house interpreters during business hours, which is the way my facility does it. The two predominant languages in my facility's community are represented by real live certified medical interpreters onsite M-F, 9-5.
Now, the sticking point is "assuring the competence of language assistance provided by staff." What does that exactly mean, and how is it measured?
When the job listing says "Bilingual Spanish-English" required, I would say that English speaking applicants are being sidelined out of work. How many of those job listings in one day does one have to come across to get the message, which is stated in English?
... To learn to speak English would be uncomfortable for her and why should she when she can get by without it.
Interesting discussion... nursing school made me uncomfortable...grad school is making me uncomfortable...just getting out of bed every day is uncomfortable!! (especially today...laptop in bed...)
TothepointLVN, you always bring up some interesting points and good discussion!!
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Language translators that you can type your message.....are pretty good for the basic stuff. Coming from a family of immigrants and my husband first generation off the boat........ I too, become frustrated that there are those who do not speak English, have social security numbers and medicare even if they have never worked in this country. My family who immigrated had to speak English and prove they could support themselves before their families could come here.
Paco69, part of the reason you don't get bent out of shape about it is because you already hit the goldmine on being bilingual. You speak Spanish. When people say "bilingual" that's the ONLY language usually meant. In my area, however, it can mean Spanish or Polish.
My stepdaughter is bilingual--probably learned the same way you did: from her parents--but her second language is NOT Spanish nor Polish. She is decidedly SOL in the "bilingual" department.
Being bilingual means nothing in the US, unless it's the right second language you speak.
We have Spanish translators in the hospital from 7a-11p, but overnight, all we have is the phones. They are great for the AOx3 pt; no problem. However, when you have a pt with dementia who answers the question- do you know where you are? by repeatedly shouting/ screaming "I'm underwater" in their native language, the only thing the phone would do in this situation is become a projectile for the pt to chuck at the staff. I am the only nurse on my unit, at night, that speaks Spanish (I am not a native speaker, though; it is funny when my pts or coworkers as where I'm from, and I answer, "Chicago," and they are expecting to hear the name of another country). My co-workers use the phones (I think we have 2 on the unit) whenever they can, but I am more than happy to help when I can. I am also happy that I can make my pts more comfortable by speaking their native language. However, I do not do consents or anything of that nature. I have found that some of our older pts, though they may be AOx3, do not like/ trust the phone. They want to be able to speak to someone face to face, to explain what they want, so I'm glad to help try and figure out what the individual needs. However, I do find it frustrating when I meet someone who has lived here for 20+ years and still does not speak any English. I especially found this a lot when I lived in San Diego- there was no real need for them to learn English, due to everything from driving tests to the bank to most any store and church services being available in Spanish.
I see the political side (If you come here legally and contribute to the economy, welcome to the U.S.! I do believe if you're mentally capable you should the effort to learn functional English, and that its unfair to increase the cost of healthcare by requiring an interpreter while the business or taxpayer foot the bill.) and the nursing side somewhat differently. If you are a non-English speaker under my care I'm going to do everything I can to get you what you need.
My brother gets touchy about interpreters because my sis in law is deaf, and struggles to get appropriate interpreter services, despite the fact that she's protected by the ADA and she doesn't have the option to learn spoken English. She has an advantage in that she is comfortable with English syntax, but many deaf people are trained only in ASL, which is remarkably different (it is a separate and unique language with some English crossover) and can cause miscommunication even if everything is written down.
our hospital has whats called a Martti which is a video conference with speakers of over 50 languages (including ASL) that are trained in medical speak - you press a button on the computer monitor, and it sends you to a service which asks you what language and they get someone on a video conference call...
usually with Spanish speakers they have someone that speaks English or they speak enough but we've had a few Mandarin Chinese speaking people that we've had to use it for...a few of the docs also speak enough Spanish to get the point across to lay down, relax and spread your legs (I work in OB)...
I had one patient who couldn't speak or understand one simple word in English. Not even something like "thank you"; the daughter had to translate. The patient had been living in U.S. for 15 years! I was so shocked. I don't understand how someone can't speak the country's language just even barely enough to survive. It must be terrible to totally depend on someone to survive; not being able to speak for yourself. How can one live like this? I can't think of any reason not to learn very simple words of language just enough to live. I think it is ridiculous and pitiful.
CrunchRN, ADN, RN
4,556 Posts
The problem with self study is that it does not make you fluent so you have the potential to screw up big time.