Not even a word of English

[MomRN0913]

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.

[farmerjane]

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.

What resources do you suppose people have to facilitate their language acquisition? I live in a large city with a lot of immigrants from different areas. There are community centers that offer ESOL classes free of charge...and the waiting lists are about 18 months to 2 years long. Not to mention that often these immigrants are working menial jobs, which means physical labor and long hours for low pay, so paying for classes and finding one to fit one's schedule would be challenging.

I understand the sentiment that people should learn English if they want to live (well) here, but the reality of it is far, far more complex than "learn the language, damn it."

[RNsRWe, ASN, RN]

What resources do you suppose people have to facilitate their language acquisition? I live in a large city with a lot of immigrants from different areas. There are community centers that offer ESOL classes free of charge...and the waiting lists are about 18 months to 2 years long. Not to mention that often these immigrants are working menial jobs, which means physical labor and long hours for low pay, so paying for classes and finding one to fit one's schedule would be challenging.

What resources did my grandparents and great-grandparents have when they got off boats from foreign countries to start a new life in the USA? They were broke and spoke no English. What did they do? They learned the language of their new homeland (and yes, it was and still is English). The older ones learned from family members and neighbors who had also learned to speak it. The younger ones learned from schoolmates, friends, anywhere they went where people were eager to show their new English skills! They knew that now that they were NOT in Poland, Russia, etc (insert country of origin here) they had to learn English and that was that. Period. And it was DONE.

I understand the sentiment that people should learn English if they want to live (well) here, but the reality of it is far, far more complex than "learn the language, damn it."

No, not really. The difference between "then" and "now" is that "then" people didn't cater to foreign-language speakers at all: they HAD to learn the language to survive. And you know what? Somehow they did just that.

There's NO REASON that Spanish-speakers in the USA today CANNOT learn the language. I don't accept that it's too hard, it's too costly, it's too difficult to find places to learn. If people coming by the BOATLOADS day after day and stuffing themselves into tenement housing in the lower East Side of Manhattan in the early 1900's could do it, so can those who declare "it's too tough for me" in the early 2000's. Just a matter of incentive, and today THERE IS NONE!

[Double-Helix, BSN, RN]

Can your company use a translation service? My hospital uses a company called Language Line, which has certified translators in over 50 different languages. You simply use any phone to dial the Language Line number and the operator asks which language you need translated, you get a translator on the phone, and then you pass the phone back and forth between the client and the nurse. Or, you can have the translator call the client, so you use one phone, the client uses another which makes the conversation more smooth.

It's really not recommended to struggle to understand a language or to translate if you're not fluent. Errors and mistakes can easily be made in the patient's history, medications, education, etc. It's also nearly impossible to assess whether the teaching has been understood- even using a family member is dangerous because you can't confirm they are understanding/passing on the right information. I'd bring up this issue with a senior member of your company.

[handkeswife]

I live in Houston, and I have to say it bothers me horribly. It's not so much the elderly patients that don't speak English, but like someone else said, the 2nd and 3rd generation who speak none or little. Other countries are not this accomodating. I blew my top the other day when I was at the grocery store (A large, national chain) and the cashier couldn't understand a question I was asking.

[prmenrs, RN]

I have lived and worked in a border city for >40 years; the last place I worked had waaay more Spanish-only customers than English--they wanted to have their baby in the US. Depending on their social class, they: expected the staff to speak Spanish and were more than a little ticked when we didn't, or didn't speak it well enough in their POV; were happy @ any attempt to communcate in Spanish and made an effort to speak "Spanglish" in return; did not speak speak any English and made no effort to communicate. Sometimes there was a 4th category of people who spoke another indigineous language--Aztec or Mayan or ??

Anytime a pt asked me, "How come there aren't more Spanish speaking nurses", I gave them my "wouldn't you like to go to nursing school?" pep talk.

The translator phones were a God-send and worth every penny. People still put "need more Spanish speaking staff" on their Price-Gaineys, but the phones helped a LOT!! And once every so often, we got a Chinese mom or an African country mom. I liked the phones! Every room had @ least one, sometimes 2 of them, and we had 2 or 3 in the nursery, too.

Accountability improves as well because each interpreter has a number that can be written into the chart: "Spanish/Korean/Urdu translation provided by Cyracom interpreter #xyz".

They even had speed dial for Spanish.

[Seas]

What resources do you suppose people have to facilitate their language acquisition? I live in a large city with a lot of immigrants from different areas. There are community centers that offer ESOL classes free of charge...and the waiting lists are about 18 months to 2 years long. Not to mention that often these immigrants are working menial jobs, which means physical labor and long hours for low pay, so paying for classes and finding one to fit one's schedule would be challenging.

I understand the sentiment that people should learn English if they want to live (well) here, but the reality of it is far, far more complex than "learn the language, damn it."

haha. Get yourself a handbook. School is not the only way. Anything is better than having to have someone with you to do basic living activities in life. What happens if you can't have a translator with you the whole time? Are you going to die? There is NO excuse not to learn the very basics of a language of the country just enough to get by. Seriously, what is so hard about it? Unless one has mental issues to keep them from learning.

[itk3838]

it is such a great topic to discuss here, since in the field of medical interpretation major changes are coming on governmental level.

prerequisites | the national board of certification for medical interpreters

"california has made great strides in improving linguistic understanding in the medical field. in early 2009, california passed a law requiring all insurance or health care plans to provide interpreters for patients with limited english proficiency at no additional cost. kaiser permanente, the california-based managed care organization, asks patients their language preference before administering care.kaiser also developed a physician assessment program which tests doctors’ proficiency in other languages, determining whether they can assist patients speaking that language without a medical interpreter."

due to so many medical errors that occur along the way, medical interpreters required to go through rigorous training of medical terminology and cultural awareness in order to provide safe atmosphere for both clients and medical personnel. friends and relatives are no longer allowed to interpret during client's visits.

we all can share comic stories like... "ambulance was called for a rescue to pick up a client on a street, who looks like (s)he is very agitated and abnormal according to the bystanders. when (s)he is brought to the hospital they finally asked professional interpreter to provide interpretation and first words from this client were: "i can't take it anymore! may i use your bathroom, i don't know how to find a toilet in the city all day, people don't speak my language."

it is an exaggeration, but besides language we have cultural and religious differences (on a top of physical challenges) to be aware of when we provide medical care. all these people have rights for safe and equal treatment.

your facility should use professional medical interpreters in order to avoid possible errors or medical litigation's.

[tothepointeLVN, LVN]

I think in our drive for diversity which is a GOOD thing we forget about the areas where homogization would be a good thing. Language would be one of them. We need to be able to communicate effeciently with each other. Even if everyone spoke english it wouldn't take away diversity. Compare New Zealand English to American English and you'll hear variations in accent and syntax but we can still effectively communicate with each other.

In my area bilingual = English + Spanish. Employers get upset if you claim to be bilingual but your languages are English + German or English + Maori.

[BrandonLPN, LPN]

I've never understood why someone would move to country and not learn it's language. If I were to move to Mexico I'd be expected to learn Spanish. If I moved to France I'd better learn French if I wanted a job. Why is it different for people immigrating to the US?

[Bobmo88]

i was born and raised in southern california and currently work in a hospital located in a city with a large spanish speaking population. i am mexican-american but i grew up speaking english in the house and only learned a few words of spanish growing up. even my grandmother, who was born in mexico and spoke mostly spanish, spoke to my brother and i in broken english. i took spanish all four years in high school, 2 classes at the community college then decided to pursue a bachelor's in spanish while on the wait list for an adn program. before majoring in spanish, i practiced by speaking to customers at my old job as an auto parts salesman and then speaking to patients when i get my job as an er tech.

i would say the majority of the patients do speak a decent amount of english or have a family member that is able to explain what is going on but they feel more comfortable speaking in spanish and they understand their care better in their native language. yes there are some people that do not speak a word of english and have been in this country for many years. i in fact get quite irritated when they are angry at other staff members when they don't speak spanish, one of my co-workers will even tell them (in spanish) "if i can speak both languages then you can too. don't get mad at others because they don't speak spanish, you've been here for many years." but there are also many who try hard to learn the language and are even ashamed they aren't able to speak it as well as they like but i respect them for their effort. as hard as people think spanish is, i think it is a lot harder to go from speaking spanish to english.

other languages i run into frequently are tagalog and indigenous languages from mexico such as zapotec and mixteco. most of the tagalog speakers either speak some english or have family members that do if not, many of our nurses are filipino. the indigenous languages are the ones that are tough if they don't speak spanish very well because sometimes the interpreters from cyracom can't understand what the patient is saying due to variations in the same language.

i find languages fascinating and wish i spoke more, i am working on portuguese for the world cup in 2014 and wish there were more speakers in my area. i dealt with one patient who spoke portuguese and was able to communicate with her using my limited knowledge of portuguese and falling back on talking to her in spanish if i didn't know the words in portuguese.

even though languages barriers can be at times challenging, i enjoy the opportunity to interact with people from different cultures.

[dudette10, MSN, RN]

I understand the sentiment that people should learn English if they want to live (well) here, but the reality of it is far, far more complex than "learn the language, damn it."

No, it's not.

People who don't know English are immersed in the language. I live in a household where my husband speaks a second language fluently. He hasn't spoken it on a regular basis in ages, so our kids don't know how to speak it. However, when I go to his homeland with him, I understand quite a bit of what his relatives are saying. This is with *this much* exposure.

My husband's mother had a fifth grade education--God love her, she is not the sharpest tool in the shed--and learned how to speak English by working in a factory where there were a lot of ESL people. His father learned English quite well prior to marrying his mother. My husband can't remember one time where he had to serve as translator to his parents.

Yes, it can be done, and it has been done for generations of immigrants prior to the most recent wave.

[DarkBluePhoenix]

I've never understood why someone would move to country and not learn it's language. If I were to move to Mexico I'd be expected to learn Spanish. If I moved to France I'd better learn French if I wanted a job. Why is it different for people immigrating to the US?

Because we are the US. We are the chickens who can't stand up against this kind of crap. And the immigrants know this and take advantage of it. Why learn the language of the country you moved to cause yours sucked when your language/culture etc... is catered to you everywhere!?