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.

[amzyRN]

There might be reasons they aren't speaking English, since if anyone has lived in a place very long, it seems likely they automatically pick up come words. I know that when I've been in Spanish speaking stores I've been reluctant to speak Spanish because I felt awkward about my accent. Maybe these patients feel the same way, or maybe they feel intimidated and are afraid to communicate. Maybe they had a really really hard time learning the language and actually don't know the language at all. I think your post has been very thought provoking about how we feel about providing care to others who are from another culture. I know a lot of the frustration is that it makes it challenging to provide care to patients who cannot communicate with us. Someone noted that if American's were living in another country they should learn the language, which I think would be helpful to do, which I would try to do if I were living in another country, but if I did not and could not learn I think I should still have access to health care and would expect that the medical professionals in that country could speak English. In most countries, I think, medical professionals can speak multiple languages, including English. I've heard in France, they have menus in English now for Americans who don't speak French.

[That Guy, BSN, RN, EMT-B]

I would expect myself to learn the primary language of where I moved to, but I'm also not going to expect anything handed to me either.

[anotherone, BSN, RN]

I have always been on the edge of the RN/BSN debate but this post pushes me solidly into the required BSN camp. The multiple-year foreign language requirement not only enables you to communicate with patients who don't speak English fluently, it also increases your compassion for people who don't speak your language because can't help but appreciate the difficulty involved in learning another language.

To the OP - your post makes me sick. Let us hope you never fall ill in a foreign country. Though, it's highly unlikely that would occur because it's highly unlikely that you have a passport. God help you and your patients.

Yes, In 4 years of a class here and there you will be completely competent at translating medical terms for a langauge you may only use a few times and then only in your job setting.(sarcasm) Is this just for some languages? Should we allocate a certain amount per usuage and then send those nurses to those areas, so spanish, mandarian, arabic ,vietnamese etc get more speakers than french, japanese, croation ? ........................... I learned 4 years of russian should I now have to live in brooklyn my whole life as a nurse, what good does that do if I move to an area where people understand russian even less than english?I think most people place visitors/travelors to a different standard than those who chose to become residents here and have been here for YEARS.

[amzyRN]

I am actually not offended by people who refuse to speak my language, as long as I am able to find a way to provide care that is safe and effective to them. I find it frustrating to provide care when there is no translator and have had to use hand gestures at times, but I have no lingering resentment of "those" people after the day is done. But I think people have a right to get annoyed by things and people and say something about it openly.

[That Guy, BSN, RN, EMT-B]

I am actually not offended by people who refuse to speak my language, as long as I am able to find a way to provide care that is safe and effective to them. I find it frustrating to provide care when there is no translator and have had to use hand gestures at times.

Especially if they know ASL....

[bubblejet50]

I know a very small amount of Spanish and most of it is irrelevant to nursing. I used to teach swim lessons and one session I had a three year old who was deaf and only read lips in Spanish and did not know American Sign Language. I learned that there is a Spanish Sign Language which differs with actual signs from the American Sign Language. Well since his parents expected him to learn how to swim I found one of my Spanish speaking friends and had them translate a few phrases. I guess if a patient needed to blow bubbles or sit there or float on their back I could tell them. lol. I also had a resident at the long term care facility I used to work at that was deaf and I remembered my American Sign Language alphabet from the Girl Scouts many, many years ago. He would get mad if people did not understand sign language. I could spell but I didn't know signs. It's hard. I think that patients who do not speak English should not get mad when staff does not speak their language. As of right now the only official language in the USA is English so until that changes I think that staff should not be held to know more than one language. I understand in highly populated areas asking for bilingual staff but for non-English speakers to just expect someone to know their language is not right.

[Nccity2002, MSN, RN]

[QUOTE=MomRN0913;6744157]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.

Welcome to America. It is what it is and with a growing Hispanic population, I do not see that changing, anytime soon. As nurses, we have a moral and ethical responsibility to check personal biases/agendas at the door. Why do I make this comment? Just based on some of the responses...including the OP post, above(I can't help but wonder how this mentality affect patient care.)

Sometimes it is wise to take a step back and evaluate our attitudes and be careful not to short change our patients because of personal beliefs.

To the OP: Why no be proactive and take this opportunity to find out what resources are available at your facility to help you and others (staff and patients), in future situations (because trust me...you will find yourself in this situation, again).

[lovedijah]

Initially I said, "It is what it is, maybe we as nurses need to adapt somewhat".

Now I think I may have been slightly off.

When I was a server, it was common for us to get people who didn't speak English. But the word for water in lots of language is simple. People could always point. And some people just wanted a "hamburgeuso". Well, duh. Hamburger coming up. Also, in the event someone wanted over easy eggs, but their hand symbols look like scrambled- we could always make the eggs over or more than likely they would just deal with it and I'd never know the mistake. Basically, I could do my job without being fluent.

But as a nurse? Even if you can say in the other language, "Open your legs please, I am going to insert this...", "Hi my name is Dijah. I'm your nurse", "We are waiting on the doctor to come in", it still leaves lots to be desired. These are all basic things we are capable of learning, but they aren't the words to educate patients about their conditions, be an advocate or anything else important. Hola, mi nombre es Dijah. Yet, If I can't understand my patient is having chest pain from their language, What good is any of it. I almost want to say, that you would need to be entirely fluent in another language to provide care. You don't want to be thinking, "Did I say this right" in regards to the pregnant lady having complications.

If "they" don't want to learn the language, can't learn the language, don't feel comfortable speaking the lanuage. Whatever the reason, I know it's difficult- we can argue the same points. Their life is on the line. Our license and ability to afford our life is on the line if things go wrong. So we're all stuck and in the same place, waiting for translators or machines. I can only hope the time it takes to get the translator- things don't head in the wrong direction.

Meanwhile, I just have to laugh because my husband is military and he can only do his job in certain places. Most of them being places like Japan, New Mexico, Germany- all places where I'm sure speaking another language would be beneficial, yet I only speak English. I sure hope that Rosetta Stone works out for me.

[farmerjane]

Although many English speakers complain about Spanish speakers growth and inability to speak English clearly or none, nearly all second-generation Hispanic-Americans speak English fluently and only lass then half speak correct Spanish.

You are blaming this very small percentage for not speaking English, but in reality you need to blame your government. We see shortage of ESL teachers and linguistic program cut for immigrants. People tend to leave closer to their native speakers in order to gather needed information and socialize.

This is part of what I was trying to say as well.

Look, I know that language and literacy are essential for life skills, for better access to resources like healthcare, and for getting out of poverty. I would never say otherwise. I was just trying to get people to understand that, when looking at immigrant populations, it is quite difficult to separate literacy and language issues from other socioeconomic barriers. And not just barriers here but also those they had in the country that they came from. The level of education someone had in their home country has a big influence on their willingness and ability to learn.

Again, not saying that people shouldn't try. I would always encourage someone to learn the language of their host country, at least some basics. But I was really just trying to point out that there are bigger reasons that "just don't want to" for a lot of people. (And yes, there are those who just don't want to. I know that...more disclaimers)

[Emilynn09]

For me, the concern comes with communication. How am I to be an effective nurse if I can't communicate with my patient or have them

Communicate with me. This person needs a nurse who can speak with them, or you need a translator with you.

[itk3838]

Every patient has rights to request medical interpreter, who is professional in certain specialty. Medical terminology alone is very hard to translate into certain languages and sometime there are no equivalent translations. If bilingual nurses will have special courses about medical terminology they will have excellent tool on their hands, but it's not the case here. We are talking about hardship that most nurses have during their working hours when they have patients who speak limited English or none.

Solution is in your management, they should use ether Language Line, AT&T services or any other medical interpretation services for daily usage. You shouldn't be forced to study second language ether. You just need to master these tools of telephone or video conferencing and use it in order to provide clear communication among your clients. Professional interpreters have 2-5 years of special linguistic education, not just one simple medical terminology course at the community college (it's not enough).

Reluctance to speak English can be overcome with extended education at elementary school level where children are taught in both languages, like language immersion programs. They are very successful. Small percentage of people who don't speak English at all, they still must pass citizenship exam somehow and it is required minimum ability in English, they are learning but as you know your abilities to learn foreign languages decline with aging. In any large city you can find areas where people live and don't have to use English every day, they are surrounded by services and shops in their own language.

First wave of immigrants are always higher class citizens who are well educated and have better financial situation, they are the ones who form new businesses and assimilate easier then others. Uneducated families can't provide enough knowledge for their children and as a result you can see that certain populations don't finish college degrees. It’s just a statistics. Right now we can see a progress in this area, so many charter schools encourage this types of population to proceed into higher education. They get grants from the government but it is not widely advertised.

Change is on its way, so be patient and use it every possible tool to communicate with your clients. Learn about other cultures as much as you can -they are fascinating.

[itk3838]

Let me ask you, why your facility don't provide medical interpreters at the time of the appointment? It is required extra step but it is easy to obtain. Phone and video conference equipment's are not effective in some areas, I do agree with you. It takes longer to provide care and gather all needed information but still it can be done. If you will use it more often, then you will be less frustrated with this type of technology.