IELTS, TSE: A Regulation? or a Discrimination?...

suzanne4, RN · May 19, 2004

I live in Thailand now but worked for many years in the US, many,many years.

Yes,there has been a big problem with miscommunication in the medical field, from foreign doctors, as well as nurses. And in an emergency, that is a big problem.

Sure, everyday at the calm bedside, things are fine. But with telephone orders and report over the phone, big problems. I have taken report in Spanish at times just to make it easier for everyone. And have given report in Spanish to nurses. In the Philippines many of you do speak English, but you are still covered under the ruling that you must have the set of English exams. Same thing with nurses from India.............and there is a larger communication problem because of pronunciation with nurses and doctors from there.

This si the reason that I set up my school, to teach conversational skills. These are not taught in nursing school, not are they taught in any other program over here. The speaking skills are actually the most important in my prior experience of working with foreign nurses.

Good luck on your exam............. :balloons:

mattsmom81 · May 19, 2004

I am glad that the requirements are getting stricter on how well English is spoken (AS WELL as understood) I've encountered many many problems with this. Too many foreign medical persons THINK they are speaking our language well when they are actually very difficult to understand. They also misinterpret what patients are trying to tell them, as well as other nurses and doctors orders verbally.

We all do our best to adapt but IMO the language requirement HAD to be looked at.

heart queen · May 19, 2004

Hope this helps. I believe that any misconceptions or erronious interpertations come from cultural barriers as much as language. We, in America, based on the location have a multitude of "slang, that is not taught, can't be learned in classes or a book. In one city alone, we have such cultural diversity that a simple word like cup, has many different words... meaning the varried dialect, and verbage is different, the language itself is not difficult to manuver. But even I have a difficult time with different cultures, having a coversation. Understanding just what is trying to be conveyed IS and can be a huge challenge in many parts of our country , I know having moved several states away to the south, where I was just lost, for months.

It's difficult enough to have to adapt to a different culture, moving one state gives you this, then you must adapt to the coloquialisms and slang that the "locals" speak. It's tough.

From speaking with canadians whom I worked with who took the test, it is difficult because it asks PROPER english, which to even those who spoke "english" it was a bit foreign to them.

So the test, and there does need to be a competency test, is more gramatical than possibly most Americans could score well as well as thoses who are foreign, since so few of us speak in "gramatical correctness".

Then you start working, and the language you learned is even now a bit foreign to where you work due to the cultural differences.

Does this make sense?

Sure you should pass the test, my experience with foreign nurses is that it is more difficult afterwards, when you are at the bedside.

Not meant to discourage, God know we need your skills, just trying to help explain. Just be willing to learn and adapt. Let us know how it goes!

caroladybelle, BSN, RN · May 19, 2004

Since becoming a traveler (about 2 years), I have known dozens of patients that complain that they cannot understand the foreign nurse that they have had. I have taken report from nurses in my speciality that I could barely understand their English. Then I (or they) get floated to to another department, where the care/meds/procedures are not as familiar, and things can get dangerous. Or one tries to take report from someone with poor spoken English, on a crowded noisy unit and it becomes impossible. Patients frequently refuse care from foreign nurses, because after they have had several shifts with ones that they could not understand, they refuse anyone with an accent or a different appearance.

In oncology, explaining the technology of treating their disease is difficult enough for native English speakers. It is even more difficult when there is language gap. My patients often ask long complicated questions that require deep but simple explanations to understand or they may refuse their difficult therapy. And in the USA, patients are considered "customers" that we have to provide exceptional service (sad but true). Many of those patients/customers get very unhappy or ocasional hostile if they cannot understand their care provider thoroughly.

I have also dealt with nurses that have passed those tests, yet still have substandard English. I can only imagine the problems if it were dropped. And I am not that fussy about language...there are many nurses/patients/managers that are much fussier than I.

chronicTX · May 21, 2004

hello heart queen,

TRUE! Thanks for making me understand. I don't feel threatened anymore because I'm very much willing to learn. I had an english instructor for this test (who's from Alabama) who said that himself. I'm glad it's not just us. I just felt sorry that we have to spend a lot of money taking this test repeatedly til' we pass. The bottom line is that, how will we communicate effectively when we get there...:wink2:

chronicTX · May 21, 2004

hi caroladybelle,

Thank you for this information. I understand that these problems has made us foreign medical proffesionals a little bit pushy. We know we are capable of our responsibilities and being able to communicate well in english as our secondary language, is the one that we have to deal with and learn through time. However, it's sad that we are less preffered to render our care because of our race and not much better with a language barrier, but I know there are a lot of ways we can be better appreciated. :rolleyes:

kshoe · Jul 12, 2004

All immigrants to the U.S. need to be respectful of our country. Part of that respect, especially if you are a health care provider, is to be able to communicate therapeutically with the patient. In addition you owe it to your patient to be able to understand there spoken needs. I know of many foreign born nurses in the city where I work who absolutely cannot communicate with their patients. To me, that is a form of abuse. Bottom line, if nurses having English as a second language want to live in America, then speak the language of our patients.

Juliebaby · Jul 13, 2004

All immigrants to the U.S. need to be respectful of our country. Part of that respect, especially if you are a health care provider, is to be able to communicate therapeutically with the patient. In addition you owe it to your patient to be able to understand there spoken needs. I know of many foreign born nurses in the city where I work who absolutely cannot communicate with their patients. To me, that is a form of abuse. Bottom line, if nurses having English as a second language want to live in America, then speak the language of our patients.

I agree, although put a little harsh. It is imperetive that patients understand you and vise versa. It seems as though the OP has fairly good english skills. I think you will do fine.

fergus51 · Jul 13, 2004

I have also worked with nurses whose english skills were seriously lacking (though none were Philippino). Trust me, we would not be doing you any favors by NOT having strict requirements to practice here as far as spoken English is concerned. No one doubts your skills as a nurse but without being able to communicate well, nursing skills are useless. I don't know if TSE is the best measure of your ability to speak coherently, but it's the one we have. Better to have foreign nurses repeat the test until they pass it ,than to get them out here to work and find out they can't.

Destinystar · Jul 16, 2004

first of all i hope you pass the tse. with the nursing shortage being as severe as it is i would think that the us would want to make it as easy as possible for people to come here and practice nursing. treating people differently b/c they have an accent based on their national origin in my opinion is a form of discrimination. i have never had any problems understanding people who speak english as a second language. i would think that america could set a better example. my oldest son was raised in japan and speaks esl. he has to attend esl classes in america. my husband speaks very little english. the fact that you speak esl does not make you less of a nurse it makes you more valuable. remember success is the best revenge!!!:)

hello everyone,
i just don't get it! the tse (test for spoken english) and/or ielts is required for foreign nurses and other professionals who wish to work in the us. okay, i understand that for us nurses, one of our invaluable tools in dealing with our clients is our good communication skills. tse and ielts are a form of regulation to ensure that foreign professional nurses will be able to deliver services adequately and accurately. that's fairly acceptable... make no mistake, i'm in favor of these regulations. however, i do not understand why is it so hard to pass? we've passed our cgfns and nclex exams. we've passed the toefl. most of us took these exams only once and passed. but the tse/ielts is the one that we prepare for the most. ridiculous isn't it? you know why? it's the most difficult to pass! alright, i've never tried it before but i have to. i need it for my visascreen. the information i'm getting from it is non-reassuring. you wouldn't believe- most of the nurses i know from my country have at least taken the tst/ielts at least 4-5 times before they passed it. i'm trying to make an appeal especially to us nurses. have you ever had difficulties in communicating with foreign nurses who earned their us-rn status? we may not speak fluently because we are born with our native tongue and english may be our 2nd language. are the raters expecting us to speak like the native-born americans? common, we can speak english. we may have a funny tone /diction but we understand english fairly well. being such doesn't make us less of an efficient nurse because we had the same education and has passed the same exams. how could that be difficult for us? i'm taking tse this june 2004. will i make it ?

movealong · Jul 17, 2004

Only 1 nurse stands out in my memory, and she was Chinese. very nice lady, but her English was not up to par. I could understand her, but thought she had a problem understanding us. Errors were made by her frequently.

Other than that, most of the foreign nurses I worked with were great.