Patient whose primary language is not English

rogramjet · May 4, 2005

I am a diabetes educator. Mexican American's are at high risk for developing diabetes. We have a large immigrant worker population. I see many Mexican AMerican diabetics, and communicating with them is not easy. Because of all of the problems I have I have been stuck on a committee to improve the system. Our hospital uses a language line for translation. This does not work for everybody. If I am giving insulin intruction, or teaching someone to use a meter, it is hard to give that kind of demonstration with a phone line interpretor. In Washington State we are not allowed to use family members or bilingual staff for clinical explanations. If you are explaining anything clinical you must use a licenced interpreter. There are options, DSHS will provide in person interpreters for Medicaid patients if they have 48 hours notice. Other thatn that we are stuck with the phone service. I have reported this, I chart this, and the hospital is getting tired of paying for the cost of hour long education sessions on the phone line, so we are getting a licensed interpreter to be on call for the hospital. Another problem is that some of these immigrants don't speak English, but also don't speak Spanis. They speak a naive language that is actually ancient Mayan. We had a Gestational Diabetic who spoke only this native langage, her husband spoke her language and a little Spanish and no English. So I spoke in English, my translator spoke in Spanish, the husband would then tell his wife what he understood which wasn't much. It was a nightmare.

As part of this committee we are re-writing all of the P&P related to these issues. We have a contract written for an on-call translator who speaks Spanish and many of the native Mexican languages as well. It is now being finalized with the attorney. So I would say that documenting and reporting to the higher ups that there is a problem can make a positive change. But make sure you document that an interpretor was used and that persons name. Remember always CYA.

I hope that helps. Sorry I went so long.

suzanne4, RN · May 5, 2005

Depends on where the patient is from. You have to be aware fo the different customs from that particular region. And they can differ greatly from one area of a country to another.............

Also, you should have a translator serivce available in your hospital via phone that is available 24/7 if you do not have an actual in-house service available.

Do not allow family members to be used as translators, it must be done by a licensed translator..........

There are actually some excellent books out on cultural diversity when carying for patients.........

If you can be more specific on the types of patients and where they are from, then I can offer you more insight............

redwinggirlie · May 5, 2005

1. Eliciting health information is difficult. I find a translator or use the translation telephone service at our hospital. Finding translators is not difficult, however.

2. Learning basic parts of the language, and the strategies listed above.

3. I've had no problems at all. After a lengthy hospital stay, we begin to learn more words of each other's language, customs and get into a routine which works just fine.

mudd92 · May 7, 2005

Depends on where the patient is from. You have to be aware fo the different customs from that particular region. And they can differ greatly from one area of a country to another.............
Also, you should have a translator serivce available in your hospital via phone that is available 24/7 if you do not have an actual in-house service available.
Do not allow family members to be used as translators, it must be done by a licensed translator..........
There are actually some excellent books out on cultural diversity when carying for patients.........
If you can be more specific on the types of patients and where they are from, then I can offer you more insight............

Thank you for the information.

The instructor would like us to find out the nurse's experience. The challenge, strategies and the effectiveness of the strategies used when interacting with the patinet. If you have any experience with Hispanic or Asian population would be good. Thanks.

mudd92

suzanne4, RN · May 7, 2005

Thank you for the information.
The instructor would like us to find out the nurse's experience. The challenge, strategies and the effectiveness of the strategies used when interacting with the patinet. If you have any experience with Hispanic or Asian population would be good. Thanks.
mudd92

I lived and worked in SE Asia, and have worked both in Arizona, as well as California...........being able to speak a functional Spanish is extremely helpful with Hispanic patients..........Knowing the customs of the different Asian populations has also been quite useful to me........also what to do and what not to do.........

sunshine9 · May 7, 2005

I am a diabetes educator. Mexican American's are at high risk for developing diabetes. We have a large immigrant worker population. I see many Mexican AMerican diabetics, and communicating with them is not easy. Because of all of the problems I have I have been stuck on a committee to improve the system. Our hospital uses a language line for translation. This does not work for everybody. If I am giving insulin intruction, or teaching someone to use a meter, it is hard to give that kind of demonstration with a phone line interpretor. In Washington State we are not allowed to use family members or bilingual staff for clinical explanations. If you are explaining anything clinical you must use a licenced interpreter. There are options, DSHS will provide in person interpreters for Medicaid patients if they have 48 hours notice. Other thatn that we are stuck with the phone service. I have reported this, I chart this, and the hospital is getting tired of paying for the cost of hour long education sessions on the phone line, so we are getting a licensed interpreter to be on call for the hospital. Another problem is that some of these immigrants don't speak English, but also don't speak Spanis. They speak a naive language that is actually ancient Mayan. We had a Gestational Diabetic who spoke only this native langage, her husband spoke her language and a little Spanish and no English. So I spoke in English, my translator spoke in Spanish, the husband would then tell his wife what he understood which wasn't much. It was a nightmare.
As part of this committee we are re-writing all of the P&P related to these issues. We have a contract written for an on-call translator who speaks Spanish and many of the native Mexican languages as well. It is now being finalized with the attorney. So I would say that documenting and reporting to the higher ups that there is a problem can make a positive change. But make sure you document that an interpretor was used and that persons name. Remember always CYA.
I hope that helps. Sorry I went so long.

That sounds like a complete nightmare. It must be the most difficult thing when all you want to do is help somebody and you cannot communicate with them.

mitchsmom · May 7, 2005

Seems like you would have to rely on graphics and physical demonstrations alot if you had someone using a very rare language.

suzanne4, RN · May 7, 2005

Seems like you would have to rely on graphics and physical demonstrations alot if you had someone using a very rare language.

There is no such thing as a rare language anymore, as far as getting a translator for this. ATT has a spectacular service, even if you are not sure of the language, you use a two receiver telephone, and hand the phone to the patient, the operator will ask them some questions and then tell you exactly which language that they are speaking, as well as dialect and will put a licensed translator on line with you..............you can do all of your teaching this way, just as the do at the United Nations if you have seen how an interpreter is used.............not hard at all.

Nurse Ratched, RN · May 7, 2005

It's a bear to deal with cultural differences more than language differences.

Case in point, we deal with a lot of Asian students who don't like saying no to authority figures (health care providers, in this case.) They agree to do something when in the office (referral, testing, whatever) and then don't show up. Then they won't respond to efforts to follow up (efforts which are required by our policies to prevent future accusations that we didn't adequately inform of the need for such testing, should the pt have a bad outcome as a result of failure to follow recommendations.) It's a lot of extra paperwork, in addition to potential harm to the patient who won't ask questions to clarify. Part of it is language, although we use the AT&T line Suzanne referred to, but the primary concern is the cultural tendency to be non-confrontational.