I had a 78 year old woman patient, bunch of kids and grandkids in the room. The patient spoke only Spanish and the grandson was translating. As I was exiting the grandma patient said something forceful so I turned and asked the man what she'd just said, and it was exactly that: "People in Healthcare should speak Spanish."
I was, well, insulted, speechless, fill in the blank. The patient had not been much of a problem until then. I stared at the grandson and didn't reply, just left. As I thought about it, I started thinking. I'm not a foreigner, why should I learn another language? I'm in the middle of the country to boot! And, why are these people insulting their caregiver anyway?
Talking this out with other nurses, I guess I wasn't the first one to hear such stuff. Is this something I should get used to?
I think to a certain extent this is a moral/ethical issue, as opposed to simply a "patient care" issue. There is no law that healthcare providers in the US must speak any language other than English.. As others have said, by doing so you may be breaking your own moral/ethical standards as a US citizen by enabling what you consider to be an offensive/arrogant choice by that individual to move to a country and refuse to speak the dominant language. I am not saying that translation services should be avoided, but that instead they should be used just as they would for any other foreign-language speaker that enters the healthcare facility. Most HC facilities have rules that English is the only language to be spoken on the shift, except when on break. This is because you are not likely to have very effective communication amongst a team when multiple languages are being used. Translation services are thus used at the stopgap, and should continue to be used for any and all foreign-speakers that have not learned the dominant language.
So lets say that, by accident, you became fluent in Spanish, would you avoid using it with your patients so you don't enable their offensive and arrogant choice?
With regards to English speaking people learning another language.
I contacted my local TAFE (community college) near me wanting to learn another main stream language to help my job. I was told they don't do languages at every TAFE and would have to travel to the nearest one in the city, and they only have classes on week nights (there are no weekend classes). Now, that means I would have to re-arrange shift work, still do my university post grad study, take the car if I was going to work after the class (night shift) AND pay for parking, plus I would have to take more time off to do study for the language class and for the exam/s.
I have paid approximately $10,000 or more to move to another state and paid for all my different legal certificates, police and gov't checks to be able to work as a RN.
Unless the government starts paying for us to do these classes, or pays for my parking, I won't be doing it. It just isn't worth it. And another interesting thing is we don't even get taught basic Aboriginal here in Aust - there are 600 Aboriginal languages and hundreds of dialects on top of that - so there is no way anyone could learn even the basics of those languages. And there are no 'main' Aboriginal languages to learn - everyone has their own dialect from their part of the country, though sometimes they can understand each others' words or sentences a little.
It is just not a practical solution I'm afraid, and baby, I've given the gov't ENOUGH of my money just to have the right to work as a nurse - they aren't getting anymore of my hard earned cash.
This topic reminds me of when I was a student working with another RN on a cardiac/renal ward.
We cared for a patient over a few shifts who only spoke Mandarin. He was actually some sort of scientist doing cancer research (in an English speaking country). Whether he'd only just emigrated here, I don't know. His wife did speak some English (not enough to really understand well). Well, there was a cleaner who spoke his language so the nurses always used to be calling her away from her work to translate. I however, as a student RN, refused to do this. The legal implications are just too staggering. And the hospital did have a policy saying only official translators could be used, and family members were not to be used either. I shuddered as a student to think what would happen to me or the other nurse AND the hospital if we gave him something & he couldn't tell us he'd been allergic to it maybe - the implications are just too horrendous to contemplate. I imagine standing up in court:
Lawyer: 'And did you ask this patient b4 u gave him this drug if he'd had any allergic reactions previously, or in the past 24-48 hours?'
Me: 'Yes we did'.
Lawyer: 'And how did you communicate this information to the patient, did u use an official translator?'
Me: ' Uh...no, we used the cleaner on shift that day as she was the only one who spoke Mandarin.'
Does not sound good does it?
I mean this Mandarin speaking guy wanted to know EVERY little nuance of his care (which is his right). We would show him his med's and everything b4 we gave it to him, but he refused everything and all care until we got a translator. His wife could not translate the medications to him as she didn't know about them. He would actually knock the medication out of your hand, argue and shrill very loudly in his own language until he got a translator - he was like a spoiled brat (he was about 50 years old I think).
He was loud, rude, arrogant and extremely demanding. I mean you can't get translators on the weekend and what else could the nurses do but use a cleaner who knew the language? The RNs could get translators for him on the phone sometimes but they would have to wait hours for them to call back sometimes.
It makes life very difficult in our workplace when people will not learn any English at all - I don't know what these types of people expect us to do, realistically, although older people who won't learn English are very set in their ways. And I have always said not speaking English in an English speaking country is extremely dangerous too.
I honestly don't know anyone, in any line of work, who is required to learn another language.
I think most people had to take a year or two of a world language (not necessarily Spanish) in HS to get into college.
If most people had to a foreign language class to into college, then wouldn't most jobs that require a college a degree also require some foreign language classes as a result? My cousin, who teaches math at an inner-city elementary school is required be fluent in spanish, as are all the other teachers at her school. It's not unheard of.
If most people had to a foreign language class to into college, then wouldn't most jobs that require a college a degree also require some foreign language classes as a result? My cousin, who teaches math at an inner-city elementary school is required be fluent in spanish, as are all the other teachers at her school. It's not unheard of.
I think most people have taken a foreign language class at some point in HS and college, but many don't remember much from those classes. I know I don't. I know there are some people who have to be fluent in other languages for their jobs. I was just making a point that it's rare, at least around here, and we do have a large population of hispanics. What about police officers, lawyers, and court officials? Is anyone pushing for them to be required to speak Spanish?
Ok let me be more specific most indians are related to south americans.I believe that the real americans are south americans not European Americans who came here uwelcomed,killed and enslaved the native inhabitants of this big land.This past cannot be excused,forgotten or erased.I always tell my illegal south american friends that they are more american than any European American ever will be.Seriously this is a huge paradox,irony.
No, it can't, but as I said before.....those alive today had nothing to do with this history. It came up in another thread involving a similar vein (that being, things that happened centuries ago).......no, it's not excused or erased, or forgotten, but eventually, the BLAMING part and hence the accomodation part DOES need to be stopped.
There are many controllable factors such as language that can improve a patient's outcomes; people with asthma have better outcomes if they don't live in urban areas, people don't get coccidioidomycosis if they don't live in desert areas, everyone is better off if they don't smoke, poor people would have better health outcomes if they just ate healthier (and more expensive) food.
I'll definitely try to educate patients has to how they can improve their outcomes, but I'm not going to refuse to expend any energy doing things that wouldn't have to be done if the patient just took the initiative. I don't choose to not control that which is in my control just because the patient chose not to control something that is in their control, that would be petty and childish of me.
Yes, as has been pointed out, you still get paid if you don't speak spanish, and if your only goal is to get paid, then you're meeting your goals. My goal is to provide the best patient care I can, and when I have 2 or 3 spanish speaking patients a month for about 8 months of the year, it's worth the effort to lean spanish in order to provide good care, this may not be true where you live. It would be nice if my patients spoke English, but considering they spend about 14 hours a day picking berries, 7 days a week, and many don't read or write even in Spanish, I've come to realize that it is far more practical for me to learn medical spanish than it is to expect that they learn english, particularly since English is not our national language and there is no requirement that they learn english.
Now, the bolded statement sure is a stereotype, isn't it? Guess stereotypes are only OK in certain situations.
To whoever made the point that it will be harder for English only speakers to get jobs, etc......it SHOULD be harder NOW for only Spanish speakers to get jobs. Period.
MunoRN, RN
8,058 Posts
So lets say that, by accident, you became fluent in Spanish, would you avoid using it with your patients so you don't enable their offensive and arrogant choice?